A patient who has recently started taking simvastatin (Zocor) reports several symptoms to the nurse. Which assessment finding is most important to communicate to the health care provider?

Decrease in LDL cholesterol from last visit.

Generalized muscle aches.

Nausea when taking the medication on an empty stomach

Clear, light yellow urine output

Answer and Explanation

The Correct Answer is B

A. A decrease in LDL cholesterol is a desired effect of simvastatin and does not indicate a problem.

B. Generalized muscle aches are a significant concern for patients on statin medications, such as simvastatin. This can be indicative of a serious side effect called rhabdomyolysis, a condition where muscle tissue breaks down and can lead to kidney damage. This should be communicated to the healthcare provider immediately for further evaluation and possible discontinuation of the medication.

C. Nausea when taking the medication on an empty stomach is a common side effect and may be addressed with guidance on when to take the medication.

D. Clear, light yellow urine is normal and does not require further action.

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Correct Answer is C

Explanation

A. Bilateral lower extremity reddening when legs are dangled could be seen in other conditions like deep vein thrombosis (DVT) but is not typical of CVI.

B. Shiny white skin with "hole-punch" ulcers is more characteristic of arterial insufficiency rather than venous insufficiency.

C. Chronic venous insufficiency (CVI) is characterized by impaired venous return, which leads to fluid buildup, skin changes, and ulcer formation. The skin becomes leathery and brown due to hemosiderin deposition from blood pooling in the lower extremities. Ulcers often occur around the ankles and have irregular borders.

D. Red, swollen, tender areas in one calf are more indicative of DVT, not chronic venous insufficiency.

A. Avoid straining or blowing your nose forcefully. B. Brush your teeth vigorously to avoid gum infections. C. if a dose of the medication is missed, double the dose at the next scheduled time D. Rotate injection sites when on this medication

Correct Answer is A

Explanation

A. Warfarin is an anticoagulant, which increases the risk of bleeding. Activities like straining or forceful nose blowing can increase the risk of bleeding, particularly nasal or internal bleeding, so the nurse should advise the client to avoid these actions.

B. Brushing teeth vigorously is not recommended with warfarin because it can lead to bleeding gums. The nurse should suggest using a soft toothbrush and brushing gently.

C. If a dose of warfarin is missed, the client should not double the dose. They should take the missed dose as soon as they remember, unless it's close to the time for the next dose, in which case they should skip the missed dose and resume the normal dosing schedule.

D. Warfarin is an oral medication, so rotating injection sites is not applicable. This advice is more relevant for injectable medications like insulin or heparin.

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A patient who has recently started taking simvastatin (Zocor) reports several symptoms to the nurse. Which assessment finding is most important to communicate to the health care provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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