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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When interviewing the parents of a child with asthma, it is most important to assess the child's environment for what factor?
- A. Household pets
- B. New furniture
- C. Lead based paint
- D. Plants such as cactus
Correct Answer: A
Rationale: Animal dander is a very common allergen affecting persons with asthma. Other triggers may include pollens, carpeting and household dust.
A nurse is caring for a client with an exacerbation of chronic obstructive pulmonary disease (COPD) and a history of type 2 diabetes mellitus requiring insulin. The client has been prescribed prednisone. The nurse anticipates which need?
- A. Close monitoring for hypotension
- B. Gradually increasing the prednisone dose
- C. Increasing the insulin dose
- D. Monitoring and recording intake and output
Correct Answer: C
Rationale: Prednisone increases blood glucose, necessitating a higher insulin dose in diabetes. Hypotension is not a primary concern, prednisone is not typically titrated upward, and intake/output monitoring is less critical.
A laboring woman prefers to lie in the supine position during labor. The nurse teaches her that this is not a good position for which reason?
- A. It will cause more back pressure.
- B. Her baby will not come down well into the pelvis.
- C. Her blood pressure may drop and cause the baby's heart rate to drop.
- D. Contractions will be too close together, not giving her a rest.
Correct Answer: C
Rationale: Supine position can compress the vena cava, causing maternal hypotension and reduced fetal perfusion, leading to fetal heart rate drops.
A culture is taken of a lesion suspected of being herpes. The nurse knows that the specimen:
- A. Should be packed on ice
- B. Should be kept warm
- C. Should be double bagged
- D. Requires no special handling
Correct Answer: A
Rationale: Herpes culture specimens should be packed on ice to preserve the virus for accurate laboratory testing.
Which situations would prompt the health care team to use the client’s advance directive to make a decision regarding care? Select all that apply.
- A. Client diagnosed with lumbar spinal cord compression has paraplegia
- B. Client’s Glasgow Coma Scale (GCS) score is 3
- C. Client is refusing a life-saving treatment due to religious beliefs
- D. Client with intracerebral hemorrhage has aphasia
- E. Oriented client has cancer and is on a ventilator
Correct Answer: B,D
Rationale: Advance directives guide care when clients cannot communicate decisions, as with a GCS of 3 (unconscious) or aphasia from hemorrhage. Paraplegia, religious refusal, and ventilator use in an oriented client do not impair decision-making capacity.