A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Take the medication an hour after antacids.

Notify the healthcare provider (HCP) of lethargy.

Monitor for any signs of sexual dysfunction.

Decrease cigarette use to a pack per day.

Answer and Explanation

The Correct Answer is D

A. Take the medication an hour after antacids: Antacids can interfere with the absorption of cimetidine, so spacing them apart is a correct approach. This statement indicates appropriate understanding of medication timing and does not require further instruction.

B. Notify the healthcare provider (HCP) of lethargy: Cimetidine can cause central nervous system effects like confusion or lethargy, particularly in older adults or those with renal impairment. Reporting such symptoms is appropriate and reflects safe medication awareness.

C. Monitor for any signs of sexual dysfunction: Cimetidine has been associated with gynecomastia, decreased libido, and impotence in some cases. The client should be aware of and monitor for these potential effects.

D. Decrease cigarette use to a pack per day: Smoking impairs ulcer healing and increases gastric acid secretion, which can counteract the effects of cimetidine. Reducing to a pack per day is still harmful; the client should be encouraged to stop smoking entirely, not just cut back.

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Correct Answer is B

Explanation

A. Excessive bruising: While statins can rarely affect platelet function, leading to bruising, this is not commonly associated with elevated creatine kinase (CK) levels. Bruising is more indicative of coagulation issues rather than muscle injury.

B. Muscle tenderness: Elevated CK levels in a client taking atorvastatin suggest muscle injury, such as myopathy or rhabdomyolysis. Muscle tenderness, pain, or weakness are hallmark symptoms of these conditions. Prompt assessment is crucial, as continued statin use in the presence of muscle damage can lead to serious complications, including kidney failure .

C. Nausea and vomiting: These symptoms are nonspecific and can result from various causes. While they may occur in rhabdomyolysis, they are not primary indicators and should be considered in the broader clinical context.

D. Peripheral edema: Swelling in the extremities is not a typical sign of statin-induced muscle injury. It is more commonly associated with cardiac, renal, or hepatic conditions.

A. Avoid driving or operating machinery. B. Take a missed dose as soon as possible. C. Standing slowly when getting up from bed. D. Avoid intake of alcoholic beverages.

Correct Answer is C

Explanation

A. Avoid driving or operating machinery: Drowsiness and dizziness can occur with atenolol, especially when initiating therapy, but these effects are usually mild. While it's reasonable to use caution initially, this is not the most critical teaching point compared to orthostatic safety.

B. Take a missed dose as soon as possible: Although this may seem helpful, patients should not double doses or take extra doses close together. If a significant amount of time has passed, the missed dose may need to be skipped to prevent bradycardia or hypotension.

C. Standing slowly when getting up from bed: Atenolol, a beta-blocker, can cause orthostatic hypotension, especially in older adults. Teaching the client to rise slowly helps reduce the risk of dizziness and falls, making this a high-priority safety instruction following discharge.

D. Avoid intake of alcoholic beverages: Alcohol may enhance the hypotensive effects of beta-blockers, but moderate consumption is not strictly contraindicated. This advice is relevant but less urgent than preventing injury from orthostatic hypotension.

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A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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