1.
The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect?
Correct Answer
B. Oral route
Explanation
The oral route of administration requires higher dosages of drugs to achieve a therapeutic effect. This is because oral medications must pass through the digestive system before being absorbed into the bloodstream, which can result in a significant amount of the drug being metabolized or excreted before reaching its target site. In contrast, medications administered intravenously bypass the digestive system and are delivered directly into the bloodstream, allowing for more efficient and immediate absorption, and therefore requiring lower dosages.
2.
The patient is experiencing chest pain and need to take sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
Correct Answer
A. Under the tongue
Explanation
The nurse instructs the patient to place the tablet under the tongue because sublingual medications are absorbed through the mucous membranes under the tongue. Placing the tablet on top of the tongue, at the back of the throat, or in the space between the cheek and the gum would not allow for proper absorption of the medication.
3.
The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect?
Correct Answer
C. Oral route
Explanation
The oral route of administration requires higher dosages of drugs to achieve a therapeutic effect compared to other routes. This is because when a drug is taken orally, it has to pass through the digestive system before being absorbed into the bloodstream. This process, known as first-pass metabolism, can lead to a significant reduction in the drug's bioavailability. To compensate for this, higher doses are typically needed to ensure that enough of the drug reaches the target site in the body to produce the desired therapeutic effect.
4.
The patient is experiencing chest pain and need to take sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
Correct Answer
D. Under the tongue
Explanation
The nurse instructs the patient to place the sublingual nitroglycerin tablet under the tongue. This is because the sublingual route allows for rapid absorption of the medication into the bloodstream through the rich supply of blood vessels under the tongue. Placing the tablet under the tongue ensures that the medication is not swallowed and bypasses the digestive system, allowing for quicker relief of chest pain.
5.
The patient is complaining of a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest ?
Correct Answer
B. A powder
Explanation
The nurse would suggest a powder as the fastest medication form to help reduce the pain of a headache. Powders are typically dissolved in liquid before consumption, which allows for faster absorption into the bloodstream compared to other forms such as capsules or tablets. This quick absorption can lead to faster relief from pain symptoms.
6.
The patient is asking the nurse about current U.S. laws and regulation of herbal products. According to the Dietary Supplement and Health Education Act (DSHEA) of 1994, which statement is true?
Correct Answer
C. Medicinal herbs are viewed as dietary supplements.
Explanation
The correct answer is that medicinal herbs are viewed as dietary supplements. This is because the Dietary Supplement and Health Education Act (DSHEA) of 1994 categorizes herbal products as dietary supplements rather than drugs. This means that they are regulated differently and do not have to prove therapeutic efficacy or meet the same standards as drugs. Additionally, herbal remedies are not protected by patent laws.
7.
The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask?
Correct Answer
A. “How long have you been using the medication?”
Explanation
The best assessment question for the nurse to ask is "How long have you been using the medication?" This question is important to determine if the client has been using the medication for an extended period of time, as prolonged use of oxymetazoline can lead to rebound congestion and worsening of symptoms. By asking this question, the nurse can gather information about the duration of medication use and assess if it aligns with the client's worsening symptoms. This will help the nurse in identifying a possible cause for the client's worsening condition.
8.
The client receives albuterol (Proventil) via inhaler. He asks the nurse why he can’t just take a pill. What is the best response by the nurse?
Correct Answer
C. “When you inhale the drug the blood supply in your lungs picks it up rapidly, resulting in quicker effects.”
Explanation
The best response by the nurse is "When you inhale the drug the blood supply in your lungs picks it up rapidly, resulting in quicker effects." This is because the inhaler allows the medication to directly reach the lungs, where it can be quickly absorbed into the bloodstream. This leads to faster relief of symptoms compared to taking a pill, which would need to be absorbed through the gastrointestinal tract.
9.
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?
