a client with hyperlipidemia is prescribed simvastatin zocor which instruction should the nurse include in the teaching plan
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Nursing Elites

HESI RN

Pharmacology HESI

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

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. Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:

Correct answer: D

Rationale: The primary action of tamoxifen, an antineoplastic medication used in metastatic breast carcinoma, is to compete with estradiol for binding to estrogen receptors in tissues with high receptor concentrations. By doing so, tamoxifen reduces DNA synthesis and estrogen response, leading to its therapeutic effect in inhibiting the growth of estrogen-sensitive breast cancer cells.

3. A client is receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?

Correct answer: D

Rationale: Morphine sulfate suppresses the cough reflex, which can lead to the retention of secretions in the lungs. Encouraging the client to cough and deep breathe helps prevent pneumonia by clearing the airways of any accumulated secretions. This intervention is crucial in clients receiving morphine sulfate to maintain optimal respiratory function.

4. The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:

Correct answer: B

Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.

5. A client with chronic pain is prescribed transdermal fentanyl (Duragesic) patches. Which instruction should the nurse include in the teaching plan?

Correct answer: B

Rationale: Clients using transdermal fentanyl (Duragesic) patches should avoid using heating pads over the patch as heat can increase the release of the medication, potentially leading to overdose. The patch should be applied to a different site each time, changed every 72 hours, and the old patch should be removed before applying a new one to prevent accidental overdose or excessive drug absorption.

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