Nokea
A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?
- A. Take the medication at night to reduce the risk of muscle pain.
- B. Avoid consuming grapefruit juice while taking this medication.
- C. Take the medication in the morning with breakfast.
- D. Avoid taking the medication with alcohol to reduce the risk of liver damage.
Correct Answer: A
Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.
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A client with amyotrophic lateral sclerosis (ALS) is admitted to the hospital. Which intervention should the nurse include in the plan of care?
- A. Administer muscle relaxants as prescribed.
- B. Assist the client with activities of daily living (ADLs).
- C. Provide nutritional support to prevent aspiration.
- D. Encourage the client to participate in physical therapy.
Correct Answer: C
Rationale: The correct intervention for a client with ALS is to provide nutritional support to prevent aspiration. ALS causes muscle weakness, including the muscles used for swallowing, increasing the risk of aspiration. Providing proper nutrition and support can help prevent this complication. Administering muscle relaxants (Choice A) may not be suitable for ALS as it can further weaken muscles. While assisting with ADLs (Choice B) and encouraging physical therapy (Choice D) are important aspects of care, the priority for a client with ALS is to prevent complications related to swallowing and nutrition.
A hospital client is at a high risk of developing bacterial endocarditis. Which of the following prophylactic measures is likely to be most effective?
- A. Avoiding exposure to individuals known to carry the streptococcus bacterium
- B. Daily administration of low-dose corticosteroids
- C. Prophylactic antimicrobial therapy before any invasive procedure
- D. Routine vaccinations against meningococcal and pneumococcal infections
Correct Answer: C
Rationale: Prophylactic antimicrobial therapy before any invasive procedure is the most effective measure in preventing bacterial endocarditis in at-risk individuals. This measure helps to reduce the risk of bacterial infection during invasive procedures, which can lead to endocarditis. Choice A is incorrect as avoiding exposure to individuals with streptococcus does not address the primary preventive measure needed. Choice B is incorrect as corticosteroids do not prevent bacterial endocarditis, and daily administration is not the recommended prophylactic measure. Choice D is incorrect as routine vaccinations against meningococcal and pneumococcal infections are important for other conditions but not specifically for preventing bacterial endocarditis.
The nurse is preparing to administer a vaccine to a newborn. Before administering the vaccine, the nurse should
- A. warm the vaccine to room temperature.
- B. gently cleanse the chosen injection site.
- C. check the infant's temperature.
- D. administer the full dose at a single injection site.
Correct Answer: C
Rationale: Before administering a vaccine to a newborn, it is essential for the nurse to check the infant's temperature. This is important to ensure that the newborn does not have a fever, which could indicate an underlying infection or illness. Warming the vaccine to room temperature is not necessary and could be harmful. Vigorously massaging the injection site is not recommended as it can cause discomfort and tissue damage. Dividing the dose for administration to three injection sites is not standard practice for vaccine administration to a newborn.
When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?
- A. The possibility of pregnancy
- B. The patient's adherence to the medication schedule
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct Answer: B
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.
A client with cystic fibrosis is admitted with a pulmonary exacerbation. Which intervention should the nurse prioritize?
- A. Administer a high-calorie, high-protein diet.
- B. Initiate airway clearance techniques.
- C. Encourage the client to maintain an active lifestyle.
- D. Monitor for signs of respiratory distress.
Correct Answer: B
Rationale: During a pulmonary exacerbation in cystic fibrosis, the priority intervention is to initiate airway clearance techniques. These techniques help clear mucus from the airways, improving ventilation and reducing the risk of respiratory complications. Administering a high-calorie, high-protein diet is beneficial for overall nutrition but is not the priority during an exacerbation. Encouraging an active lifestyle is important for long-term health but does not address the immediate need for managing exacerbations. Monitoring for signs of respiratory distress is important, but initiating airway clearance techniques takes precedence in the management of pulmonary exacerbations in cystic fibrosis.