Nokea
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 nurse is administering an antacid to a client with gastroesophageal reflux disease. Which statement best describes the scientific rationale for administering this medication?
- A. This medication will suppress gastric acid secretion.
- B. This medication will decrease the gastric pH.
- C. This medication will coat the stomach lining.
- D. This medication interferes with prostaglandin production.
Correct Answer: C
Rationale: Antacids neutralize acid and coat the stomach, relieving GERD symptoms. Acid suppression, pH decrease, or prostaglandins are unrelated.
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Rationale: Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug.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.
An adult has angina and is to be discharged on transdermal nitroglycerin. Which statement by the client indicates that the client needs additional teaching?
- A. I am glad that I can continue walking.
- B. I will change the site each day.
- C. I will be able to continue to drink alcoholic beverages.
- D. I will need to get up slowly.
Correct Answer: C
Rationale: Alcohol can enhance nitroglycerin’s hypotensive effects, increasing the risk of dizziness or fainting, requiring avoidance.
A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?
- A. Clinical specialty certification in the associated area of practice
- B. Documentation on the specific client record with a focus on the nursing process
- C. Yearly evaluations and proficiency reports prepared by nurse's manager
- D. Verification of provider's orders for the plan of care with identification of outcomes
Correct Answer: B
Rationale: Documentation is the key to protect nurses when a lawsuit is filed. The thorough documentation should include all steps of the nursing process - assessment, analysis, plan, intervention, evaluation.
The client with postmenopausal osteoporosis is prescribed the bisphosphonate alendronate (Fosamax). Which discharge instruction should the nurse discuss with the client?
- A. The medication must be taken with the breakfast meal only.
- B. Remain upright for at least 30 minutes after taking medication.
- C. The tablet should be chewed thoroughly before swallowing.
- D. Stress the importance of having monthly hormone levels.
Correct Answer: B
Rationale: Alendronate requires upright posture for 30 minutes post-dose to prevent esophageal irritation, per FDA guidelines. Meal timing, chewing, or hormone levels are incorrect.