Nokea
The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client taking rosuvastatin (Crestor)?
- A. Report unexplained muscle weakness to the physician
- B. Allow six months for the drug to take effect
- C. Take the medication with fruit juice
- D. Report difficulty sleeping
Correct Answer: A
Rationale: Rosuvastatin a statin can cause myopathy or rhabdomyolysis. Unexplained muscle weakness is a serious side effect requiring immediate reporting to prevent complications. The other options are not specific to rosuvastatin therapy.
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A client with human immunodeficiency syndrome has gastrointestinal symptoms, including diarrhea. The nurse should teach the client to avoid:
- A. Calcium-rich foods
- B. Canned or frozen vegetables
- C. Processed meat
- D. Raw fruits and vegetables
Correct Answer: D
Rationale: Raw fruits and vegetables can harbor pathogens, worsening diarrhea in AIDS due to immune compromise. Calcium foods, canned vegetables, and processed meats are safer.
A 70-year-old client is almost finished receiving her second unit of packed red blood cells. The client, who weighs 80 lb, has started complaining of being short of breath and now has crackles in the bases of her lungs. After slowing or stopping the transfusion, the most appropriate initial nursing action would be to:
- A. Raise the client's head and place her feet in a dependent position
- B. Notify the physician
- C. Place the client on 2 liters of O2 via nasal cannula
- D. Administer furosemide (Lasix) 20 mg IV push
Correct Answer: A
Rationale: Raising the head and placing feet in a dependent position reduces venous return and pulmonary congestion, addressing transfusion-related circulatory overload.
The client is admitted with a diagnosis of acute leukemia. Which nursing intervention is the priority?
- A. Administering pain medication
- B. Preventing infection
- C. Monitoring blood glucose levels
- D. Encouraging high-fiber foods
Correct Answer: B
Rationale: Acute leukemia causes immunosuppression, making infection prevention (e.g., hand hygiene, protective isolation) the priority to avoid life-threatening complications. Pain, glucose, and diet are secondary.
A client with leukemia who has been receiving Trimetrexate (methotrexate) has an order for Wellcovorin (leucovorin). The rationale for administering Wellcovorin is to:
- A. Treat anemia caused by the methotrexate
- B. Create a synergistic effect that shortens treatment time
- C. Increase the number of circulating neutrophils
- D. Reverse drug toxicity and prevent tissue damage
Correct Answer: D
Rationale: Leucovorin (Wellcovorin) is a rescue therapy given after methotrexate to reverse its toxicity and protect healthy cells from damage particularly in bone marrow and mucosal tissues. It does not treat anemia enhance synergy or increase neutrophils.
The nurse is preparing to administer a dose of warfarin (Coumadin). The client’s INR is 3.5. What action should the nurse take?
- A. Administer the dose as ordered.
- B. Withhold the dose and notify the physician.
- C. Double the dose to achieve therapeutic range.
- D. Administer half the dose.
Correct Answer: B
Rationale: An INR of 3.5 is above the therapeutic range (2–3 for most conditions), indicating increased bleeding risk. The nurse should withhold the dose and notify the physician for further orders. Adjusting the dose independently is unsafe.