Question 1

A patient with high blood lipids asks the nurse why the lipid profile did not improve after 3 months following a low-fat diet.What is the nurse's best response?&#10;A) &#34;You may need to follow a no-fat diet to improve your lipid profile.&#34;&#10;B) &#34;You must follow a low-fat diet for at least 6 months to see improvement.&#34;&#10;C) &#34;You will definitely need to be prescribed a drug to see improvement.&#34;&#10;D) &#34;You may have a genetic factor that is causing your high blood lipid levels.&#34;

Accepted Answer

People who do not show lipid profile improvement after following a low-fat diet for 3 months often have a genetic factor that leads to familial hyperlipidemia.This tends to run in families and requires antilipidemic drugs to lower blood lipid levels.Telling the patient that a drug is definitely required may be correct in this case,but it does not address the patient's question.

Question 2

A patient who has been prescribed lovastatin (Mevacor)asks the nurse why all urine must be saved for intake and output measurements.What is the nurse's best response?&#10;A) &#34;All patients on this unit have orders for strict intake and output measurements.&#34;&#10;B) &#34;Intake and output measurements are important indicators of how well your kidneys are functioning.&#34;&#10;C) &#34;A side effect of this drug can be blockage of urine flow through the kidneys and decreased urine output.&#34;&#10;D) &#34;Sometimes this drug can cause the kidneys to make extra urine resulting in increased urine output and dehydration.&#34;

Accepted Answer

Renal failure can occur if rhabdomyolysis (muscle breakdown)happens as an adverse effect of statin drugs.The protein released from broken-down muscle can block urine flow through the kidneys leading to decreased urine output.Telling the patient that intake and output measurement is an important assessment of kidney function is essentially correct,but it does not fully address the patient's question.

Question 3

A patient who is prescribed ezetimibe (Zetia)has developed swelling around the eyes,nose,and lips.What is the nurse's priority action at this time?&#10;A) Elevate the head of the bed.&#10;B) Notify the prescriber.&#10;C) Assess the patient's airway.&#10;D) Check the patient's blood pressure.

Accepted Answer

Swelling under the skin,usually around the eyes,nose,and lips are symptoms of angioedema,a rare adverse effect of ezetimibe.It is caused by blood vessel dilation and may be life-threatening when it affects the airways.

Question 4

A patient who has been taking niacin (Niacor)daily for 1 week reports intense itching.What is the nurse's best response?&#10;A) &#34;This is a common side effect and many people can control it by taking aspirin.&#34;&#10;B) &#34;Stop taking the drug and talk with your prescriber as soon as possible.&#34;&#10;C) &#34;Unless your skin forms blisters or peels, continue to take the drug.&#34;&#10;D) &#34;Do you have any other drug allergies?&#34;

Accepted Answer

Niacin causes a mild systemic inflammatory response with vasodilation that can result in the sensation of itching.This is not an allergy but can be very distressing to the patient.Often,taking aspirin reduces the inflammatory response and eliminates the itchiness.If the patient has no other health problems that would be worsened by aspirin,this should be tried first.

Question 5

A patient prescribed niacin extended action (Niaspan)reports all of the following new onset problems.For which problem does the nurse notify the prescriber?&#10;A) Moderate itchiness, especially at night&#10;B) Six to seven loose stools daily&#10;C) Increased nighttime urination&#10;D) Swollen, painful great toe

Accepted Answer

One adverse reaction to niacin is an increase in uric acid crystals and calcium that can precipitate in joints and cause gout.The great toe is one of the most common sites of gout.The condition is painful and reduces mobility.Usually,the patient can continue the niacin therapy along with another drug that reduces uric acid production.Drinking plenty of water can also reduce the precipitation of uric acid.

Question 6

A patient who is prescribed atorvastatin (Lipitor)reports experiencing some muscle pain and weakness.What is the nurse's best action?&#10;A) Administer ordered acetaminophen (Tylenol) as needed.&#10;B) Document the finding as the only action.&#10;C) Reassure the patient that this is an expected side effect.&#10;D) Hold the drug and notify the prescriber.

Accepted Answer

Atorvastatin is an HMG-CoA reductase inhibitor (statin)drug.Patients may develop rhabdomyolysis (muscle breakdown)as an adverse effect of these drugs.Signs and symptoms include general muscle soreness,muscle pain,and weakness.The drug should be held and the prescriber notified.The patient will need to be prescribed another antihyperlipidemic drug.

