Question 1

A client is beginning drug therapy with lovastatin (Mevacor).The nurse instructs the client to take the dose of this medication&#10;A) at bedtime.&#10;B) with the evening meal.&#10;C) at midmorning.&#10;D) on rising in the morning.&#10;

Accepted Answer

Lovastatin should be taken with the evening meal, as this is the time when cholesterol synthesis is highest. This will ensure optimal effectiveness of the drug.

Question 2

The nurse should alert the client beginning drug therapy with niacin (Nicobid)that which of the following is an adverse effect obvious to others?&#10;A) Dry skin&#10;B) Acne&#10;C) Skin bruising&#10;D) Flushing of the face and neck&#10;

Accepted Answer

Niacin commonly causes flushing of the face and neck, which may be obvious and uncomfortable for the client. The other options (dry skin, acne, and skin bruising) are not typically associated with niacin use.

Question 3

The nurse would explain which of the following information to a client with hyperlipidemia who will begin taking colestipol hydrochloride (Colestid)?&#10;A) The drug has few significant adverse effects&#10;B) Serum potassium should be monitored because of decreased potassium absorption&#10;C) Constipation and possible impaction are fairly common adverse effects&#10;D) It requires the concurrent use of water-soluble vitamins&#10;

Accepted Answer

Constipation and possible impaction are fairly common adverse effects of colestipol hydrochloride (Colestid).

Question 4

The nurse includes in a teaching plan for the client with hyperlipidemia that cholestyramine (Questran)decreases lipid levels by which of the following mechanisms?&#10;A) Decreasing bile secretion&#10;B) Enhancing the absorption of bile acids&#10;C) Increasing cholesterol excretion&#10;D) Decreasing lipid synthesis in the liver&#10;

Accepted Answer

Cholestyramine works by binding to bile acids in the intestine, forming a complex that is excreted in the feces. Since bile acids are made from cholesterol, their excretion results in a decrease in cholesterol levels in the body.

Question 5

When teaching about primary hyperlipidemia the client should be encouraged to continue with an exercise program because it&#10;A) elevates low-density lipoprotein.&#10;B) elevates high-density lipoprotein.&#10;C) decreases intermediate-density lipoprotein.&#10;D) decreases very-low-density lipoprotein.&#10;

Accepted Answer

Exercise has been shown to increase high-density lipoprotein (HDL) levels, which helps to remove low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) from the bloodstream, thus reducing the risk of cardiovascular disease in primary hyperlipidemia.

Question 6

The nurse would question a newly written order for simvastatin (Zocor)for a client who has which of the following health problems?&#10;A) Hepatitis&#10;B) Diabetes mellitus&#10;C) Bronchial asthma&#10;D) Duodenal ulcer&#10;

Accepted Answer

Simvastatin can cause liver damage and is contraindicated in individuals with active liver disease, including hepatitis.

Question 7

The nurse concludes that a client who has an elevated level of which of the following lipoproteins is at high risk for developing atherosclerosis?&#10;A) Very-high-density lipoprotein&#10;B) Very-low-density lipoprotein&#10;C) Low density lipoprotein&#10;D) High-density lipoprotein&#10;

Accepted Answer

Low density lipoprotein is known as the "bad" cholesterol and is associated with an increased risk for atherosclerosis. Elevated levels of LDL are often seen in individuals with poor dietary habits, obesity, and a sedentary lifestyle. High-density lipoprotein, on the other hand, is known as the "good" cholesterol and helps to remove excess cholesterol from the bloodstream, reducing the risk for atherosclerosis. Very-low-density lipoprotein carries mainly triglycerides and is also associated with an increased risk for atherosclerosis, while very-high-density lipoprotein is associated with a decreased risk for this condition.

Question 8

The nurse understands that colestipol (Colestid)is used to reduce serum cholesterol levels because it has which of the following actions?&#10;A) Binds bile salts in the gastrointestinal tract to prevent reabsorption&#10;B) Inhibits secretion of cholesterol by liver into bile salts&#10;C) Impairs synthesis of cholesterol by the liver&#10;D) Prevents the liver from taking up excess cholesterol in the blood&#10;

Accepted Answer

Colestipol (Colestid) works by binding to bile salts in the gastrointestinal tract, which prevents their reabsorption. This leads to an increased excretion of bile salts, which in turn stimulates the liver to produce more bile salts from cholesterol. The liver's increased production of bile salts then leads to a reduction in serum cholesterol levels.

