Nursing Elites

1. A client with a new prescription for simvastatin is receiving teaching from a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?

• A. 'I should take this medication in the evening.'
• B. 'I should avoid drinking grapefruit juice.'
• C. 'I should expect my urine to be red-orange while taking this medication.'
• D. 'I will need to take this medication for the rest of my life.'

Correct answer: A

Rationale: The correct answer is A. Taking simvastatin in the evening is recommended because cholesterol synthesis increases at night. This timing maximizes the effectiveness of the medication in lowering cholesterol levels. Choice B is incorrect because grapefruit juice should be avoided with certain statins, but simvastatin is not significantly affected by grapefruit juice. Choice C is incorrect as red-orange urine is not an expected side effect of simvastatin. Choice D is incorrect because simvastatin is typically prescribed for managing cholesterol levels and may not need to be taken for the rest of the client's life.

2. A client with a diagnosis of heart failure is being discharged. What information should the nurse emphasize to the client regarding the use of a daily weight log?

• A. Report any weight gain of more than 2 pounds in a day
• B. Weigh yourself after eating breakfast each morning
• C. Use the same scale each day to check your weight
• D. Record your weight daily and report any changes

Correct answer: A

Rationale: The correct answer is A: 'Report any weight gain of more than 2 pounds in a day.' Sudden weight gain of more than 2 pounds in a day may indicate fluid retention and worsening heart failure. This information is crucial for early intervention and monitoring of the client's condition. Weighing after eating breakfast (choice B) may not provide consistent results due to varying food and fluid intake. Using the same scale each day (choice C) ensures accuracy and consistency in weight measurements. Recording weight daily (choice D) is more frequent than necessary and may not be practical for all clients. It is essential to focus on significant weight changes to prevent unnecessary alarm or confusion.

3. A client with heart failure is receiving digoxin. Which finding should indicate to the nurse that the client is experiencing digoxin toxicity?

• A. Constipation
• B. Blurred vision
• C. Bradycardia
• D. Dry cough

Correct answer: C

Rationale: Bradycardia is a hallmark sign of digoxin toxicity. Digoxin, a medication used to treat heart conditions, can lead to toxicity manifesting as bradycardia. Bradycardia occurs due to the drug's effect on slowing down the heart rate excessively. Constipation (Choice A) is not typically associated with digoxin toxicity. Blurred vision (Choice B) is more commonly linked to visual disturbances caused by digoxin, but it is not a defining sign of toxicity. Dry cough (Choice D) is not a recognized symptom of digoxin toxicity. It is crucial for the nurse to recognize the early signs of digoxin toxicity to prevent serious complications and provide appropriate interventions promptly.

4. The client with a diagnosis of heart failure is receiving furosemide (Lasix). Which laboratory value is most important for the nurse to monitor?

• A. Blood glucose
• B. Serum sodium
• C. Serum potassium
• D. Blood urea nitrogen (BUN)

Correct answer: C

Rationale: The correct answer is C: Serum potassium. When a client is receiving furosemide, a loop diuretic, it can lead to potassium loss. Monitoring the serum potassium levels is crucial to prevent life-threatening complications such as cardiac arrhythmias. Blood glucose (Choice A) is not directly impacted by furosemide. Serum sodium (Choice B) may be affected, but monitoring potassium is more critical due to the risk of arrhythmias. Blood urea nitrogen (BUN) (Choice D) is important for assessing kidney function but is not the most crucial value to monitor in a client taking furosemide.

5. A client has a new prescription for metoprolol. Which of the following instructions should the nurse include?

• A. Monitor your blood pressure daily.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: A

Rationale: The correct answer is A, 'Monitor your blood pressure daily.' When a client is prescribed metoprolol, it is important to monitor blood pressure daily because the medication can cause hypotension, leading to low blood pressure. Regular monitoring allows for the early detection of any potential issues and adjustment of treatment if necessary. Choices B, C, and D are incorrect. Taking metoprolol with food is not necessary, increasing potassium-rich foods is not directly related to metoprolol therapy, and avoiding grapefruit juice is more relevant for certain other medications that interact with grapefruit.

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