Question 7

Which statement about cholesterol is true?&#10;A) The one source of cholesterol is from the foods a person eats.&#10;B) Cholesterol always has harmful effects on a person's body.&#10;C) Too much cholesterol leads to a deficit of bile acids that digest fat.&#10;D) It is a fatty, waxy material present in cell membranes of the body.

Accepted Answer

Cholesterol is a fatty,waxy material that the body needs to function and is present in cell membranes everywhere in the body.There are two sources of cholesterol: food and the liver.The body needs small amounts of cholesterol for important functions including production of hormones,vitamin D,and bile acids that help digest fat.Inadequate amounts of cholesterol would lead to a deficit of bile acids.

Question 8

Which statement by a patient who has been prescribed an antilipidemic drug indicates to the nurse the need for additional teaching?&#10;A) &#34;Once my lipid profile levels are normal, I will no longer need to take the drug.&#34;&#10;B) &#34;Taking this drug will decrease my risk for having a heart attack.&#34;&#10;C) &#34;My goal is to increase my HDL cholesterol and decrease my LDL cholesterol.&#34;&#10;D) &#34;I will continue walking and watching the fat in my diet while I'm taking this drug.&#34;

Accepted Answer

All lipid-lowering drugs reduce high blood lipid levels,but they do not cure the problem.Treatment is long term,and these drugs need to be taken even after blood fat levels are normal.

Question 9

Which laboratory blood value is more important for the nurse to monitor with a patient who is prescribed both colestipol (Colestid)and warfarin (Coumadin)?&#10;A) Hematocrit&#10;B) Hemoglobin&#10;C) Red blood cell (RBC) count&#10;D) International normalized ratio (INR)

Accepted Answer

Colestipol can change the action of the anticoagulant warfarin in two ways.They can decrease the absorption of vitamin K,which would intensify the effects of warfarin and increase the risk for bleeding (as evidenced by a high INR).Bile acid sequestrants can also directly bind warfarin in the intestinal tract and cause its rapid elimination.This action would inactivate warfarin activity and increase the risk for clot formation (as evidenced by an INR level that is lower than the therapeutic range).Although all of the above laboratory blood values can help diagnose a bleeding problem,the most sensitive test is the INR.

Question 10

Which laboratory finding does the nurse report to the prescriber before giving any antihyperlipidemic drug?&#10;A) Aspartate aminotransferase 41 IU/L&#10;B) Alanine aminotransferase 24 IU/L&#10;C) Alkaline phosphatase 130 IU/L&#10;D) Gamma-glutamyltransferase 50 IU/L

Accepted Answer

The normal range for aspartate aminotransferase is 10 to 34 IU/L.This laboratory value is high and indicates that the patient has liver problems.One of the side effects of these drugs is liver damage.All of the other liver functions tests are within normal limits.

Question 11

A patient who is prescribed cholestyramine (Questran)tablets reports experiencing bloating,nausea,and gas.What is the nurse's best action?&#10;A) Hold the drug and notify the prescriber.&#10;B) Document the finding as the only action.&#10;C) Administer the drug before meals to avoid nausea.&#10;D) Teach the patient to drink 12 to 16 ounces of water with the drug.

Accepted Answer

The answer of A patient who is prescribed cholestyramine (Questran)tablets...

Question 12

A patient prescribed atorvastatin (Lipitor)reports all of the following problems or changes since starting this drug.Which problem or change does the nurse report to the prescriber?&#10;A) Abdominal cramps and bloating&#10;B) Muscle aches and weakness&#10;C) Urinating more at night&#10;D) Loss of taste for sweets

Accepted Answer

The answer of A patient prescribed atorvastatin (Lipitor)reports all of...

Question 13

A patient has been prescribed an antihyperlipidemic drug.Which laboratory value does the nurse report to the prescriber?&#10;A) Total cholesterol 198 mg/dL&#10;B) Triglycerides 135 mg/dL&#10;C) Low density lipoprotein (LDL) 195 mg/dL&#10;D) High density lipoprotein (HDL) 60 mg/dL

Accepted Answer

The answer of A patient has been prescribed an antihyperlipidemic...

