Nokea
The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?
- A. I take my Lipitor with a glass of milk after my breakfast.
- B. I take my Lipitor and wait 30 minutes before taking my other medications.
- C. I take my Lipitor 30 minutes after I eat something.
- D. I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.
Correct Answer: D
Rationale: Grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to breakdown the drug, which leads to excessive amounts of the drug in the body.
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The client taking rifampin brings a sample of urine that is orange in color to the clinic. Which interventions should the nurse implement? Select all that apply.
- A. Send the urine to the lab for culture and sensitivity (C&S).
- B. Reassure the client that this is normal and harmless.
- C. Teach that the urine that is orange can stain clothing.
- D. Question continuation of rifampin with the HCP.
- E. Inform that sweat and tears can also turn orange-colored.
Correct Answer: B,C,E
Rationale: A: A C&S is unnecessary because orange-colored urine is a normal finding in the client taking rifampin. B: The nurse should reassure the client that orange-colored urine is a normal finding in the client taking rifampin (Rifadin). C: The nurse should teach the client that the orange-colored urine and sweat can stain clothing and that the client should consider wearing nonwhite clothing or using undergarments if sweating is excessive. D: It is unnecessary to question continuation of rifampin if the urine is orange-colored because this is a normal finding. E: The nurse should inform the client that other body fluids, such as tears, sweat, and saliva, can also turn orange-colored with the use of rifampin (Rifadin).
High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by:
- A. the inability of the kidneys to excrete the drug metabolites
- B. rapid cell catabolism
- C. toxic effects of the prophylactic antibiotics that are given concurrently
- D. the altered blood pH from the acid medium of the drugs
Correct Answer: B
Rationale: Chemotherapy causes rapid cell destruction, releasing uric acid as a metabolite, which can elevate levels and risk conditions like gout or kidney stones.
Which of the following is true when administering a nasal spray medication?
- A. The client should blow their nose gently before the medication is administered.
- B. The medication should be sprayed in front of the nose.
- C. The medication should be administered as the patient exhales.
- D. The client should lay flat when the medication is administered.
Correct Answer: A
Rationale: The client should blow their nose gently before the medication is administered. This is to clear the nasal passages to allow the medication to be properly administered. When administering the medication, the client should sit upright, insert the applicator into the designated nostril, and spray the medication as the patient inhales.
When caring for a client with a possible diagnosis of placenta previa, which of the following admission procedures should the nurse omit?
- A. perineal shave
- B. enema
- C. urine specimen collection
- D. blood specimen collection
Correct Answer: B
Rationale: An enema risks dislodging the placenta in placenta previa, potentially causing severe bleeding, and should be avoided.
The severely depressed client tells the nurse, “I don't need these antidepressants; they're too expensive! I'm going to use St. John's wort instead.†Which is the most appropriate response by the nurse?
- A. It would be a safe alternative, especially if you need to watch your finances.
- B. What about taking St. John's wort and an antidepressant for greater effectiveness?
- C. St. John's wort may cost less, but it has not been shown to improve severe depression.
- D. I have some information showing the effective use of St. John's wort. Let's go over it.
Correct Answer: C
Rationale: St. John's wort has not been clinically proven effective for severe depression.