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 D

Explanation

The correct answer is D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

Peak levels measure the highest concentration of the drug in the bloodstream and should be drawn immediately after the IV infusion is completed.
Trough levels measure the lowest concentration of the drug and should be drawn 30 minutes before the next scheduled dose. This helps ensure the drug remains within therapeutic levels and prevents toxicity.

Why the other options are incorrect:

A. One hour after completion of the IV dose and one hour before the next administration – Waiting one hour for the peak level is too long and may lead to an inaccurate measurement.
B. Two hours after completion of the IV dose and two hours before the next administration – Waiting two hours for both peak and trough levels is too late for effective monitoring.
C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration – The sample drawn mid-infusion does not represent peak levels, making this method ineffective.

Key takeaway:

Proper timing of vancomycin peak and trough monitoring ensures therapeutic drug levels while minimizing nephrotoxicity and ototoxicity.

A. Administer a second dose of naloxone. B. Prepare to assist with chest tube insertion. C. Determine Glasgow Coma Scale score. D. Initiate cardiopulmonary resuscitation (CPR). . E. None F. None

Correct Answer is A

Explanation

The patient’s respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and unresponsiveness indicate severe respiratory depression and a life-threatening emergency. Naloxone was administered an hour ago, but its effects typically last 30–90 minutes, and opioid effects may outlast it, especially with long-acting opioids. The priority is to address the immediate threat to life.

A. Administer a second dose of naloxone: Naloxone reverses opioid-induced respiratory depression. Given the recurrence of severe symptoms, a repeat dose is appropriate to counteract potential ongoing opioid effects.
B. Prepare to assist with chest tube insertion: This is irrelevant, as there’s no indication of pneumothorax or other conditions requiring a chest tube.
C. Determine Glasgow Coma Scale score: While assessing neurological status is useful, it’s not the priority when the patient is in acute respiratory failure.
D. Initiate cardiopulmonary resuscitation (CPR): CPR is indicated for cardiac arrest, but the patient has a respiratory rate (albeit critically low) and no mention of absent pulse, so CPR is not yet warranted.

The most appropriate action is to administer a second dose of naloxone to reverse the opioid-induced respiratory depression, followed by close monitoring and supportive care (e.g., oxygen, ventilation support if needed).

Final Answer: A. Administer a second dose of naloxone.

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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 client is receiving intravenous vancomycin, and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times would provide the best determination of these levels?

Correct Answer is D

Explanation

Explanation:

Why the other options are incorrect:

Key takeaway:

The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take?

Correct Answer is A

Explanation

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