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 history of heart failure is prescribed metoprolol (Lopressor). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Hypotension
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Metoprolol is a beta-blocker commonly used in heart failure to reduce blood pressure. One of the common side effects of metoprolol is hypotension, which can lead to dizziness, lightheadedness, and even fainting. Therefore, monitoring for hypotension is essential to prevent adverse effects and ensure patient safety. Choices A, C, and D are incorrect. Tachycardia is not a common side effect of metoprolol, as it actually reduces heart rate. Hypertension is also not a common side effect of this medication, as it is intended to lower blood pressure. Hyperglycemia is not a typical side effect of metoprolol.

3. The healthcare provider is monitoring a client with chronic stable angina. Which symptom would indicate that the client's condition is worsening?

• A. Increased shortness of breath with exertion
• B. Improved tolerance to activity
• C. Decreased frequency of chest pain
• D. Stable blood pressure readings

Correct answer: A

Rationale: Increased shortness of breath with exertion is a concerning symptom in a client with chronic stable angina as it may indicate inadequate oxygen supply to the heart muscle, suggesting a worsening condition. This could be a sign of reduced blood flow to the heart, leading to increased work for the heart during exertion, resulting in increased shortness of breath. Choice B, improved tolerance to activity, is incorrect as it would indicate a positive response to treatment. Choice C, decreased frequency of chest pain, is incorrect as it would also suggest an improvement in the client's condition. Choice D, stable blood pressure readings, are not indicative of a worsening condition in chronic stable angina.

4. A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action?

• A. Assist the client to get back into bed.
• B. Report the chest pain episode to the healthcare provider.
• C. Tell the client to stand still and take the client's blood pressure.
• D. Give a nitroglycerin (Nitrostat) tablet and assist the client to the bathroom.

Correct answer: A

Rationale: In a client with myocardial infarction experiencing chest pain during activity, the priority action is to stop the activity immediately to reduce the heart's workload and oxygen demand. Assisting the client back to bed helps in reducing stress on the heart and can prevent worsening of the condition. Reporting the chest pain episode to the healthcare provider is important but should not delay taking immediate action to alleviate symptoms. Taking the client's blood pressure and administering nitroglycerin are secondary actions after ensuring the client's safety and comfort. Therefore, the correct action is to assist the client back into bed.

5. The client is reinforcing instructions for a low-sodium diet. Which statement by the client indicates a need for further teaching?

• A. I will avoid adding salt to my food while cooking.
• B. I will use salt substitutes instead of regular salt.
• C. I can eat as much processed food as I like since it's usually low in sodium.
• D. I will read food labels to check for sodium content.

Correct answer: C

Rationale: The correct answer is C. Processed foods often contain high amounts of sodium, so they should be limited or avoided on a low-sodium diet. Choosing processed foods can lead to increased sodium intake, counteracting the purpose of following a low-sodium diet. Option A shows an understanding of avoiding added salt, Option B suggests using alternatives to regular salt, and Option D indicates a willingness to check food labels for sodium content, all of which are appropriate for a low-sodium diet. Therefore, the client's statement about eating processed foods freely is incorrect and requires further teaching.

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