A nurse is assessing a client who is withdrawing from opioid use. Which of the following findings should the nurse expect?

A. "I will notify your provider of your decision.": Informing the provider ensures that the client’s refusal is documented and that the healthcare team can discuss alternatives or address potential risks. This approach respects client autonomy while maintaining safety.

B. "Most people feel better after they have taken these medications.": This statement attempts to persuade the client rather than explore their reasons for refusal, which may not address underlying concerns or promote informed decision-making.

C. "If you do not take your medications, you will not recover.": Using scare tactics can create fear or mistrust and is not an effective way to encourage adherence. It does not support patient-centered care.

D. "Why are you refusing your medications?": Asking "why" can come across as judgmental and may make the client defensive. Open-ended, nonjudgmental questions are more effective for understanding the client’s perspective.

A. Take the medication in the morning: Simvastatin is more effective when taken in the evening because cholesterol synthesis is higher at night. Taking it in the morning may reduce its lipid-lowering effect.

B. Report muscle tenderness: Muscle pain, tenderness, or weakness can indicate myopathy or rhabdomyolysis, serious adverse effects of statins. Clients should report these symptoms promptly for evaluation and possible medication adjustment.

C. This medication can cause kidney damage: Simvastatin primarily affects the liver and muscles. While rhabdomyolysis can indirectly impact kidney function, kidney damage is not a common direct effect of the medication.

D. Avoid drinking grapefruit juice for 3 hr after taking this medication: Grapefruit juice can inhibit metabolism of simvastatin, increasing the risk of toxicity. Avoiding grapefruit entirely, rather than timing it around the dose, is the recommended precaution.