Question 1

A female patient has serum lipid levels performed, which reveal a total cholesterol of 285 mg/dL, triglycerides of 188 mg/dL, a low-density lipoprotein (LDL) of 175 mg/dL, and a high-density lipoprotein (HDL) of 40 mg/dL. The patient's blood pressure is 138/72 mm Hg. The patient is currently not receiving any prescription medications. Which of the following would be the most appropriate medication (or medications) to be started at this time?

A) Amlodipine and atorvastatin (Caduet)
B) Colestipol HCl (Colestid)
C) Fenofibrate (TriCor)
D) Atorvastatin (Lipitor)

Atorvastatin (Lipitor)

Accepted Answer

The patient has elevated LDL and total cholesterol levels, as well as lower HDL levels, putting her at high risk for atherosclerotic cardiovascular disease. Atorvastatin (Lipitor) is a statin medication that is recommended as first-line treatment to reduce LDL levels and lower the risk of cardiovascular events. The patient's blood pressure is also elevated, but it is not high enough to warrant immediate antihypertensive medication. Colestipol HCl (Colestid) is a bile acid sequestrant that can lower LDL levels, but it is not recommended as first-line therapy. Fenofibrate (TriCor) is primarily used to lower triglyceride levels and may be added as adjunct therapy if needed, but it is not recommended as initial monotherapy for this patient. Amlodipine and atorvastatin (Caduet) combines a calcium channel blocker with a statin, but the patient's blood pressure is not high enough to warrant immediate antihypertensive medication, and combination therapy should not be started until each medication is titrated to its appropriate dose.

Question 2

A patient has been taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports abdominal cramping and constipation. The patient's serum low-density lipoprotein (LDL) has decreased from 170 to 110 mg/dL, and triglycerides have not changed from 150 mg/dL since beginning the medication. The provider changes the medication to colesevelam HCl (Welchol). The patient asks the nurse why the medication was changed, and the nurse will explain that colesevelam HCl is ordered for which reason?

A) It has fewer side effects.
B) It has more convenient dosing.
C) It provides greater LDL reduction.
D) It provides greater triglyceride reduction.

It has fewer side effects.

Accepted Answer

Colesevelam HCl (Welchol) is known to have fewer gastrointestinal side effects compared to cholestyramine (Questran), making it a preferable option for patients who experience abdominal cramping and constipation with cholestyramine.

Question 3

A patient has been prescribed cilostazol. Which statement by the client indicates the need for further teaching?&#10;A) &#34;I can take the medication with food if it causes nausea.&#34;&#10;B) &#34;This medication is used to improve blood flow.&#34;&#10;C) &#34;I can continue to take ginkgo biloba to improve my memory.&#34;&#10;D) &#34;I should be cautious when standing.&#34;

Accepted Answer

Cilostazol can increase the risk of bleeding and should not be taken with herbal supplements such as ginkgo biloba which also increase the risk of bleeding. The client should be advised to discontinue the use of ginkgo biloba while taking cilostazol.

Question 4

A patient will begin taking rosuvastatin (Crestor) to treat hyperlipidemia. The patient asks the nurse how to take the medication for best effect. Which statement by the nurse is correct?&#10;A) &#34;Increase your fluid intake while taking this medication.&#34;&#10;B) &#34;Stop taking the medication if you develop muscle aches.&#34;&#10;C) &#34;Take the medication with food to improve absorption.&#34;&#10;D) &#34;You may increase dietary fat while taking this medication.&#34;

Accepted Answer

The answer of A patient will begin taking rosuvastatin (Crestor)...

Question 5

A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports abdominal discomfort and constipation. The nurse will provide which instruction to the patient?&#10;A) Increase fluid intake and slowly increase fiber intake.&#10;B) Stop taking the medication immediately.&#10;C) Take an over-the-counter laxative.&#10;D) Take the medication on an empty stomach.

Accepted Answer

Cholestyramine can cause constipation and abdominal discomfort. Increasing fluid intake and slowly increasing fiber intake can help alleviate these symptoms. Stopping the medication immediately or taking an over-the-counter laxative is not recommended without consulting a healthcare provider. Taking the medication on an empty stomach can also exacerbate GI symptoms.

