A client with hyperlipidemia is prescribed simvastatin (Zocor). Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the evening.
- B. Report any muscle pain to your healthcare provider.
- C. Avoid increasing your intake of grapefruit juice.
- D. Do not take the medication with a high-fat meal.
Correct Answer: B
Rationale: Muscle pain can be a sign of a serious side effect of simvastatin (Zocor) known as rhabdomyolysis and should be reported to the healthcare provider immediately. The medication is usually taken in the evening to coincide with the body's natural production of cholesterol. Grapefruit juice should be avoided as it can increase the risk of toxicity by affecting the metabolism of the medication. Additionally, taking simvastatin with a high-fat meal can reduce its effectiveness, so it should be taken without food or with a light meal.
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A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse instruct the client to report to the healthcare provider?
- A. Dizziness
- B. Constipation
- C. Peripheral edema
- D. Dry cough
Correct Answer: C
Rationale: The correct answer is C, 'Peripheral edema.' Amlodipine (Norvasc) can cause peripheral edema, which is an accumulation of fluid in the extremities and should be reported to the healthcare provider. Dizziness and constipation are possible side effects of amlodipine but are generally less concerning. Dry cough is more commonly associated with ACE inhibitors, not calcium channel blockers like amlodipine.
The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct Answer: D
Rationale: The correct answer is 'D: Orthostatic hypotension.' Etoposide is associated with orthostatic hypotension, a sudden drop in blood pressure that can occur when transitioning from lying down to standing up. It is important for the nurse to monitor the client's blood pressure during the infusion to detect and manage this potential side effect.
A client is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?
- A. Fatigue
- B. Tremors
- C. Cold intolerance
- D. Excessively dry skin
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?
- A. I will avoid potassium-rich foods.
- B. I will not use a salt substitute.
- C. I will monitor my weight daily.
- D. I will increase my fluid intake as prescribed.
Correct Answer: A
Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.
A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?
- A. Monitor for renal failure.
- B. Monitor psychosocial status.
- C. Monitor for signs of bleeding.
- D. Have heparin sodium available.
Correct Answer: C
Rationale: The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.