When educating a client starting a new prescription for simvastatin, which instruction should the nurse provide?

Correct Answer: B

Rationale: In educating a client starting a new prescription for simvastatin, it is crucial to emphasize reporting any muscle pain immediately (Option B). This instruction is essential because simvastatin, as a statin medication, can rarely cause a serious side effect called rhabdomyolysis, characterized by muscle pain, weakness, and dark urine. Early detection and management of this adverse effect are vital to prevent serious complications. Option A (Take the medication in the morning) is incorrect because the timing of simvastatin administration is not as critical as adherence to the prescribed schedule. However, some healthcare providers may recommend taking it in the evening based on individual patient factors. Option C (Avoid taking the medication with grapefruit juice) is generally a good practice for certain medications, but it is not specifically related to simvastatin. Grapefruit juice can interfere with the metabolism of some drugs but not usually with simvastatin. Option D (Take the medication at bedtime) is not the most critical instruction for a client starting simvastatin. While some providers do recommend taking statins in the evening based on their pharmacokinetics, the key focus should be on monitoring and reporting muscle pain promptly. Educationally, this rationale highlights the importance of recognizing and managing potential adverse effects of medications, emphasizing patient safety and adherence to instructions. It underscores the significance of patient education in promoting medication safety and optimizing therapeutic outcomes.

Correct Answer: C

Rationale: The correct test to monitor the therapeutic effect of heparin is the activated partial thromboplastin time (aPTT). Heparin's action is to prolong the clotting time, and aPTT reflects this effect. Monitoring aPTT helps ensure that the client is within the therapeutic range to prevent clot formation while minimizing the risk of bleeding complications. PT/INR is used to monitor warfarin therapy, platelet count assesses for potential thrombocytopenia, and WBC count evaluates for signs of infection or inflammation, not the therapeutic effect of heparin.

Correct Answer: C

Rationale: In the context of a client with a UTI and a history of recurrent infections, the correct laboratory test that the provider needs to wait for before prescribing an antibiotic is the sensitivity test (Option C). This test is crucial because it helps identify the specific antibiotic that will be most effective against the particular strain of bacteria causing the infection. Gram stain (Option A) is used to identify the type of bacteria present but does not provide information on which antibiotic will be most effective. Culture (Option B) is essential for identifying the specific bacteria causing the infection, but sensitivity testing is needed to determine the most appropriate treatment. Specific gravity (Option D) is a measure of urine concentration and not relevant to choosing an antibiotic. Educationally, understanding the rationale behind waiting for sensitivity results emphasizes the importance of targeted therapy in treating infections. It highlights the need for precise identification of pathogens to optimize treatment outcomes, prevent antibiotic resistance, and minimize side effects. This knowledge is crucial for nurses in providing safe and effective care to patients with infections.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer: "I will inform my doctor if I experience diarrhea." This statement indicates that the client understands the importance of monitoring and reporting a common side effect of Tetracycline, which is diarrhea. Option A is incorrect because taking Tetracycline with milk can decrease its absorption due to chelation, making the medication less effective. Option C is incorrect because discontinuing the medication prematurely can lead to treatment failure and potential development of antibiotic resistance. Option D is incorrect because Tetracycline should not be taken just before bedtime as lying down after taking it can increase the risk of esophageal irritation and ulceration. Educationally, this question highlights the importance of patient education regarding medication administration and side effect monitoring. It emphasizes the need for healthcare providers to ensure that patients comprehend instructions correctly to achieve optimal treatment outcomes and prevent potential complications. This case also underscores the significance of healthcare providers' role in promoting medication safety and adherence through effective patient teaching.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Pyridoxine (Vitamin B6). Isoniazid (INH), commonly used to treat tuberculosis, can lead to peripheral neuropathy as a side effect due to its ability to deplete pyridoxine levels in the body. Pyridoxine supplementation helps prevent or alleviate this adverse effect by supporting nerve function. Option A) Ascorbic acid (Vitamin C) is not directly related to preventing INH side effects. Option C) Folic acid (Vitamin B9) is essential for cell growth but is not specifically indicated for INH therapy. Option D) Cyanocobalamin (Vitamin B12) is important for nerve function but is not the primary vitamin depleted by INH. Educationally, understanding the relationship between drug therapy and vitamin deficiencies is crucial for nurses to provide safe and effective care. Knowing which supplements to administer in conjunction with certain medications can mitigate potential adverse effects and improve patient outcomes. This knowledge underscores the importance of pharmacological principles in nursing practice.