Nursing Elites

1. When completing a nursing history for a client taking Simvastatin, which of the following disorders should the nurse identify as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in clients with active moderate-to-severe liver disorders, particularly if they are already on a statin like simvastatin. Hepatitis C is a liver condition that can be exacerbated by Ezetimibe, leading to potential complications. Therefore, the nurse should identify active hepatitis C as a contraindication to adding Ezetimibe to the client's medications. Choices A, B, and D are incorrect because they are not directly related to the contraindication of Ezetimibe in clients taking Simvastatin.

2. A client is receiving Cefotaxime IV for a severe infection. Which finding indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?

• A. Diaphoresis
• B. Epistaxis
• C. Diarrhea
• D. Alopecia

Correct answer: C

Rationale: Diarrhea is an adverse effect of cefotaxime and other cephalosporins that requires reporting to the provider. Severe diarrhea might indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening. Diaphoresis, epistaxis, and alopecia are not typically associated with cefotaxime use and are less likely to indicate a serious adverse reaction necessitating immediate reporting.

3. A client has been prescribed Atorvastatin to lower cholesterol. Which of the following instructions should the nurse include?

• A. Take this medication with a full glass of water.
• B. Report any muscle pain to your provider immediately.
• C. Avoid drinking grapefruit juice while taking this medication.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to 'Report any muscle pain to your provider immediately.' Muscle pain can be a sign of rhabdomyolysis, a rare but serious side effect of statins like atorvastatin. It is crucial to monitor for potential complications, and reporting muscle pain promptly can lead to timely intervention if needed. Choices A, C, and D are incorrect because they do not address a critical side effect of atorvastatin or provide essential information for the client's safety and well-being.

4. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and is experiencing muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

5. A client has a new prescription for Digoxin. Which of the following findings should the nurse identify as a potential sign of Digoxin toxicity?

• A. Nausea
• B. Dry mouth
• C. Hypoglycemia
• D. Tinnitus

Correct answer: A

Rationale: Nausea is a potential sign of Digoxin toxicity. Other signs of Digoxin toxicity include vomiting, visual disturbances, and confusion. Nausea can be an early indicator of toxicity and should be closely monitored by the nurse. Dry mouth and hypoglycemia are not typically associated with Digoxin toxicity. Tinnitus is more commonly associated with medications like aspirin or loop diuretics, not Digoxin.

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