A nurse is teaching a female client who is to start taking atorvastatin. Which of the following baseline examinations should the nurse include?

Choice A reason: Atorvastatin, a statin, inhibits HMG-CoA reductase, reducing cholesterol synthesis in the liver. It can elevate liver enzymes (ALT, AST), indicating hepatotoxicity. Baseline liver function tests are essential to assess hepatic health before starting therapy, ensuring no pre-existing liver damage and monitoring for drug-induced liver injury during treatment. Choice B reason: Thyroid function tests assess thyroid hormone levels, relevant for conditions like hypothyroidism, which can elevate lipids. Atorvastatin does not directly affect thyroid function or metabolism, so these tests are not routinely required before starting therapy unless thyroid disease is suspected as a contributor to hyperlipidemia. Choice C reason: Renal function tests monitor kidney health, critical for drugs cleared renally. Atorvastatin is primarily metabolized by the liver via cytochrome P450 3A4, not excreted by kidneys. While statins may rarely cause rhabdomyolysis affecting kidneys, baseline renal tests are not mandatory unless renal disease is suspected. Choice D reason: Blood glucose tests are relevant for diabetes management. Atorvastatin may slightly increase glucose levels, but this is a minor, long-term effect. Baseline glucose testing is not required unless diabetes is suspected. Liver function is the primary concern due to the drug’s hepatic metabolism and potential hepatotoxicity.