Nursing Elites

1. A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?

• A. Take the medication on an empty stomach.
• B. Avoid taking folic acid supplements.
• C. Report any signs of infection immediately.
• D. Increase intake of vitamin C-rich foods.

Correct answer: C

Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.

2. The healthcare professional is preparing client teaching materials on commonly used medications. Which client is most likely to benefit from a client education package about simvastatin?

• A. A 50-year-old male with a history of angina
• B. A 75-year-old male with bone cancer
• C. An 18-year-old pregnant female with diabetes
• D. A 40-year-old female with frequent vaginal infections

Correct answer: A

Rationale: Simvastatin is a medication used to lower cholesterol levels and prevent cardiovascular diseases. It is commonly prescribed for individuals at risk of heart-related conditions. Angina is a symptom of underlying heart disease, and individuals with this condition would benefit most from simvastatin to help manage their cholesterol levels and reduce the risk of cardiovascular events. Therefore, the 50-year-old male with a history of angina is the most suitable candidate for client education regarding simvastatin. Choices B, C, and D are not the most appropriate candidates for simvastatin education because bone cancer, pregnancy with diabetes, and frequent vaginal infections are not conditions typically treated with simvastatin.

3. A client is prescribed atorvastatin. The practical nurse should monitor the client for which potential adverse effect?

• A. Muscle pain and weakness
• B. Headache
• C. Hepatotoxicity
• D. Gastrointestinal bleeding

Correct answer: A

Rationale: The correct answer is A: Muscle pain and weakness. Atorvastatin is known to potentially cause muscle pain and weakness, which could indicate muscle damage or rhabdomyolysis. This adverse effect should be closely monitored by the practical nurse to ensure early detection and appropriate management. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin use. Headache is a less common side effect, hepatotoxicity is rare but serious, and gastrointestinal bleeding is not a common adverse effect of atorvastatin.

4. A client with hypertension is prescribed metoprolol. The healthcare provider should monitor the client for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: A

Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate and reducing blood pressure. One of the potential side effects of metoprolol is bradycardia, which is a slow heart rate. Monitoring for bradycardia is crucial as it can be an adverse effect of this medication.

5. A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved?

• A. Dependent edema reduced from +3 to +1.
• B. Serum HDL increased from 35 to 55 mg/dL.
• C. Pulse rate reduced from 150 to 90 beats/min.
• D. Blood pressure reduced from 160/90 to 130/80 mm Hg.

Correct answer: D

Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication. Dependent edema, serum HDL levels, and pulse rate are not typically influenced by losartan, making choices A, B, and C incorrect.

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