Nursing Elites

1. A client has a new prescription for Atorvastatin. Which of the following instructions should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to avoid drinking grapefruit juice when taking Atorvastatin. Grapefruit juice can interfere with the metabolism of Atorvastatin, leading to increased blood levels of the medication, which can result in a higher risk of adverse effects, such as muscle pain and liver damage. It is important for the client to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices A, C, and D are incorrect. While taking Atorvastatin with food may be recommended for some individuals to reduce stomach upset, it is not a crucial instruction. The timing of Atorvastatin administration can vary depending on individual needs and is not universally fixed to the morning. Increasing potassium-rich foods is not directly related to Atorvastatin use and is not a standard precautionary measure associated with this medication.

2. While caring for a client receiving epoetin alfa to treat anemia, which finding should the nurse monitor for?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Leukocytosis (increased white blood cells) and hyperkalemia (high potassium levels) are not typically associated with epoetin alfa therapy. Fever is also not a common adverse effect of this medication.

3. When teaching a client with a new prescription for Sulfasalazine, which instruction should the nurse include?

• A. Expect orange discoloration of urine and skin.
• B. Increase your intake of high-sodium foods.
• C. Take the medication with a full glass of milk.
• D. Expect your stools to be black and tarry.

Correct answer: A

Rationale: The correct instruction to include when teaching a client with a new prescription for Sulfasalazine is to expect orange discoloration of urine and skin. Sulfasalazine can cause this harmless side effect, which does not necessitate discontinuation of the medication. It is crucial for the nurse to educate the client about this expected outcome to prevent unnecessary concern or discontinuation of the medication. Choices B, C, and D are incorrect. Increasing intake of high-sodium foods is not recommended with Sulfasalazine, as it can worsen certain side effects. Taking the medication with a full glass of milk is not necessary for Sulfasalazine administration. Expecting stools to be black and tarry is not an expected side effect of Sulfasalazine.

4. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?

• A. Take two more sublingual tablets at the same time.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes then take a second sublingual tablet.

Correct answer: B

Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.

5. A client has been on levothyroxine therapy for several months. Which of the following findings indicates a therapeutic response to the medication?

• A. Decrease in level of thyroxine (T4)
• B. Increase in weight
• C. Increase in hours of sleep per night
• D. Decrease in level of thyroid stimulating hormone (TSH)

Correct answer: D

Rationale: A therapeutic response to levothyroxine is indicated by a decrease in the level of TSH. This decrease signifies that the body requires less stimulation to produce thyroid hormone, reflecting a normalization of thyroid function due to the medication's effectiveness. Choices A, B, and C are incorrect as an increase in T4 levels, weight gain, and increased sleep hours are not indicative of a therapeutic response to levothyroxine therapy.

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