An increase in which serum lab value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?

Low-density lipoprotein (LDL)

Prothrombin time (PT).

Creatine phosphokinase (CK)

High-density lipoprotein (HDL).

Answer and Explanation

The Correct Answer is D

A. Low-density lipoprotein (LDL): Atorvastatin's primary effect is to decrease LDL cholesterol levels. A decrease in LDL levels would indicate the medication is working as intended, not an increase.
B. Prothrombin time (PT): PT is a measure of blood clotting, which is not directly affected by atorvastatin. This value is more relevant for monitoring anticoagulant therapy.

C. Creatine phosphokinase (CK): CK levels can be used to monitor for muscle damage or side effects related to statin use. An increase in CK levels would suggest muscle damage, not the effectiveness of the statin.
D. High-density lipoprotein (HDL): Atorvastatin is a statin medication used to lower cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol, which is a key target in reducing the risk of coronary artery disease (CAD). While the primary goal of atorvastatin is to lower LDL cholesterol, an increase in HDL cholesterol (often termed "good" cholesterol) is also desirable as it can help reduce the risk of CAD. Therefore, an increase in HDL is a positive indicator that the medication is having a beneficial effect.

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Correct Answer is C

Explanation

A. Frequently assess the client’s blood pressure: While monitoring blood pressure is important, it is not as critical as monitoring the ECG in cases of diltiazem overdose. Diltiazem is a calcium channel blocker that can lead to significant cardiac effects.
B. Observe the client for signs of gastric irritation: This is relevant for some medications, but in the case of diltiazem overdose, the primary concern is the potential for severe cardiac effects rather than gastric irritation.
C. Monitor electrocardiogram (ECG) continuously: Diltiazem overdose can lead to serious cardiac arrhythmias, such as bradycardia, AV block, or other conduction disturbances. Continuous ECG monitoring is crucial to detect these potentially life-threatening complications.
D. Assess for changes in level of consciousness: While important, changes in level of consciousness are secondary to the immediate need to monitor cardiac function closely in the context of diltiazem overdose.

A. Hypokalemia. B. Hyponatremia C. Hyperphosphatemia. D. Hypermagnesemia.

Correct Answer is A

Explanation

A. Hypokalemia: Hydrochlorothiazide is a thiazide diuretic that can cause potassium loss through increased urine production. A common side effect of thiazide diuretics is hypokalemia, which can lead to symptoms such as palpitations or the sensation of the heart skipping beats. Therefore, it is crucial to check the client’s potassium levels to determine if hypokalemia is contributing to the client's symptoms.
B. Hyponatremia: While thiazide diuretics can affect sodium levels, hypokalemia is more directly associated with the symptoms described. Hyponatremia (low sodium levels) might also occur but is less commonly linked to the symptom of a skipped heartbeat compared to hypokalemia.
C. Hyperphosphatemia: Hydrochlorothiazide is not known to cause significant changes in phosphate levels, and hyperphosphatemia is not typically associated with the sensation of skipped heartbeats.
D. Hypermagnesemia: This condition, which involves elevated magnesium levels, is not a common side effect of hydrochlorothiazide. Hypokalemia is a more relevant concern for the symptoms described.

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An increase in which serum lab value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?

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Naxlex Comprehensive Predictor Exams

A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

Correct Answer is C

Explanation

During a home visit, a client informs the nurse about feeling like the heart is skipping beats. When reviewing the client's record, the nurse notes that the client is taking hydrochlorothiazide. Based on these assessment data, the nurse plans to obtain a blood sample to check for which condition?

Correct Answer is A

Explanation

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