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. A client is prescribed lisinopril for hypertension. What potential adverse effect should the practical nurse (PN) instruct the client to monitor for?

• A. Persistent cough
• B. Constipation
• C. Increased appetite
• D. Dry skin

Correct answer: A

Rationale: Corrected Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. This cough is distinctive and different from other causes of cough. It is essential for the client to be aware of this potential side effect as it can indicate a serious issue. Instructing the client to monitor for a persistent cough and report it to the healthcare provider promptly is crucial to ensure timely intervention and management. Choices B, C, and D are incorrect as constipation, increased appetite, and dry skin are not commonly associated with lisinopril use for hypertension. Therefore, the practical nurse should focus on educating the client about monitoring and reporting a persistent cough.

3. The practical nurse (PN) is obtaining the medical history of a client starting a new prescription for conjugated estrogens PO daily. Which medical condition is not treated by this medication?

• A. Menopausal symptoms
• B. Prostatic cancer
• C. Thromboembolic diseases
• D. Abnormal uterine bleeding

Correct answer: C

Rationale: Conjugated estrogens, such as Premarin, are not used in the treatment of thromboembolic diseases. These medications are contraindicated in conditions predisposing to thromboembolic diseases due to their association with an increased risk of thromboembolism, stroke, pulmonary embolism, and myocardial infarction. Choices A, B, and D are incorrect because conjugated estrogens are commonly prescribed for managing menopausal symptoms, abnormal uterine bleeding, and certain hormone-responsive cancers, but not for thromboembolic diseases.

4. A client with major depressive disorder is prescribed bupropion. Which statement by the client indicates the need for further teaching?

• A. This medication may cause weight gain.
• B. This medication may take several weeks to take effect.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A because bupropion is associated with weight loss rather than weight gain. It is important for the client to be aware of this potential side effect. Choice B is correct because bupropion may take several weeks to exhibit its full therapeutic effects. Choice C is also accurate as alcohol consumption should be avoided while taking bupropion due to the risk of seizures. Choice D is correct as taking bupropion in the morning with food can help reduce the risk of gastrointestinal side effects.

5. A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?

• A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
• B. Discontinue the use of both products if transient blurring occurs after administration.
• C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
• D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.

Correct answer: C

Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.

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