A patient with diabetes and hypothyroidism is being admitted to an assisted living facility. During the admission assessment, the patient reports difficulty falling asleep. The nurse shows an understanding of sleep dysfunction and the older patient when asking:

"How do you feel about leaving your home to live here?"

"Are you taking medication for your thyroid problem?"

"Have you ever been prescribed a sleeping medication?"

"How long have you been a diabetic?"

Answer and Explanation

The Correct Answer is C

A.   This question addresses the emotional and psychological impact of relocating to an assisted living facility. Emotional stress and adjustment issues can affect sleep patterns. While important for understanding the patient's emotional state and potential stressors, this question may not directly address the specific physiological or medical causes of sleep difficulties.
B.   This question focuses on the management of hypothyroidism, which can influence sleep patterns. Hypothyroidism and its treatment can affect energy levels and sleep quality. Medications for hypothyroidism could impact sleep if they are not well managed or if the dosage needs adjustment. However, this question alone might not cover other potential causes of sleep difficulties.
C.   This question aims to identify if the patient has a history of using sleeping medications, which can help in understanding their sleep patterns and possible reliance on such treatments. Knowing whether the patient has used sleeping medications can provide insight into their current sleep issues and help the nurse assess if previous treatments have been effective or if adjustments are needed. This question is directly related to assessing and addressing sleep difficulties.
D.   This question gathers information about the duration of diabetes, which can help in understanding the patient’s overall management of the condition. While the duration of diabetes is important for overall health management, it does not directly address the sleep issues the patient is experiencing. Diabetes can affect sleep, but this question does not specifically target the sleep problem.

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Correct Answer is A

Explanation

A. When a patient is taking multiple medications, it's important to review them for potential interactions. Polypharmacy, the use of multiple medications, is common in older adults and can increase the risk of adverse drug reactions, side effects, and decreased effectiveness of medications.
B. While it's important to educate the patient about the risks of polypharmacy, the nurse's initial priority should be to assess the medications for potential interactions.
C. This is an important step in patient education, but it should be done after the nurse has reviewed the medications for potential interactions.
D. While it's important to verify the appropriateness of each medication, the nurse's initial priority should be to assess for potential interactions.

A. 2.5 tablets B. 1 tablet C. 3 tablets D. 0.5 tablet

Correct Answer is A

Explanation

0.25 mg = 250 mcg

Number of tablets = Desired dose (mcg) / Tablet strength (mcg) Plugging in the given values:

Number of tablets = 250 mcg / 100 mcg/tablet Number of tablets = 2.5 tablets

Therefore, the nurse should administer 2.5 tablets of levothyroxine sodium (Synthroid) to the patient.

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A patient with diabetes and hypothyroidism is being admitted to an assisted living facility. During the admission assessment, the patient reports difficulty falling asleep. The nurse shows an understanding of sleep dysfunction and the older patient when asking:

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Naxlex Comprehensive Predictor Exams

The nurse admitting an 89-year-old patient to an assisted living facility notes that the patient is currently taking numerous prescribed and over-the-counter medications. The nurses initial intervention is to:

Correct Answer is A

Explanation

The nurse is caring for an older patient with hypothyroidism and receives an order to administer 0.25 mg of levothyroxine sodium (Synthroid) PO every morning before breakfast. The nurse has on hand 100 mcg/tablet. How many tablet(s) should the nurse administer?

Correct Answer is A

Explanation

To best minimize patient anxiety and help ensure a successful history assessment interview, the geriatric nurse first:

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