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

Peripheral edema.

Muscle tenderness.

Nausea and vomiting.

Excessive bruising.

Answer and Explanation

The Correct Answer is B

Choice A reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to increased CK levels. CK is an enzyme that is released when muscle tissue is damaged. Peripheral edema is more likely to be caused by heart failure, kidney disease, or venous insufficiency.

Choice B reason: Muscle tenderness is a sign of myopathy, which is a rare but serious adverse effect of atorvastatin. Myopathy is a condition where muscle fibers are damaged and inflamed, leading to muscle weakness and pain. Increased CK levels indicate muscle injury and can be a marker of myopathy. The nurse should monitor the client for muscle symptoms and report them to the prescriber.

Choice C reason: Nausea and vomiting are common gastrointestinal side effects of atorvastatin, but they are not associated with increased CK levels. Nausea and vomiting can be managed by taking the medication with food or reducing the dose.

Choice D reason: Excessive bruising is not a typical side effect of atorvastatin, and it is not linked to increased CK levels. Excessive bruising can be caused by bleeding disorders, anticoagulant therapy, or trauma. The nurse should assess the client for other signs of bleeding, such as hematuria, hematemesis, or melena.

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Correct Answer is B

Explanation

Choice A reason: Neutropenic precautions are necessary when the WBC count is critically low, typically below the normal range. Since the client’s WBC count is now within the normal range, these precautions are no longer required.

Choice B reason: Filgrastim is designed to increase white blood cell (WBC) production in individuals with neutropenia. In this case, the client’s WBC count has increased from 2,500/mm³ (2.5 x 10⁹/L) to 5,000/mm³ (5 x 10⁹/L), reaching the lower limit of the normal reference range (5,000 to 10,000/mm³ or 5 to 10 x 10⁹/L). This indicates that the medication has achieved its desired effect, and it is appropriate to inform the client of this positive outcome.

Choice C reason:reason: Reviewing culture and sensitivity reports would be relevant if there was evidence of infection or a need to evaluate ongoing treatment for an infection. This is not indicated by the scenario provided.

Choice D reason: While assessing vital signs is generally important, there is no indication in this scenario that an acute issue requiring immediate vital sign monitoring is present.

A. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication. B. One hour after completion of the IV dose and one hour before the next administration of the medication. C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. D. Two hours after completion of the IV dose and two hours before the next administration of the medication.

Correct Answer is A

Explanation

Choice A reason: This is the best option to measure the peak and trough levels of vancomycin, as it reflects the highest and lowest concentrations of the drug in the blood. The peak level indicates the efficacy and potential toxicity of vancomycin, while the trough level indicates the clearance and potential subtherapeutic effect of vancomycin. The peak level should be drawn immediately after completion of the IV dose, as it takes about 30 minutes for vancomycin to reach its maximum concentration in the blood. The trough level should be drawn 30 minutes before the next administration of the medication, as it represents the lowest concentration of vancomycin in the blood before it is replenished by another dose.

Choice B reason: This is not a good option to measure the peak and trough levels of vancomycin, as it may not capture the true highest and lowest concentrations of the drug in the blood. The peak level may be lower than expected, as it takes about 30 minutes for vancomycin to reach its maximum concentration in the blood. The trough level may be higher than expected, as it is drawn too close to the next administration of the medication.

Choice C reason: This is not a good option to measure the peak and trough levels of vancomycin, as it does not reflect the highest and lowest concentrations of the drug in the blood. The peak level is drawn too early, as vancomycin has not reached its maximum concentration in the blood yet. The trough level is drawn too late, as vancomycin has already started to decline in the blood.

Choice D reason: This is not a good option to measure the peak and trough levels of vancomycin, as it may miss the highest and lowest concentrations of the drug in the blood. The peak level is drawn too late, as vancomycin may have already started to decline in the blood. The trough level is drawn too early, as vancomycin may have not reached its minimum concentration in the blood yet.

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

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Naxlex Comprehensive Predictor Exams

After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm3 (2.5 x 109/L) to 5,000/mm3 (5 x 109/L). Which action should the nurse implement? White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 109/L)]

Correct Answer is B

Explanation

A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Correct Answer is A

Explanation

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