Nursing Elites

1. When assessing a client taking Gemfibrozil, which of the following findings should the nurse identify as an adverse reaction to the medication?

• A. Mental status changes
• B. Tremor
• C. Jaundice
• D. Pneumonia

Correct answer: C

Rationale: Jaundice is an adverse reaction that can occur in clients taking Gemfibrozil due to the potential development of liver impairment. Other symptoms of liver impairment may include anorexia and upper abdominal discomfort. Monitoring for signs of jaundice is crucial to detect and manage adverse effects of the medication promptly. Mental status changes (choice A) are not commonly associated with Gemfibrozil use. Tremor (choice B) is not a typical adverse reaction of Gemfibrozil. Pneumonia (choice D) is not directly linked to Gemfibrozil use but can be a complication in some cases.

2. A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?

• A. aPTT of 90 seconds
• B. Platelet count of 150,000/mm³
• C. INR of 1.0
• D. Hgb of 15 g/dL

Correct answer: A

Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.

3. A client has a new prescription for Simvastatin. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication at bedtime.
• B. I should avoid eating grapefruit while taking this medication.
• C. I will need to monitor my blood sugar closely while taking this medication.
• D. I will stop taking the medication if I develop muscle pain.

Correct answer: B

Rationale: The correct answer is B. Grapefruit can increase the levels of simvastatin in the blood, leading to an increased risk of serious side effects, including muscle pain or damage. Therefore, it is crucial for the client to avoid consuming grapefruit while taking this medication to prevent potential complications.

4. A client has a new prescription for Diltiazem. Which of the following statements should the nurse include in the teaching?

• A. This medication may cause dry mouth.
• B. You should avoid drinking grapefruit juice.
• C. You may experience a rapid heart rate.
• D. Increase your intake of fiber-rich foods.

Correct answer: B

Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.

5. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

• A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
• B. I will call the provider to get a prescription for discontinuing the IV heparin today.
• C. Both heparin and warfarin work together to dissolve the clots.
• D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.

Correct answer: A

Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.

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