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 healthcare professional is assessing a client who has a new prescription for warfarin. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Frequent urination
• C. Hypokalemia
• D. Bleeding gums

Correct answer: D

Rationale: Bleeding gums are a sign of excessive anticoagulation with warfarin, indicating a potential risk of bleeding complications. It is crucial to report this finding promptly to the provider for further assessment and adjustment of the medication regimen to prevent serious bleeding events. Weight gain, frequent urination, and hypokalemia are not typically associated with warfarin use and are not immediate concerns that require urgent reporting to the provider.

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

• A. Take the medication at bedtime.
• B. Monitor your heart rate daily.
• C. Increase your intake of potassium-rich foods.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking atenolol. Atenolol can lead to bradycardia, a slow heart rate. By monitoring heart rate daily, the client can promptly identify any significant changes and seek medical attention if necessary. This proactive approach enables early detection of potential adverse effects of atenolol, contributing to the client's safety and well-being. Choices A, C, and D are incorrect because taking atenolol at bedtime, increasing potassium-rich foods intake, or avoiding dairy products are not specific instructions related to the potential side effects of atenolol.

4. Before administering a calcium channel blocker to a client with hypertension, what parameter should the nurse check?

• A. Serum calcium level
• B. Apical pulse
• C. Blood pressure
• D. Respiratory rate

Correct answer: C

Rationale: Before administering a calcium channel blocker to a client with hypertension, the nurse should check the client's blood pressure. Calcium channel blockers are prescribed to lower blood pressure, so it is essential to assess the current blood pressure to ensure safe administration and monitor the medication's effectiveness. Checking the serum calcium level (Choice A) is not necessary before administering a calcium channel blocker, as it does not directly impact the drug's action. Monitoring the apical pulse (Choice B) is important for other types of medications like beta-blockers, not specifically for calcium channel blockers. Assessing the respiratory rate (Choice D) is not directly related to administering calcium channel blockers for hypertension.

5. A client with a diagnosis of heart failure is receiving digoxin (Lanoxin) and furosemide (Lasix). The LPN/LVN should closely monitor the client for which potential complication?

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

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that promotes the loss of potassium in the urine, potentially leading to hypokalemia. Hypokalemia increases the risk of digoxin toxicity, as digoxin's effects can be potentiated in the presence of low potassium levels. Monitoring for hypokalemia is crucial to prevent adverse effects and maintain the therapeutic effectiveness of digoxin in clients with heart failure. Choices A, C, and D are incorrect because furosemide does not typically cause hyperkalemia, hypernatremia, or hyponatremia. Instead, it commonly leads to hypokalemia due to increased potassium excretion.

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