Mandy, a patient, calls the clinic today because he is taking atorvastatin (Lipitor) to treat his high cholesterol and is having pain in both of his legs. You instruct him to:

Correct Answer: A

Rationale: In this scenario, with the patient experiencing leg pain while taking atorvastatin (Lipitor), a medication commonly used to treat high cholesterol, it is essential to prioritize the patient's safety and well-being. Leg pain can be a sign of a rare but serious side effect known as rhabdomyolysis, which can lead to muscle breakdown and potentially affect kidney function. Therefore, it is crucial to immediately discontinue the medication (atorvastatin) and have the patient come in to the clinic to be seen today for further evaluation and management. This will allow healthcare providers to assess the severity of the leg pain, conduct necessary tests, and determine the appropriate course of action to ensure the patient's health and safety.

Correct Answer: D

Rationale: The most common undesirable effect of thrombolytic therapy is internal and superficial bleeding. Thrombolytic medications work by dissolving blood clots, which can lead to an increased risk of bleeding. This bleeding can occur internally, such as in the gastrointestinal tract or brain, or externally, in the form of bruising or easy bleeding from cuts or wounds. It is crucial for healthcare providers to closely monitor patients receiving thrombolytic therapy for signs of bleeding and to promptly address any concerns to prevent complications. Dysrhythmias, nausea and vomiting, and anaphylactic reactions are less common adverse effects associated with thrombolytic therapy compared to bleeding.

Correct Answer: D

Rationale: The best way to avoid problems with flushing or pruritus when taking niacin for antilipemic therapy is to take the medication with a full glass of water on an empty stomach. This method helps to minimize the chances of flushing or itching commonly associated with niacin therapy. Niacin can cause flushing by dilating blood vessels, leading to redness, warmth, and itching of the skin. Taking it on an empty stomach with water can help reduce the intensity of these side effects. Starting with a low initial dose and then gradually increasing it can also help to reduce flushing and other adverse effects associated with niacin therapy.

Correct Answer: A

Rationale: The nurse should include the instruction to avoid drinking large amounts of green tea when providing dietary teaching for a patient receiving warfarin therapy. Green tea is high in vitamin K, which can interfere with the effectiveness of warfarin, an anticoagulant medication. Maintaining a consistent intake of vitamin K is important for patients on warfarin in order to keep their INR (International Normalized Ratio) levels stable. It is not necessary to avoid all sources of vitamin K, but rather to keep intake consistent and moderate. Drinking large amounts of green tea, which is high in vitamin K, can potentially impact the patient's INR levels and increase the risk of bleeding or clotting issues.

Correct Answer: B

Rationale: The high alert nursing implication for Morphine is to assess the level of consciousness, blood pressure, pulse, and respiration. Morphine is a potent opioid analgesic that can cause respiratory depression, sedation, and hypotension as side effects. Monitoring the patient's vital signs and neurological status is crucial to detect any signs of overdose or adverse reactions promptly. Maintaining vigilant observation of these parameters can help prevent serious complications and ensure the safe administration of Morphine.