A patient who has recently started taking pravastatin (Pravachol) and niacin reports several symptoms to the nurse. Which information is most important to communicate to the health care provider?

Correct Answer: A

Rationale: The correct answer is A: Generalized muscle aches and pains. This is the most important information to communicate because it could indicate a serious side effect known as rhabdomyolysis, a rare but severe condition that can be caused by statins (like pravastatin) and niacin. Rhabdomyolysis is characterized by muscle breakdown that can lead to kidney damage. It is crucial to monitor and address this symptom promptly. Choice B (Dizziness with rapid position changes) may be related to orthostatic hypotension, a common side effect of some medications but is not as urgent as potential rhabdomyolysis. Choice C (Nausea when taking the drugs before meals) is a common side effect of niacin and may be managed by adjusting the timing of medication administration. Choice D (Flushing and pruritus after taking the drugs) is a common side effect of niacin known as flushing and is generally not considered as serious as

Correct Answer: C

Rationale: The correct answer is C: Monitor peripheral pulses. After cardiac catheterization, monitoring peripheral pulses is crucial to assess for any signs of complications such as decreased blood flow or vascular compromise. This intervention helps in early detection of potential issues and ensures prompt intervention if needed. A: Helping the client ambulate to the bathroom may be appropriate but monitoring peripheral pulses takes priority for assessing immediate complications post-cardiac catheterization. B: Fluid restriction is not indicated unless specifically prescribed by the healthcare provider. It is not a standard nursing intervention post-cardiac catheterization. D: Inserting an indwelling urinary catheter is not a priority intervention after cardiac catheterization unless there are specific indications such as monitoring urine output closely. Monitoring peripheral pulses takes precedence in this scenario.

Correct Answer: C

Rationale: The correct answer is C because an increase in pulmonary artery diastolic pressure indicates left-sided heart failure. In this scenario, the left side of the heart is unable to adequately pump blood to the rest of the body, causing an increase in pressure in the pulmonary circulation. This finding is consistent with the pathophysiology of left-sided heart failure. A: A drop in central venous pressure is more indicative of hypovolemia or right-sided heart failure. B: An increase in the cardiac index may suggest improved cardiac output, not specifically left-sided heart failure. D: A decline in mean pulmonary artery pressure is not a typical finding in left-sided heart failure.

Correct Answer: D

Rationale: The correct answer is D: Indomethacin (Indocin). Indomethacin is a prostaglandin inhibitor that helps close the patent ductus arteriosus in infants by constricting the ductus arteriosus. This drug is specifically used for this purpose due to its mechanism of action. Digoxin (A) is a cardiac glycoside used for heart conditions, not to close PDA. Prednisone (B) is a corticosteroid that does not have a direct effect on closing PDA. Furosemide (C) is a diuretic used for managing fluid overload, not for closing PDA.

Correct Answer: A

Rationale: The correct answer is A because in aortic stenosis, there is an obstruction of blood flow from the heart to the body. Strenuous activities can worsen the condition by increasing the workload on the heart, leading to angina and fainting. Preoperative preparation focuses on reducing the risk of complications during surgery. Therefore, advising the client to avoid strenuous exercise, stairs, and lifting helps minimize the risk of exacerbating symptoms and potential complications before surgery. Explanation for other choices: B: Taking short walks may be too strenuous for a client with aortic stenosis and can potentially worsen symptoms. C: Allowing unrestricted activity can be dangerous for a client with aortic stenosis, as it may lead to worsening symptoms and increased risk of complications. D: Gradually increasing activity can be risky for a client with aortic stenosis, as it can increase the workload on the heart and exacerbate symptoms.