Question 14

A hospitalized patient who is prescribed lovastatin (Mevacor)80 mg orally looks at the four tablets the nurse provides and says "At home,I only take two pills for 80 mg.I think this is too many pills." What is the nurse's best action?

A) Hold the dose and contact the prescriber.
B) Remind the patient that the prescriber knows what is best for his or her particular health problem.
C) Explain that each tablet contains 20 mg of the drug instead of 40 mg, and that four 20-mg tablets are the same dosage as two 40-mg tablets.
D) Explain to the patient that while at home a lower dosage of the drug may have been prescribed than what is required while being hospitalized.

Accepted Answer

The answer of A hospitalized patient who is prescribed lovastatin...

Question 15

What does the nurse include in a teaching plan for a woman of childbearing age who is prescribed a statin drug?&#10;A) &#34;These drugs should not be taken during pregnancy, but are safe to use when breastfeeding.&#34;&#10;B) &#34;Statins are pregnancy category X drugs and should not be taken while pregnant or breastfeeding.&#34;&#10;C) &#34;Because these drugs control fats produced by the liver, they will help control weight gain during pregnancy.&#34;&#10;D) &#34;You can take these drugs during pregnancy as long as you do not have a history of muscle or liver problems.&#34;

Accepted Answer

The answer of What does the nurse include in a...

Question 16

Which statement made by a patient who has been prescribed simvastatin (Zocor)indicates the need for more teaching?&#10;A) &#34;I have been taking this drug every night at bedtime.&#34;&#10;B) &#34;I have stopped using butter when I cook and have been using olive oil instead.&#34;&#10;C) &#34;My LDL cholesterol level today is 101 mg/dL so the drug has cured my cholesterol problem.&#34;&#10;D) &#34;I hope that by reducing my fatty food intake, I might not have to take medications to manage my cholesterol problem.&#34;

Accepted Answer

The answer of Which statement made by a patient who...

Question 17

How do antihyperlipidemic drugs from the statin class lower &#34;bad&#34; cholesterol levels?&#10;A) They act as a filter in the blood to trap bad cholesterol and allow white blood cells to destroy it.&#10;B) They block the absorption of dietary fats through the walls of the intestinal tract.&#10;C) They bind to cholesterol in the intestinal tract and promote its excretion in stool.&#10;D) They decrease normal liver production of cholesterol.

Accepted Answer

The answer of How do antihyperlipidemic drugs from the statin...

Question 18

Why do the most common side effects of any bile acid sequestrant include bloating,abdominal discomfort,and constipation?&#10;A) Many patients are lactose intolerant and these drugs contain lactose.&#10;B) Bile acid sequestrants exert their effects directly in the intestinal tract.&#10;C) The action of bile acid sequestrants on the liver releases bile into the intestinal tract.&#10;D) The drugs inhibit the absorption of dietary fiber, increasing its concentration and effects in the intestinal tract.

Accepted Answer

The answer of Why do the most common side effects...

Question 19

A patient who is prescribed simvastatin (Zocor)asks the nurse why liver function tests must be drawn every 6 months.What is the nurse's best response?&#10;A) &#34;They are important because early liver problems do not cause symptoms.&#34;&#10;B) &#34;They help your prescriber decide what your dose of simvastatin should be.&#34;&#10;C) &#34;They tell your prescriber how well your body is responding to the therapy.&#34;&#10;D) &#34;They indicate how much cholesterol is being produced by your liver.&#34;

Accepted Answer

The answer of A patient who is prescribed simvastatin (Zocor)asks...

Question 20

A patient who is prescribed niacin (Niacor)reports experiencing flushing and hot flashes.What is the nurse's best action?&#10;A) Hold the drug and notify the prescriber.&#10;B) Give the niacin at least 1 hour before meals.&#10;C) Reassure the patient that this is an expected side effect.&#10;D) Administer the ordered nonsteroidal anti-inflammatory drug (NSAID) 30 minutes before the niacin.

Accepted Answer

The answer of A patient who is prescribed niacin (Niacor)reports...

Question 21

Which are symptoms of late liver disease?&#10;A) Yellowing of the skin&#10;B) Light-colored diluted urine&#10;C) Pale gray-colored stools&#10;D) Pain on the right side just below the ribs&#10;E) Reddened mucous membranes in the mouth

Accepted Answer

The answer of Which are symptoms of late liver disease?&#10;A)...

