# A 60-year-old client newly prescribed atorvastatin 40 mg orally once daily for hyperlipidemia is being given discharge teaching. Which statement by the client indicates the teaching has been effective?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374917&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A 60-year-old client newly prescribed atorvastatin 40 mg orally once daily for hyperlipidemia is being given discharge teaching. Which statement by the client indicates the teaching has been effective?

## Option

1. "I will report any new muscle pain, weakness, tenderness, or dark urine to the provider promptly, and I understand the lab will check my liver enzymes periodically." **✔ Correct answer**
2. "I understand that grapefruit juice is a healthy beverage, so I'll continue drinking it each morning with my atorvastatin since it fits my diet and I enjoy it."
3. "Since I've heard that moderate alcohol can improve HDL levels, I'll start having a daily glass of red wine to complement my atorvastatin treatment and protect my heart."
4. "When my follow-up labs show that my LDL cholesterol has returned to normal, I'll discontinue the atorvastatin on my own since the medication will have done its job."

**Correct answer: 1**

## Explanation

Statin teaching priorities
HMG-CoA reductase inhibitors (-statins) lower LDL by inhibiting hepatic cholesterol synthesis and have proven CV mortality reduction. Three patient-safety priorities: muscle symptom monitoring (myalgia is the most common adverse effect; new pain·weakness·tenderness·dark urine could indicate rhabdomyolysis — report immediately), hepatotoxicity monitoring (baseline LFT and as clinically indicated; report jaundice·RUQ pain·anorexia·dark urine), and drug/food interaction awareness — atorvastatin·simvastatin·lovastatin are CYP3A4 substrates with significant grapefruit interaction raising the risk of myopathy. Statins should also be continued lifelong unless adverse effect or alternative therapy is indicated; self-discontinuation reverses CV benefit. Alcohol increases hepatotoxicity risk and is not therapeutic. Atorvastatin and rosuvastatin can be taken any time of day; short-acting simvastatin/lovastatin are taken in the evening.

## In-depth explanation

Clinical reasoning summary
Statin teaching priorities
HMG-CoA reductase inhibitors (-statins) lower LDL by inhibiting hepatic cholesterol synthesis and have proven CV mortality reduction. Three patient-safety priorities: muscle symptom monitoring (myalgia is the most common adverse effect; new pain·weakness·tenderness·dark urine could indicate rhabdomyolysis — report immediately), hepatotoxicity monitoring (baseline LFT and as clinically indicated; report jaundice·RUQ pain·anorexia·dark urine), and drug/food interaction awareness — atorvastatin·simvastatin·lovastatin are CYP3A4 substrates with significant grapefruit interaction raising the risk of myopathy. Statins should also be continued lifelong unless adverse effect or alternative therapy is indicated; self-discontinuation reverses CV benefit. Alcohol increases hepatotoxicity risk and is not therapeutic. Atorvastatin and rosuvastatin can be taken any time of day; short-acting simvastatin/lovastatin are taken in the evening.

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