Nokea
The nurse is reinforcing teaching for a client with hyperlipidemia who has a new prescription for simvastatin. The nurse should instruct the client to take simvastatin
- A. at noon immediately following a meal
- B. in the morning on an empty stomach
- C. at bedtime without regard to food
- D. in the afternoon with a snack
Correct Answer: C
Rationale: Simvastatin is most effective at bedtime, when cholesterol synthesis peaks, and can be taken with or without food. Morning or afternoon dosing reduces efficacy.
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A paraplegic client is in the hospital to be treated for an electrolyte imbalance. Which level of care is the client currently receiving?
- A. primary prevention
- B. secondary prevention
- C. tertiary prevention
- D. health promotion
Correct Answer: B
Rationale: This client is receiving secondary prevention. The current focus of health care is on preventive care. Leavell and Clark (1965) described the three levels of preventive care as primary, secondary, and tertiary. Secondary preventive care focuses on early detection of disease, prompt intervention, and health maintenance for clients experiencing health problems.
The nurse is reinforcing teaching to a client with a history of diverticulitis about lifestyle changes the client should make to reduce the risk of future episodes. Which information should the nurse reinforce to reduce the risk of future episodes? Select all that apply.
- A. Drink plenty of fluids
- B. Exercise regularly
- C. Follow a low-fiber diet
- D. Increase whole grains, fruits, and vegetables in the diet
- E. Increase intake of red meat
Correct Answer: A,B,D
Rationale: Fluids, exercise, and high-fiber foods (whole grains, fruits, vegetables) prevent constipation and reduce diverticulitis risk. Low-fiber diets and red meat increase risk by promoting constipation and inflammation.
A client on the oncology unit is to receive heparin sodium 5 units per kilogram of body weight by subcutaneous route every 4 hours. The client weighs 105.6 lbs. How many units should the client receive in a 24-hour period?
- A. 800
- B. 1080
- C. 1440
- D. 1960
Correct Answer: C
Rationale: The client weighs 48 kg and should receive 5 units/kg, or 240 units every 4 hours. This would be 1440 units in 24 hours. The answers in A, B, and D are incorrect calculations.
The nurse reports that a client with a Mantoux test has an induration of 10 mm. The nurse knows that the induration indicates:
- A. Infection with the tubercle bacillus
- B. Exposure to the tubercle bacillus
- C. Questionable exposure to the tubercle bacillus
- D. No exposure to the tubercle bacillus
Correct Answer: B
Rationale: A 10 mm induration indicates exposure to the tubercle bacillus, requiring further evaluation to determine active infection.
Which are appropriate examples of cost-effective care? Select all that apply.
- A. Considering the inside of the sterile glove wrapper as a small sterile field
- B. Donning clean, rather than sterile, gloves to remove a client’s dressing
- C. Returning opened, unused supplies from a client’s room to the central supply room
- D. Reusing a tourniquet for multiple clients unless it is visibly soiled
- E. Using remaining sterile saline in a bottle opened 48 hours ago before discarding
Correct Answer: A,B
Rationale: Using the glove wrapper as a sterile field and clean gloves for dressing removal reduce waste without compromising safety. Returning supplies, reusing tourniquets, and using old saline risk contamination or infection.