Question 1

The nurse is providing group education about lipids to clients who have been diagnosed with hyperlipidemia. What does the best instruction include?&#10;A) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from your body and gets rid of it in your liver.&#10;B) High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque build -up.&#10;C) High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.&#10;D) High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein {LDL}), and promotes excretion of it through the kidneys.

Accepted Answer

High density lipoprotein (HDL) is often referred to as "good" cholesterol because it carries cholesterol from other parts of the body to the liver, where it can be removed from the body. This can help lower the risk of heart disease and stroke.

Question 2

The client is receiving niacin. Although this drug is effective in lowering lipid levels, the client complains of uncomfortable flushing. What is the best education by the nurse?&#10;A) &#34;Take one aspirin thirty minutes before you take your niacin.&#34;&#10;B) &#34;Be sure to take your niacin on an empty stomach as soon as you arise.&#34;&#10;C) &#34;Take your niacin tablet with food and at least one full glass of water.&#34;&#10;D) &#34;It may be time to ask your doctor about switching to another drug.&#34;

Accepted Answer

Taking aspirin 30 minutes before niacin can help reduce the flushing side effect by inhibiting the release of prostaglandins that cause the flushing.

Question 3

The client is receiving a statin drug. Which assessment data would be a priority for the nurse to report to the physician?&#10;A) urine output of 200 ml/hour&#10;B) urine output of 20 ml/hour&#10;C) bowel sounds markedly increased in all four quadrants of the abdomen&#10;D) moderate elevation in liver function tests (LFTs)

Accepted Answer

A urine output of 20 ml/hour indicates possible acute kidney injury, which is a serious side effect of statin drugs. This must be reported immediately to the physician. While other options may also require attention, the priority is addressing acute kidney injury.

Question 4

The client is receiving gemfibrozil (Lopid). The nurse has completed discharge instructions about this medication. The nurse recognizes that teaching has been effective when the client makes which statement?

A) "My doctor said it really doesn't matter how I take this medication."
B) "Taking this medication with yogurt will help it to absorb better."
C) "I must take this medication with food or I can have heartburn."
D) "I should take this medication on an empty stomach to help it absorb better."

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Accepted Answer

Gemfibrozil (Lopid) should be taken with food to reduce the risk of heartburn. Option A is incorrect as it is important to follow the doctor's instructions on medication administration. Option B is incorrect as there is no evidence to support taking gemfibrozil with yogurt to improve absorption. Option D is incorrect as gemfibrozil should be taken with food to improve its absorption.

Question 5

The client is taking a statin drug. Which assessment data would be a priority for the nurse to report immediately to the physician?&#10;A) &#34;I know I just started this medicine yesterday, but my stomach really is upset.&#34;&#10;B) &#34;My calves hurt, and I had a hard time walking to the bathroom.&#34;&#10;C) &#34;Will you call my doctor? I have a really bad headache.&#34;&#10;D) &#34;My heart rate really went up this morning.&#34;

Accepted Answer

The client's complaint of calf pain and difficulty walking could be a symptom of rhabdomyolysis, a serious side effect of statin drugs that can cause muscle breakdown and kidney damage. This requires immediate medical attention. The other complaints may be side effects of the medication, but are not as urgent as the possibility of rhabdomyolysis.

Question 6

The client tells the nurse she is confused about what she has been reading about lipids. What is (are) the best response(s) by the nurse? Select all that apply.&#10;A) Triglycerides are the major form of fat in the body.&#10;B) Phospholipids are essential to building plasma membranes.&#10;C) Cholesterol in the diet is unnecessary as the liver synthesizes it.&#10;D) Cholesterol is a building block for estrogen and testosterone.&#10;E) Phospholipids will help prevent Alzheimer's disease.

Accepted Answer

Triglycerides are indeed the major form of fat in the body. Phospholipids are essential for building plasma membranes. The liver synthesizes cholesterol, making dietary cholesterol unnecessary. Cholesterol is a precursor for steroid hormones like estrogen and testosterone. However, there is no conclusive evidence that phospholipids prevent Alzheimer's disease.

Question 7

The client has serum cholesterol levels of: Low density lipoprotein (LDL) = 3.37 mmol/L High density lipoprotein (HDL) = 0.9 mmol/L
Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 3.7 In planning care with this client, what is the best outcome?

A) The nurse will educate the client about diet and exercise.
B) The client will achieve normal lipid levels through compliance with medications.
C) The nurse will validate that the client understands the importance of lifestyle changes.
D) The client will maintain normal lipid levels without the use of medications.

Accepted Answer

Maintaining normal lipid levels without the use of medications is an ideal outcome, as it indicates the client has successfully implemented lifestyle modifications such as diet and exercise. Medications may be necessary for some individuals, but minimizing their use is beneficial in terms of cost, potential side effects, and long-term sustainability of the intervention. The nurse should still educate the client about diet and exercise, validate their understanding, and encourage compliance with lifestyle changes, but the best outcome is the achievement and maintenance of normal lipid levels without medications.

Question 8

The client tells the nurse, that they are concerned about weight loss and have heard about a drug called orlistat (Xenical) and ask if they need a prescription. What is the best response by the nurse?&#10;A) &#34;Yes, you must have a prescription to obtain orlistat (Xenical).&#34;&#10;B) &#34;No, orlistat is available in any health food store.&#34;&#10;C) &#34;No, orlistat is available over -the -counter.&#34;&#10;D) &#34;Orlistat (Xenical), is not a weight loss drug, but a drug used to treat hypertension&#34;.

