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 with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin 0.4 mg sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, what should the nurse do next?

• A. Administer another nitroglycerin tablet.
• B. Apply 1 to 3 L/minute of oxygen via nasal cannula.
• C. Call for a 12-lead electrocardiogram (ECG) to be performed.
• D. Wait an additional 5 minutes, then give a second nitroglycerin tablet.

Correct answer: A

Rationale: When a client with angina pectoris continues to experience chest pain despite initial nitroglycerin administration and stable blood pressure, the appropriate next step is to administer another nitroglycerin tablet. This helps to further dilate coronary arteries, improving blood flow to the heart muscle and relieving chest pain. Applying oxygen via nasal cannula (Choice B) may be necessary if the client displays signs of respiratory distress or hypoxemia, but in this case, the priority is addressing the unresolved chest pain. Calling for a 12-lead electrocardiogram (ECG) (Choice C) is important to assess for any changes in the client's cardiac status, but administering another nitroglycerin tablet takes precedence in managing the ongoing chest pain. Waiting an additional 5 minutes before giving a second nitroglycerin tablet (Choice D) may delay symptom relief and potentially worsen the client's condition if the chest pain persists.

3. Which statement indicates that a client with coronary artery disease (CAD) understands disease management?

• A. I will walk for one-half hour daily.
• B. As long as I exercise, I can eat anything I wish.
• C. My weight plays no role in this disease.
• D. My father's high cholesterol is irrelevant.

Correct answer: A

Rationale: Choice A is the correct answer because regular physical activity, such as walking for half an hour daily, is beneficial for managing coronary artery disease (CAD) and promoting heart health. Walking helps improve circulation, reduce cholesterol levels, and maintain a healthy weight, all of which are crucial for managing CAD. Choice B is incorrect because diet also plays a significant role in CAD management, not just exercise. Choice C is incorrect because weight management is essential in controlling CAD risk factors. Choice D is incorrect because family history of high cholesterol can increase the risk of CAD, making it relevant for disease management.

4. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?

• A. Take one tablet daily with breakfast
• B. Take one tablet every 5 minutes as needed, up to three times
• C. Take one tablet every hour until pain subsides
• D. Take one tablet only if pain does not subside after 30 minutes

Correct answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.

5. A client has a new prescription for docusate sodium. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication with a full glass of water.
• B. Take the medication at bedtime.
• C. Take the medication on an empty stomach.
• D. Avoid taking the medication with antacids.

Correct answer: A

Rationale: Corrected Rationale: When taking docusate sodium, it is important to take the medication with a full glass of water to help ensure its proper effectiveness. This helps prevent the stool from hardening and makes it easier to pass, especially for individuals experiencing constipation. Choice B is incorrect because there is no specific instruction to take docusate sodium at bedtime. Choice C is incorrect because docusate sodium does not need to be taken on an empty stomach. Choice D is incorrect because there is no need to avoid taking docusate sodium with antacids.

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