Correct Answer
B. Oral candidiasis and dry mouth
Explanation
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss the potential adverse effects of oral candidiasis and dry mouth. Inhaled corticosteroids can increase the risk of developing oral candidiasis, which is a fungal infection in the mouth. Dry mouth is also a common side effect of inhaled corticosteroids. These adverse effects can be managed and minimized with proper oral hygiene and the use of a spacer device while using the inhaler. It is important for the nurse to educate the patient about these potential adverse effects and how to prevent or manage them.
10.
Discharge planning for the client prescribed tetracycline will include which of the following?
Correct Answer
A. Do not take the medication with milk.
Explanation
Tetracycline should not be taken with milk because calcium in milk can bind to tetracycline and reduce its absorption in the body. This can decrease the effectiveness of the medication. Therefore, it is important for the client to avoid taking tetracycline with milk.
11.
The client asks the nurse why there aren’t better drugs for human immunodeficiency virus (HIV) infection when so much money is spent on research. What is the best response by the nurse?
Correct Answer
C. “Developing new drugs is difficult because the virus mutates so readily”
Explanation
The best response by the nurse is "Developing new drugs is difficult because the virus mutates so readily." This explanation is accurate because HIV is a highly mutable virus, meaning it can change and adapt to its environment quickly. This makes it challenging to develop effective drugs that can target and eliminate the virus. The constant mutation of the virus allows it to develop resistance to medications, making it difficult to find a cure or develop new drugs that can effectively combat HIV.
12.
The nurse informs the patient that the drug most likely to be ordered for the client with herpes simplex virus is which of the following ?
Correct Answer
A. Acyclovir (Zovirax)
Explanation
Acyclovir (Zovirax) is the correct answer because it is an antiviral medication commonly used to treat herpes simplex virus infections. It works by inhibiting the replication of the virus, reducing the severity and duration of outbreaks. Zidovudine (Retrovir) is an antiretroviral medication used to treat HIV, not herpes simplex virus. Nystatin (Fungizone) is an antifungal medication used to treat fungal infections, not herpes simplex virus. Metronidazole (Flagyl) is an antibiotic used to treat bacterial and parasitic infections, not herpes simplex virus.
13.
A client has been prescribed oseltamivir (Tamiflu) after complaining of influenza-like symptoms. That information should the nurse provide for this client?
Correct Answer
A. Get this prescription filled and begin taking the medication immediately
Explanation
The nurse should provide the client with the information to get the prescription filled and begin taking the medication immediately. This indicates that the medication is necessary and should be started as soon as possible to help alleviate the symptoms of influenza.
14.
A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct?
Correct Answer
C. “You should expect to take these drugs for as long as 24 months.”
Explanation
The correct answer is "You should expect to take these drugs for as long as 24 months." This response is correct because the standard treatment for tuberculosis typically lasts for a minimum of 6 months and can extend up to 24 months, depending on the severity of the infection. It is important for the patient to complete the full course of medication to ensure the eradication of the bacteria and prevent the development of drug-resistant tuberculosis.
15.
A patient newly diagnosed with tuberculosis (TB) has been taking antituberculor drugs for 1 week calls the clinic and is very upset. He says, “My urine is dark orange! What’s wrong with me?” Which response by the nurse is correct?
Correct Answer
A. This is an expected side effect of the medicine. Let’s review what to expect.”
Explanation
The correct answer explains that the dark orange urine is an expected side effect of the medication used to treat tuberculosis. The nurse reassures the patient that this is a normal reaction and suggests reviewing the expected side effects to provide the patient with more information and alleviate their concerns.
16.
The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?
Correct Answer
A. Numbness and tingling of extremeties
Explanation
Numbness and tingling of extremities is a potential adverse effect of antitubercular drug therapy that should be reported to the prescriber. This could indicate peripheral neuropathy, which is a serious side effect that requires immediate medical attention. It is important for the patient to inform the prescriber about this symptom so that appropriate measures can be taken to manage or adjust the medication regimen if necessary.
17.
