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ATI RN Pharmacology 2023 IV
Total Questions : 67
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, "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.
- 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 (Reference range: 0.3 to 5 microunits/mL)
- Free Thyroxine (Free T4): 2.8 ng/dL (Reference range: 0.8 to 2.8 ng/dL)
- Helicobacter pylori Serum IgG: 0.9 (Reference range: Less than 0.75)
Day 2:
- Follow-up Instructions:
- Continue previous home medications.
- Begin Esomeprazole 20 mg once daily PO for 14 days.
Day 1:
- Temperature: 36.6°C (97.9°F)
- Heart Rate: 80/min
- Respiratory Rate: 18/min
- Blood Pressure: 132/88 mm Hg
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
The client is at risk for decreased absorption due to medication interactions.
Rationale
Esomeprazole works by reducing the production of stomach acid, thereby raising the pH level in the stomach. Levothyroxine, like many other medications, is absorbed primarily in the upper part of the small intestine where a more acidic environment is optimal for absorption. When stomach acid production is reduced by esomeprazole, the pH of the stomach increases, which can decrease the dissolution and absorption of levothyroxine.
0900:
- The client is being seen in the office.
- The client reports feeling fatigued and having a heavy menstrual cycle the past year.
- Upon assessment, the client's conjunctiva and mucosal membranes are pale.
- Provider notified and laboratory samples to be drawn.
2 Days Later:
- Provider reviewed laboratory results and prescription written.
0930:
- Ferritin: 7 ng/mL (10 to 150 ng/mL)
- Iron: 45 mcg/dL (60 to 160 mcg/dL)
- Hemoglobin: 8.5 g/dL (12 to 16 g/dL)
2 Days Later:
- Ferrous Sulfate 325 mg PO every other day
A nurse is caring for a female client in a provider's office.
The nurse notifies the client and provides teaching about the newly prescribed medication. For each of the statements made by the client, click to specify whether the statement indicates an understanding or no understanding of the teaching provided.
Explanation
A. This statement indicates that the client understands that black stools can indicate gastrointestinal bleeding, a potential side effect of iron supplementation. Notifying the provider is appropriate in this case to assess for any significant bleeding.
B. Taking the medication with orange juice can increase iron absorption due to the vitamin C content.
D. Antacids can reduce the absorption of iron supplements. Therefore, avoiding taking antacids close to the time of taking iron supplements is recommended to ensure optimal absorption.
C. While some iron supplements are best absorbed on an empty stomach, Ferrous Sulfate is typically recommended to be taken with food to reduce gastrointestinal side effects. Taking it on an empty stomach might increase the risk of stomach upset.
E. This statement does not directly relate to iron supplementation. Iron supplements do not typically require rinsing the mouth afterward.
3 months ago:
- Client seen in provider's office for routine physical.
Today:
- Client reports dizziness and light-headedness upon standing.
- Client reports waking up at night to void
3 months ago:
- Sodium 142 mEq/L (136 to 145 mEq/L)
- Potassium 3.8 mEq/L (3.5 to 5 mEq/L)
Today:
- Sodium 136 mEq/L (136 to 145 mEq/L)
- Potassium 3.4 mEq/L (3.5 to 5 mEq/L)
3 months ago:
- Hydrochlorothiazide 50 mg PO daily
A nurse in a provider's office is caring for a client.
What actions should the nurse take?
Select all that apply.
A nurse is teaching a client who has a prescription for an epinephrine auto-injector. The nurse should instruct the client to take which of the following actions first?
A nurse is teaching a client who has a new prescription for a metered-dose inhaler. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
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