Which data indicates to the nurse that the client's current dose of simvastatin has been effective?

Total cholesterol 198 mg/dL

Blood pressure 132/80

Serum triglycerides 172 mg/dL

Low density lipoprotein (LDL) 90 mg/dL

Answer and Explanation

The Correct Answer is D

Choice A reason: Total cholesterol is not the best indicator of the effectiveness of simvastatin, a drug that lowers cholesterol levels and reduces the risk of cardiovascular disease. ¹ Total cholesterol includes both LDL and HDL (high density lipoprotein), which have opposite effects on the heart and blood vessels. ² The normal range of total cholesterol for adults is less than 200 mg/dL, but this does not reflect the balance between LDL and HDL.

Choice B reason: Blood pressure is not directly related to the effectiveness of simvastatin, although high blood pressure and high cholesterol are both risk factors for cardiovascular disease. ³ Simvastatin does not lower blood pressure, but it may prevent or slow down the development of atherosclerosis, which is the narrowing and hardening of the arteries due to plaque buildup. ¹ The normal range of blood pressure for adults is less than 120/80 mmHg.

Choice C reason: Serum triglycerides are another type of fat in the blood that can contribute to cardiovascular disease. ² Simvastatin can lower triglyceride levels, but this is not its main effect. ¹ The normal range of serum triglycerides for adults is less than 150 mg/dL.

Choice D reason: LDL is the main target of simvastatin therapy, as it is the "bad" cholesterol that can cause plaque buildup and damage the arteries. ¹ Simvastatin works by inhibiting an enzyme that produces LDL in the liver. The optimal level of LDL for adults is less than 100 mg/dL, and even lower for those with high risk of cardiovascular disease. ² A LDL level of 90 mg/dL indicates that the client's current dose of simvastatin has been effective.

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Correct Answer is C

Explanation

Choice A reason: The second intercostal space, right of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, right of sternum, is the location where the aortic valve can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice B reason: The third intercostal space, left of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The third intercostal space, left of sternum, is the location where the pulmonary valve, which separates the right ventricle and the pulmonary artery, can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice C reason: The second intercostal space, left of sternum, is the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, left of sternum, is the location where the aortic murmur will be most audible, as it is the closest to the aorta, the largest artery in the body. ³

Choice D reason: The fourth intercostal space, left mid-clavicular line, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The fourth intercostal space, left mid-clavicular line, is the location where the tricuspid valve, which separates the right atrium and the right ventricle, can be best heard, but not the location where the aortic murmur will be most audible. ³

A. Fried chicken, baked beans, French fries, and cake B. Tomato soup, fried flounder, white rice, and a grapefruit C. Barbecue pulled pork sandwich, fresh green beans, mashed potatoes, and ice cream D. Baked tuna, fresh broccoli, brown rice, and fresh cantaloupe

Correct Answer is D

Explanation

Choice A reason: This is a high-fat, high-sodium, and high-calorie meal that is not suitable for a client with hypertension. Fried foods, processed meats, and baked beans are sources of saturated fat and sodium that can raise blood pressure and cholesterol levels. Cake is a source of added sugar that can contribute to obesity and diabetes.

Choice B reason: This is a moderate-fat, moderate-sodium, and moderate-calorie meal that is not ideal for a client with hypertension. Fried flounder and tomato soup are sources of fat and sodium that can increase blood pressure. White rice is a refined carbohydrate that can spike blood sugar levels and increase the risk of diabetes.

Choice C reason: This is a high-fat, high-sodium, and high-calorie meal that is not appropriate for a client with hypertension. Barbecue pulled pork sandwich, mashed potatoes, and ice cream are sources of saturated fat and sodium that can elevate blood pressure and cholesterol levels. Fresh green beans are the only healthy component of this meal.

Choice D reason: This is a low-fat, low-sodium, and low-calorie meal that is suitable for a client with hypertension. Baked tuna, fresh broccoli, brown rice, and fresh cantaloupe are sources of lean protein, fiber, complex carbohydrates, vitamins, minerals, and antioxidants that can lower blood pressure and cholesterol levels, prevent obesity and diabetes, and promote cardiovascular health.

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Which data indicates to the nurse that the client's current dose of simvastatin has been effective?

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Naxlex Comprehensive Predictor Exams

The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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