A patient who has been taking isoniazid (INH) has a new prescription for pyridoxine (Vit B6). She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition?
Correct Answer
C. PeripHeral neuropathy
Explanation
Pyridoxine (Vitamin B6) is often given concurrently with isoniazid (INH) to prevent peripheral neuropathy. INH is an antituberculosis medication that can cause peripheral neuropathy as a side effect. Pyridoxine helps to prevent this by protecting the nerves from damage. Therefore, the patient needs to take pyridoxine along with INH to reduce the risk of developing peripheral neuropathy.
18.
The nurse will assess the patient for which potential contraindication to antitubercular therapy?
Correct Answer
B. Hepatic impairment
Explanation
The nurse will assess the patient for potential contraindication to antitubercular therapy, specifically hepatic impairment. Hepatic impairment refers to a condition where the liver is not functioning properly. Antitubercular medications are metabolized in the liver, and if the liver is impaired, it may not be able to properly process these medications, leading to potential toxicity or adverse effects. Therefore, it is important for the nurse to assess the patient for any signs or symptoms of hepatic impairment before initiating antitubercular therapy.
19.
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
Correct Answer
C. Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.”
Explanation
The nurse's correct statement is to advise the patient to change positions slowly and rise slowly after sitting or lying to prevent dizziness and possible fainting due to blood pressure changes. This instruction is important because furosemide is a diuretic that can cause a decrease in blood pressure, leading to orthostatic hypotension. By changing positions slowly, the patient can minimize the risk of experiencing dizziness or fainting episodes.
20.
The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?
Correct Answer
A. Spironolactone (Aldactone)
Explanation
Spironolactone (Aldactone) is a potassium-sparing diuretic, meaning it helps the body retain potassium and excrete sodium and water. Hyperkalemia refers to high levels of potassium in the blood, which can lead to various symptoms such as muscle weakness, irregular heartbeat, and numbness or tingling. Since spironolactone is specifically designed to retain potassium, it can potentially cause hyperkalemia in patients. Therefore, it is important for nurses to monitor patients taking spironolactone for signs and symptoms of hyperkalemia to ensure their potassium levels remain within a safe range.
21.
When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient’s fluid volume status?
Correct Answer
D. Intake, output, and daily weight.
Explanation
When a patient is receiving diuretic therapy, monitoring intake, output, and daily weight would best reflect the patient's fluid volume status. Diuretics increase urine production, leading to increased fluid loss. Monitoring intake and output provides information about the patient's fluid balance, while daily weight measurements can indicate changes in fluid volume. Serum potassium and sodium levels may be affected by diuretic therapy, but they do not directly reflect fluid volume status. Blood pressure and pulse can provide information about cardiovascular function but may not specifically indicate fluid volume status. Measurement of abdominal girth and calf circumference may be useful in assessing for fluid accumulation, but they do not provide a comprehensive assessment of fluid volume status.
22.
A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?
Correct Answer
B. Osmotic diuretics
Explanation
Osmotic diuretics are used to reduce intracranial pressure in patients with cerebral edema. These diuretics work by increasing the osmotic pressure in the renal tubules, causing water to be pulled from the brain tissue into the bloodstream and then excreted in the urine. This reduces the fluid volume in the brain, thereby decreasing intracranial pressure. Thiazide diuretics, loop diuretics, and vasodilators are not typically used for this purpose.
23.
A 79 year old patient is taking a diuretic for treatment of hypertension. This patient is very independent and ants to continue to live at home. The nurse will know that which teaching point is important for this patient?
Correct Answer
C. He needs to take extra precautions while standing up because of possible orthostatic hypotension and resulting injury from falls.
Explanation
The correct answer emphasizes the importance of taking extra precautions while standing up due to the risk of orthostatic hypotension, which is a common side effect of diuretic medication. Orthostatic hypotension can cause dizziness and increase the risk of falls and injury, especially in elderly patients. This teaching point is important for the patient's safety and well-being while living independently at home.
