Nursing Elites

1. 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.

2. Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?

• A. Gout
• B. Asthma
• C. Thrombophlebitis
• D. Myocardial infarction

Correct answer: C

Rationale: Megestrol acetate can increase the risk of thromboembolic events. Clients with a history of thrombophlebitis should not receive this medication due to the increased risk of thromboembolic events. Therefore, the nurse should contact the registered nurse if thrombophlebitis is documented in the client's history to ensure appropriate medication management.

3. Which of the following herbal therapies would be prescribed for its use as an antispasmodic? Select all that apply.

• A. Aloe
• B. Kava
• C. Ginger
• D. Chamomile

Correct answer: D

Rationale: Chamomile is known for its antispasmodic properties. It helps in relaxing muscles and reducing spasms. Aloe is a laxative, kava has anxiolytic and sedative effects, and ginger is commonly used to relieve nausea.

4. A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:

• A. Telling the client not to take the medication with food
• B. Suggesting that the client taper the dose until taste returns to normal
• C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
• D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor

Correct answer: C

Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.

5. While taking trimethoprim-sulfamethoxazole (TMP-SMZ), a client should be instructed to report which symptom if it develops during the course of this medication therapy?

• A. Nausea
• B. Diarrhea
• C. Headache
• D. Sore throat

Correct answer: D

Rationale: Clients prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) should be educated about potential blood disorders associated with the medication. Early signs of these disorders include symptoms like sore throat, fever, and pallor. If the client experiences any of these symptoms, they should promptly notify their healthcare provider. Nausea, diarrhea, and headache are common side effects of TMP-SMZ that usually do not require immediate medical attention.

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