Nursing Elites

1. When providing teaching to a client with a new prescription for atorvastatin, which of the following instructions should the nurse include?

• A. Take the medication in the evening.
• B. Take the medication with food.
• C. Increase your intake of grapefruit juice.
• D. Avoid consuming dairy products.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for atorvastatin is to take the medication in the evening. Atorvastatin is more effective when taken at night because cholesterol synthesis is higher during this time. This timing helps optimize the drug's cholesterol-lowering effects and enhances its overall efficacy in managing lipid levels. Choices B, C, and D are incorrect. Taking atorvastatin with food can decrease its absorption, grapefruit juice can interact with atorvastatin leading to increased side effects, and there is no specific need to avoid dairy products while on atorvastatin unless instructed otherwise by the healthcare provider.

2. A client has a new prescription for heparin. Which of the following laboratory results should be monitored to evaluate the effectiveness of the medication?

• A. Prothrombin time (PT)
• B. International normalized ratio (INR)
• C. Activated partial thromboplastin time (aPTT)
• D. Platelet count

Correct answer: C

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory result that should be monitored to evaluate the effectiveness of heparin. Heparin works by prolonging the aPTT, and monitoring this parameter helps ensure the medication's effectiveness and safety in preventing clot formation. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor the effectiveness of warfarin, another anticoagulant. Platelet count is essential to assess platelet function and clotting disorders, but it is not specifically used to monitor heparin therapy.

3. A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor the client for which potential electrolyte imbalance?

• A. Hyperkalemia
• B. Hypernatremia
• C. Hypokalemia
• D. Hypocalcemia

Correct answer: C

Rationale: When a client with heart failure is prescribed furosemide, the nurse should monitor for hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, which increases the risk of hypokalemia. Hypokalemia can have serious implications such as cardiac dysrhythmias. Therefore, it is essential to closely monitor the client's serum potassium levels while on furosemide to prevent complications. Hyperkalemia (Choice A) is incorrect because furosemide leads to potassium loss, not retention. Hypernatremia (Choice B) is not typically associated with furosemide use. Hypocalcemia (Choice D) is not a common electrolyte imbalance caused by furosemide.

4. Which laboratory test should be monitored to evaluate the effectiveness of anticoagulant therapy in a client with deep vein thrombosis (DVT)?

• A. Complete blood count (CBC)
• B. Activated partial thromboplastin time (aPTT)
• C. Serum electrolytes
• D. Liver function tests

Correct answer: B

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory test monitored to evaluate the effectiveness of anticoagulant therapy, particularly with heparin. It measures the time it takes for blood to clot, and monitoring aPTT helps ensure the therapeutic range is maintained to prevent clot formation and excessive bleeding. Choices A, C, and D are incorrect because a complete blood count (CBC) assesses overall health, serum electrolytes evaluate the body's electrolyte balance, and liver function tests assess liver health, none of which directly evaluate the effectiveness of anticoagulant therapy for DVT.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. The nurse should monitor the client for which sign of theophylline toxicity?

• A. Drowsiness
• B. Bradycardia
• C. Nausea
• D. Constipation

Correct answer: C

Rationale: Nausea is an early sign of theophylline toxicity. The nurse should closely monitor the client for this symptom as it can progress to more severe toxicity. Nausea can be a warning sign to prevent further complications and adjust the dosage as necessary. Drowsiness (choice A) is a common side effect of theophylline but not a specific sign of toxicity. Bradycardia (choice B) and constipation (choice D) are not typically associated with theophylline toxicity. Therefore, the correct answer is C.

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