Nursing Elites

1. A client with a history of coronary artery disease (CAD) is prescribed simvastatin (Zocor). The nurse should teach the client about which potential side effect?

• A. Muscle pain
• B. Dry mouth
• C. Drowsiness
• D. Diarrhea

Correct answer: A

Rationale: Muscle pain is a common side effect of statins like simvastatin and can indicate a serious condition called rhabdomyolysis. Rhabdomyolysis is a severe condition where muscle fibers break down rapidly, releasing myoglobin into the bloodstream, which can lead to kidney damage. Therefore, it's important for the nurse to educate the client about this potential side effect and to promptly report any muscle pain to the healthcare provider. Dry mouth, drowsiness, and diarrhea are not commonly associated with simvastatin use and are less concerning compared to the risk of rhabdomyolysis.

2. A healthcare provider is reviewing the medication administration record of a client who has a latex allergy. Which of the following medications should the healthcare provider identify as a potential risk for an allergic reaction?

• A. Cefoxitin
• B. Amoxicillin
• C. Erythromycin
• D. Metronidazole

Correct answer: A

Rationale: The correct answer is A, Cefoxitin. Cefoxitin can contain latex in the stopper of the vial, which may pose a risk for allergic reaction in individuals with latex sensitivity. Amoxicillin, Erythromycin, and Metronidazole do not typically contain latex components in their formulations. Healthcare providers should be vigilant in identifying and avoiding medications with latex components to prevent adverse reactions in patients with known latex allergies.

3. The client is reinforcing teaching for peripheral artery disease (PAD). Which statement by the client indicates correct understanding?

• A. I will keep my legs elevated on pillows while resting.
• B. I will avoid crossing my legs when sitting.
• C. I will wear tight compression stockings to improve circulation.
• D. I will apply heat to my legs to relieve pain and improve circulation.

Correct answer: B

Rationale: The correct answer is B. Crossing the legs can further impede blood flow in clients with PAD, worsening symptoms. Avoiding leg crossing helps maintain adequate blood flow and reduces the risk of complications associated with peripheral artery disease. Choices A, C, and D are incorrect because elevating the legs, wearing tight compression stockings, and applying heat can exacerbate symptoms in PAD by restricting blood flow or causing potential harm.

4. The healthcare provider is teaching a client about the use of nitroglycerin patches for angina pectoris. Which instruction should the healthcare provider include?

• A. Apply the patch to the same site each day
• B. Remove the patch at bedtime to prevent tolerance
• C. Cover the patch with a bandage to keep it in place
• D. Rotate the application site every 24 hours

Correct answer: D

Rationale: Rotating the application site every 24 hours is crucial when using nitroglycerin patches to prevent skin irritation and ensure consistent absorption of the medication. By rotating the site, the risk of local skin reactions is reduced, and the effectiveness of the nitroglycerin patch is maintained. Applying the patch to the same site each day (Choice A) can lead to skin irritation. Removing the patch at bedtime (Choice B) is not necessary as long as the prescribed wearing schedule is followed. Covering the patch with a bandage (Choice C) is not recommended as it may interfere with proper absorption.

5. The nurse is caring for a client diagnosed with heart failure who is taking digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse monitor for?

• A. Hypertension
• B. Bradycardia
• C. Hyperglycemia
• D. Insomnia

Correct answer: B

Rationale: The correct answer is B: Bradycardia. Bradycardia is a common sign of digoxin toxicity, as digoxin can cause decreased heart rate. Therefore, monitoring the client for signs of bradycardia is crucial. Choices A, C, and D are incorrect. Hypertension is not typically associated with digoxin toxicity; instead, hypotension may occur. Hyperglycemia is not a common sign of digoxin toxicity. Insomnia is also not a typical sign of digoxin toxicity; instead, some patients may experience visual disturbances, confusion, or other neurological symptoms.

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