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The client diagnosed with coronary artery disease is prescribed an HMG-CoA reductase inhibitor to help reduce the cholesterol level. Which assessment data should be reported to the health-care provider?
- A. Complaints of flatulence.
- B. Weight loss of two (2) pounds.
- C. Complaints of muscle pain.
- D. No bowel movement for two (2) days.
Correct Answer: C
Rationale: Muscle pain with statins may indicate myopathy or rhabdomyolysis, requiring urgent HCP reporting. Flatulence, weight loss, or constipation are less serious.
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The health care provider has written 'Morphine sulfate 2 mgs IV every 3-4 hours prn for pain' on the chart of a child weighing 22 lb. (10 kg). What is the nurse's initial action?
- A. Check with the pharmacist
- B. Hold the medication and contact the provider
- C. Administer the prescribed dose as ordered
- D. Give the dose every 6-8 hours
Correct Answer: B
Rationale: Hold the medication and contact the provider. The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child typically should receive 1.0 mg every 3 to 4 hours.
A client confides in the RN that a friend has told her the medication she takes for depression, Wellbutrin, was taken off the market because it caused seizures. What is an appropriate response by the nurse?
- A. Ask your friend about the source of this information.'
- B. Omit the next doses until you talk with the doctor.'
- C. There were problems, but the recommended dose is changed.'
- D. Your health care provider knows the best drug for your condition.'
Correct Answer: C
Rationale: Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug. The drug was reintroduced in 1989 with specific recommendations regarding dose ranges to limit the occurrence of seizures. The risk of seizure appears to be strongly associated with dose.
The elderly client is in a long-term care facility. If the client does not have a daily bowel movement in the morning, he requests a cathartic, bisacodyl (Dulcolax). Which action is most important for the nurse to take?
- A. Ensure the client gets a cathartic daily.
- B. Discuss the complications of a daily cathartic.
- C. Encourage the client to increase fiber in the diet.
- D. Refuse to administer the medication to the client.
Correct Answer: B
Rationale: Daily cathartics risk dependence and electrolyte imbalance; discussing complications educates and promotes safer alternatives like fiber.
The client with type 2 diabetes mellitus is prescribed glyburide (Micronase), a sulfonylurea. Which statement indicates the client understands the medication teaching?
- A. I should carry some hard candy when I go walking.
- B. I must take my insulin injection every morning.
- C. There are no side effects I need to worry about.
- D. This medication will make my muscles absorb insulin.
Correct Answer: A
Rationale: Glyburide can cause hypoglycemia; carrying candy prepares for low blood sugar during activity. Insulin, no side effects, or muscle absorption are incorrect.
A nurse is to collect a sputum specimen for acid-fast bacillus (AFB) from a client. Which action should the nurse take first?
- A. Ask client to cough sputum into container
- B. Have the client take several deep breaths
- C. Provide an appropriate specimen container
- D. Assist with oral hygiene
Correct Answer: D
Rationale: Assist with oral hygiene. Obtain a specimen early in the morning after mouth care. The other responses follow this first action: the client should take several deep breaths then cough into the appropriate sterile container to obtain the AFB specimen of the sputum.