A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory values indicates the treatment has been effective?

Decreased HDL levels

Increased serum transaminase levels

Decreased LDL levels

Increased creatine kinase levels

Answer and Explanation

The Correct Answer is C

Atorvastatin is an HMG-CoA reductase inhibitor that lowers cholesterol by blocking the rate-limiting step of hepatic cholesterol synthesis. Its primary therapeutic goal is the reduction of atherogenic lipoproteins to prevent cardiovascular disease and stroke. Effective therapy is measured by a significant improvement in the lipid profile, specifically targeting the reduction of low-density lipoproteins (LDL).

Rationale:

A. Decreased HDL levels would indicate a worsening of the patient's cardiovascular risk profile rather than effective treatment. High-density lipoprotein (HDL) is considered "good" cholesterol because it helps remove other forms of cholesterol from the bloodstream. A successful response to statin therapy would involve maintaining or slightly increasing HDL levels to provide better cardioprotective benefits.

B. Increased serum transaminase levels are an adverse effect of atorvastatin indicating potential hepatotoxicity, not therapeutic effectiveness. Statins are metabolized by the liver and can occasionally cause inflammation or damage to hepatocytes. If these enzymes (AST and ALT) rise significantly, the nurse must report this finding as it may necessitate the discontinuation of the medication.

C. Decreased LDL levels are the hallmark indicator of effective atorvastatin therapy. Low-density lipoprotein is the primary target for statins because it contributes to plaque buildup in the arteries, leading to atherosclerosis. A significant reduction in LDL proves that the HMG-CoA reductase inhibitor is successfully lowering the production of harmful cholesterol and reducing overall cardiovascular risk.

D. Increased creatine kinase (CK) levels are a laboratory marker for muscle damage and a sign of a serious adverse effect called rhabdomyolysis. This condition involves the breakdown of skeletal muscle fibers, which can lead to acute renal failure. Elevated CK levels are a reason for concern and immediate clinical intervention, not a sign that the cholesterol-lowering treatment is working.

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Correct Answer is A

Explanation

Total parenteral nutritionis a complex hypertonic solution containing essential nutrients delivered via a central venous accessdevice. It bypasses the gastrointestinal tract to provide complete metabolic support for patients with severe malabsorption or bowel failure.

Rationale:

A.Daily weights are essential for monitoring fluid volume status and the effectiveness of nutritional support in patients receiving home total parenteral nutrition. Rapid weight gain exceeding 1 kg per day may indicate fluid retention or heart failure, while weight loss suggests inadequate caloric intake. Consistent recording allows the healthcare team to adjust the macronutrient composition to meet the client's metabolic demands safely.

B.Speeding up the infusion rate to compensate for a delay is strictly contraindicated as it can cause severe hyperglycemia or hyperosmolar hyperglycemic state. The high glucose concentration in TPN requires a steady infusion rate to allow the pancreas to secret adequate insulin. If an infusion falls behind, the nurse must instruct the client to maintain the prescribed rate and notify the provider rather than "catching up."

C.A single container of total parenteral nutrition must not infuse for more than 24 hr to prevent the growth of bacteria and fungi. The high concentration of dextrose and lipids provides an ideal medium for microbial proliferation, significantly increasing the risk of central line-associated bloodstream infections. Bags and tubing must be discarded and replaced daily using strict aseptic technique to maintain the safety of the infusion.

D.Central line dressings typically do not require changes every 24 hr unless they become damp, loose, or visibly soiled. Standard protocols usually recommend changing transparent semipermeable dressings every 7 days or gauze dressings every 48 hr to minimize the risk of introducing pathogens into the insertion site. Frequent, unnecessary dressing changes can irritate the skin and increase the potential for accidental catheter dislodgement.

A. Decreased blood pressure B. Increased appetite C. Tremors D. Muscle weakness

Correct Answer is C

Explanation

Albuterol is a short-acting beta-2 agonist(SABA) that induces bronchodilationby relaxing smooth muscle in the airway. While it primarily targets pulmonary receptors, it can also stimulate beta-1 receptorsin the heart and beta-2 receptors in skeletal muscle. This systemic stimulation results in cardiovascular and neuromuscular side effects that clients must be able to identify.

Rationale:

A.Albuterol is more likely to cause an increase in blood pressure and heart rate rather than a decrease, due to its sympathomimetic properties. Stimulation of the adrenergic system increases cardiac output and peripheral resistance. Therefore, instructing the client to watch for hypotension would be clinically inaccurate and could lead to a failure to recognize relevant cardiovascular side effects.

B.Increased appetite is not a recognized adverse effect of albuterol nebulization. The medication acts as a stimulant, which typically has a neutral or mildly suppressive effect on appetite rather than an inductive one. The nurse should focus education on cardiovascular and neurological symptoms that are direct consequences of the medication’s action on the sympathetic nervous system.

C.Tremors are a classic adverse effect of albuterol because the drug stimulates beta-2 receptors in the skeletal muscles, causing fine muscle contractions. This is particularly common after nebulized treatments where a higher systemic dose may be absorbed. The nurse should reassure the client that this effect is common but should be reported if it becomes severe or interferes with daily activities.

D.Muscle weakness is not an expected side effect of albuterol; instead, muscle excitability or cramping is more common. While albuterol can cause a temporary shift of potassium into cells (hypokalemia), which can lead to weakness, it is not the primary side effect clients should observe for. Tremors are a far more frequent and immediate neuromuscular response to beta-agonist therapy.

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A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory values indicates the treatment has been effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who will receive total parenteral nutrition (TPN) at home. Which of the following information should the nurse include?

Correct Answer is A

Explanation

A nurse is caring for a client who has received an albuterol nebulization treatment. Which of the following findings should the nurse instruct the client to observe as an adverse effect of this medication?

Correct Answer is C

Explanation

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