Nokea
Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?
- A. Constipation.
- B. Decreased appetite.
- C. Restlessness.
- D. Intolerance to cold.
Correct Answer: C
Rationale: Restlessness indicates hyperthyroidism, suggesting excessive levothyroxine. Constipation, decreased appetite, and cold intolerance are hypothyroidism symptoms, not overdose.
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History and physical
The client is a 26-year-old female with acute appendicitis. She has a 12 year history of type 1 diabetes mellitus and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.
Nurses notes
0730
Admitted the client. She is awake and alert. She rates her pain 2 on a 0 to 10 pain scale. Her pulses are equal bilaterally. Heart rate is 76 beats/minute, normal sinus rhythm. Her oxygen saturation is 100% on room air. She has a gauze dressing over her surgical site, which is clean and dry. Her temperature is 98.5° F (37.0° C) orally. She urinated 50 mL upon arrival in the unit and is reporting she
Lab results
Blood glucose 279mg/dl
Orders
Admit to the surgical floor
• Dextrose 5% and 0.9% sodium chloride IV to infuse at 125 mL/hr
Advance diet as tolerated
• Insulin glargine 12 units SUBQ every 24 hours
. Ceftriaxone 2 gram IV piggy back (IVPB) every
24 hours for 3 days, first dose given in surgery
The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.
- A. The dose of insulin drawn up in the syringe
- B. The expiration date on the insulin vial
- C. The type of insulin to be administered
- D. The sliding scale insulin lispro prescription
- E. The insulin concentration
- F. The insulin vial for color and clarity
- G. The history and physical with the diabetes diagnosis listed
Correct Answer: A,B,C,D,E,F
Rationale: Dose, type, prescription, concentration, vial clarity, and expiration ensure safe insulin administration. B and G are standard nurse assessments, not requiring double-checking.
A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective?
- A. Denies having coughing spells.
- B. Able to sleep through the night.
- C. Expectorating bronchial secretions.
- D. Reports reduced nasal discharge.
Correct Answer: B
Rationale: Benzonatate suppresses cough, and sleeping through the night indicates effective cough control. Denying coughing spells is less specific, expectoration relates to expectorants, and nasal discharge is unrelated to antitussive effects.
A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?
- A. Administer the medication as prescribed.
- B. Monitor the client for a rash or hives.
- C. Contact the healthcare provider.
- D. Give with prescribed antihistamine.
Correct Answer: B
Rationale: Cephalexin may cause cross-reactivity in penicillin-allergic clients, so monitoring for allergic reactions like rash or hives is critical. Administering without monitoring, contacting the provider immediately, or giving antihistamines prophylactically are less appropriate.
The nurse is caring for a client with hypertension, gastroesophageal reflux, and osteoarthritis. While performing a bedside assessment, the nurse observes the client is alert and oriented, but is exhibiting signs of jaundice. The nurse should notify the healthcare provider about which scheduled medication?
- A. Captopril.
- B. Acetaminophen.
- C. Omeprazole.
- D. Prednisone.
Correct Answer: B
Rationale: Acetaminophen can cause liver toxicity, manifesting as jaundice, especially with high doses. Captopril, omeprazole, and prednisone are less commonly associated with jaundice.
When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?
- A. Exhibits fewer emotional outbursts.
- B. Improved ability to concentrate.
- C. Decreased episodes of incontinence.
- D. Sleeps soundly through the night.
Correct Answer: D
Rationale: Zolpidem is a sedative for insomnia, and sleeping soundly through the night indicates its effectiveness. Emotional outbursts, concentration, and incontinence are not primary targets of zolpidem.