Question 6

A patient begins taking nicotinic acid (Niacin) and reports dizziness and flushing of the skin. The nurse will perform which action?&#10;A) Recommend that the patient take a baby aspirin with their niacin dose.&#10;B) Counsel the patient to increase fluid intake.&#10;C) Request an order for renal function tests.&#10;D) Schedule the medication to be taken with meals.

Accepted Answer

Taking a baby aspirin 30 minutes before niacin can help reduce flushing, a common side effect of niacin.

Question 7

A patient has a serum cholesterol level of 270 mg/dL. The patient asks the nurse what this level means. Which response by the nurse is correct?&#10;A) &#34;You have a high cholesterol which places you at risk for coronary artery disease.&#34;&#10;B) &#34;You have a moderately elevated cholesterol and risk for coronary artery disease.&#34;&#10;C) &#34;You have a low risk for coronary artery disease.&#34;&#10;D) &#34;You have no risk for coronary artery disease.&#34;

Accepted Answer

A cholesterol level of 270 mg/dL is considered high, and high cholesterol is a risk factor for coronary artery disease.

Question 8

A patient, who has intermittent claudication, has been taking 100 mg of cilostazol (Pletal) twice times daily with meals for 2 weeks. The patient calls the clinic and reports continued pain in both legs during exercise. How will the nurse advise the patient?

A) "It can take from 2-12 weeks for the medication to help with your claudication symptoms."
B) "Notify the provider of the continued pain and request increasing the dose."
C) "You should stop the medication immediately since it is not working."
D) "Take the medication right before you exercise for best effects."

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Accepted Answer

Cilostazol (Pletal) can take from 2 to 12 weeks to improve symptoms of intermittent claudication, so patients should be advised to continue taking the medication as prescribed for at least this duration before expecting significant improvement.

Question 9

A patient has been taking atorvastatin (Lipitor) for several months to treat hyperlipidemia. The patient reports severe muscle weakness and tenderness. The nurse will counsel the patient to do which of the following?

A) ask the provider about switching to simvastatin.
B) contact the provider to report these symptoms.
C) start taking ibuprofen to combat these effects.
D) stop taking the medication immediately.

Accepted Answer

Severe muscle weakness and tenderness can be symptoms of rhabdomyolysis, a serious condition in which muscles break down and release their contents into the bloodstream. This can be a rare but serious side effect of atorvastatin. The nurse should counsel the patient to contact the provider to report these symptoms and potentially switch to a different medication or adjust the dose. Starting ibuprofen or stopping the medication without consulting the provider could be dangerous and potentially worsen the symptoms.

Question 10

The nurse provides teaching to a patient who will begin taking simvastatin (Zocor) to treat hyperlipidemia. Which statement by the patient indicates understanding of the teaching?&#10;A) &#34;I may have diarrhea as a result of taking this medication.&#34;&#10;B) &#34;I may stop taking this medication when my lipid levels are normal.&#34;&#10;C) &#34;I will need an annual eye examination while taking this medication.&#34;&#10;D) &#34;I will increase my intake of vitamins A, D, and E while taking this medication.

Accepted Answer

The statement "I will need an annual eye examination while taking this medication" indicates understanding of the teaching because simvastatin can cause rare but serious side effects such as vision changes and eye pain, so patients need to have regular eye exams to monitor for these potential complications. Choices A, B, and D are incorrect because diarrhea is not a common side effect of simvastatin, lipid levels may fluctuate and require ongoing medication management, and there is no need to increase vitamin intake specifically while taking this medication.

Question 11

A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice daily, 30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin) once daily. The nurse will contact the provider to discuss

A) decreasing the dose of gemfibrozil.
B) giving the warfarin at noon.
C) increasing the dose of warfarin.
D) ordering frequent INR levels.

Accepted Answer

The answer of A patient is admitted to the hospital,...

Question 12

A patient will begin taking simvastatin (Zocor) to decrease serum cholesterol. When teaching the patient about this medication, the nurse will counsel the patient to take which action?&#10;A) Return to the clinic annually for laboratory testing.&#10;B) Take care when rising from a sitting to standing position.&#10;C) Take the medication in the evening for best effect.&#10;D) Use ibuprofen as needed for severe muscle aches and pain.

Accepted Answer

The answer of A patient will begin taking simvastatin (Zocor)...

Deck 41: Antihyperlipidemics and Peripheral Vasodilators