Nursing Elites

1. When educating a client starting a new prescription for simvastatin, which instruction should the nurse provide?

• A. Take the medication in the morning.
• B. Report any muscle pain immediately.
• C. Avoid taking the medication with grapefruit juice.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct instruction for a client starting simvastatin is to report any muscle pain immediately because it could be indicative of rhabdomyolysis, a serious side effect of the medication. This prompt reporting can help prevent further complications and ensure timely medical intervention. Choice A is incorrect because simvastatin can be taken at any time of the day. Choice C is generally true for many medications, but there is no specific interaction between grapefruit juice and simvastatin. Choice D is also incorrect as there is no specific recommendation to take simvastatin at bedtime.

2. In which of the following cases is Lansoprazole not used?

• A. Gastritis
• B. Peptic Ulcers
• C. Zollinger-Ellison syndrome
• D. Thalamus hypertrophy

Correct answer: D

Rationale: Lansoprazole is a proton pump inhibitor mainly used to treat conditions related to the stomach, such as gastritis, peptic ulcers, and Zollinger-Ellison syndrome. Thalamus hypertrophy is not a condition that Lansoprazole is indicated for; it is used for gastrointestinal issues and not neurological conditions.

3. What is the antidote for Heparin?

• A. Atropine
• B. Protamine sulfate
• C. Calcium carbonate
• D. Ferrous sulfate

Correct answer: B

Rationale: Protamine sulfate is the specific antidote used to reverse the effects of Heparin by binding to heparin and neutralizing its anticoagulant properties. It is crucial to administer Protamine sulfate promptly in cases of Heparin overdose or when immediate reversal of Heparin's effects is required to prevent bleeding complications. Atropine is not the antidote for Heparin; it is commonly used for treating bradycardia. Calcium carbonate is used to treat conditions like acid indigestion, heartburn, or calcium deficiency. Ferrous sulfate is a form of iron supplement used to treat or prevent iron deficiency anemia. None of these alternatives are antidotes for Heparin.

4. A client has a new prescription for lisinopril. Which of the following findings should the nurse monitor as an adverse effect of this medication?

• A. Cough
• B. Hyperglycemia
• C. Headache
• D. Dry mouth

Correct answer: A

Rationale: A common adverse effect of lisinopril is a persistent dry cough. Lisinopril is an ACE inhibitor that can cause irritation in the respiratory tract, leading to a cough. Monitoring for a persistent cough is essential as it may indicate a serious adverse effect that requires medical attention. Hyperglycemia (Choice B) is not a common adverse effect of lisinopril. Headache (Choice C) and dry mouth (Choice D) are not typically associated with lisinopril use. Therefore, the correct answer is A: Cough.

5. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.

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