24.
When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics?
Correct Answer
B. They have a rapid onset of action and cause rapid diuresis.
Explanation
Loop diuretics have a rapid onset of action and cause rapid diuresis. This means that they work quickly to increase urine production and decrease fluid volume in the body. They are commonly used in the management of conditions such as heart failure and edema. Loop diuretics act by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidneys, leading to increased urine output. They are considered to be very potent and have a relatively long duration of action, but the statement about their diuretic effect lasting up to 48 hours is not accurate.
25.
A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient’s routine?
Correct Answer
B. In the morning
Explanation
Taking the diuretic in the morning would be the least disruptive to the patient's routine. This is because diuretics increase urine production, which can lead to increased frequency of urination. By taking the medication in the morning, the patient will have the opportunity to empty their bladder throughout the day, minimizing the need for frequent trips to the bathroom during the night. This allows the patient to have a more restful sleep and maintain their usual routine without interruptions.
26.
During a blood transfusion, the patient begins to have chills and back pain. What is the nurse’s priority actions?
Correct Answer
D. Discontinue the infusion immediately, and notify the prescriber
Explanation
The correct answer is to discontinue the infusion immediately and notify the prescriber. This is because the patient experiencing chills and back pain during a blood transfusion may be showing signs of a transfusion reaction, which can be life-threatening. Discontinuing the infusion and notifying the prescriber allows for prompt evaluation and appropriate management of the situation to ensure patient safety.
27.
The nurse is working with a graduate nurse to prepare an intravenous dose of potassium. Which statement by the graduate nurse reflects a need for further teaching?
Correct Answer
B. ”The intravenous potassium dose will be given undiluted.”
Explanation
The statement "The intravenous potassium dose will be given undiluted" reflects a need for further teaching because potassium should always be diluted before administration to prevent irritation and damage to the veins. Undiluted potassium can cause pain, burning, and even tissue damage at the injection site. Diluting the medication helps to ensure safe and effective administration.
28.
When monitoring a patient for signs of hypokalemia, the nurse looks for what early sign?
Correct Answer
C. Muscle weakness
Explanation
Muscle weakness is an early sign of hypokalemia. Hypokalemia is a condition characterized by low levels of potassium in the blood. Potassium is essential for proper muscle function, and when levels are low, it can lead to muscle weakness. Other symptoms of hypokalemia may include fatigue, constipation, and palpitations. However, muscle weakness is often one of the first signs to appear. It is important for the nurse to monitor for this symptom as it can indicate the need for potassium supplementation or other interventions to address the underlying cause of hypokalemia.
29.
A patient is receiving an infusion of fresh frozen plasma. Based on this order, the nurse interprets that this patient has which condition?
Correct Answer
B. Coagulation disorder
Explanation
The nurse interprets that the patient has a coagulation disorder because fresh frozen plasma is commonly used to treat patients with clotting factor deficiencies or other bleeding disorders. This suggests that the patient's condition is related to their blood's ability to clot properly, rather than anemia, previous transfusion reaction, or hypovolemic shock.
30.
The nurse is preparing to transfuse a patient with a unit of packed red blood cells. Which intravenous solution is correct for use with the PRBC transfusion?
Correct Answer
A. 0.9% sodium chloride (NS)
Explanation
The correct intravenous solution for use with the PRBC transfusion is 0.9% sodium chloride (NS). This is because NS is an isotonic solution, meaning it has the same osmolarity as blood and will not cause red blood cells to shrink or swell. It is the most compatible solution for transfusion, as it will not cause any adverse reactions or hemolysis of the red blood cells. Dextrose solutions, such as D5W or 5% dextrose in 0.45% sodium chloride, are not recommended for use with PRBC transfusions as they can cause red blood cell hemolysis. Lactated Ringer's solution is also not recommended for PRBC transfusion as it contains calcium, which can cause clotting and interfere with the transfusion process.
31.
