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 D
Explanation
Choice A reason: Lorazepam is a benzodiazepine that is used to treat anxiety, insomnia, and seizures. It is metabolized by the liver and does not have a significant effect on the kidneys. The nurse should monitor the client for signs of sedation, respiratory depression, and dependence.
Choice B reason: Digoxin is a cardiac glycoside that is used to treat heart failure and arrhythmias. It is eliminated by the kidneys and can cause toxicity if the renal function is impaired. The nurse should monitor the client's serum digoxin level, heart rate, and rhythm, and signs of toxicity, such as nausea, vomiting, visual disturbances, and confusion.
Choice C reason: Sucralfate is a mucosal protectant that is used to treat peptic ulcer disease. It forms a protective barrier over the ulcer and does not get absorbed into the bloodstream. It does not affect the kidneys and has few side effects. The nurse should monitor the client's symptoms and advise them to take the medication on an empty stomach.
Choice D reason: Vancomycin is an antibiotic that is used to treat serious infections caused by gram-positive bacteria. It is nephrotoxic and can cause AKI, especially in high doses or prolonged use. The nurse should monitor the client's serum vancomycin level, renal function tests, urine output, and signs of AKI, such as oliguria, edema, and electrolyte imbalances.
Correct Answer is C
Explanation
Choice A reason: Confirming that the daughter is aware of the progressive nature of the disease is not the best response, as it does not address the daughter's misconception about the drug. The nurse should educate the daughter that rivastigmine does not cure or stop the progression of Alzheimer's disease, but only slows down the cognitive decline.
Choice B reason: Affirming the decision to use the medication when the symptoms start to worsen is not appropriate, as it contradicts the evidence-based practice. The nurse should inform the daughter that rivastigmine is most effective when used in the early stages of Alzheimer's disease, as it can delay the need for institutionalization and improve the quality of life.
Choice C reason: Explaining that the drug should be used early in the course of the disease process is the best response, as it corrects the daughter's misunderstanding and provides accurate information. The nurse should explain that rivastigmine works by inhibiting the enzyme that breaks down acetylcholine, a neurotransmitter that is involved in memory and learning. By increasing the level of acetylcholine in the brain, rivastigmine can improve the cognitive function and behavior of the client.
Choice D reason: Assessing the client's current mental status before deciding to support the decision is not relevant, as it does not address the daughter's concern or the rationale for the drug. The nurse should already have the client's baseline mental status from the initial assessment and diagnosis. The nurse should focus on educating the daughter about the benefits and risks of rivastigmine and encouraging her to follow the prescribed regimen.
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