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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While gaining weight and having pink buccal mucosa can be signs of overall improved health, they are not specific indicators of effective treatment for vitamin B12 deficiency¹².
Choice B reason: Paresthesia (a sensation of tingling, tickling, pricking, or burning of a person's skin) of the hands and feet is a common symptom of vitamin B12 deficiency¹². If the client no longer has this symptom, it could indicate that the treatment for vitamin B12 deficiency has been effective¹².
Choice C reason: Eating more iron-fortified cereals can contribute to overall nutritional health, but it's not directly related to the treatment of vitamin B12 deficiency¹².
Choice D reason: While stopping alcohol consumption can improve overall health, it's not a specific indicator of effective treatment for vitamin B12 deficiency¹²..
Correct Answer is C
Explanation
Choice A reason: Placing the patch on the anterior chest is not the best discharge instruction for this client. Clonidine is a drug that lowers blood pressure by stimulating alpha-2 receptors in the brain. ¹ The patch delivers the drug through the skin and into the bloodstream. ² The patch should be applied to a hairless area on the upper arm or torso, not the chest, to ensure proper absorption and avoid irritation. ³
Choice B reason: Removing the patch if a headache develops is not a good discharge instruction for this client. Headache is a common side effect of clonidine, especially when starting or changing the dose. ² Removing the patch abruptly may cause a rebound increase in blood pressure, which can be dangerous. ³ The client should keep the patch on for 7 days, unless instructed otherwise by the provider, and report any severe or persistent headaches.
Choice C reason: Rotating the application sites and inspecting the skin is the best discharge instruction for this client. Rotating the sites helps prevent skin irritation and allergic reactions from the patch. ³ Inspecting the skin helps detect any signs of infection, inflammation, or rash that may require medical attention. The client should also wash the old site with soap and water after removing the patch. ²
Choice D reason: Monitoring weight on a daily basis is not a necessary discharge instruction for this client. Weight is not a sensitive indicator of the effectiveness or safety of clonidine therapy. Weight may be monitored periodically to assess the client's fluid status and possible signs of heart failure, which clonidine can help prevent. ¹ However, this is not a priority action for the client using the patch.
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