Deck 29: Pharmacotherapy of Hyperlipidemia

Question 1

The nurse is teaching a client who has been prescribed medication to manage HDL cholesterol.Which statement by the client indicates that the teaching has been understood?

A)"Treatment of HDL cholesterol will also decrease my LDL cholesterol level."
B)"Treatment of HDL cholesterol will also raise my LDL cholesterol level."
C)"If I can increase my HDL level,I will be less likely to have a heart attack."
D)"If I can decrease my HDL level,I will be less likely to have a heart attack."

Answer 1

"If I can increase my HDL level,I will be less likely to have a heart attack."

Question 2

A client who takes avorstatin (Lipitor)daily has been prescribed erythromycin for sinusitis.To prevent consequences of an adverse effect of this combination of drugs,it is most important for the nurse to monitor this client for which clinical manifestation?

A)Lack of expected response to erythromycin.
B)New onset of muscle pain.
C)Abdominal pain and cramping.
D)Bleeding from the oral cavity and bruising.

Answer 2

New onset of muscle pain.

Question 3

A nursing student is preparing a presentation on the different types of lipids.The student will include which classification of lipids in the presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Triglycerides
B)Phospholipids
C)Steroids
D)Lecithins
E)Bile acids

Answer 3

Triglycerides
Phospholipids
Steroids

Question 4

The nurse is caring for a client diagnosed with coronary artery disease.When examining the results of laboratory tests,the nurse notes that which findings are consistent with this diagnosis?

A)Decreased total serum cholesterol and LDL,and elevated HDL
B)Elevated total serum cholesterol,LDL,and HDL
C)Elevated total serum cholesterol and LDL,and decreased HDL
D)Decreased total serum cholesterol,LDL,and HDL

Question 5

Cholesterol,triglycerides,and phospholipids travel between the liver and peripheral tissues through which mechanism?

A)Bound to apoproteins
B)As unbound free molecules
C)Bound to albumin
D)Bound separately in molecule complexes

Question 6

The nurse is reviewing the adverse effects associated with statins with a client who is prescribed this classification of medication to reduce blood cholesterol levels.The nurse knows the client has understood the teaching when the client states which serious adverse effects associated with statins? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Headache
B)Abdominal pain
C)Myopathy
D)Muscle or joint pain
E)Rhabdomyolysis

Question 7

An elevation in low-density lipoprotein (LDL)most likely would be related to which comorbid condition?

A)Diabetes mellitus
B)Renal insufficiency
C)Iron-deficiency anemia
D)Hyperthyroidism

Question 8

The nurse is teaching a client with a lipid disorder about dietary modifications to manage the condition.Which statement by the client indicates an appropriate understanding of the rationale underlying a recommendation to increase the intake of plant sterols?

A)"I will eat oatmeal or cold oat cereal for breakfast every morning."
B)"I will try to increase the amount of lettuce I eat."
C)"I will snack on toasted pumpkin seeds."
D)"If I eat enough spinach and other green vegetables,I can stop taking my cholesterol-lowering medicine."

Question 9

The nurse planning care for a client newly diagnosed with elevated serum cholesterol,triglycerides,and LDL initiates a dietary consult for which reason?

A)This particular pattern of dyslipidemia is not amenable to pharmacological agents.
B)Nonpharmacologic approaches to dyslipidemia should be initiated before pharmacologic agents are prescribed.
C)These levels are sufficiently high that pharmacologic intervention alone is unlikely to be successful.
D)Dietary modifications can be useful for lipid disorders,but only as an adjunct intervention after pharmacologic therapy for clients has been initiated.

Question 10

The nurse is teaching a client with elevated LDL cholesterol and decreased HDL cholesterol about strategies to manage this disorder.The client asks the nurse why there is a difference in the direction of change in the goals for altering HDL versus LDL cholesterol.Which response by the nurse is the most appropriate?

A)"It is most important to increase HDL cholesterol,and if we can reduce LDL cholesterol also,that might be of some help."
B)"We want to reduce HDL cholesterol and increase LDL cholesterol because these changes will protect you against atherosclerosis."
C)"We want to increase HDL cholesterol,which helps rid the body of excess cholesterol,and to decrease LDL cholesterol,which carries excess cholesterol to the body tissue to be stored."
D)"I think you have misunderstood what I have told you,since we want both values to be reduced."

Question 11

The nurse is providing teaching to a client who has been placed on oral cholestyramine for management of a lipid disorder.Which statement by this client indicates the need for further teaching about this drug?

A)"I should take my warfarin at least 1 hour before I take my cholestyramine."
B)"Before I take this medicine,I should mix it in 2 ounces of water,then add another 2-4 ounces before I swallow it."
C)"I should stop taking a daily multivitamin pill."
D)"I should keep all appointments for monitoring my warfarin therapy,since I might need to decrease the dose of this drug."

Question 12

A student is discussing lipid transport through the blood with a nursing instructor.The student asks the educator which apoproteins are important to lipid transport.Which responses by the educator are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)A-I
B)A-II
C)A-III
D)A-IV
E)B-100

Question 13

The nurse is teaching a client regarding therapeutic lifestyle changes that can be implemented to control cholesterol levels in the blood.Which statements made by the client indicate an appropriate understanding of the teaching session? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"I will maintain an optimal weight."
B)"I will implement a medically supervised exercise plan."
C)"I will increase intake of dietary saturated fats and cholesterol."
D)" I will decrease soluble fiber in my diet."
E)"I will eliminate tobacco use."

Question 14

Which statement indicates that a client understands teaching about avorstatin (Lipitor)?

