Nursing Elites

1. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast.
• D. Avoid taking the medication with alcohol to reduce the risk of liver damage.

Correct answer: A

Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.

2. When a healthcare professional observes muscle stiffening occurring within 6 to 14 hours after death, the healthcare professional should document this finding as _____ present.

• A. Livor mortis
• B. Gangrene
• C. Algor mortis
• D. Rigor mortis

Correct answer: D

Rationale: The correct answer is D, Rigor mortis. Rigor mortis is the stiffening of muscles after death, typically beginning within 6 to 14 hours. Livor mortis (choice A) refers to the pooling of blood in the lowest tissues causing discoloration, gangrene (choice B) is the death of body tissue due to lack of blood flow, and algor mortis (choice C) is the cooling of the body after death.

3. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?

• A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• B. Apply the gel to the face and neck for maximum absorption.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back for better results.

Correct answer: A

Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.

4. Which disorder is caused by a Staphylococcus aureus organism producing a toxin leading to exfoliation and large blister formation?

• A. Herpes simplex I virus
• B. Bullous impetigo
• C. Necrotizing fasciitis
• D. Cellulitis

Correct answer: B

Rationale: Bullous impetigo is the correct answer because it is caused by a Staphylococcus aureus toxin that leads to exfoliation and the formation of large blisters. Herpes simplex I virus (Choice A) causes cold sores and is not associated with exfoliation and blister formation. Necrotizing fasciitis (Choice C) is a severe skin infection involving the deeper layers of skin and subcutaneous tissues, typically caused by bacteria such as Streptococcus or Clostridium species, not Staphylococcus aureus. Cellulitis (Choice D) is a common bacterial skin infection, but it does not involve exfoliation and blister formation as seen in bullous impetigo.

5. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?

• A. Her advanced age may influence the expression and perception of pain.
• B. Her polypharmacy may complicate the pain management process.
• C. Her underlying conditions may mask or exacerbate the pain.
• D. Her cognitive function may decline, making pain assessment difficult.

Correct answer: B

Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.

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