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. A client has a new prescription for Clopidogrel. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking aspirin while on this medication.' Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs also affect platelet function and can further increase the risk of bleeding when combined with Clopidogrel. Therefore, it is important for the client to avoid taking aspirin while on this medication to reduce the risk of excessive bleeding. Choices A, C, and D are incorrect because there is no specific requirement to take Clopidogrel with food, avoid foods high in potassium, or take it at bedtime. The key instruction here is to avoid aspirin to prevent potential bleeding complications.

3. A client has a new prescription for Furosemide. What instruction should be included by the nurse during discharge?

• A. Take the medication at bedtime.
• B. Increase intake of foods high in potassium.
• C. Avoid sun exposure.
• D. Limit fluid intake.

Correct answer: B

Rationale: The correct answer is to instruct the client to increase intake of foods high in potassium. Furosemide, a loop diuretic, can lead to potassium depletion. Increasing the intake of foods rich in potassium can help prevent hypokalemia, a potential side effect of Furosemide. Choice A is incorrect as Furosemide is usually recommended to be taken in the morning to avoid disrupting sleep with frequent urination. Choice C is irrelevant to the medication. Choice D is also incorrect as Furosemide is a diuretic and may require increased, not limited, fluid intake to prevent dehydration.

4. A client has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

• A. Crushing the medication might cause you to have a stomachache or indigestion.
• B. Crushing the medication is a good idea, and I can mix it in some ice cream for you.
• C. Crushing the medication would release all the medication at once, rather than over time.
• D. Crushing is unsafe, as it destroys the ingredients in the medication.

Correct answer: A

Rationale: Crushing an enteric-coated medication can cause it to break down in the stomach instead of the intestines, potentially leading to gastrointestinal distress like stomachache or indigestion. It is important to take enteric-coated medications whole to ensure they are properly absorbed in the intestines and to prevent irritation to the stomach.

5. During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.

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