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: This is incorrect. Walking directly in front of the client may block their view and increase their risk of falling. The nurse should walk to the side and slightly behind the client to provide support and guidance³.
Choice B reason: This is correct. Walking along the affected left side allows the nurse to assist the client with balance, weight shifting, and foot clearance. The nurse should also encourage the client to use the handrail on their strong side³.
Choice C reason: This is incorrect. Walking directly behind the client may not allow the nurse to see the client's gait pattern or intervene quickly if the client loses balance. The nurse should walk to the side and slightly behind the client to monitor and assist them³.
Choice D reason: This is incorrect. Walking along the unaffected right side may not provide adequate support or protection for the client's affected side. The nurse should walk along the affected left side to help the client with their hemiplegic gait³.
Correct Answer is C
Explanation
Choice A reason: Performing a 12-lead electrocardiogram and calling a rapid response is not the first action that the nurse should take. A 12-lead electrocardiogram is a test that measures the electrical activity of the heart and can help diagnose a heart attack or other cardiac problems. ¹ A rapid response is a team of healthcare professionals that can provide immediate care to a client who is experiencing a life-threatening emergency. ² However, these actions are not the priority for a client who has chest pain while brushing their teeth. The nurse should first assess the client's condition and provide comfort measures before performing any tests or calling for help.
Choice B reason: Withholding the client's medications until the healthcare provider arrives is not the first action that the nurse should take. The client's medications may include drugs that can relieve chest pain, such as nitroglycerin, aspirin, or beta-blockers. ³ These drugs can help dilate the blood vessels, prevent blood clots, or reduce the workload of the heart. ³ The nurse should not withhold these medications, as they may help the client's condition and prevent further complications. The nurse should check the client's medication orders and administer them as prescribed.
Choice C reason: Instructing the client to stop the activity and provide a chair is the first action that the nurse should take. Chest pain is a common symptom of coronary artery disease, which is a condition where the arteries that supply blood to the heart become narrowed or blocked by plaque. ⁴ Chest pain can be triggered by physical or emotional stress, such as brushing the teeth, which can increase the heart rate and blood pressure. ⁵ The nurse should instruct the client to stop the activity and provide a chair, as this can help reduce the stress on the heart and ease the chest pain. The nurse should also monitor the client's vital signs and oxygen saturation, and provide oxygen if needed.
Choice D reason: Calling the healthcare provider immediately about the client's complaint is not the first action that the nurse should take. The healthcare provider may need to be notified about the client's condition, especially if the chest pain is severe, persistent, or accompanied by other symptoms, such as shortness of breath, nausea, or sweating. ⁵ However, the nurse should first assess the client's condition and provide comfort measures before calling the healthcare provider. The nurse should also be prepared to initiate emergency protocols if the chest pain does not improve or worsens.
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