Nokea
The nurse is caring for a client taking levothyroxine (Synthroid) for hypothyroidism. Which finding indicates a side effect of this medication?
- A. weight loss
- B. weight gain
- C. light sensitivity
- D. excessive sleepiness
Correct Answer: A
Rationale: Weight loss can indicate excessive levothyroxine dosing, as it increases metabolism, unlike the other options, which are not typical side effects.
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The unit nurse is teaching a nursing student about increased intracranial pressure (ICP). The nurse knows the teaching was effective if the student nurse makes which statement?
- A. Altered level of consciousness is a late sign of increased ICP.'
- B. Elevated temperature is the earliest indication of increased ICP.'
- C. Late signs of increased ICP include narrowed pulse pressure and a lowered heart rate.'
- D. Late signs of increased ICP include increased systolic blood pressure and a widened pulse pressure.'
Correct Answer: D
Rationale: Late ICP signs include Cushing’s triad: increased systolic BP, widened pulse pressure, and bradycardia, reflecting brainstem compression.
The nurse is working with an unlicensed assistive personnel (UAP). In planning the morning's care, which tasks can the nurse delegate to the UAP? Select all that apply.
- A. feeding a client who has lost the use of his hands
- B. starting an IV in a confused client who pulled her IV out
- C. assisting a stable and alert client up to the bedside commode
- D. checking an apical pulse in a client prior to administering digoxin
- E. ambulating a client in the hall for the first time since surgery to repair a fractured T5 vertebra
Correct Answer: A, C
Rationale: Feeding and assisting a stable client to the commode are within the UAP’s scope, while starting an IV, checking an apical pulse, and ambulating a post-surgical client require nursing judgment.
A client with osteomylitis has an order for a trough level to be done because he is taking Gentamycin. When should the nurse call the lab to obtain the trough level?
- A. Before the first dose
- B. 30 minutes before the fourth dose
- C. 30 minutes after the first dose
- D. 30 minutes before the first dose
Correct Answer: B
Rationale: Trough levels measure the lowest drug concentration and are drawn just before a dose after steady-state, typically around the fourth dose for Gentamicin.
A client requires insertion of a nasogastric tube. When preparing the client for the procedure, the nurse should place the client in which of the following positions?
- A. High Fowler's position with the head tilted forward.
- B. High Fowler's position with the head tilted backward.
- C. Semi-Fowler's position with the head in a neutral position.
- D. Semi-Fowler's position with the head tilted backward.
Correct Answer: A
Rationale: High Fowler's position with the head tilted forward (A) facilitates nasogastric tube insertion by aligning the esophagus and reducing the risk of aspiration. Tilting the head backward (B, D) or using a neutral position in semi-Fowler's (C) is less effective for this procedure.
A 19-year-old male with type 1 diabetes has the flu. The nurse expects what insulin changes may be required during the illness?
- A. stopping all insulin
- B. needing more insulin
- C. needing less insulin
- D. using the same amount of insulin
Correct Answer: B
Rationale: Illness increases insulin resistance due to stress hormones, often requiring more insulin to manage hyperglycemia in type 1 diabetes.