The nurse is reviewing the client’s laboratory values. Which serum laboratory value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?
Low-density lipoprotein (LDL).
High-density lipoprotein (HDL).
Prothrombin time (PT).
Creatine phosphokinase (CK).
The Correct Answer is A
Choice A reason:
Low-density lipoprotein (LDL) is often referred to as “bad” cholesterol because high levels can lead to plaque buildup in arteries and result in heart disease and stroke. Atorvastatin is a statin medication that works by reducing the production of cholesterol in the liver, specifically targeting LDL cholesterol. Lowering LDL levels is a primary goal in managing and reducing the risk of coronary artery disease.
Choice B reason:
High-density lipoprotein (HDL) is known as “good” cholesterol because it helps remove other forms of cholesterol from the bloodstream. While atorvastatin can also help increase HDL levels, the primary indicator of its effectiveness in reducing the risk of coronary artery disease is the reduction in LDL levels.
Choice C reason:
Prothrombin time (PT) is a measure of how long it takes blood to clot. It is not directly related to the effectiveness of atorvastatin in managing cholesterol levels or reducing the risk of coronary artery disease. PT is more relevant in the context of anticoagulant therapy.
Choice D reason:
Creatine phosphokinase (CK) is an enzyme found in the heart, brain, and skeletal muscles. Elevated CK levels can indicate muscle damage, which can be a side effect of statin therapy. However, CK levels are not used to measure the effectiveness of atorvastatin in lowering cholesterol or reducing the risk of coronary artery disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Inquiring about perceived anxiety is important because anxiety can contribute to sleep difficulties. However, in the context of a client taking dextroamphetamine-amphetamine, the timing of the medication is more directly related to sleep disturbances. While anxiety should be assessed, it is not the most critical factor in this scenario.
Choice B Reason:
Determining what time the dose is taken is crucial because dextroamphetamine-amphetamine is a stimulant that can interfere with sleep if taken too late in the day. Extended-release formulations are designed to provide a steady release of medication throughout the day, but taking the dose too late can lead to insomnia. Adjusting the timing of the dose can help mitigate sleep disturbances.
Choice C Reason:
Determining daily caffeine intake is relevant because caffeine is a stimulant that can also contribute to sleep difficulties. However, the primary concern in this scenario is the timing of the dextroamphetamine-amphetamine dose. While caffeine intake should be assessed, it is secondary to the medication timing.
Choice D Reason:
Asking about the client’s bedtime routine is important for understanding overall sleep hygiene. Good sleep hygiene practices can help improve sleep quality. However, in this context, the timing of the stimulant medication is more directly related to the reported sleep difficulties. Therefore, while bedtime routine is important, it is not the most critical assessment.
Correct Answer is D
Explanation
Choice A reason:
Requesting a prescription to change the route of administration and use the available heparin is not appropriate. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable on a unit-for-unit basis. They have different pharmacokinetics and dosing requirements. Changing the route without proper guidance can lead to incorrect dosing and potential complications.
Choice B reason:
Calculating and administering the equivalent dose of the available low molecular weight heparin is incorrect. LMWH and UFH have different dosing protocols and are not directly interchangeable. Administering LMWH instead of UFH without proper conversion and guidance can result in inappropriate anticoagulation.
Choice C reason:
Diluting the available heparin in 250 ml of normal saline solution prior to IV administration is not appropriate. The prescription specifies heparin 5000 units IV STAT, which indicates an immediate need for intravenous administration. Diluting and administering it in this manner does not align with the urgency of the order.
Choice D reason:
Advising the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately is the correct action. This ensures that the client receives the prescribed medication in the correct form and dosage as ordered by the healthcare provider. It is crucial to follow the specific instructions for heparin administration to ensure patient safety and effective anticoagulation.
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