Nursing Elites

1. A nurse is teaching a client about the use of atorvastatin. Which of the following should be included?

• A. Monitor for muscle pain
• B. It can cause weight gain
• C. It is safe during pregnancy
• D. It is an anticoagulant

Correct answer: A

Rationale: The correct answer is A: 'Monitor for muscle pain.' Atorvastatin can cause muscle pain and liver function abnormalities, so clients should be monitored for these side effects. Choice B is incorrect because atorvastatin is not known to cause weight gain. Choice C is incorrect as atorvastatin is contraindicated during pregnancy due to potential harm to the fetus. Choice D is incorrect because atorvastatin is a statin medication used to lower cholesterol levels, not an anticoagulant.

2. A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation. Which of the following results should the nurse report to the provider?

• A. WBC count 11,000/mm³
• B. Hgb 11.2 g/dL
• C. Hct 34%
• D. Platelets 140,000/mm³

Correct answer: D

Rationale: A platelet count of 140,000/mm³ is at the lower end of the normal range but can be concerning in pregnancy, especially if there are signs of thrombocytopenia or bleeding. Thrombocytopenia in pregnancy can lead to complications such as bleeding during childbirth or excessive bleeding postpartum. The other laboratory values mentioned are within normal ranges for pregnancy and do not typically raise immediate concerns. High WBC counts can be a normal response to pregnancy, hemoglobin levels around 11.2 g/dL and hematocrit levels around 34% are also considered normal in the third trimester.

3. A postpartum client's fundus is firm, 3 cm above the umbilicus, and displaced to the right. Which of the following interventions should the nurse take?

• A. Massage the fundus
• B. Administer oxytocin
• C. Assist the client to void then reassess the fundus
• D. Notify the healthcare provider

Correct answer: C

Rationale: The correct intervention for a postpartum client with a firm, displaced fundus is to assist the client to void then reassess the fundus. Displacement of the uterus to the right is often a sign of bladder distention, which can prevent the uterus from contracting properly and increase the risk of postpartum hemorrhage. By helping the client to void, the nurse can alleviate the bladder distention, allowing the uterus to contract effectively. Massaging the fundus (Choice A) may not address the underlying issue of bladder distention. Administering oxytocin (Choice B) is not indicated without assessing and addressing the cause of the displacement. Notifying the healthcare provider (Choice D) is premature before implementing initial nursing interventions to address the potential cause of the displaced fundus.

4. A nurse is providing teaching to a client who has mild persistent asthma and has been prescribed montelukast. Which of the following statements should the nurse include in the teaching?

• A. This medication can be used to help manage asthma symptoms during an acute asthma attack
• B. This medication should be taken before exercise and physical activity
• C. This medication should be taken regularly as prescribed without discontinuing abruptly
• D. This medication helps decrease swelling and mucus production

Correct answer: D

Rationale: Montelukast works as a leukotriene receptor antagonist, reducing inflammation and mucus production, which helps prevent asthma attacks but is not used for acute treatment. It is important for the client to understand that montelukast should be taken regularly to manage asthma symptoms and should not be abruptly discontinued. Taking the medication before exercise is not a typical instruction for montelukast.

5. A client has a new prescription for oxcarbazepine. Which of the following should the nurse monitor?

• A. Liver function
• B. Serum sodium levels
• C. Blood glucose
• D. Heart rate

Correct answer: B

Rationale: The correct answer is B: Serum sodium levels. Oxcarbazepine can lead to hyponatremia, making it crucial to monitor serum sodium levels. Monitoring liver function (choice A) is not typically associated with oxcarbazepine use. Blood glucose (choice C) monitoring is more relevant in medications affecting blood sugar levels. Heart rate (choice D) is not directly impacted by oxcarbazepine.

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