Nursing Elites

1. A client is prescribed atorvastatin (Lipitor) for hyperlipidemia. Which instruction should the nurse include in the teaching plan?

• A. Take the medication in the morning.
• B. Avoid consuming grapefruit juice.
• C. Increase intake of dairy products.
• D. Take the medication with food.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening because cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin use, and the medication can be taken with or without food.

2. A client with hyperlipidemia is prescribed simvastatin (Zocor). Which instruction should the nurse include in the teaching plan?

• A. Take the medication in the evening.
• B. Report any muscle pain to your healthcare provider.
• C. Avoid increasing your intake of grapefruit juice.
• D. Do not take the medication with a high-fat meal.

Correct answer: B

Rationale: Muscle pain can be a sign of a serious side effect of simvastatin (Zocor) known as rhabdomyolysis and should be reported to the healthcare provider immediately. The medication is usually taken in the evening to coincide with the body's natural production of cholesterol. Grapefruit juice should be avoided as it can increase the risk of toxicity by affecting the metabolism of the medication. Additionally, taking simvastatin with a high-fat meal can reduce its effectiveness, so it should be taken without food or with a light meal.

3. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?

• A. Potassium level
• B. Creatinine level
• C. Cholesterol level
• D. Blood urea nitrogen

Correct answer: A

Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.

4. Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline study has been completed?

• A. Electrolyte levels
• B. Coagulation times
• C. Liver enzyme levels
• D. Serum creatinine level

Correct answer: C

Rationale: Before starting INH therapy for tuberculosis, it is essential to assess liver enzyme levels as INH can cause hepatotoxicity. Monitoring liver enzyme levels before and during the initial 3 months of therapy is crucial to detect any liver damage early and prevent further complications. Choice A, electrolyte levels, are not directly impacted by INH therapy. Choice B, coagulation times, are not routinely monitored before starting INH therapy. Choice D, serum creatinine level, is not specifically required as a baseline study before initiating INH therapy for tuberculosis.

5. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?

• A. An additional dose of prednisone daily
• B. A decreased amount of daily Humulin NPH insulin
• C. An increased amount of daily Humulin NPH insulin
• D. The addition of an oral hypoglycemic medication daily

Correct answer: C

Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.

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