A client is prescribed levothyroxine (Synthroid) for hypothyroidism. When is the best time for the nurse to instruct the client to take this medication?

Correct Answer: C

Rationale: Levothyroxine replaces thyroid hormone, requiring optimal absorption for efficacy. Taking it on an empty stomach in the morning avoids interference from food (e.g., calcium, iron), which reduces uptake, ensuring consistent T4 levels. With breakfast or dinner , absorption drops due to dietary interactions, risking subtherapeutic effects. At bedtime is viable but less ideal if food was recent, and morning aligns with circadian thyroid function. This timing leverages levothyroxine's pharmacokinetics'long half-life but sensitivity to gut contents'maximizing bioavailability. Instructing this prevents treatment failure in hypothyroidism, where precise dosing matters, making C the best time for administration and client education.

Correct Answer: D

Rationale: Phenytoin is an antiepileptic medication that is used to control seizures. One of the common side effects of phenytoin is the development of tremors, which are involuntary shaking movements of the body. Patients taking phenytoin may experience tremors as a result of the medication's effects on the central nervous system. It is important for healthcare providers to monitor patients taking phenytoin for the development of tremors and manage them accordingly.

Correct Answer: C

Rationale: Phenytoin (Dilantin) belongs to the therapeutic class of anticonvulsants. Anticonvulsants are medications primarily used to treat and prevent seizures and are commonly prescribed for patients with epilepsy. Phenytoin works by stabilizing the electrical activity in the brain to prevent abnormal brain activity that leads to seizures. It is not classified as a mood stabilizer or bronchodilator; its main purpose is to control epileptic seizures.

Correct Answer: D

Rationale: Given the patient's history of liver transplant and current medications (prednisone and azathioprine), the nurse should pay close attention to an increased cholesterol level. Corticosteroids (such as prednisone) and immunosuppressants (such as azathioprine) can both contribute to dyslipidemia, leading to elevated cholesterol levels. Monitoring cholesterol levels is crucial in this patient population to assess cardiovascular risk and potentially adjust medications or lifestyle interventions accordingly. The other findings mentioned (soft non-tender lump in the shoulder, grade 1+ pitting edema in the feet, swollen and pinkish gums) may be important to note but do not directly relate to the patient's history of liver transplant and medication regimen.

Correct Answer: C

Rationale: Higher potency (lower dose for effect) can coexist with lower efficacy (max effect), true, as potency reflects affinity, not ceiling effect. Higher receptor affinity increases potency, true, per receptor theory. Lower potency doesn't mandate lower efficacy; a less potent drug can achieve the same max effect with more dose, making this false. Higher potency with equal efficacy is true (e.g., partial agonists). This pharmacodynamic distinction is vital for drug selection, where efficacy often trumps potency.

Correct Answer: C

Rationale: Anatomy, physiology, and microbiology underpin pharmacology, enabling nurses to grasp drug actions and patient responses, enhancing care through informed medication use. As an outgrowth oversimplifies their integration. Curriculum mandates explain requirements, not value. Understanding is key, but applying it to care-like knowing antibiotic targets or drug effects on organs-grounds pharmacology in practice, making it the best rationale.

Correct Answer: D

Rationale: Intravenous nitroglycerin can be given in infusions with other medications, such as saline or dextrose solutions, to manage acute conditions like acute myocardial infarction. Combining nitroglycerin with other medications in an infusion is a common practice to treat patients in critical conditions and optimize therapy. This allows healthcare providers to administer multiple medications simultaneously through the same IV line, ensuring prompt and effective treatment.

Correct Answer: C

Rationale: Daily coffee (caffeine) for 3 months likely leads to tolerance . Regular use reduces adenosine blockade's stimulant effect. Fatigue decrease and alertness wane with tolerance. Tremors and withdrawal (E) need higher doses or cessation. Tolerance fits her chronic intake.

Correct Answer: D

Rationale: Weight loss, tachycardia, and goitre suggest hyperthyroidism (e.g., Graves'). Verapamil controls rate but not thyroid function. Radioactive iodine (131I) treats long-term, not immediately. Carbamazepine is for seizures, L-thyroxine worsens hyperthyroidism. Atenolol, a beta-blocker, immediately reduces tachycardia and symptoms by blocking adrenergic effects, suitable for acute management while awaiting antithyroid drugs (e.g., propylthiouracil). Its symptomatic relief is critical in hyperthyroid crises.