Nursing Elites

1. A patient with hyperlipidemia is prescribed atorvastatin. What lab test should be monitored periodically to assess for adverse effects?

• A. Liver function tests
• B. Complete blood count
• C. Blood glucose levels
• D. Serum potassium

Correct answer: A

Rationale: The correct answer is A: Liver function tests. Patients on atorvastatin should have their liver function tests monitored periodically to detect any potential liver damage. Atorvastatin, a statin medication used to lower cholesterol levels, can rarely cause liver enzyme abnormalities, so regular monitoring is essential to identify any adverse effects early on. Monitoring the complete blood count (choice B), blood glucose levels (choice C), or serum potassium (choice D) is not typically required specifically for atorvastatin therapy. While these tests may be important for other conditions or medications, liver function tests are the most relevant for monitoring the adverse effects of atorvastatin.

2. A patient with chronic heart failure is prescribed furosemide. What is the primary action of this medication?

• A. Increase cardiac output
• B. Reduce fluid retention
• C. Decrease heart rate
• D. Lower blood pressure

Correct answer: B

Rationale: Furosemide is a loop diuretic that acts by inhibiting sodium and chloride reabsorption in the loop of Henle, leading to increased diuresis. By reducing fluid retention, furosemide helps decrease the workload on the heart in patients with chronic heart failure. This medication does not directly increase cardiac output, decrease heart rate, or lower blood pressure as its primary action.

3. In a patient with a history of chronic iron deficiency anemia requiring a recent blood transfusion and an extensive GI work-up, which statement is true based on their medications?

• A. A dedicated small bowel series has a high likelihood of being positive
• B. 81 mg of aspirin per day decreases the benefit of using a COX II inhibitor
• C. The patient should have a provocative arteriogram with heparin infusion to identify the source of blood loss
• D. Hormonal therapy has been shown to be effective in decreasing blood loss due to arteriovenous malformations

Correct answer: B

Rationale: The correct answer is B. Taking even a low dose of aspirin per day, such as 81 mg, can reduce the protective effect on the gastrointestinal mucosa that is gained from using a COX II selective inhibitor. Aspirin can increase the risk of gastrointestinal bleeding, which can counteract the benefits of COX II inhibitors in protecting the stomach lining.

4. The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse implement to prevent autonomic dysreflexia?

• A. Restrict the client's fluid intake.
• B. Keep the client's room warm.
• C. Ensure the client's bladder is emptied regularly.
• D. Limit the client's intake of high-fiber foods.

Correct answer: C

Rationale: To prevent autonomic dysreflexia in clients with spinal cord injuries, it is crucial to ensure the client's bladder is emptied regularly. Bladder distention is a common trigger for autonomic dysreflexia in these clients. Keeping the bladder empty helps prevent the complications associated with autonomic dysreflexia, such as dangerously high blood pressure. Choices A, B, and D are incorrect. Restricting fluid intake can lead to dehydration, keeping the room warm is not directly related to preventing autonomic dysreflexia, and limiting high-fiber foods is not a primary intervention for this condition.

5. A client with newly diagnosed hypertension is prescribed enalapril (Vasotec). Which instruction should the nurse provide to the client?

• A. Increase your intake of potassium-rich foods.
• B. Report any persistent cough to your healthcare provider.
• C. Take the medication with a full meal.
• D. Avoid grapefruit juice while taking this medication.

Correct answer: B

Rationale: The correct instruction for the nurse to provide the client taking enalapril (Vasotec) is to report any persistent cough to their healthcare provider. Enalapril can cause a side effect of a persistent cough, and it is essential for the healthcare provider to be notified if this occurs to evaluate the need for a medication adjustment or change. Choices A, C, and D are incorrect. Increasing potassium-rich foods is not specifically related to enalapril use; there is no requirement to take enalapril with a full meal, and avoiding grapefruit juice is more relevant for medications metabolized by the CYP3A4 enzyme, not typically for enalapril.

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