Nokea
The nurse is preparing to administer Synthroid, a thyroid hormone replacement, to the client diagnosed with hypothyroidism. Which assessment data would indicate the client is receiving too much medication?
- A. Bradypnea and weight gain.
- B. Lethargy and hypotension.
- C. Irritability and tachycardia.
- D. Normothermia and constipation.
Correct Answer: C
Rationale: Excess Synthroid causes hyperthyroidism symptoms like irritability and tachycardia. Bradypnea, lethargy, or constipation suggest hypothyroidism.
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A client with amyotrophic lateral sclerosis has a percutaneous endoscopic gastrostomy (PEG) tube for the administration of feedings and medications. Which nursing action is appropriate?
- A. Pulverize all medications to a powdery condition
- B. Squeeze the tube before using it to break up stagnant liquids
- C. Cleanse the skin around the tube daily with hydrogen peroxide
- D. Flush adequately with water before and after using the tube
Correct Answer: D
Rationale: Flush adequately with water before and after using the tube. Flushing the tube before and after use not only provides for good tube maintenance, it is flushing that moves medications through. Not all medications should be crushed, for example sustained release preparations should not be cut or pulverized. Stagnant liquids are reduced by flushing after tube use. Cleansing is important, but soap and water are sufficient without the added irritation of hydrogen peroxide.
The client asks the clinic nurse if he should take 2,000 mg of vitamin C a day to prevent getting a cold. On which scientific rationale should the nurse base the response?
- A. Vitamin C in this dosage will help cure the common cold.
- B. This vitamin must be taken with echinacea to be effective.
- C. This dose of vitamin C is not high enough to help prevent colds.
- D. Megadoses of vitamin C may cause crystals to form in the urine.
Correct Answer: D
Rationale: Megadoses of vitamin C (>2,000 mg/day) can lead to oxalate crystal formation in urine, increasing kidney stone risk. Evidence for cold prevention is weak, and echinacea or higher doses are not supported.
The client in end-stage renal disease is receiving aluminium hydroxide (Amphojel). Which assessment data indicate the medication is effective?
- A. The client denies complaints of indigestion.
- B. The client is not experiencing burning on urination.
- C. The client has had a normal, soft bowel movement.
- D. The client's phosphate level has decreased.
Correct Answer: D
Rationale: Amphojel binds phosphate in ESRD, lowering serum levels; decreased phosphate indicates effectiveness. Indigestion, urination, or bowel movements are unrelated.
The client with coronary artery disease is prescribed atorvastatin (Lipitor) to help decrease the client's cholesterol level. Which intervention should the nurse discuss with the client concerning this medication?
- A. The client should eat a low-cholesterol, low-fat diet.
- B. The client should take this medication with each meal.
- C. The client should take this medication in the evening.
- D. The client should monitor daily cholesterol levels.
Correct Answer: C
Rationale: Atorvastatin is most effective at night when cholesterol synthesis peaks, per pharmacodynamics. Diet is supportive, meals are irrelevant, and daily monitoring is impractical.
The employee health nurse is observing a student nurse administer a PPD tuberculin test to a new employee. Which behavior would warrant immediate intervention by the employee health nurse?
- A. The student nurse inserts the needle at a 45-degree angle.
- B. The student nurse cleanses the forearm with alcohol.
- C. The student nurse circles the injection site with ink.
- D. The student nurse instructs the employee to return in three (3) days.
Correct Answer: A
Rationale: PPD tests require a 10–15-degree angle for intradermal injection to form a wheal; 45 degrees is incorrect and warrants intervention. Other actions are standard.