Accepted Answer

Orlistat (Xenical) is a prescription drug that is only available with a prescription from a healthcare provider. It is not available over-the-counter or in health food stores. The nurse should inform the client that they need to see their healthcare provider to obtain a prescription for orlistat. It is also important to note that orlistat is a weight loss drug, specifically a lipase inhibitor that blocks the absorption of fat in the digestive tract.

Question 9

The client tells the nurse that his doctor wants him to take a medication for his high cholesterol, but he doesn't know which one would be best. What is (are) the best response(s) by the nurse? Select all that apply.

A) "The best drugs to raise your high density lipoprotein (HDL) levels are the fibric acid drugs."
B) Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high.
C) "The statin drugs inhibit the making of cholesterol and are considered the best choice."
D) "The statin drugs are good, but will cause a lot of flushing if you swallow them with warm fluids."
E) The bile resins keep cholesterol from being absorbed, but have some side effects.

Accepted Answer

B) Fibric acid drugs are indeed known for their ability to decrease triglycerides, which is a type of fat in the blood, but they may not significantly lower LDL cholesterol, which is often the primary target in reducing cardiovascular risk.C) Statin drugs are widely recognized as the first-line treatment for lowering LDL cholesterol levels. They work by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver.E) Bile acid sequestrants (or bile resins) work by binding to bile acids in the intestine, preventing them from being reabsorbed. This forces the liver to use more cholesterol to produce bile acids, thereby lowering the level of cholesterol in the blood. They can be effective in lowering cholesterol levels but may have gastrointestinal side effects.

Question 10

The client is receiving cholestryamine (Novo -Cholamine, PMS -Cholestyramine), and complains of constipation. The physician orders bisacodyl (Ducolax) tablets. When is the best time for the nurse to administer the bisacodyl (Ducolax) tablets?

A) Bisacodyl (Ducolax) can be given any time, but must be taken with food.
B) Four hours after administration of cholestryamine (Novo -Cholamine,PMS -Cholestyramine).
C) One hour after administration of cholestryamine (Novo -Cholamine,PMS -Cholestyramine).
D) The drugs can be administered together.

Accepted Answer

Cholestyramine is a medication that is primarily used to treat high levels of cholesterol. A common side effect of this medication is constipation or gastrointestinal obstruction. Therefore, when assessing for side effects, the primary focus of the nurse should be on the gastrointestinal system, specifically assessing for bowel sounds in all four abdominal quadrants to detect any potential gastrointestinal obstruction. The other options listed are not directly related to the side effects of cholestyramine.

Question 11

The nurse has completed nutritional teaching with the client who has a high low density lipoprotein (LDL) level. The nurse recognizes that teaching has been effective when the client makes which menu choice?

A) grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole -wheat bread, and low -fat chocolate pudding
B) low -fat hamburger with whole -wheat bun, tossed salad with walnuts and olive oil, and raisin -oatmeal cookie
C) grilled chicken salad with strawberries and pecans, baked macaroni and cheese, and low -fat brownie
D) beef tenderloin with gravy and noodles, fruit salad with apples and grapefruit, slice of rye bread, and apple pie

Accepted Answer

The answer of The nurse has completed nutritional teaching with...

Question 12

The client says to the nurse &#34;My doctor says I have heart disease and I need to decrease cholesterol in my diet. How did this happen?&#34; What is the best response by the nurse?&#10;A) &#34;The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol build -up in them.&#34;&#10;B) &#34;Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries.&#34;&#10;C) &#34;It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet.&#34;&#10;D) &#34;Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy.&#34;

Accepted Answer

The answer of The client says to the nurse &#34;My...

Question 13

The client is receiving atorvastatin (Lipitor). Which new medication order would the nurse validate with the physician?&#10;A) Ketoconazole (Nizoral) 200 mg by mouth every morning.)&#10;B) Pioglitazone (Actos) 20 mg by mouth every morning&#10;C) Fluoxetine (Prozac) 20 mg by mouth every morning.&#10;D) Propranolol (Inderal) 30mg by mouth every morning and every evening.

Accepted Answer

The answer of The client is receiving atorvastatin (Lipitor). Which...

Question 14

The client is receiving a statin drug. The nurse notes an increase in creatine phosphokinase (CPK) levels. What is the nurse's priority action?&#10;A) Administer the drug and continue to assess for muscle pain.&#10;B) Hold the drug and obtain another creatine phosphokinase (CPK) level in six hours.&#10;C) Hold the drug and notify the physician.&#10;D) Administer the drug and obtain another creatine phosphokinase (CPK) level in six hours.

Accepted Answer

The answer of The client is receiving a statin drug....

Question 15

The client is receiving cholestryamine (Novo -Cholamine, PMS -Cholestyramine), and complains of constipation. The physician orders bisacodyl (Ducolax) tablets. When is the best time for the nurse to administer the bisacodyl (Ducolax) tablets?

A) Bisacodyl (Ducolax) can be given any time, but must be taken with food.
B) Four hours after administration of cholestryamine (Novo -Cholamine,PMS -Cholestyramine).
C) One hour after administration of cholestryamine (Novo -Cholamine,PMS -Cholestyramine).
D) The drugs can be administered together.

Accepted Answer

The answer of The client is receiving cholestryamine (Novo -Cholamine,...

Deck 22: Drugs for Lipid Disorders