A client takes atorvastatin (Lipitor), with laboratory results showing a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?

Correct Answer: A

Rationale: The correct answer is A: Ask if the client eats grapefruit. Atorvastatin can interact with grapefruit juice, leading to increased drug levels and potential toxicity. The elevated BUN and creatinine levels suggest possible kidney impairment, which could be exacerbated by the drug interaction. Assessing for grapefruit consumption allows the nurse to address this potential risk factor. B: Assessing for dehydration would not directly address the potential drug interaction with grapefruit. C: Hospital admission is not necessary based solely on the information provided; this would be an extreme action without further assessment. D: Obtaining a random urinalysis would not provide relevant information related to the potential drug interaction with grapefruit.

Correct Answer: C

Rationale: The correct answer is C: It is hypertension with no specific cause. Rationale: 1. Essential hypertension is also known as primary or idiopathic hypertension. 2. It is the most common type of hypertension, accounting for about 90-95% of cases. 3. The exact cause of essential hypertension is unknown, but it is believed to be due to a combination of genetic, environmental, and lifestyle factors. 4. Choices A, B, and D are incorrect because essential hypertension is not caused by another disease, does not necessarily require treatment as essential means "fundamental," and is not specifically severe or life-threatening.

Correct Answer: A

Rationale: The correct answer is A: African American churches. This target audience is appropriate because African Americans have a higher prevalence of hypertension compared to other ethnic groups. By providing education and screening at African American churches, the nurse can reach a population that is at higher risk for hypertension. Churches are also community hubs where individuals gather regularly, making it an effective platform for health promotion. Choice B: Asian American groceries is incorrect as it does not specifically target a population with a high prevalence of hypertension. Choice C: High school sports camps may not be an ideal target audience for hypertension education as the focus is typically on physical fitness rather than chronic disease management. Choice D: Women's health clinics may not reach the priority population of African Americans who have a higher prevalence of hypertension.

Correct Answer: C

Rationale: The correct question to ask first is C: "Do you experience shortness of breath with basic activities?" This is because shortness of breath is a common and concerning symptom in COPD patients that can greatly impact their quality of life and indicate disease progression. By addressing this symptom first, the nurse can assess the severity of the client's condition and determine the immediate need for intervention or treatment. Asking about support system (A) is important but not as urgent as addressing the primary symptom. Inquiring about the client's understanding of the disease (B) and medications (D) is also important but should come after addressing the immediate symptom of shortness of breath.

Correct Answer: B

Rationale: Step 1: The nurse must acknowledge the client's concern about the cost of the inhaler. Step 2: Suggesting community services shows empathy and addresses the financial aspect. Step 3: Encouraging daily use aligns with the standard treatment guidelines. Step 4: By addressing both cost and importance of daily use, the nurse promotes adherence and support. Summary of other choices: A: Incorrect. This option doesn't address the client's financial concerns. C: Incorrect. Focusing on fears of breathlessness doesn't directly address the client's cost concern. D: Incorrect. While discussing daily use is important, not directly addressing the cost concern may lead to non-adherence.