The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which patient would be best treated with this transfusion?
Correct Answer
C. A patient with severe anemia
Explanation
A patient with severe anemia would be best treated with a transfusion of packed red blood cells (PRBCs). Severe anemia is characterized by a low red blood cell count or low hemoglobin levels, leading to a decreased oxygen-carrying capacity in the blood. Transfusing PRBCs can help restore the patient's red blood cell count and improve oxygen delivery to the tissues. Patients with a coagulation disorder, clotting-factor deficiency, or massive blood loss would require different treatments, such as clotting factors or fluids to replace lost blood volume.
32.
After a severe auto accident, a patient has been taken to the trauma unit and has an estimated blood loss of more than 30% of his blood volume. The nurse prepares administer which product?
Correct Answer
B. Whole blood
Explanation
After a severe auto accident, a patient with an estimated blood loss of more than 30% of their blood volume requires immediate blood transfusion. Whole blood is the most suitable product to administer in this situation as it contains red blood cells, plasma, platelets, and clotting factors. This helps to restore the patient's blood volume and replace the components that were lost due to the accident. Packed red blood cells, fresh frozen plasma, and albumin may be used in specific cases, but whole blood is the most appropriate choice in this scenario.
33.
A patient who is severely anemic also has acute heart failure with severe edema due to fluid overload. The prescriber wants to raise the patient’s hemoglobin and hematocrit levels. The nurse anticipates that the patient will receive which blood product?
Correct Answer
A. Packed red blood cells (PRBCs)
Explanation
In this scenario, the patient is severely anemic and also has acute heart failure with severe edema due to fluid overload. Packed red blood cells (PRBCs) would be the most appropriate blood product to raise the patient's hemoglobin and hematocrit levels. PRBCs contain a concentrated amount of red blood cells, which can help increase the patient's oxygen-carrying capacity and improve their anemia. Fresh frozen plasma contains clotting factors and is typically used to treat bleeding disorders or coagulation deficiencies, which are not the primary concerns in this case. Albumin is a protein solution that can help increase blood volume, but it does not directly address the anemia. Whole blood is a less common option and is usually reserved for specific situations where multiple blood components are needed.
34.
The nurse notes in a patient’s medication history that the patient has been taking desmopressin (DDVAP). Based on this finding, the nurse interprets that the patient has which disorder?
Correct Answer
C. Diabetes insipidus
Explanation
Based on the patient taking desmopressin (DDVAP), the nurse can interpret that the patient has diabetes insipidus. Desmopressin is a medication commonly used to treat diabetes insipidus, a disorder characterized by excessive thirst and urination due to inadequate production or response to antidiuretic hormone (ADH). This medication helps to decrease urine output and increase water reabsorption in the kidneys, thereby alleviating the symptoms of diabetes insipidus.
35.
A 16 year-old who is taking somatropin comes into the office because he had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next?
Correct Answer
D. The somatropin dosage may be adjusted
Explanation
The correct answer is "The somatropin dosage may be adjusted." This is because the patient experienced an asthma attack during a race, which could be a potential side effect of somatropin. Adjusting the dosage may help to alleviate this side effect and ensure the patient's safety.
36.
A pituitary drug is prescribed for a patient with a hormone deficiency, and the nurse provides instructions about the medication. Which statement by the patient indicates a need for further instruction?
Correct Answer
A. ”I am looking forward to a cure for my condition with this hormone replacement.”
Explanation
The patient's statement indicates a need for further instruction because hormone replacement therapy does not cure hormone deficiencies. It only provides the necessary hormones that the body is lacking. The patient should be informed that the medication will help manage their condition, but it will not completely cure it.
37.
An 8 year-old child has been diagnosed with true pituitary dwarfism and is being treated with somatropin. In follow-up visits, the nurse will monitor for which expected outcome?
