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.

Answer and Explanation

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.

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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.

A. Provide the client a heating pad to place on the neck. B. Obtain a prescription for physical therapy services. C. Give a PRN prescription for benztropine. D. Obtain an extra pillow for the client to use at night.

Correct Answer is C

Explanation

Choice A reason: Providing a heating pad to the client may provide some temporary relief, but it does not address the underlying cause of the neck discomfort, which is likely due to extrapyramidal side effects (EPS) of the antipsychotic medication.

Choice B reason: Obtaining a prescription for physical therapy services may be beneficial for the client's overall health and well-being, but it is not the best intervention for the acute problem of neck discomfort. Physical therapy may also require a referral and a waiting period, which would delay the relief for the client.

Choice C reason: Giving a PRN prescription for benztropine is the best intervention for the nurse to implement, as benztropine is an anticholinergic medication that can counteract the EPS of the antipsychotic medication. Benztropine can reduce the muscle stiffness and spasms that cause the neck discomfort.

Choice D reason: Obtaining an extra pillow for the client to use at night may help the client sleep better, but it does not address the neck discomfort during the day. It also does not treat the EPS of the antipsychotic medication, which may worsen over time.

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A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?

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