Deck 32: Pharmacotherapy of Hyperlipidemia

Question 1

The nurse is caring for a client with coronary artery disease.When examining the results of laboratory tests, the nurse notes which of the following findings, which are consistent with this diagnosis?
1)Elevated total serum cholesterol, LDL, and HDL
2)Decreased total serum cholesterol, LDL, and HDL
3)Elevated total serum cholesterol and LDL, and decreased HDL
4)Decreased total serum cholesterol and LDL, and elevated HDL

Answer 1

3

Question 2

The nurse is teaching a patient about reducing her risk for coronary artery disease.An elevation in which laboratory value is most directly associated with atherosclerosis, leading to coronary artery disease?
1)Low-density lipoprotein (LDL)
2)Very low-density lipoprotein (VLDL)
3)High-density lipoprotein (HDL)
4)Total cholesterol

Answer 2

1

Question 3

A client taking gemfibrozil (Lopid)and rosuvastatin (Crestor)reports that he is having muscle and joint pain.The nurse's response is based on an interpretation that this complaint might indicate:
1)Hepatic injury.
2)Myopathy.
3)Peripheral neuropathy.
4)An inflammatory response.

Answer 3

2

Question 4

Nicotinic acid and aspirin have been prescribed for a client with hyperlipidemia.The nurse explains that this drug combination has been prescribed because:
1)Severe headaches are common during the early weeks of nicotinic acid therapy.
2)A common side effect of nicotinic acid therapy is joint pain.
3)Aspirin can decrease discomfort associated with nicotinic acid therapy.
4)Taking niacin and aspirin together increases the therapeutic effect of nicotinic acid.

Question 5

An elevation in low-density lipoprotein (LDL)most likely would be related to which comorbid condition?
1)Renal insufficiency
2)Hyperthyroidism
3)Diabetes mellitus
4)Iron-deficiency anemia

Question 6

The nurse is assigned to care for a client who has been taking cholestyramine (Questran).To maintain safety for this client relative to potential effects of this drug, the nurse should monitor:
1)Serum glucose.
2)Triglycerides.
3)Neutrophil count.
4)Serum transaminases.

Question 7

The nurse is teaching a client who has been prescribed medication to manage his HDL cholesterol.Which statement by the client indicates he has understood teaching?
1)"If I can increase my HDL level, I will be less likely to have a heart attack."
2)"If I can decrease my HDL level, I will be less likely to have a heart attack."
3)"Treatment of HDL cholesterol will also raise my LDL cholesterol level."
4)"Treatment of HDL cholesterol will also decrease my LDL cholesterol level."

Question 8

The nurse planning care for a patient newly diagnosed with elevated serum cholesterol, triglycerides, and LDL initiates a dietary consult because:
1)Dietary modifications can be useful for lipid disorders, but only as an adjunct intervention after pharmacologic therapy for clients has been initiated.
2)This particular pattern of dyslipidemia is not amenable to pharmacological agents.
3)These levels are sufficiently high that pharmacologic intervention alone is unlikely to be successful.
4)Non-pharmacologic approaches to dyslipidemia should be initiated before pharmacologic agents are prescribed.

Question 9

The nurse is evaluating a client's response to teaching about managing her dyslipidemia.Which statement by this client indicates that she needs additional teaching?
1)"I will read labels carefully so my daily cholesterol intake is no more than 200 mg."
2)"I will switch to using olive oil for cooking."
3)"I will include several servings of beans in what I eat each week."
4)"If a label lists cholesterol as an ingredient, I won't eat this food."

Question 10

Which goal is appropriate for a person attempting to control cholesterol and low-density lipoprotein levels?
1)Limit dietary fat to less than 50% of total calories.
2)Limit cholesterol intake to less than 200 mg daily.
3)Limit saturated fat intake to less than 15% of total calories.
4)Increase plant sterol intake to 1-2 grams daily.

Question 11

The nurse is caring for a client taking both gemfibrozil (Lopid)and warfarin (Coumadin).To maintain safety for relative to the interaction of these drugs, the nurse should monitor the client closely for:
1)Bleeding.
2)Clot formation.
3)Myolysis.
4)Hyperlipidemia.

Question 12

Which statement indicates that a client understands teaching about avorstatin (Lipitor)?
1)"I should always take this drug on an empty stomach."
2)"I should take this drug with breakfast."
3)"I might have to increase my dose of digoxin."
4)"I should stop taking this drug if I decide to try to become pregnant."

Question 13

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
1)Lack of expected response to erythromycin.
2)Abdominal pain and cramping.
3)New onset of muscle pain.
4)Bleeding from the oral cavity and bruising.

Question 14

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.The nurse's best response is:
1)"I think you have misunderstood what I have told you, since we want both values to be reduced."
2)"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.
3)"It is most important to increase HDL cholesterol, and if we can reduce LDL
Cholesterol also, that might be of some help."
4)"We want to reduce HDL cholesterol and increase LDL cholesterol because these changes will protect you against atherosclerosis."

Question 15

Which statement indicates that a client has understood instructions about cholestyramine?
1)"I will drink plenty of fluids while I am taking this drug."
2)"I will take this drug when I wake up in the morning."
3)"I should report to my doctor any increase in swelling of my ankles."
4)"I should take this drug at least one hour before taking any other drugs."

Question 16

A 58-year-old female is 75 pounds over her 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?
1)Elevated LDL and total cholesterol, normal VLDL and triglycerides
2)Elevated chylomicrons, normal cholesterol, triglycerides more than three times normal
3)Elevated VLDL, triglycerides, and cholesterol; glucose intolerance
4)Elevated LDL, VLDL, total cholesterol, chylomicrons; triglycerides more
Than three times normal

Question 17

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 that she needs further teaching about this drug?
1)"I should keep all appointments for monitoring my warfarin therapy, since I might need to increase the dose of this drug."
2)"I should continue taking a daily multivitamin pill."
3)"I should take my warfarin at least one hour before I take my cholestyramine."
4)"Before I take this medicine, I should mix it in 2 ounces of water, then add another 2-4 ounces before I swallow it."

Question 18

Cholesterol, triglycerides, and phospholipids travel between the liver and peripheral tissues:
1)Bound separately in molecule complexes.
2)Bound to albumin.
3)Bound to apoproteins.
4)As unbound free molecules.

Question 19

The nurse is reviewing a client's laboratory results.Which finding is of most concern?
1)HDL cholesterol 62 mg/dL
2)LDL cholesterol 92 mg/dL
3)Triglycerides 349 mg/dL
4)Total cholesterol 202 mg/dL

Question 20

The nurse is teaching a client with a lipid disorder about dietary modifications to manage his condition.Which statement by the client indicates that he understands the rationale underlying a recommendation to increase his intake of plant sterols?
1)"If I eat enough spinach and other green vegetables, I can stop taking my cholesterol-lowering medicine."
2)"I will eat oatmeal or cold oat cereal for breakfast every morning."
3)" I will try to increase amount of lettuce I eat."
4)"I will snack on toasted pumpkin seeds."

Question 21

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?
1)"I will avoid taking this drug with meals."
2)"I should always take this drug right before breakfast."
3)"I might need to increase my dose of digoxin while I am taking this drug."
4)"I will stop taking this drug if I am trying to get pregnant."

Question 22

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