A)"I should always take this drug on an empty stomach."
B)"I should stop taking this drug if I decide to try to become pregnant."
C)"I might have to increase my dose of digoxin."
D)"I should take this drug with breakfast."

Question 15

Niacin and aspirin have been prescribed for a client diagnosed with hyperlipidemia.Which statement regarding why this drug combination is prescribed is the most accurate?

A)"A common side effect of niacin therapy is joint pain."
B)"Taking niacin and aspirin together increases the therapeutic effect of niacin."
C)"Aspirin can decrease discomfort associated with niacin therapy."
D)"Severe headaches are common during the early weeks of niacin therapy."

Question 16

Which goal is appropriate for a person attempting to control cholesterol and low-density lipoprotein levels?

A)Limit cholesterol intake to less than 200 mg daily.
B)Limit saturated fat intake to less than 15% of total calories.
C)Limit dietary fat to less than 50% of total calories.
D)Increase plant sterol intake to 1-2 grams daily.

Question 17

The nurse is evaluating a client's response to teaching about managing dyslipidemia.Which statement by this client indicates that additional teaching is needed?

A)"I will read labels carefully so my daily cholesterol intake is no more than 200 mg."
B)"I will include several servings of soybeans in what I eat each week,since they provide lecithin."
C)"I will switch to using olive oil for cooking."
D)"I will decrease my intake of both cholesterol and saturated fat."

Question 18

The nurse is teaching a client about reducing the risk for coronary artery disease.An elevation in which laboratory value is most directly associated with atherosclerosis,leading to coronary artery disease?

A)Total cholesterol
B)Very low-density lipoprotein (VLDL)
C)Low-density lipoprotein (LDL)
D)High-density lipoprotein (HDL)

Question 19

An adult client is 75 pounds over the ideal weight,eats a diet high in carbohydrates,and drinks 3-4 alcoholic beverages daily.Which pattern of dyslipidemia most likely fits all the findings and behaviors demonstrated by this client?

A)Elevated VLDL,triglycerides,and cholesterol; glucose intolerance
B)Elevated chylomicrons,normal cholesterol,triglycerides more than three times normal
C)Elevated LDL,VLDL,total cholesterol,chylomicrons; triglycerides more than three times normal
D)Elevated LDL and total cholesterol,normal VLDL and triglycerides

Question 20

The nurse is reviewing a client's laboratory results.Which finding is of most concern?

A)HDL cholesterol 62 mg/dL
B)Triglycerides 349 mg/dL
C)LDL cholesterol 92 mg/dL
D)Total cholesterol 202 mg/dL

Question 21

The nurse is caring for a client taking both gemfibrozil (Lopid)and warfarin (Coumadin).To maintain safety relative to the interaction of these drugs,the nurse should monitor the client closely for which clinical manifestation?

A)Myolysis
B)Clot formation
C)Bleeding
D)Hyperlipidemia

Question 22

A nurse is evaluating outcomes of teaching for a client with a new prescription for avorstatin (Lipitor).Which response indicates that the client has understood teaching about this drug?

A)"I will avoid taking this drug with meals."
B)"I might need to increase my dose of digoxin while I am taking this drug."
C)"I will stop taking this drug if I am trying to get pregnant."
D)"I should always take this drug right before breakfast."

Question 23

A seasoned nurse is reviewing the different classifications of medications that are used to decrease blood cholesterol levels with a new nurse on a medical-surgical unit.The seasoned nurse knows the new nurse has comprehended the information when she states which medications as fibric acid agents? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Atromid-S
B)Zetia
C)Lopid
D)Colestid
E)Zocor

Question 24

The nurse is planning care for a client who is receiving drug therapy for a lipid disorder.What outcomes depict that the client is experiencing the therapeutic effects of the medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Lowered total cholesterol
B)Lowered LDL
C)Increased HDL
D)Elevated liver enzymes
E)Decreased BUN and creatinine

Question 25

A client is being discharged after a hospital admission for chest pain with a multidrug regimen that includes a new prescription for cholestyramine (Questran).It is most important for the nurse to include which information in discharge teaching about this drug?

A)"You must carefully follow instructions for mixing this drug with liquid."
B)"If you experience bloating or constipation,you should stop taking this drug."
C)"We will monitor your kidney function while you are taking this drug."
D)"Do not take vitamin supplements while taking cholestyramine."

Question 26

The nurse is assigned to care for a client who is prescribed cholestyramine (Questran).To maintain safety for this client relative to potential effects of this drug,the nurse should monitor which laboratory test?

A)Serum glucose
B)Serum transaminases
C)Neutrophil count
D)Serum potassium level

Question 27

The nurse educator is teaching a group of students about HMG-CoA Reductase medications.The nurse knows the students understood the lesson when they state which drugs as examples of this classification? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Lipitor
B)Lescol
C)Questran
D)Mevacor
E)WelChol

Question 28

A client taking gemfibrozil (Lopid)and rosuvastatin (Crestor)reports muscle and joint pain.The nurse's response is based on an interpretation that this complaint might indicate which manifestation?

A)Hepatic injury
B)Peripheral neuropathy
C)Myopathy
D)An inflammatory response

Question 29

Which statement indicates that a client has understood instructions about cholestyramine?

A)"I will take this drug when I wake up in the morning."
B)"I should take this drug at least 1 hour before taking any other drugs."
C)"I will drink plenty of fluids while I am taking this drug."
D)"I should report to my doctor any increase in swelling of my ankles."

Question 30

The nurse is preparing to discharge a client from a medical-surgical unit.The client is going home on niacin therapy to decrease blood cholesterol levels.In educating the client on medication safety,the nurse should instruct the client to report which adverse effects to the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Nausea
B)Vomiting
C)Stomach pain
D)Joint pain
E)Jaundice