Correct Answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes.

Correct Answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure.

Correct Answer: B

Rationale: The presence of red blood cells in the urine is a significant finding that can indicate nephrotoxicity, a potential adverse effect of gentamicin. Nephrotoxicity can lead to kidney damage, and monitoring for this adverse reaction is crucial during gentamicin therapy.

Correct Answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. This medication belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Therefore, it is essential for the nurse to emphasize this potential adverse effect during client teaching to ensure the client is aware of the associated risks.

Correct Answer: A

Rationale: A persistent dry cough is a common adverse effect of Enalapril, which is an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to cough. If the client experiences a persistent dry cough, it is essential to notify the healthcare provider for further evaluation and possible medication adjustment.