Nokea
The LPN/LVN is assisting with the care of a client who has been diagnosed with a myocardial infarction (MI). Which laboratory test result would the nurse expect to see elevated within the first 24 hours of the client's admission?
- A. Serum troponin
- B. Serum creatinine
- C. Serum sodium
- D. Serum albumin
Correct Answer: A
Rationale: Elevated serum troponin levels are indicative of myocardial damage and are commonly used as a diagnostic marker for myocardial infarction. Troponin levels typically rise within a few hours of an MI and remain elevated for several days, making it a crucial test for early detection and monitoring of cardiac injury. Serum creatinine is not typically elevated in the acute phase of a myocardial infarction. Serum sodium and serum albumin levels are not directly associated with myocardial infarction and are unlikely to be elevated in the first 24 hours following an MI.
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When providing teaching to a client with a new prescription for atorvastatin, which of the following instructions should the nurse include?
- A. Take the medication in the evening.
- B. Take the medication with food.
- C. Increase your intake of grapefruit juice.
- D. Avoid consuming dairy products.
Correct Answer: A
Rationale: The correct instruction for a client with a new prescription for atorvastatin is to take the medication in the evening. Atorvastatin is more effective when taken at night because cholesterol synthesis is higher during this time. This timing helps optimize the drug's cholesterol-lowering effects and enhances its overall efficacy in managing lipid levels. Choices B, C, and D are incorrect. Taking atorvastatin with food can decrease its absorption, grapefruit juice can interact with atorvastatin leading to increased side effects, and there is no specific need to avoid dairy products while on atorvastatin unless instructed otherwise by the healthcare provider.
A client with chronic obstructive pulmonary disease (COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which instruction should the nurse reinforce to ensure correct use?
- A. Inhale deeply and slowly after activating the MDI.
- B. Hold the breath for 5 seconds after inhaling the medication.
- C. Rinse the mouth immediately after using the MDI.
- D. Exhale fully before placing the mouthpiece in the mouth.
Correct Answer: A
Rationale: Inhaling deeply and slowly after activating the MDI is the correct instruction to ensure effective delivery of the medication to the lungs. This technique helps the medication reach the lower airways where it can be most beneficial in managing COPD symptoms. Inhaling too quickly or not deeply enough may result in improper drug delivery and reduce the effectiveness of the treatment. Holding the breath for 5 seconds after inhaling the medication (Choice B) may not be necessary and could cause discomfort without additional benefits. Rinsing the mouth immediately after using the MDI (Choice C) is not necessary unless specified by the healthcare provider. Exhaling fully before placing the mouthpiece in the mouth (Choice D) is not ideal as it may result in inadequate medication delivery to the lungs.
The LPN/LVN is reinforcing discharge instructions to a client who has been prescribed nitroglycerin sublingual tablets for angina. Which statement by the client indicates a need for further teaching?
- A. I will keep my nitroglycerin tablets in the original glass bottle.
- B. I will sit or lie down when I take a nitroglycerin tablet.
- C. I will take a nitroglycerin tablet every 5 minutes if chest pain persists, up to a total of 3 tablets.
- D. I can swallow the nitroglycerin tablet with a glass of water if it does not dissolve quickly.
Correct Answer: D
Rationale: The correct answer is D. Nitroglycerin sublingual tablets should not be swallowed; they must dissolve under the tongue to be effective. Choice A is correct as nitroglycerin tablets should be stored in their original glass container to prevent degradation. Choice B is correct as sitting or lying down when taking a nitroglycerin tablet helps prevent dizziness or fainting due to a sudden drop in blood pressure. Choice C is correct as taking a nitroglycerin tablet every 5 minutes for a maximum of 3 tablets is the correct protocol for managing angina symptoms.
The healthcare provider is monitoring a client with chronic stable angina. Which symptom would indicate that the client's condition is worsening?
- A. Increased shortness of breath with exertion
- B. Improved tolerance to activity
- C. Decreased frequency of chest pain
- D. Stable blood pressure readings
Correct Answer: A
Rationale: Increased shortness of breath with exertion is a concerning symptom in a client with chronic stable angina as it may indicate inadequate oxygen supply to the heart muscle, suggesting a worsening condition. This could be a sign of reduced blood flow to the heart, leading to increased work for the heart during exertion, resulting in increased shortness of breath. Choice B, improved tolerance to activity, is incorrect as it would indicate a positive response to treatment. Choice C, decreased frequency of chest pain, is incorrect as it would also suggest an improvement in the client's condition. Choice D, stable blood pressure readings, are not indicative of a worsening condition in chronic stable angina.
A client has a new prescription for metformin. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Monitor for signs of hypoglycemia.
- C. Increase fluid intake.
- D. Expect a metallic taste in the mouth.
Correct Answer: C
Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.