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. Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication?

• A. Hematocrit level
• B. Hemoglobin level
• C. Prothrombin time (PT)
• D. Activated partial thromboplastin time (aPTT)

Correct answer: D

Rationale: The correct answer is D, activated partial thromboplastin time (aPTT). Heparin affects the intrinsic pathway of coagulation. Monitoring aPTT helps ensure that heparin sodium is within the therapeutic range to prevent clot formation. Hematocrit and hemoglobin levels assess red blood cell concentrations and are not specific to monitoring heparin therapy. Prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium, which affects the extrinsic pathway of coagulation, not heparin.

3. A client who has been taking isoniazid (INH) for tuberculosis asks the nurse about the medication. Which statement by the client indicates the need for further teaching?

• A. I should limit my alcohol intake.
• B. I should notify my doctor if I notice a yellowish skin color.
• C. I should take the medication with an empty stomach.
• D. I should notify my doctor if I experience numbness and tingling in my extremities.

Correct answer: C

Rationale: Isoniazid (INH) is best absorbed when taken on an empty stomach. However, if gastrointestinal upset occurs, it can be taken with food. Limiting alcohol intake, monitoring for jaundice, and notifying the doctor of peripheral neuropathy symptoms are all appropriate actions while taking INH.

4. Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which of the following food items?

• A. Milk
• B. Water
• C. Apple juice
• D. Orange juice

Correct answer: D

Rationale: Iron absorption is enhanced by the presence of vitamin C. Orange juice is a good source of vitamin C, which can improve the absorption of iron when taken together. Therefore, administering iron supplements with orange juice is the best choice to optimize iron absorption for the child.

5. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?

• A. Take the medication with a full glass of water.
• B. Increase your intake of purine-rich foods.
• C. Stop taking the medication if you experience a gout attack.
• D. Take the medication with or without food.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.

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