Nursing Elites

1. A healthcare provider is educating a client who has a new prescription for Simvastatin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the healthcare provider should include is to 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Simvastatin, leading to potential side effects like muscle pain and liver damage. Instructing the client to avoid grapefruit juice helps prevent these adverse effects and ensures the medication's efficacy. Choices A, C, and D are incorrect because taking Simvastatin with food, at a specific time, or increasing potassium-rich foods intake are not essential instructions for this medication.

2. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?

• A. Lowered heart rate
• B. Increased myocardial contractility
• C. Decreased conduction through the AV node
• D. Vasoconstriction of renal blood vessels

Correct answer: B

Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.

3. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.

4. When discussing immunizations, which vaccine series is typically completed before a child's first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The rotavirus vaccine series is usually completed before a child's first birthday. It is given to infants in a series of doses starting at 2 months of age and must be completed by 8 months of age. This vaccine helps protect against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the Pneumococcal conjugate vaccine, Meningococcal conjugate vaccine, and Varicella vaccine are not typically completed before a child's first birthday.

5. A male client recently started taking Haloperidol. Which of the following findings is the highest priority to report to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are an indication of acute dystonia, a serious side effect of Haloperidol that can quickly progress to a crisis situation. Immediate medical attention is necessary to prevent complications. Shuffling gait and drowsiness are common side effects of Haloperidol but are not as urgent as neck spasms. Impotence is not typically associated with Haloperidol use. Therefore, identifying neck spasms as the priority finding is crucial for the client's safety.

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