A nurse is assessing a client who has been taking simvastatin to treat hyperlipidemia. Which statement made by the client describes an adverse effect of the medication that should be reported to the provider immediately?
"I've had gas pains for the last day."
"I've had a headache for a couple of days."
"I have occasional constipation."
"My legs feel weak, and I get pain in my calves."
The Correct Answer is D
Choice A Reason:
Gas pains, while uncomfortable, are not typically a serious adverse effect of simvastatin and do not usually require immediate medical attention unless they are severe or persistent.
Choice B Reason:
Headaches are a common side effect of many medications, including simvastatin, and are not generally considered an emergency. However, if the headache is severe, persistent, or accompanied by other symptoms, it should be reported to a healthcare provider.
Choice C Reason:
Occasional constipation is another common side effect and is not usually a cause for immediate concern unless it becomes severe or chronic.
Choice D Reason:
Muscle weakness and pain, especially in the calves, can be a sign of a serious condition called rhabdomyolysis, which is a rare but serious adverse effect of statins like simvastatin. This condition involves the breakdown of muscle tissue and can lead to kidney damage. It should be reported to a healthcare provider immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Asking the client to share the joke may imply that the nurse believes the client is laughing at a joke, which may not be the case. It's important to recognize that uncontrollable laughter can be a symptom of schizophrenia and not necessarily a response to humor.
Choice B Reason:
This response is open-ended and nonjudgmental, inviting the client to explain their behavior without making assumptions. It allows the client to share their experience, which could be related to an internal stimulus such as a hallucination or simply a response they cannot control.
Choice C Reason:
Asking "Why are you laughing?" could be perceived as confrontational or accusatory. It might make the client feel defensive or misunderstood, especially if the laughter is a symptom of their condition and not something they are doing voluntarily.
Choice D Reason:
Saying "I don't think I said anything funny" focuses on the nurse's perspective rather than the client's experience. It could inadvertently dismiss the client's behavior as inappropriate or unjustified, which is not supportive in a therapeutic relationship.
Correct Answer is A
Explanation
Choice A Reason:
Switching to heparin is not the standard response for a high INR. Heparin may be used in conjunction with warfarin when starting anticoagulation therapy, but it is not typically used as a substitute in response to an elevated INR.
Choice B Reason:
Giving the dose as prescribed would not be appropriate when the INR is significantly above the therapeutic range. Continuing the same dose could increase the risk of bleeding complications.
Choice C Reason:
Increasing the dose would be contraindicated as the INR is already too high. Increasing the warfarin dose would further elevate the INR and increase the risk of bleeding.
Choice D Reason:
Holding the dose is the correct action when the INR is significantly above the therapeutic range, which is generally between 2.0 to 3.0 for most indications. The healthcare provider should be notified, and the warfarin dose should be held until the INR returns to the therapeutic range. Vitamin K may also be administered to help lower the INR more quickly if necessary.
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