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 a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:

• A. Drink at least 2 L of fluid per day.
• B. Take the daily dose at bedtime.
• C. Avoid changing brands of the medication without health care provider (HCP) approval.
• D. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.

Correct answer: B

Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.

3. Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

• A. Gastric atony
• B. Urinary strictures
• C. Neurogenic atony
• D. Gastroesophageal reflux

Correct answer: B

Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications. Gastric atony, neurogenic atony, and gastroesophageal reflux are not contraindications for the administration of Bethanechol chloride for urinary retention.

4. A client has just taken a dose of trimethobenzamide (Tigan). The nurse plans to monitor this client for relief of:

• A. Heartburn
• B. Constipation
• C. Abdominal pain
• D. Nausea and vomiting

Correct answer: D

Rationale: The correct answer is D: Nausea and vomiting. Trimethobenzamide (Tigan) is an antiemetic medication used to treat nausea and vomiting. Therefore, the nurse would monitor the client for relief of nausea and vomiting after taking this medication.

5. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

• A. Tinnitus
• B. Diarrhea
• C. Constipation
• D. Decreased respirations

Correct answer: A

Rationale: The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.

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