A nurse is monitoring a patient who is receiving atorvastatin.
The nurse knows which lab value will reveal that the medication is working?
A decrease in HDL levels.
A decrease in LDL levels.
An increase in total cholesterol.
An increase in triglycerides.
The Correct Answer is B
This question assesses the monitoring of HMG-CoA reductase inhibitors. It requires understanding the pharmacological goal of atorvastatin therapy, which is the reduction of atherogenic lipids in the blood to prevent long-term cardiovascular events and stabilize atherosclerotic plaques in patients at high risk.
Choice A rationale
High-density lipoprotein (HDL) is "good" cholesterol, with a normal range ≥ 40 mg/dL for men and ≥ 50 mg/dL for women. Atorvastatin therapy aims to increase or maintain HDL, so a decrease would indicate a non-therapeutic or adverse treatment outcome.
Choice B rationale
Low-density lipoprotein (LDL) is the primary target of atorvastatin. A therapeutic response is evidenced by a decrease in LDL levels, which should ideally be ≤ 100 mg/dL in high-risk patients, as LDL is directly linked to the development of atherosclerosis.
Choice C rationale
Total cholesterol, normal range ≤ 200 mg/dL, is a measure of various lipoproteins. Atorvastatin therapy is intended to lower total cholesterol. An increase in total cholesterol would suggest that the current dosage is ineffective at achieving the desired therapeutic lipid goals.
Choice D rationale
Triglycerides, normal range ≤ 150 mg/dL, are another component of the lipid panel. While some statins have a modest effect on triglycerides, the primary goal of atorvastatin is LDL reduction, and an increase would not indicate a positive therapeutic effect for the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This question focuses on pharmacokinetics and therapeutic drug monitoring. It requires identifying the timing for trough level blood draws, which are essential to ensure the drug concentration remains within the therapeutic range without reaching toxic levels, particularly with narrow-therapeutic-index drugs like gentamicin.
Choice A rationale
Drawing blood 30 minutes after the infusion is complete would measure the peak concentration of the medication. This does not provide information about the lowest drug levels occurring at the end of the dosing interval, which is necessary for trough assessment.
Choice B rationale
The trough level represents the lowest concentration of a drug in the patient's serum, which occurs immediately before the administration of the next dose. Drawing the blood at this time is required to ensure the medication stays within the safe therapeutic range.
Choice C rationale
Drawing blood 30 minutes before stopping the infusion would occur while the medication is still being actively administered. This would result in an inaccurate, elevated serum concentration reading that does not reflect the patient's true trough level for the drug.
Choice D rationale
Drawing the level 1 hour after the infusion is complete would measure a concentration that is still decreasing toward the trough level. This does not provide the required data at the actual minimum concentration point reached before the next scheduled dose.
Correct Answer is C
Explanation
This question assesses knowledge of drug contraindications. It requires identifying the liver as the primary site of acetaminophen metabolism and recognizing that in patients with severe hepatic impairment, the risk of hepatotoxicity is drastically increased, necessitating an alternative analgesic to ensure patient safety and prevent failure.
Choice A rationale
Acetaminophen is a safe and effective antipyretic for patients with high fever. A fever of 103.4 degrees F is not a contraindication for acetaminophen, as it is standard practice to use this medication to reduce febrile responses in hospitalized patients.
Choice B rationale
Acetaminophen is an effective analgesic for postoperative pain and does not have the adverse gastrointestinal or coagulation side effects associated with NSAIDs. It is typically a safe and appropriate choice for pain management in patients recovering from abdominal surgical procedures.
Choice C rationale
Acetaminophen is metabolized in the liver. In severe hepatitis, hepatic function is critically impaired, significantly increasing the risk of toxic metabolite accumulation. Therefore, acetaminophen is contraindicated, and an alternative analgesic must be selected to prevent further liver damage in the patient.
Choice D rationale
Acetaminophen does not inhibit platelet aggregation or affect the coagulation cascade. It is an appropriate analgesic choice for patients with deep vein thrombosis, as it does not interfere with their anticoagulant therapy or pose a risk of bleeding complications.
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