Nokea
The nurse is caring for the client taking atorvastatin. The nurse should assess for which adverse effects?
- A. Constipation and hemorrhoids
- B. Muscle pain and weakness
- C. Fatigue and dysrhythmias
- D. Flushing and postural hypotension
Correct Answer: B
Rationale: A: Bile acid sequestrants act by inhibiting bile acids from absorption by the small intestine. This results in fewer bile acids in the small intestine, which may lead to constipation and hemorrhoids. B: Atorvastatin (Lipitor) is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor (statin) used to lower lipid levels. Statins can cause muscle tissue injury manifested by muscle ache or weakness. Muscle injury can progress to myositis (muscle inflammation) or rhabdomyolysis (muscle disintegration). C: Diarrhea, not constipation, has been found to be a side effect of statin medications. D: Side effects of niacin, a lipid-lowering agent, include flushing, dysrhythmias, and postural hypotension.
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The unresponsive client with DM is admitted to the ED with a serum glucose level of 35 mg/dL. Which medication should the nurse plan to administer?
- A. Exenatide
- B. Pramlintide
- C. Miglitol
- D. Glucagon
Correct Answer: D
Rationale: A: Exenatide (Byetta), a synthetic incretin mimetic, is used as an adjunct in type 2 diabetes to decrease blood glucose levels. B: Pramlintide (Symlin) lowers postprandial glucose levels by slowing gastric emptying. C: Miglitol (Glyset), an alpha-glucosidase inhibitor, lowers postprandial serum glucose levels. D: The nurse should plan to administer glucagon (GlucaGen). Glucagon, administered intramuscularly, intravenously, or subcutaneously, is used in unconscious clients with diabetes to reverse severe hypoglycemia from insulin overdose. Normal serum glucose is 70 to 110 mg/dL.
The LPN is teaching a 25-year-old client about HPV. Which statements made by the client indicate understanding of the teaching? Select all that apply.
- A. I can only get HPV if my boyfriend has symptoms.
- B. HPV can cause cancers later in life, which is why it is important to prevent it now.
- C. I feel a bit better about having HPV now that I know that almost all sexually active people have it at some point.
- D. It's a bummer that I'm too old for the vaccine.
- E. If I take my birth control diligently, I can significantly reduce my risk for HPV.
Correct Answer: B
Rationale: HPV infection is common and most adults will have HPV at some point in their life. It can be transmitted via skin-to-skin contact as well through vaginal, anal, or oral sex. HPV infections can cause cancer, though most infections will disappear within two years. Transmission of HPV can occur even if someone is not symptomatic of infection. The HPV vaccine is recommended for children age 9 up to adults age 26. The only way to help prevent sexual transmission of HPV between partners is with condom use.
Which of the following is not considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct Answer: D
Rationale: Insulin is not required in continuous treatment for every Type II diabetic, as many can manage with lifestyle changes and oral medications.
The nurse is to administer vancomycin to the client diagnosed with sepsis. The client is to have a peak and trough level completed on this dose of vancomycin. Which action should the nurse initiate first?
- A. Determine if the trough level has already been drawn on the client.
- B. Check drug compatibilities before infusing into an existing IV line.
- C. Evaluate the client's culture and sensitivity (C&S) report results.
- D. Calculate the rate at which the vancomycin should be infused.
Correct Answer: A
Rationale: A: A trough level must be drawn before vancomycin (Vancocin) is administered. This is the first action because if the trough level has not been drawn, it will delay the vancomycin dose and could result in a medication error. B: Checking medication compatibilities is important, but this can be completed while the laboratory is obtaining the trough level. C: Checking C&S report results is important, but this can be completed while the laboratory is obtaining the trough level. D: Calculating the administration rate is important, but this can be completed while the laboratory is obtaining the trough level.
The nurse is caring for a female client who has recently been diagnosed with cancer and will soon begin chemotherapy. Which of these statements would require additional follow-up and education?
- A. I will be most susceptible to an infection between 7 and 12 days after chemotherapy.
- B. I should try to get my annual teeth cleaning in before beginning chemotherapy.
- C. I should wait until all my hair falls out to purchase a wig.
- D. I should try to drink 8-10 glasses of water a day.
Correct Answer: C
Rationale: This client is at risk for altered body image secondary to the hair loss from chemotherapy. A wig can be helpful in coping with this, and the client should shop for a wig before his or her hair falls out so that he or she can better match his or her color and style. The remaining statements are accurate.