Nokea
The nurse is teaching a client with a new diagnosis of hypothyroidism about levothyroxine (Synthroid). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication on an empty stomach.
- B. I should report chest pain to my doctor.
- C. I should avoid taking this with antacids.
- D. I should stop this medication if my thyroid levels are normal.
Correct Answer: D
Rationale: Stopping levothyroxine when thyroid levels are normal is incorrect, as hypothyroidism requires lifelong replacement therapy. Options A, B, and C are correct: empty stomach dosing improves absorption, chest pain may indicate overdose, and antacids interfere with absorption.
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A 24-year-old woman who is 30 weeks pregnant is seen in the outpatient clinic for a routine visit.
The nurse would be MOST concerned if the client made which of the following statements?
- A. During the day I seem to get hot flashes and chills.
- B. I am having some trouble with constipation and hemorrhoids.
- C. At the end of the day I have leg cramps.
- D. When I put my hand on my abdomen, I can feel it tense and relax.
Correct Answer: A
Rationale: Strategy: 'MOST concerned' indicates a complication. (1) correct-should be reported to the physician (2) common due to pressure of growing fetus (3) common due to compression of nerves supplying lower extremities or reduced calcium levels, should take oral calcium supplements if ordered, stretch until spasm is relieved (4) Braxton-Hicks contractions common, should rest and change position
A client is admitted with irritable bowel syndrome.
The nurse would anticipate the client's history to reflect which of the following?
- A. Pattern of alternating diarrhea and constipation.
- B. Chronic diarrhea stools occurring 10-12 times per day.
- C. Diarrhea and vomiting with severe abdominal distention.
- D. Bloody stools with increased cramping after eating.
Correct Answer: A
Rationale: Strategy: Think about each answer choice. (1) correct-condition is often called spastic bowel disease; no inflammation is present (2) refers to inflammatory bowel disease such as ulcerative colitis or Crohn's disease (3) refers to inflammatory bowel disease such as ulcerative colitis or Crohn's disease (4) bloody stools do not occur
The nurse is caring for a client with a history of heart failure who is receiving metoprolol (Lopressor) 50 mg PO bid. Which of the following findings would be of GREATest concern to the nurse?
- A. Heart rate of 50 bpm.
- B. Blood pressure of 130/80 mmHg.
- C. Respiratory rate of 18 breaths/min.
- D. Oxygen saturation of 95%.
Correct Answer: A
Rationale: A heart rate of 50 bpm indicates bradycardia, a serious side effect of metoprolol, a beta-blocker, requiring immediate evaluation to prevent reduced cardiac output. Options B, C, and D are normal: blood pressure 130/80 mmHg, respiratory rate 18 breaths/min, and oxygen saturation 95% are stable.
The nurse is caring for a client who is receiving a continuous IV infusion of propofol (Diprivan) for sedation. Which of the following findings should the nurse report immediately?
- A. Respiratory rate of 12 breaths/min.
- B. Blood pressure of 100/60 mmHg.
- C. Heart rate of 80 bpm.
- D. Oxygen saturation of 90%.
Correct Answer: D
Rationale: An oxygen saturation of 90% indicates hypoxemia, a serious propofol side effect. Options A, B, and C are acceptable.
The physician orders naproxen sodium (Anaprox) 250 mg enteric-coated tablets PO bid for a 45-year-old man.
Which response, if made by the client, would indicate that the nurse's teaching about the medication has been effective?
- A. I can join my wife in a glass of wine with our dinner when we eat in a restaurant.'
- B. I should avoid milk and dairy products when I take this pill.'
- C. I should call my doctor if my stools turn very dark.'
- D. I don't like to take pills so I will crush the pill and add it to some applesauce.'
Correct Answer: C
Rationale: Strategy: 'Teaching has been effective' indicates you are looking for a true statement. (1) alcohol increases risk of GI bleeding (2) should be taken with food, milk, or antacid to decrease GI upset (3) correct-NSAIDS can cause GI bleeding (4) enteric-coated tablet should not be broken