Correct Answer
B. Increased growth
Explanation
The nurse will monitor for increased growth as the expected outcome in a child being treated with somatropin for true pituitary dwarfism. Somatropin is a synthetic growth hormone that helps stimulate growth in children with growth hormone deficiency. By monitoring the child's growth, the nurse can assess the effectiveness of the treatment and ensure that the child is responding positively to the medication. Increased muscle strength and increased height when the child reaches puberty may also be potential outcomes, but the primary focus is on monitoring for increased growth. Decreased urinary output is not directly related to the treatment for pituitary dwarfism and is therefore not the expected outcome.
38.
A patient’s medication order indicates that he is to receive dose of cosyntropin (Cortrosyn). The nurse is aware that this drug is used to diagnose which condition?
Correct Answer
C. Adrenocortical suffiency
Explanation
Cosyntropin (Cortrosyn) is a synthetic form of adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol. Therefore, it is used to diagnose adrenocortical sufficiency, also known as adrenal insufficiency or Addison's disease. This condition occurs when the adrenal glands do not produce enough cortisol, leading to symptoms such as fatigue, weight loss, and low blood pressure. By administering cosyntropin and measuring cortisol levels, healthcare providers can determine if the adrenal glands are functioning properly.
39.
Vasopressin is used in the treatment of
Correct Answer
A. Diabetes insipidus
Explanation
Vasopressin is used in the treatment of diabetes insipidus because it helps to regulate water balance in the body. Diabetes insipidus is a condition characterized by excessive thirst and urination due to the inability of the body to properly regulate water levels. Vasopressin, also known as antidiuretic hormone, helps to reduce urine production and increase water reabsorption in the kidneys, thereby alleviating the symptoms of diabetes insipidus. It is not used in the treatment of dehydration, electrolyte imbalances, or diabetes mellitus.
40.
A 19 year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she called the clinic to report that she does not feel better. Which response from the nurse is correct?
Correct Answer
A. "The full therapeutic effects may not occur for 3 to 4 weeks.”
Explanation
Levothyroxine is a medication used to treat hypothyroidism by replacing or supplementing the thyroid hormone in the body. However, it takes time for the medication to reach therapeutic levels and for the patient to start experiencing the full benefits. It is important for the nurse to inform the patient that it may take 3 to 4 weeks before she starts feeling better, as this is a realistic timeframe for the medication to take effect. The response about surgery is not applicable in this situation and is not a correct response.
41.
When monitoring a patient who is taking a thyroid replacement hormone, which adverse effect needs to be reported to the prescriber?
Correct Answer
C. Palpitations
Explanation
Palpitations need to be reported to the prescriber when monitoring a patient who is taking a thyroid replacement hormone. Palpitations refer to an abnormal awareness of the heartbeat, which can be a sign of an irregular or rapid heart rate. This adverse effect may indicate that the patient's thyroid hormone dosage needs adjustment or that there may be an underlying cardiac issue that needs further evaluation. Therefore, it is essential to report palpitations promptly to the prescriber for appropriate management.
42.
A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?
Correct Answer
D. In the morning
Explanation
The nurse will instruct the patient to take the medication in the morning because thyroid replacement therapy is typically taken on an empty stomach. Taking the medication in the morning ensures that the patient has not eaten for several hours, allowing for optimal absorption of the medication. Additionally, taking the medication in the morning helps to mimic the body's natural production of thyroid hormone, which is highest in the morning.
43.
A patient has been taking levothyroxine (Synthroid) for more than a decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. Which is the nurse’s best advice?
Correct Answer
D. ”It’s better not to switch brands unless we check with your doctor.”
Explanation
Switching brands of levothyroxine can have varying effects on a patient's thyroid hormone levels. Even though the active ingredient is the same, the inactive ingredients can differ between brands, which may affect how the medication is absorbed and utilized by the body. Therefore, it is important for the patient to consult with their doctor before making any changes to their medication regimen. The nurse's best advice is to not switch brands without first checking with the doctor to ensure the patient's thyroid levels remain stable.
44.
