A nurse is reinforcing teaching with a client who is starting simvastatin.
Which of the following information should the nurse include?
Change position slowly when rising from a chair.
Maintain a steady intake of green leafy vegetables.
Consume no more than 1 L/day of fluid.
Report any muscle pain or weakness to the healthcare provider.
The Correct Answer is D
Report any muscle pain or weakness to the healthcare provider. This is because simvastatin This is because simvastatin can cause a rare but serious side effect of muscle damage (rhabdomyolysis), which can lead to kidney failure. Muscle pain or weakness can be signs of muscle breakdown and kidney damage, and should be reported to the healthcare provider as soon as possible.
Choice A is wrong because changing position slowly when rising from a chair is not related to simvastatin. This is a precaution for people who take medications that lower blood pressure, such as diuretics or beta blockers, to prevent dizziness or fainting.
Choice B is wrong because maintaining a steady intake of green leafy vegetables is not specific to simvastatin. This is a general dietary recommendation for people who take anticoagulants, such as warfarin, to prevent bleeding complications.
Choice C is wrong because consuming no more than 1 L/day of fluid is not advised for people who take simvastatin. This is a restriction for people who have heart failure or kidney disease, to prevent fluid overload. People who take simvastatin should drink enough fluids to stay hydrated and avoid dehydration, which can increase the risk of kidney damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Nitroglycerin is a medication that dilates the blood vessels and improves blood flow to the heart. It is used to treat angina, a condition that causes chest pain due to reduced oxygen supply to the heart. However, nitroglycerin can lose its effectiveness over time if it is used continuously. This is called tolerance, and it means that the patient will need higher doses of the medication to achieve the same relief. To avoid tolerance, patients who use transdermal nitroglycerin patches are instructed to remove the patch at bedtime and apply a new one in the morning. This creates a nitrate-free interval of about 8 to 12 hours, which allows the body to restore its sensitivity to nitroglycerin.
Choice A is wrong because an allergic response is not a common side effect of nitroglycerin. Some patients may experience skin irritation or rash at the site of application, but this is usually mild and does not require discontinuation of the medication.
Choice C is wrong because overdosage is unlikely with transdermal nitroglycerin patches. The patches deliver a controlled amount of nitroglycerin through the skin over a period of time. The risk of overdosage is higher with other forms of nitroglycerin, such as tablets or sprays, which are taken as needed for acute angina attacks.
Choice D is wrong because forgetting to remove the patch in the morning is not a serious problem. The patch will continue to deliver nitroglycerin until it is removed, but it will not cause harm to the patient. However, it may reduce the effectiveness of the next patch if there is no nitrate-free interval between them.
Correct Answer is A
Explanation
Atorvastatin is a type of statin, which are the most potent antilipidemic agents and have proven to lower the risk of myocardial infarction. Statins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver.By reducing the production of cholesterol, statins lower the levels of low-density lipoprotein (LDL) and triglycerides, and slightly increase the levels of high-density lipoprotein (HDL) in the blood.
Choice B, niacin, is wrong because niacin is not as effective as statins in lowering LDL and preventing cardiovascular events.Niacin is a water-soluble vitamin that can lower LDL and triglycerides, and increase HDL, but it can also cause flushing, itching, and liver toxicity.
Choice C, gemfibrozil, is wrong because gemfibrozil is a type of fibric acid derivative, which are mainly used to lower triglycerides and increase HDL, but have little effect on LDL.
Fibric acid derivatives work by activating a receptor called PPAR-alpha, which regulates the metabolism of lipids in the liver and muscle.Fibric acid derivatives can also increase the risk of gallstones and muscle damage.
Choice D, ezetimibe, is wrong because ezetimibe is a selective cholesterol absorption inhibitor, which blocks the absorption of dietary and biliary cholesterol in the intestine.Ezetimibe can lower LDL by about 15-20%, but it has not been shown to reduce the risk of myocardial infarction on its own.Ezetimibe is usually combined with a statin for better efficacy and safety.
Normal ranges for lipid levels are:
• Total cholesterol: less than 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women
• Triglycerides: less than 150 mg/dL
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