A nurse is assessing a client who has been taking simvastatin to treat hyperlipidemia. Which statement made by the client describes an adverse effect of the medication that should be reported to the provider immediately?

"I've had gas pains for the last day."

"I've had a headache for a couple of days."

"I have occasional constipation."

"My legs feel weak, and I get pain in my calves."

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Gas pains, while uncomfortable, are not typically a serious adverse effect of simvastatin and do not usually require immediate medical attention unless they are severe or persistent.

Choice B Reason:

Headaches are a common side effect of many medications, including simvastatin, and are not generally considered an emergency. However, if the headache is severe, persistent, or accompanied by other symptoms, it should be reported to a healthcare provider.

Choice C Reason:

Occasional constipation is another common side effect and is not usually a cause for immediate concern unless it becomes severe or chronic.

Choice D Reason:

Muscle weakness and pain, especially in the calves, can be a sign of a serious condition called rhabdomyolysis, which is a rare but serious adverse effect of statins like simvastatin. This condition involves the breakdown of muscle tissue and can lead to kidney damage. It should be reported to a healthcare provider immediately.

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Correct Answer is B

Explanation

Choice A reason:
Magnesium sulfate is used in the management of severe preeclampsia primarily for seizure prophylaxis. One of the key side effects of magnesium sulfate is its impact on neuromuscular transmission, leading to diminished deep-tendon reflexes as serum magnesium levels rise. The therapeutic range for anticonvulsant prophylaxis is typically between 5-8 mg/dL. Reflexes may begin to diminish when serum levels reach 8-12 mg/dL, indicating potential magnesium toxicity. Therefore, diminished reflexes are a warning sign to reassess the infusion rate and possibly reduce or discontinue the medication.

Choice B reason:
A respiratory rate of 16 breaths per minute falls within the normal adult range and suggests that the client's respiratory system is not being adversely affected by the magnesium sulfate infusion. Respiratory rate is a critical parameter to monitor during magnesium sulfate therapy, as respiratory depression is a serious side effect of magnesium toxicity. Maintaining a normal respiratory rate indicates that it is safe to continue the infusion at the current rate.

Choice C reason:
While a urine output of 50 mL/hr is on the lower end of the normal range, it is still considered adequate for most adults. In the setting of magnesium sulfate therapy for severe preeclampsia, maintaining adequate urine output is essential for ensuring that the kidneys can excrete the magnesium to prevent accumulation and toxicity. If urine output decreases significantly, it may necessitate reevaluation of the infusion rate or additional interventions to support renal function.

Choice D reason:
A heart rate of 56 beats per minute is slightly bradycardic but may not be clinically significant if the client is asymptomatic. However, magnesium has a direct effect on cardiac function, and high levels can lead to bradycardia and other cardiac conduction abnormalities. It is important to monitor the client's heart rate and rhythm during magnesium sulfate therapy to detect any early signs of cardiac involvement due to magnesium toxicity.

A. Obesity B. The client drinks several glasses of beer every night. C. Use of a thiazide diuretic. D. Depression. E. Hypertension.

Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason:
Obesity is a significant risk factor for gout. It can lead to increased production and decreased excretion of uric acid, which in turn can cause gout attacks. The normal body mass index (BMI) range is 18.5 to 24.9, and a BMI of 30 or above is considered obese.

Choice B reason:
Regular consumption of beer can increase the risk of gout. Beer is high in purines, which the body breaks down into uric acid, and alcohol can reduce the excretion of uric acid by the kidneys. Moderation in alcohol consumption is advised, with the recommendation being up to one drink per day for women and up to two drinks per day for men.

Choice C reason:
Thiazide diuretics are associated with an increased risk of gout. They can decrease the kidney's ability to remove uric acid from the body, leading to its accumulation. When prescribing thiazide diuretics, healthcare providers often monitor uric acid levels and consider alternative medications if the patient has a history of gout.

Choice D reason:
Depression is not directly identified as a risk factor for developing gout. However, some lifestyle factors associated with depression, such as poor diet and inactivity, could indirectly increase the risk.

Choice E reason:
Hypertension is a known risk factor for gout. High blood pressure can impair kidney function, which is responsible for excreting uric acid, thus leading to hyperuricemia and gout. The normal range for blood pressure is considered to be below 120/80 mmHg.

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A nurse is assessing a client who has been taking simvastatin to treat hyperlipidemia. Which statement made by the client describes an adverse effect of the medication that should be reported to the provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

Correct Answer is B

Explanation

A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? (Select all that apply)

Correct Answer is ["A","B","C","E"]

Explanation

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