Nokea
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.
A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?
- A. Pancreatitis
- B. Pharyngitis
- C. Tonic-clonic seizures
- D. Human immunodeficiency virus (HIV) infection
Correct Answer: D
Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?
- A. Keep insulin vials refrigerated at all times.
- B. Rotate the insulin injection sites systematically.
- C. Increase the amount of insulin before unusual exercise.
- D. Monitor the urine acetone level to determine the insulin dosage.
Correct Answer: B
Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
- A. Weight loss
- B. Relief of heartburn
- C. Reduction of steatorrhea
- D. Absence of abdominal pain
Correct Answer: C
Rationale: Pancrelipase (Pancrease MT) is a pancreatic enzyme replacement therapy used to aid digestion in clients with pancreatic insufficiency. One of the key goals of pancrelipase therapy is to reduce the amount of undigested fat in the stool, known as steatorrhea. Therefore, the nurse should evaluate the effectiveness of pancrelipase by looking for a reduction in steatorrhea, indicating improved digestion and absorption of fats.
A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
- A. 3 to 5 ng/mL
- B. 0.5 to 2 ng/mL
- C. 1.2 to 2.8 ng/mL
- D. 3.5 to 5.5 ng/mL
Correct Answer: B
Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.