A 19 year-old woman has been diagnosed with primary hyperthyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?
Correct Answer
A. "Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication”
Explanation
The correct answer is "Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication." This response is correct because primary hyperthyroidism is a condition where the thyroid gland produces too much thyroid hormone, resulting in hyperthyroidism. Levothyroxine is a medication used to treat hypothyroidism, which is the opposite condition where the thyroid gland does not produce enough thyroid hormone. The woman in the scenario is feeling better because the medication is effectively replacing the deficient thyroid hormone. However, stopping the medication can lead to a recurrence of hypothyroidism symptoms. Therefore, lifelong medication therapy is typically necessary to maintain thyroid hormone levels and prevent the symptoms from returning.
45.
During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
Correct Answer
C. Avoiding foods containing iodine
Explanation
Patients on antithyroid drugs are usually prescribed these medications to treat hyperthyroidism, a condition characterized by an overactive thyroid gland. Iodine is essential for the production of thyroid hormones, so avoiding foods that contain iodine helps to reduce the production of these hormones. Therefore, the nurse will discuss with the patient the importance of avoiding foods containing iodine to effectively manage their condition.
46.
A patient has a diagnosis of primary hypothyroidism. Which statement accurately describes this problem?
Correct Answer
C. The abnormality is in the thyroid itself
Explanation
Primary hypothyroidism refers to a condition where the abnormality lies in the thyroid gland itself. In this case, the thyroid gland is not able to produce enough thyroid hormones, leading to a decrease in the overall thyroid function. This can result in symptoms such as fatigue, weight gain, and cold intolerance. The dysfunction of the pituitary gland or hypothalamus would result in secondary or tertiary hypothyroidism, respectively, where the problem lies in the regulation of thyroid hormone production rather than the thyroid gland itself.
47.
The nurse is administering lispro (Humalog) insulin and will keep in mind that this insulin will start to have an effect within which time frame?
Correct Answer
C. 15 minutes
Explanation
Lispro (Humalog) insulin is a fast-acting insulin that starts to have an effect within 15 minutes of administration. This rapid onset of action makes it important for the nurse to closely monitor the patient's blood sugar levels after administering the medication. By understanding the time frame in which the insulin begins to work, the nurse can make appropriate adjustments to the patient's treatment plan if needed.
48.
When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including
Correct Answer
D. Confusion and sweating
Explanation
The nurse will make sure that the patient is aware of the early signs of hypoglycemia, which include confusion and sweating. These symptoms occur when the blood sugar levels drop too low and the brain does not receive enough glucose to function properly. Confusion can range from mild disorientation to severe mental impairment, and sweating is a common response to low blood sugar levels. By educating the patient about these early signs, the nurse can help them recognize and address hypoglycemia promptly.
49.
When monitoring a patient’s response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?
Correct Answer
B. Fasting blood glucose level between 70 and 110mg/dL
Explanation
A fasting blood glucose level between 70 and 110mg/dL would indicate a therapeutic response to oral antidiabetic drugs. This range suggests that the medication is effectively controlling the patient's blood glucose levels and maintaining them within the normal range. A random blood glucose level above 170mg/dL indicates poor control of blood sugar, while a blood glucose level of less than 50mg/dL after meals indicates hypoglycemia. An evening blood glucose level below 80mg/dL may also indicate hypoglycemia.
50.
The nurse is reviewing instructions for a patient with type 2 diabetes who also takes insulin injections as part of the therapy. The nurse asks the patient, “what should you do if your fasting blood glucose is 47 mg/dL?” Which response by the patient reflects a correct understanding of insulin therapy?
Correct Answer
A. I will take an oral form of glucose
Explanation
If the patient's fasting blood glucose is 47 mg/dL, it indicates hypoglycemia (low blood sugar). In this situation, the correct response would be to take an oral form of glucose to raise the blood sugar levels back to a normal range. This shows that the patient understands the need to treat hypoglycemia promptly and appropriately.