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. A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

• A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
• B. A pharmacist is the person to answer that question.
• C. Heparin does not dissolve clots. It stops new clots from forming.
• D. The oral medication you will take after this IV will dissolve the clot.

Correct answer: C

Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.

3. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

4. A client is being discharged with a new prescription for Fluoxetine for PTS. Which of the following statements should the nurse include in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the morning to avoid sleep disturbances.
• C. To minimize urinary adverse effects, ensure you urinate before taking this medication.
• D. It is recommended to wear sunglasses outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is that the client may experience a decreased desire for intimacy while taking Fluoxetine for PTS. This is important because Fluoxetine, an SSRI used to treat PTS, can lead to decreased libido as a potential adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with Fluoxetine and are not directly relevant to the medication's effects for this patient.

5. A healthcare provider is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the healthcare provider include?

• A. You should not use this medication for an acute asthma attack.'
• B. Tremors may be an adverse effect of this medication.'
• C. Long-term use of this medication can lead to hyperglycemia.'
• D. This medication can inhibit skeletal growth.'

Correct answer: B

Rationale: Tremors may occur as a result of excessive stimulation of beta2 receptors in skeletal muscles when using Albuterol. It is important to educate the parent about potential adverse effects to ensure proper monitoring and management of the adolescent client's medication regimen.

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