The client is taking gemfibrozil. What contraindication to taking the drug should the nurse tell the client about?

Correct Answer: C

Rationale: The correct answer is C: Active gallbladder disease. Gemfibrozil can increase the risk of gallstones and exacerbate gallbladder disease. The nurse should inform the client about this contraindication to avoid potential complications. A: History of MI is not a contraindication to taking gemfibrozil. In fact, gemfibrozil may be prescribed to reduce the risk of cardiovascular events in patients with a history of MI. B: History of elevated triglyceride levels is actually an indication for using gemfibrozil, not a contraindication. D: Taking aspirin with gemfibrozil can increase the risk of bleeding but is not a specific contraindication.

Correct Answer: C

Rationale: The correct answer is C: Type 1 second degree AV block. This rhythm is characterized by a slightly irregular rhythm and P waves that come in multiples, indicating a delay in the AV node conduction. In Type 1 second degree AV block, there is a progressive prolongation of the PR interval until a P wave is blocked, resulting in a skipped QRS complex. This matches the description given in the question. Choice A (Third degree AV block) is incorrect because in this condition, there is complete blockage of the electrical impulses between the atria and ventricles, resulting in an independent rhythm for both chambers. Choice B (Type 2 second degree AV block) is incorrect because in this condition, there is a consistent PR interval before a blocked P wave without progressive prolongation as seen in the question. Choice D (Junctional escape rhythm) is incorrect as it is characterized by a heart rate originating from the AV junction due to a failure of the SA node,

Correct Answer: D

Rationale: The correct answer is D because relief of chest pain with nitroglycerin is a hallmark symptom of chronic stable angina. Nitroglycerin dilates blood vessels, improving blood flow to the heart, relieving chest pain. Choices A, B, and C do not specifically indicate typical angina symptoms like relief with nitroglycerin, which is crucial in confirming the diagnosis.

Correct Answer: B

Rationale: The correct answer is B because an increase in heart rate from 66 to 98 beats/min after ambulation post-AMI indicates potential cardiac stress. This elevation could signify inadequate cardiac output or compromised heart function, prompting the need to decrease exercise intensity to prevent further strain on the heart. Choices A, C, and D do not directly reflect cardiac function and are within normal ranges post-AMI, so they would not be immediate indicators for reducing exercise level.

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