Which data indicates to the nurse that the client's current dose of simvastatin has been effective?
Total cholesterol 198 mg/dL
Blood pressure 132/80
Serum triglycerides 172 mg/dL
Low density lipoprotein (LDL) 90 mg/dL
The Correct Answer is D
Choice A reason: Total cholesterol is not the best indicator of the effectiveness of simvastatin, a drug that lowers cholesterol levels and reduces the risk of cardiovascular disease. ¹ Total cholesterol includes both LDL and HDL (high density lipoprotein), which have opposite effects on the heart and blood vessels. ² The normal range of total cholesterol for adults is less than 200 mg/dL, but this does not reflect the balance between LDL and HDL.
Choice B reason: Blood pressure is not directly related to the effectiveness of simvastatin, although high blood pressure and high cholesterol are both risk factors for cardiovascular disease. ³ Simvastatin does not lower blood pressure, but it may prevent or slow down the development of atherosclerosis, which is the narrowing and hardening of the arteries due to plaque buildup. ¹ The normal range of blood pressure for adults is less than 120/80 mmHg.
Choice C reason: Serum triglycerides are another type of fat in the blood that can contribute to cardiovascular disease. ² Simvastatin can lower triglyceride levels, but this is not its main effect. ¹ The normal range of serum triglycerides for adults is less than 150 mg/dL.
Choice D reason: LDL is the main target of simvastatin therapy, as it is the "bad" cholesterol that can cause plaque buildup and damage the arteries. ¹ Simvastatin works by inhibiting an enzyme that produces LDL in the liver. The optimal level of LDL for adults is less than 100 mg/dL, and even lower for those with high risk of cardiovascular disease. ² A LDL level of 90 mg/dL indicates that the client's current dose of simvastatin has been effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Performing daily weights is the best method to evaluate the client's response to furosemide, a drug that reduces fluid retention and swelling by increasing the urine output. ¹ Daily weights can help monitor the changes in the client's fluid status and the effectiveness of the drug. The nurse should weigh the client at the same time each day, using the same scale and clothing.
Choice B reason: Taking the blood pressure is not the best method to evaluate the client's response to furosemide. Furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ However, blood pressure can be influenced by many other factors, such as heart rate, stress, or medications. Blood pressure is not a reliable indicator of the client's fluid status or the effectiveness of the drug.
Choice C reason: Auscultating breath sounds is not the best method to evaluate the client's response to furosemide. Furosemide can help improve the breath sounds by reducing the fluid accumulation in the lungs, which can cause shortness of breath or crackles. ¹ However, breath sounds can also be affected by other factors, such as lung infections, asthma, or allergies. Breath sounds are not a reliable indicator of the client's fluid status or the effectiveness of the drug.
Choice D reason: Measuring urinary output is not the best method to evaluate the client's response to furosemide. Furosemide can increase the urinary output by stimulating the kidneys to excrete more water and electrolytes. ¹ However, urinary output can also vary depending on the fluid intake, kidney function, or other medications. Urinary output is not a reliable indicator of the client's fluid status or the effectiveness of the drug.
Correct Answer is B
Explanation
Choice A reason: Increasing the SA to AV node conduction time is not the goal of using diltiazem for variant angina. Diltiazem is a calcium channel blocker that slows down the conduction of electrical impulses in the heart, but this is not the main mechanism of action for relieving variant angina. Variant angina is caused by spasms of the coronary arteries that reduce blood flow to the heart muscle.
Choice B reason: This is the correct answer. Decreasing coronary artery spasm is the goal of using diltiazem for variant angina. Diltiazem relaxes the smooth muscle of the coronary arteries and prevents them from contracting. This improves the blood supply to the heart and reduces the pain and ischemia associated with variant angina.
Choice C reason: Diltiazem does not cause hyperexcitability in the myocardium. This is a false statement. Diltiazem has the opposite effect of reducing the contractility and excitability of the heart muscle. This lowers the oxygen demand of the heart and helps prevent anginal attacks.
Choice D reason: Increasing the heart rate is not the goal of using diltiazem for variant angina. Diltiazem actually decreases the heart rate by blocking the calcium channels in the sinoatrial node and the atrioventricular node. This reduces the workload of the heart and the oxygen consumption. A high heart rate can worsen angina by increasing the oxygen demand of the heart.
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