Simvastatin has been prescribed for a patient, and the nurse is providing instructions to the patient about the medication. Which instructions will the nurse include? (Select all that apply)
Reduce servings of raw vegetables and fruit.
Drug interactions are rare with antilipemic agents.
Report the occurrence of muscle pain immediately.
Report abnormal or unusual bleeding or yellow discoloration of the skin.
Limit fluid intake to prevent fluid overload.
Correct Answer : C,D
Choice A reason: Reducing raw vegetables and fruit is not necessary with simvastatin. Dietary vitamin K may affect warfarin, but statins are unaffected by fruits or vegetables, except grapefruit, which inhibits CYP3A4, increasing simvastatin levels. A balanced diet supports cardiovascular health, making this instruction incorrect.
Choice B reason: Drug interactions are not rare with simvastatin, a statin metabolized by CYP3A4. Inhibitors like grapefruit juice or antifungals increase simvastatin levels, risking toxicity, while inducers reduce efficacy. Patients must be educated about potential interactions, making this statement incorrect and misleading for safe statin use.
Choice C reason: Reporting muscle pain immediately is critical with simvastatin, as it may indicate myopathy or rare rhabdomyolysis. Statins disrupt muscle cell membranes, causing pain or weakness. Early reporting allows monitoring of creatine kinase levels and prevents progression to severe muscle damage, ensuring patient safety.
Choice D reason: Reporting bleeding or yellow skin (jaundice) is essential, as simvastatin can cause hepatotoxicity, elevating liver enzymes, or rare bleeding due to drug interactions. Jaundice indicates liver dysfunction, and bleeding may result from interactions with anticoagulants, necessitating prompt reporting to adjust therapy or monitor liver function.
Choice E reason: Limiting fluid intake is not required with simvastatin. Fluid overload is unrelated to statins, which affect cholesterol synthesis, not fluid balance. Adequate hydration supports general health, and no evidence suggests fluid restriction is necessary, making this instruction irrelevant and potentially harmful.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Delayed growth development is not a primary adverse effect of tetracycline in children. Tetracyclines inhibit protein synthesis and may affect bone growth minimally, but this is not well-documented. Their primary concern in children under 8 is tooth discoloration, making this incorrect.
Choice B reason: Tetracycline use in children under 8 causes permanent tooth discoloration by binding to calcium in developing teeth, forming a yellow-gray stain. This occurs during tooth enamel formation, making it a significant adverse effect, as the discoloration is irreversible, requiring cosmetic dental intervention.
Choice C reason: Drug-induced neurotoxicity is not a common effect of tetracycline. While tetracyclines can cause rare side effects like intracranial hypertension, neurotoxicity is more associated with drugs like aminoglycosides. Tooth discoloration is the primary concern in children, making this an incorrect choice.
Choice D reason: Gastrointestinal and rectal bleeding are not typical tetracycline side effects. Tetracyclines may cause gastrointestinal upset, like nausea, but bleeding is more associated with anticoagulants or NSAIDs. In children, tooth discoloration is the most significant adverse effect, making this choice incorrect.
Correct Answer is C
Explanation
Choice A reason: Drowsiness is not a common adverse effect of chloroquine, an antimalarial drug. Chloroquine inhibits heme polymerization in Plasmodium, with side effects like visual disturbances or dizziness. Drowsiness is more associated with antihistamines or CNS depressants, not chloroquine’s mechanism or pharmacokinetic profile.
Choice B reason: Constipation is not a typical side effect of chloroquine. Its primary adverse effects include gastrointestinal upset, visual toxicity, or neurological symptoms like dizziness. Chloroquine’s action on parasitic metabolism does not significantly affect gastrointestinal motility, making constipation an unlikely reaction to report.
Choice C reason: Dizziness is a known adverse effect of chloroquine, potentially due to its effects on the central nervous system or ototoxicity. Patients should report dizziness, as it may indicate toxicity or neurological involvement, requiring dose adjustment or monitoring to ensure safe antimalarial or anti-inflammatory therapy.
Choice D reason: Insomnia is not a primary adverse effect of chloroquine. While neurological effects like headache or dizziness may occur, insomnia is less common. Chloroquine’s toxicity profile focuses on visual, cardiac, or neurological symptoms, and insomnia is not typically reported, making this less critical to monitor.
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