Nokea
An adult woman has been diagnosed as having hypothyroidism. She is taking Cytomel (liothyronine sodium) 50 mcg daily. Which of the following side effects should the nurse be especially alert for?
- A. Angina
- B. Fatigue
- C. Rash
- D. Gastritis
Correct Answer: A
Rationale: Cytomel increases metabolic rate, potentially causing angina in patients with cardiovascular risk due to increased cardiac demand.
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The HCP has ordered an intramuscular antibiotic. After reconstituting the medication, the clinic nurse must administer 4.8 mL of the medication. Which action should the nurse implement first when administering this medication?
- A. Inform the HCP the amount of medication is too large.
- B. Administer the medication in the gluteal muscle.
- C. Discard the medication in the sharps container.
- D. Divide the medication and give 2.4 mL in each hip.
Correct Answer: D
Rationale: IM injections >3 mL should be divided; 2.4 mL in each hip (gluteal) ensures safe absorption. Notifying HCP, single-site injection, or discarding are incorrect.
The nurse is administering the long-acting insulin glargine (Lantus) to the client at 2200. The nurse asks the charge nurse to check the dosage. Which action should the charge nurse implement?
- A. Ask the nurse why the insulin is being given late.
- B. Check the MAR versus the dosage in the syringe.
- C. Instruct the nurse to complete a medication error form.
- D. Have the nurse notify the health-care provider.
Correct Answer: B
Rationale: Verifying MAR against syringe dosage ensures accuracy, per safety protocols. Timing questions, error forms, or HCP notification are unnecessary unless errors occur.
An adult client is receiving lithium 600 mg PO tid for the treatment of bipolar disorder. The client should be taught that it is important to have adequate amounts of which substance?
- A. Potassium
- B. Sodium
- C. Calcium
- D. Magnesium
Correct Answer: B
Rationale: Adequate sodium intake is crucial with lithium to prevent toxicity, as low sodium levels increase lithium retention.
A 66 year-old client is admitted for mitral valve replacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis since her teenage years. During the admission assessment, the nurse should ask the client if as a child she had
- A. measles
- B. rheumatic fever
- C. hay fever
- D. encephalitis
Correct Answer: B
Rationale: rheumatic fever. Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.
A 67-year-old client is to be discharged from the hospital. The client is taking digoxin and furosemide daily. Which instruction is most essential for the nurse to give this client?
- A. Take your medicine early in the day.
- B. Be sure to drink orange juice and eat bananas or melons every day.
- C. Avoid foods that are high in sodium.
- D. Drink plenty of milk.
Correct Answer: B
Rationale: Furosemide causes potassium loss; orange juice, bananas, and melons are potassium-rich, preventing hypokalemia.