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Ati Rn pharmacology proctored exam 2023
Total Questions : 70
Showing 10 questions, Sign in for moreDay 1:
Client reports for a scheduled appointment to discuss increased heartburn and acid reflux. Client has a history of hypothyroidism and hypertension. Client states, "I used to take my thyroid medicine first thing in the morning, but it really upsets my stomach, so I've started to take it right after breakfast with the rest of my pills and that seems to help some." Provider visit completed. Laboratory prescriptions received.
Day 2:
Follow up phone call to client to discuss laboratory results and provider prescriptions. Provided education regarding therapeutic medication regimen.
Day 1:
Temperature 36.6° C (97.9° F)
Heart rate 80/min
Respiratory rate 18/min
Blood pressure 132/88 mm Hg
Day 1:
Current Medications:
Aspirin EC 81 mg PO daily
Levothyroxine 100 mcg PO daily
Lisinopril 20 mg PO daily
Multivitamin 1 tablet PO daily
Day 2:
TSH 2 microunit/mL (0.3 to 5 microunits/mL)
Free Thyroxine (free T4) 2.8 ng/dL (0.8 to 2.8 ng/dL)
Helicobacter pylori Serum IgG 0.9 (less than 0.75)
Day 2
Follow up phone call: Continue previous home medications.
Begin Esomeprazole 20 mg once daily PO for 14 days
A nurse is caring for a client in an outpatient clinic.
Complete the following sentence by using the lists of options.
The client is at risk for
Explanation
- Decreased absorption: Levothyroxine should be taken on an empty stomach, typically 30–60 minutes before breakfast, to ensure optimal absorption in the gastrointestinal tract. Taking it with food or other medications, such as a multivitamin or esomeprazole, reduces its bioavailability and can blunt its therapeutic effect over time.
- Medication interactions: The client takes levothyroxine with multiple morning medications, including a multivitamin and esomeprazole. Calcium, iron, and proton pump inhibitors (like esomeprazole) interfere with levothyroxine absorption by altering stomach pH or binding the drug in the gut, increasing the risk for subtherapeutic effects.
- Toxicity: Toxicity is unlikely in this scenario because taking levothyroxine with food or interacting medications reduces, not enhances, absorption. This would more likely result in hypothyroid symptoms rather than hyperthyroidism.
- Goiter: Although poor thyroid hormone levels can eventually contribute to goiter development, this is a long-term effect of untreated or severe hypothyroidism and not an immediate concern linked to current medication timing.
- Lab results: The client’s TSH and free T4 levels are currently within normal range, suggesting stable thyroid function. The main issue is the administration timing and potential interactions, not an abnormal lab result.
- Dosage strength: The prescribed levothyroxine dosage (100 mcg) appears appropriate based on the current lab values. The problem lies in how the medication is taken rather than the dose itself.
0830:
Walk-in clinic visit for 16-year-old client accompanied by their parent. The parent states, "My daughter has a boyfriend and I want to be sure that she has some birth control before becoming sexually active." The client states, "I want to be sure I don't get pregnant or get an STI."
0915:
Witnessed consent signed by client and parent. Assisted provider with placement of intrauterine device (IUD). Client tolerated procedure well.
1000:
Administered immunization as prescribed. Provided client with a package of condoms.
0930:
Human papillomavirus (HPV) vaccine, administer first dose today IM
0930:
Vaccine information sheet discussed with client and parent. Provided education regarding contraception and prevention of sexually transmitted infections (STIs).
A nurse is caring for an adolescent client in a community health clinic.
Which of the following client statements indicate that the nurse's teaching about the immunization was effective? Select all that apply.
A nurse is reviewing a client's medical record before administering acetaminophen 650 mg PO every 6 hr. Which of the following findings indicates a need for the nurse to notify the provider?
A nurse is reviewing the medical history of a client who has a new prescription for magnesium hydroxide. Which of the following conditions should the nurse report to the provider?
A nurse is reviewing agency protocol prior to administering epoetin alfa to a client who has chronic kidney disease. Which of the following actions should the nurse plan to take?
A nurse is evaluating a return demonstration of enoxaparin administration by a client. Which of the following client actions indicates an understanding of the teaching?
A nurse is teaching a client who has a new prescription for cyclobenzaprine. Which of the following statements should the nurse include?
A nurse is assessing a client who is taking furosemide to treat heart failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?
A nurse is providing teaching to a client who has a new prescription for rifampin. Which of the following statements should the nurse include in the teaching?
A nurse is caring for a client who is receiving 0.9% sodium chloride solution to treat dehydration. Which of the following findings should the identify as an adverse effect of the infusion?
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