Question 9

In response to a client's questions about recommended total cholesterol levels,the nurse's best response would be that the desirable level in adults is&#10;A) 80 to 110 mg/dL.&#10;B) less than 200 mg/dL.&#10;C) 110 to 250 mg/dL.&#10;D) less than 350 mg/dL.&#10;

Accepted Answer

The desirable total cholesterol level in adults is less than 200 mg/dL. A level of 200-239 mg/dL is considered borderline high, and a level above 240 mg/dL is considered high. Maintaining a healthy total cholesterol level is important in reducing the risk of cardiovascular disease.

Question 10

The nurse notes that a client is taking ezetimibe (Zetia).What other lipid-lowering drug does the nurse anticipate being used by the client?&#10;A) Gemfibrozil (Lopid)&#10;B) Lovastatin (Mevacor)&#10;C) Cholestyramine (Questran)&#10;D) Nicotinic acid (Niacin)&#10;

Accepted Answer

Ezetimibe is often used in combination with a statin, such as lovastatin, to further lower cholesterol levels. Neither gemfibrozil (a fibric acid derivative), cholestyramine (a bile acid sequestrant), nor nicotinic acid (niacin) are typically used in combination with ezetimibe.

Question 11

The nurse who is teaching a client about adverse effects of rosuvastatin (Crestor)would explain that which of the following is an important adverse effect to report?&#10;A) Myalgia&#10;B) Constipation&#10;C) Headache&#10;D) Flatulence&#10;

Accepted Answer

The answer of The nurse who is teaching a client...

Question 12

The nurse determines that a client understands how to properly take cholestyramine (Questran)after stating to do which of the following?&#10;A) Take the drug with meals only&#10;B) Swallow the tablet without chewing it&#10;C) Let powder sit in fluid for 1 to 2 minutes before mixing&#10;D) Take the drug at the same time as a daily multivitamin&#10;

Accepted Answer

The answer of The nurse determines that a client understands...

Question 13

Which of the following would not be considered by the nurse to be a primary goal of treating hyperlipidemia?&#10;A) Lowering low-density lipoprotein cholesterol to at least 130 to 160 mg/dL&#10;B) Elevating high-density lipoprotein cholesterol by at least 75% to 80%&#10;C) Lowering intermediate-density lipoprotein cholesterol to at least 80 to 100 mg/dL&#10;D) Elevating very-low-density lipoprotein cholesterol by at least 50%&#10;

Accepted Answer

The answer of Which of the following would not be...

Question 14

The nurse should give which of the following medications very cautiously to a client who is taking gemfibrozil (Lopid)?&#10;A) Antipyretics&#10;B) Analgesics&#10;C) Antihypertensives&#10;D) Anticoagulants&#10;

Accepted Answer

The answer of The nurse should give which of the...

Question 15

The outpatient clinic nurse has taught a client about the newly ordered drug pravastatin (Pravachol).The nurse would set up an appointment for which of the following follow-up laboratory studies to be done periodically during therapy?

A) White blood cell count
B) Prothrombin time
C) Liver function studies
D) Blood urea nitrogen

Accepted Answer

The answer of The outpatient clinic nurse has taught a...

Question 16

The nurse concludes that which of the following adverse effects cannot be the result of drug therapy with gemfibrozil (Lopid)?&#10;A) Diarrhea&#10;B) Muscle ache&#10;C) Abdominal gas&#10;D) Dyspnea&#10;

Accepted Answer

The answer of The nurse concludes that which of the...

Question 17

The nurse who is counseling a client with an elevated cholesterol level would state that which of the following vitamins has a lipid-lowering effect?&#10;A) Nicotinic acid&#10;B) Pyridoxine&#10;C) Thiamine&#10;D) Folic acid&#10;

Accepted Answer

The answer of The nurse who is counseling a client...

Question 18

The nurse interprets that a client with which of the following elevations in serum lipids would be a good candidate for treatment with fenofibrate (Tricor)?&#10;A) Low-density lipoproteins&#10;B) Intermediate-density lipoproteins&#10;C) Triglycerides&#10;D) Chylomicrons&#10;

Accepted Answer

The answer of The nurse interprets that a client with...

Deck 31: Antihyperlipidemic Drugs