Question 22

Which actions are important when a patient is prescribed a bile acid sequestrant drug?&#10;A) Administer a daily multivitamin.&#10;B) Give other medications at least an hour before this drug.&#10;C) Schedule the drug for one hour before meals.&#10;D) Ask the patient about symptoms of constipation.&#10;E) Mix powdered forms of the drug with 2 ounces of juice or water.

Accepted Answer

The answer of Which actions are important when a patient...

Question 23

Which food,drink,or herbal supplement does the nurse warn a patient who is prescribed gemfibrozil (Lopid)to avoid?&#10;A) Caffeinated beverages&#10;B) Grapefruit juice&#10;C) St. John's wort&#10;D) Dairy products

Accepted Answer

The answer of Which food,drink,or herbal supplement does the nurse...

Question 24

The risk for which health problems can be reduced when blood levels of low-density lipoprotein (LDL)cholesterol are controlled within the normal range?&#10;A) Angina&#10;B) Asthma&#10;C) Colitis&#10;D) Heart attack&#10;E) High blood pressure&#10;F) Parkinson disease&#10;G) Stroke

Accepted Answer

The answer of The risk for which health problems can...

Question 25

Which statement does the nurse plan to include in a teaching plan for a patient who has been prescribed fenofibrate (Tricor)?&#10;A) &#34;The most common side effects of this drug are headache and muscle weakness.&#34;&#10;B) &#34;Be sure to report any upset stomach to your prescriber immediately.&#34;&#10;C) &#34;Take this drug 30 minutes after breakfast, lunch, and dinner.&#34;&#10;D) &#34;Do not drink grapefruit juice while you are taking this drug.&#34;

Accepted Answer

The answer of Which statement does the nurse plan to...

Question 26

Which health problems does the nurse teach a patient can be caused by chronic hyperlipidemia?&#10;A) Hypertension&#10;B) Pancreatitis&#10;C) Peptic ulcer disease&#10;D) Xanthoma&#10;E) Diabetes mellitus

Accepted Answer

The answer of Which health problems does the nurse teach...

Question 27

What action must the nurse be prepared to take for a diabetic patient who is prescribed niacin (Niacor)?&#10;A) Give insulin only in the presence of food.&#10;B) Check the blood glucose level more often.&#10;C) Decrease the morning insulin dosage.&#10;D) Encourage increased caloric intake.

Accepted Answer

The answer of What action must the nurse be prepared...

Question 28

A patient is prescribed niacin (Niaspan).The pharmacy sends niacin (Niacor).What is the nurse's best action?&#10;A) Hold the drug and contact the prescriber.&#10;B) Administer the Niacor in place of the Niaspan.&#10;C) Ask the pharmacy to send the patient's ordered Niaspan.&#10;D) Check the patient's chart to find out if he or she takes Niacor at home.

Accepted Answer

The answer of A patient is prescribed niacin (Niaspan).The pharmacy...

Question 29

Which teaching points does the nurse include in a teaching plan for a patient prescribed an antihyperlipidemic drug?&#10;A) Continue to follow a low-fat diet.&#10;B) Be sure to exercise regularly.&#10;C) Always take these drugs with food.&#10;D) Fast for at least 8 hours before your lipid levels are drawn.&#10;E) You will need follow-up laboratory tests once a year.

Accepted Answer

The answer of Which teaching points does the nurse include...

Question 30

A patient is prescribed colesevalam (WelChol)1875 mg twice a day.Available tablets are 625 mg each.How many tablets does the nurse administer to the patient?&#10;A) 2&#10;B) 3&#10;C) 4&#10;D) 5

Accepted Answer

The answer of A patient is prescribed colesevalam (WelChol)1875 mg...

Question 31

A patient who is prescribed gemfibrozil (Lopid)is also taking warfarin (Coumadin).What is the priority nursing action for this patient?&#10;A) Monitor liver function tests.&#10;B) Keep an accurate record of urine output.&#10;C) Give the drug 30 minutes before meals.&#10;D) Check the patient for signs of bleeding.

Accepted Answer

The answer of A patient who is prescribed gemfibrozil (Lopid)is...

Deck 16: Drugs for High Blood Lipids