A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?
Muscle tenderness.
Nausea and vomiting.
Excessive bruising.
Peripheral edema.
The Correct Answer is A
Choice A reason: Muscle tenderness is a sign of myopathy, a rare but serious adverse effect of atorvastatin and other statins. Myopathy is characterized by muscle weakness, pain, and elevated CK levels. CK is an enzyme that is released when muscle tissue is damaged. The nurse should monitor the client for muscle tenderness and report any changes to the prescriber.
Choice B reason: Nausea and vomiting are common side effects of atorvastatin, but they are not related to CK levels. The nurse should advise the client to take the medication with food and fluids to minimize gastrointestinal discomfort.
Choice C reason: Excessive bruising is not a typical side effect of atorvastatin, nor is it associated with CK levels. The nurse should assess the client for other possible causes of bleeding, such as coagulation disorders, trauma, or drug interactions.
Choice D reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to CK levels. The nurse should assess the client for other signs of fluid retention, such as weight gain, shortness of breath, or jugular venous distension. The nurse should also check the client's blood pressure and heart rate, as peripheral edema may indicate heart failure or hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Notifying the healthcare provider of the carbamazepine level is the most appropriate action for the nurse to take. Carbamazepine is an anticonvulsant drug that requires close monitoring of its serum levels to ensure therapeutic and safe effects. The normal reference range for carbamazepine is 4 to 12 mcg/mL or 16.9 to 50.8 mmol/L. A level of 84 mcg/L (35.6 mmol/L) is significantly higher than the upper limit and indicates toxicity. The nurse should report this finding to the prescriber immediately and hold the dose until further instructions.
Choice B reason: Administering the carbamazepine as prescribed is not the most appropriate action for the nurse to take. Giving the evening dose of carbamazepine when the morning level is already toxic can worsen the client's condition and cause serious adverse effects, such as confusion, drowsiness, ataxia, nystagmus, or coma. The nurse should not administer the medication without consulting the prescriber.
Choice C reason: Assessing the client for side effects of carbamazepine is an important action for the nurse to take, but it is not the most appropriate one. The nurse should assess the client for signs and symptoms of carbamazepine toxicity, such as nausea, vomiting, headache, blurred vision, or seizures. However, this action alone is not sufficient to address the problem. The nurse should also notify the prescriber and withhold the dose.
Choice D reason: Withholding this dose of the carbamazepine is a necessary action for the nurse to take, but it is not the most appropriate one. The nurse should not give the evening dose of carbamazepine when the morning level is already toxic, as this can increase the risk of complications. However, this action alone is not enough to resolve the issue. The nurse should also notify the prescriber and follow the appropriate interventions.
Correct Answer is C
Explanation
Choice A reason: This is not the laboratory finding that indicates that the medication has been effective. Serum ammonia level of 30 Mcg/dL (17.62 mmol/L) is within the normal range for adults, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate is a cation-exchange resin that binds to potassium in the intestine and removes it from the body through the stool. It does not affect the ammonia levels in the blood, which are influenced by the liver function and the urea cycle. The nurse should monitor the ammonia levels for any changes, but it is not the goal of the medication.
Choice B reason: This is not the laboratory finding that indicates that the medication has been effective. Hemoglobin level of 13.5 g/dL (135 g/L) is within the normal range for females, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate does not affect the hemoglobin levels in the blood, which are determined by the number and size of red blood cells and the oxygen-carrying capacity of the blood. The nurse should monitor the hemoglobin levels for any changes, but it is not the goal of the medication.
Choice C reason: This is the laboratory finding that indicates that the medication has been effective. Serum potassium level of 3.8 mEq/L (3.8 mmol/L) is within the normal range for adults, and it indicates that the medication has lowered the potassium levels in the blood. Sodium polystyrene sulfonate is used to treat hyperkalemia, or high potassium levels, which can occur in AKI due to the impaired renal excretion of potassium. Hyperkalemia can cause cardiac arrhythmias, muscle weakness, and paralysis. The nurse should administer sodium polystyrene sulfonate as prescribed and check the serum potassium levels regularly to ensure that they are within the normal range.
Choice D reason: This is not the laboratory finding that indicates that the medication has been effective. Serum glucose level of 120 mg/dL (6.7 mmol/L) is slightly above the normal range for adults, and it does not reflect the effect of sodium polystyrene sulfonate. Sodium polystyrene sulfonate does not affect the glucose levels in the blood, which are influenced by the carbohydrate metabolism and the insulin secretion and action. The nurse should monitor the glucose levels for any changes, but it is not the goal of the medication.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today