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Ati RN pharmacology 2023
Total Questions : 69
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.
Medication Administration Record
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 1:
Temperature 36.6° C (97.9° F)
Heart rate 80/min
Respiratory rate 18/min
Blood pressure 132/88 mm Hg
Day 2:
Follow up phone call: Continue previous home medications. Begin Esomeprazole 20 mg once daily PO for 14 days
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)
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
Levothyroxine is best absorbed on an empty stomach, typically taken 30–60 minutes before breakfast, and separately from other medications, especially multivitamins (iron and calcium) and esomeprazole (a proton pump inhibitor). The client has been taking levothyroxine after breakfast with other medications, which can interfere with its absorption. This leads to the risk of decreased therapeutic effectiveness, even though the current TSH is within normal range and free T4 is at the high end of normal.
Multivitamins (often contain calcium or iron): Can bind to levothyroxine and reduce its absorption. Esomeprazole: Alters gastric pH, which can impair levothyroxine absorption. Food intake: Taking levothyroxine with food reduces its bioavailability.
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 assessing a client prior to administering digoxin. Which of the following findings should the nurse immediately 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 reinforcing teaching with a client about levothyroxine. Which of the following statements by the client indicates an understanding of the teaching?
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 assessing a client who is receiving nebulized albuterol. The nurse should identify which of the following as an adverse effect of albuterol?
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