A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?
Muscle tenderness.
Nausea and vomiting.
Excessive bruising.
Peripheral edema.
The Correct Answer is A
Choice A reason: Muscle tenderness is a sign of myopathy, a rare but serious adverse effect of atorvastatin and other statins. Myopathy is characterized by muscle weakness, pain, and elevated CK levels. CK is an enzyme that is released when muscle tissue is damaged. The nurse should monitor the client for muscle tenderness and report any changes to the prescriber.
Choice B reason: Nausea and vomiting are common side effects of atorvastatin, but they are not related to CK levels. The nurse should advise the client to take the medication with food and fluids to minimize gastrointestinal discomfort.
Choice C reason: Excessive bruising is not a typical side effect of atorvastatin, nor is it associated with CK levels. The nurse should assess the client for other possible causes of bleeding, such as coagulation disorders, trauma, or drug interactions.
Choice D reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to CK levels. The nurse should assess the client for other signs of fluid retention, such as weight gain, shortness of breath, or jugular venous distension. The nurse should also check the client's blood pressure and heart rate, as peripheral edema may indicate heart failure or hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not a correct instruction for the nurse to provide to the client. Stopping the oral contraceptive immediately is not necessary, as it may cause irregular bleeding, hormonal imbalance, or unwanted pregnancy. The client should continue taking the oral contraceptive as prescribed, but use an additional form of contraception, such as condoms or spermicides, while taking erythromycin.
Choice B reason: This is not a correct instruction for the nurse to provide to the client. Avoiding prolonged exposure to direct sunlight is not related to the interaction between oral contraceptive and erythromycin. This instruction may be relevant for other antibiotics, such as tetracyclines or sulfonamides, that can cause photosensitivity and increase the risk of sunburn. The client should protect the skin from sun exposure as part of general health promotion, but it is not specific to erythromycin therapy.
Choice C reason: This is not a correct instruction for the nurse to provide to the client. Taking the medications at least 12 hours apart is not sufficient to prevent the interaction between oral contraceptive and erythromycin. Erythromycin is a macrolide antibiotic that can reduce the effectiveness of oral contraceptive by increasing its metabolism and clearance. The client should take the medications as prescribed, but use an additional form of contraception, such as condoms or spermicides, while taking erythromycin.
Choice D reason: This is the correct instruction for the nurse to provide to the client. Using an additional form of contraception is the best way to prevent pregnancy while taking erythromycin and oral contraceptive. Erythromycin can decrease the efficacy of oral contraceptive by increasing its metabolism and clearance. The client should use a barrier method or a spermicide, in addition to the oral contraceptive, while taking erythromycin and for at least one week after finishing the antibiotic course.
Correct Answer is D
Explanation
Choice A reason: This is not the most important laboratory value for the nurse to review. Glucose is a measure of blood sugar levels, and it may be affected by various factors, such as diet, medication, stress, or infection. However, glucose is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the glucose levels for any changes, but it is not the priority.
Choice B reason: This is not the most important laboratory value for the nurse to review. Total protein is a measure of the amount of protein in the blood, and it may reflect the nutritional status, liver function, or kidney function of the client. However, total protein is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the total protein levels for any changes, but it is not the priority.
Choice C reason: This is not the most important laboratory value for the nurse to review. Sodium is a measure of the electrolyte balance in the blood, and it may be affected by fluid intake, fluid loss, or hormonal regulation. However, sodium is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the sodium levels for any changes, but it is not the priority.
Choice D reason: This is the most important laboratory value for the nurse to review. Hemoglobin is a measure of the oxygen-carrying capacity of the blood, and it may indicate the presence of anemia, which is a common adverse effect of diclofenac. Diclofenac can cause gastrointestinal bleeding, which can lead to a decrease in hemoglobin and hematocrit levels. The client's appearance and fatigue may be signs of anemia, which can impair the tissue oxygenation and worsen the client's condition. The nurse should review the hemoglobin levels and report any abnormal findings to the healthcare provider. The nurse should also assess the client for other signs of bleeding, such as melena, hematemesis, or hematuria.
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