Nursing Elites

1. When educating a client starting a new prescription for simvastatin, which instruction should the nurse provide?

• A. Take the medication in the morning.
• B. Report any muscle pain immediately.
• C. Avoid taking the medication with grapefruit juice.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct instruction for a client starting simvastatin is to report any muscle pain immediately because it could be indicative of rhabdomyolysis, a serious side effect of the medication. This prompt reporting can help prevent further complications and ensure timely medical intervention. Choice A is incorrect because simvastatin can be taken at any time of the day. Choice C is generally true for many medications, but there is no specific interaction between grapefruit juice and simvastatin. Choice D is also incorrect as there is no specific recommendation to take simvastatin at bedtime.

2. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

3. Which of the following drugs is associated with the reaction of Cinchonism?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: B

Rationale: Cinchonism is associated with Quinidine, not Valproic acid, Isoniazid, or Ethosuximide. Cinchonism is characterized by symptoms such as tinnitus, dizziness, and headaches. Quinidine, being an antiarrhythmic agent, can lead to this condition as a side effect.

4. A healthcare professional is providing discharge instructions to a client who has a new prescription for Enoxaparin. Which of the following instructions should the healthcare professional include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct instruction is to administer Enoxaparin in the abdomen as a subcutaneous injection. This method helps prevent bleeding complications associated with the medication. Massaging the injection site after administration should be avoided to reduce the risk of local irritation or bleeding. While rotating injection sites between the arms and thighs is a good practice for some medications, it is not recommended for Enoxaparin. Consistent administration in the abdomen ensures optimal absorption and helps avoid complications.

5. A healthcare professional is caring for four clients who have Peptic Ulcer Disease. The healthcare professional should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor and potentially lead to harm to the fetus. Therefore, it should not be used in pregnant clients due to its uterotonic effects. For clients with osteoarthritis, kidney stone, or urinary tract infection, Misoprostol is not contraindicated specifically for these conditions.

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