A client taking atorvastatin has an increased serum creatine phosphokinase (CK) level. What should the nurse assess the client for?

Excessive bruising.

Peripheral edema.

Muscle tenderness.

Nausea and vomiting.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Excessive bruising is not a typical side effect of atorvastatin, and it is not linked to increased CK levels. Excessive bruising can be caused by bleeding disorders, anticoagulant therapy, or trauma.

Choice B rationale

Peripheral edema is not a common side effect of atorvastatin, and it is not related to increased CK levels. CK is an enzyme that is released when muscle tissue is damaged. Peripheral edema is more likely to be caused by heart failure, kidney disease, or venous insufficiency.

Choice C rationale

Muscle tenderness is a sign of myopathy, which is a rare but serious adverse effect of atorvastatin. Myopathy is a condition where muscle fibers are damaged and inflamed, leading to muscle weakness and pain. Increased CK levels indicate muscle injury and can be a marker of myopathy. The nurse should monitor the client for muscle symptoms and report them to the prescriber.

Choice D rationale

Nausea and vomiting are common gastrointestinal side effects of atorvastatin, but they are not associated with increased CK levels. Nausea and vomiting can be managed by taking the medication with food or reducing the dose.

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Correct Answer is C

Explanation

Choice A rationale

While salt substitutes can be a good option for some patients with heart failure, they are often high in potassium. Because spironolactone is a potassium-sparing diuretic, using a salt substitute could lead to dangerously high levels of potassium.

Choice B rationale

Protecting your skin before going outside is generally good advice, but it’s not specifically related to the use of spironolactone.

Choice C rationale

Spironolactone is a potassium-sparing diuretic, which means it can cause the body to retain potassium. Therefore, patients taking spironolactone should limit their intake of high- potassium foods to prevent hyperkalemia.

Choice D rationale

While it’s always important to monitor for side effects when taking a new medication, excessive bruising is not a common side effect of spironolactone.

A. Notify the healthcare provider of the carbamazepine level. B. Administer the carbamazepine as prescribed. C. Withhold this dose of the carbamazepine. D. Assess the patient for side effects of carbamazepine.

Correct Answer is A

Explanation

The correct answer is A:

Choice A reason: Notifying the healthcare provider is crucial because the patient’s carbamazepine level is significantly above the therapeutic range, which is 4-12 mcg/mL. A level of 84 mcg/mL indicates a high risk of toxicity, and the healthcare provider must be informed to take appropriate action, which may include adjusting the dose or discontinuing the medication.

Choice B reason: Administering the carbamazepine as prescribed would not be safe without addressing the elevated drug level. Continuing to administer the medication could increase the risk of severe side effects and toxicity due to the already high serum level.

Choice C reason: Withholding the dose may be a necessary immediate action, but it does not address the need for medical intervention to manage the patient’s elevated drug level. Therefore, while withholding the dose might be part of the response, it should follow notifying the healthcare provider.

Choice D reason: Assessing the patient for side effects is important, but it is not the most immediate action required. The priority is to notify the healthcare provider because of the potential for serious toxicity given the high carbamazepine level.

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A client taking atorvastatin has an increased serum creatine phosphokinase (CK) level. What should the nurse assess the client for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.What instructions should the nurse include in the patient’s care plan?

Correct Answer is C

Explanation

Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?

Correct Answer is A

Explanation

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