The client on atorvastatin (Lipitor) should be advised to report which of the following symptoms?
- A. Muscle pain
- B. Headache
- C. Nausea
- D. Dizziness
Correct Answer: A
Rationale: The correct answer is A: Muscle pain. Atorvastatin can cause muscle pain as a side effect, which may progress to a serious condition called rhabdomyolysis. This requires immediate medical attention. Headache, nausea, and dizziness are less common side effects of atorvastatin and generally not as serious as muscle pain in this context. Reporting muscle pain promptly can help prevent complications and ensure appropriate management.
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In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?
- A. Atropine
- B. Dopamine
- C. Digoxin
- D. Adenosine
Correct Answer: B
Rationale: The correct answer is B: Dopamine. In myocardial infarction leading to shock, dopamine is appropriate due to its positive inotropic effects, increasing cardiac output and blood pressure. Atropine is not indicated for shock in this context. Digoxin may be contraindicated in acute myocardial infarction. Adenosine is not used in managing shock.
Which of the following conditions is identified by a P wave notch in the ECG of a client?
- A. Aortic stenosis
- B. Mitral regurgitation
- C. Aortic regurgitation
- D. Mitral stenosis
Correct Answer: D
Rationale: A P wave notch on an ECG suggests mitral stenosis, indicating delayed conduction through the atria.
The nurse is caring for a heart client on digoxin and notes a potassium level of 2.5. What is the appropriate priority nursing intervention?
- A. Do nothing as this is a normal potassium level.
- B. The potassium level is low so the nurse asks for an order for potassium.
- C. The nurse asks to check the digoxin level as low potassium can increase digoxin toxicity.
- D. The nurse stops the digoxin.
Correct Answer: C
Rationale: The correct answer is C because low potassium levels can increase the risk of digoxin toxicity. Digoxin and potassium have a reciprocal relationship, so low potassium levels can lead to digoxin toxicity. Checking the digoxin level is important to monitor for toxicity.
A is incorrect because a potassium level of 2.5 is low and requires intervention. B is not the appropriate action as giving potassium without checking the digoxin levels first can worsen toxicity. D is incorrect because abruptly stopping digoxin can be harmful and should only be done under the guidance of a healthcare provider.
What condition involves the heart's electrical system malfunctioning, causing very fast heartbeats originating from the ventricles?
- A. Ventricular tachycardia
- B. Atrial fibrillation
- C. Supraventricular tachycardia
- D. Bradycardia
Correct Answer: A
Rationale: The correct answer is A: Ventricular tachycardia. Ventricular tachycardia is characterized by rapid heartbeats originating from the ventricles, resulting in an abnormal heart rhythm. This condition can be life-threatening if not promptly treated. Atrial fibrillation involves rapid, irregular heartbeats originating from the atria, not the ventricles (B). Supraventricular tachycardia also originates above the ventricles and is not specific to ventricular malfunction (C). Bradycardia, on the other hand, is a condition characterized by an abnormally slow heart rate, which is the opposite of the fast heartbeats seen in ventricular tachycardia (D).
The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse's priority action?
- A. Hold the spironolactone and notify the healthcare provider.
- B. Administer a potassium supplement.
- C. Continue the spironolactone as ordered.
- D. Increase the dose of spironolactone.
Correct Answer: A
Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. The priority action is to stop the medication and inform the healthcare provider because a potassium level of 5.8 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Continuing the medication or administering a potassium supplement would exacerbate the issue. Increasing the dose of spironolactone would be unsafe and could lead to severe complications. Therefore, holding the medication and seeking guidance from the healthcare provider is crucial in managing the client's elevated potassium level.