Nursing Elites

1. The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?

• A. Muscle pain
• B. Headache
• C. Nausea
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A: Muscle pain. Muscle pain can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin. Rhabdomyolysis is a condition where muscle fibers break down rapidly and release their contents into the bloodstream, which can lead to kidney damage. Headache, nausea, and dizziness are not commonly associated with atorvastatin use and are less likely to indicate a serious adverse reaction compared to muscle pain.

2. The client on spironolactone (Aldactone) has a potassium level of 5.6 mEq/L. What is the nurse’s priority action?

• A. Hold the spironolactone and notify the healthcare provider.
• B. Administer potassium supplements.
• C. Continue the spironolactone as ordered.
• D. Increase the dose of spironolactone.

Correct answer: A

Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. A potassium level of 5.6 mEq/L is high, indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels. Therefore, the priority action is to withhold the medication to prevent exacerbating hyperkalemia and notify the healthcare provider for further management. Option B is incorrect because administering potassium supplements would worsen the hyperkalemia. Option C is incorrect as continuing spironolactone can lead to a further increase in potassium levels. Option D is incorrect as increasing the dose of spironolactone would be inappropriate in the presence of elevated potassium levels.

3. The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?

• A. Notify the healthcare provider immediately.
• B. Continue the medication and monitor lung function.
• C. Discontinue the medication and start oxygen therapy.
• D. Reduce the dose and monitor respiratory status.

Correct answer: A

Rationale: When a client on amiodarone develops pulmonary fibrosis, a serious side effect, the immediate action the nurse should take is to notify the healthcare provider. This is crucial because pulmonary fibrosis can lead to severe respiratory compromise and requires prompt evaluation and management by the healthcare provider. Continuing the medication (choice B) can worsen the condition, and delaying action by reducing the dose and monitoring respiratory status (choice D) may not be appropriate given the seriousness of pulmonary fibrosis. Discontinuing the medication and starting oxygen therapy (choice C) may be necessary, but the priority is to notify the healthcare provider first for further assessment and guidance.

4. The nurse is administering an ACE inhibitor to a client. What is the most common side effect?

• A. Cough
• B. Dizziness
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is A: Cough. Cough is a well-known side effect of ACE inhibitors due to an increase in bradykinin levels. This irritating cough can be bothersome to clients and should be monitored. Choice B, Dizziness, is not the most common side effect of ACE inhibitors. While ACE inhibitors can cause hypotension (Choice C), cough is more prevalent. Hyperkalemia (Choice D) is a possible side effect of ACE inhibitors but is less common compared to cough.

5. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?

• A. Negative inotropic, negative chronotropic effect
• B. Positive inotropic, negative chronotropic effect
• C. Negative inotropic, positive chronotropic effect
• D. Positive inotropic, positive chronotropic effect

Correct answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.

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