Nursing Elites

1. When educating a client starting Simvastatin, which instruction should the nurse provide?

• A. Take this medication in the evening.
• B. Change positions slowly when rising from a chair.
• C. Maintain a consistent intake of green leafy vegetables.
• D. Limit fluid intake to 1 L per day.

Correct answer: A

Rationale: The correct answer is to take Simvastatin in the evening. This timing is important because the body synthesizes the most cholesterol at night. By taking the medication in the evening, its effectiveness is increased, leading to better outcomes for the client.

2. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' When administering Amitriptyline, the nurse should monitor for orthostatic hypotension. This condition can occur due to the drug's anticholinergic effects, leading to a sudden drop in blood pressure when standing up. Symptoms may include dizziness, lightheadedness, and an increased risk of falls. Monitoring for signs of orthostatic hypotension is crucial to prevent complications. Choices A, B, and C are incorrect as decreased appetite, explosive diarrhea, and decreased pulse rate are not typically associated with the administration of Amitriptyline.

3. A client with end-stage cancer receiving Morphine has been prescribed Methylnaltrexone. The client's daughter asks about the purpose of Methylnaltrexone. Which response should the nurse provide?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: Methylnaltrexone is an opioid antagonist used to treat severe constipation unresponsive to laxatives in opioid-dependent clients. It functions by blocking the mu opioid receptors in the gastrointestinal tract, helping alleviate constipation associated with opioid use. Choices A, B, and D are incorrect. Methylnaltrexone does not increase respirations, prevent dependence on Morphine, or work with Morphine to increase pain relief; its primary purpose is to relieve opioid-induced constipation.

4. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

5. A client is prescribed Lithium. Which of the following laboratory values should be monitored to assess for potential toxicity?

• A. Serum sodium
• B. Serum lithium
• C. Serum potassium
• D. Serum calcium

Correct answer: B

Rationale: When a client is prescribed Lithium, monitoring serum lithium levels is crucial to ensure they remain within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels helps prevent adverse effects associated with lithium toxicity, such as nausea, vomiting, diarrhea, tremors, and confusion.

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