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 healthcare provider is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the healthcare provider monitor?

• A. Urinary retention
• B. Tachypnea
• C. Hypertension
• D. Irritating cough

Correct answer: A

Rationale: The correct answer is urinary retention. Opioid agonists like morphine can suppress the sensation of a full bladder, leading to urinary retention. Monitoring for this complication is crucial to prevent bladder distention and related issues. Choices B, C, and D are incorrect. Tachypnea (increased respiratory rate), hypertension (high blood pressure), and irritating cough are not typically associated with opioid agonist administration for pain management.

3. Which medication is a beta blocker?

• A. Atenolol (Tenormin)
• B. Verapamil (Calan)
• C. Captopril (Capoten)
• D. Clopidogrel (Plavix)

Correct answer: A

Rationale: Atenolol (Tenormin) is a beta blocker commonly used to treat conditions like hypertension and angina by blocking the action of adrenaline on the heart. Verapamil is a calcium channel blocker, Captopril is an ACE inhibitor, and Clopidogrel is an antiplatelet medication. Therefore, the correct answer is Atenolol (Tenormin) as it belongs to the beta blocker class of medications.

4. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

• A. A client at 8 weeks of gestation who asks for an Influenza immunization
• B. A client who takes Prednisone and has a possible Fungal infection
• C. A client who has chronic liver disease and is taking Hydrocodone
• D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide

Correct answer: B

Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.

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

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: Clients prescribed with Captopril, an ACE inhibitor, are at risk of developing a persistent cough as a common adverse effect. It is essential for the client to inform their healthcare provider promptly if this side effect occurs to evaluate the need for a medication change or adjustment.

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