Nursing Elites

1. A client has been taking simvastatin for 3 days and calls the nurse at the clinic to report extreme muscle tenderness and pain. Which is the most appropriate action?

• A. Notify the health care provider.
• B. Review the medication with the client.
• C. Advise the client to avoid grapefruit juice.
• D. Remind the client to limit physical activity until evaluated by the health care provider.

Correct answer: A

Rationale: Extreme muscle tenderness and pain in a client taking simvastatin could indicate rhabdomyolysis, a serious condition. Promptly notifying the health care provider is crucial to evaluate and manage this potential medical emergency. Reviewing the medication with the client may not address the urgency of the situation. Advising the client to avoid grapefruit juice is not directly related to the client's current symptoms. Reminding the client to limit physical activity until evaluated by the health care provider is not appropriate as the client's symptoms should be assessed by a professional first.

2. Which assessment finding indicates that the expected outcome of administering donepezil to a client with Alzheimer's disease has been accomplished?

• A. Increased muscle strength and tone
• B. Fewer episodes of urinary incontinence
• C. Decreased confusion and improved mood
• D. Reversal of the disease process as evidenced by increased functioning

Correct answer: C

Rationale: The correct answer is C. Donepezil is a medication used for individuals with Alzheimer's disease. Its mechanism of action involves increasing acetylcholine levels by inhibiting its breakdown, which benefits cognitive function. The expected outcome of administering donepezil is a decrease in confusion and an improvement in mood due to the medication's impact on neurotransmitters. Choices A, B, and D are incorrect because donepezil does not primarily target muscle strength, urinary incontinence, or disease reversal; instead, it aims to slow down the progression of cognitive decline in Alzheimer's disease.

3. A client with an exacerbation of asthma is prescribed albuterol. The nurse should assess the client for which common side effect of this medication?

• A. Tremors
• B. Nausea and vomiting
• C. Insomnia
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Tremors. Albuterol, a beta-agonist medication commonly used to treat asthma exacerbations, can lead to tremors as a side effect. Tremors result from the stimulation of beta-2 receptors in muscles, particularly in the hands. Nausea and vomiting (Choice B) are generally not common side effects of albuterol. Insomnia (Choice C) is less likely to occur with albuterol, as it is a stimulant and can cause alertness rather than sleep disturbances. Dry mouth (Choice D) is not a typical side effect associated with albuterol use.

4. A client with a history of seizures is prescribed valproic acid. The nurse should monitor for which potential adverse effect?

• A. Liver toxicity
• B. Kidney stones
• C. Weight gain
• D. Pancreatitis

Correct answer: A

Rationale: Corrected Valproic acid is known to cause liver toxicity as a potential adverse effect. Regular monitoring of liver function tests is crucial to detect any signs of liver damage early on and prevent serious complications. Kidney stones, weight gain, and pancreatitis are not typically associated with valproic acid use, making them incorrect choices in this scenario.

5. The healthcare professional is creating a class for older adults in the community. Which information about laxative use in older adults would be important to include?

• A. Laxatives are not effective in older adults
• B. All laxatives are exactly the same
• C. Over-the-counter laxatives are misused
• D. Laxatives can cause potassium retention

Correct answer: C

Rationale: It is important to include information about the misuse of over-the-counter laxatives in older adults as they often misuse these medications, which can lead to dependency and other health issues. Option A is incorrect as laxatives can be effective in older adults when used appropriately. Option B is incorrect because not all laxatives are the same, they have different mechanisms of action and side effects. Option D is incorrect because laxatives can actually cause electrolyte imbalances like potassium depletion rather than retention.

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