Question 1

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 statins can affect visual acuity,so patients should be counseled to have annual eye examinations for assessment of cataract formation.The bile acid sequestrants,not statins,cause diarrhea.Statin drug therapy is lifelong or until behavioral changes prove equally effective (uncommon).Bile acid sequestrants,not statins,decrease the absorption of fat-soluble vitamins.

Question 2

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 risk for coronary artery disease.&#34;&#10;B)&#34;You have a moderate 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 value of 270 mg/dL for serum cholesterol puts the patient at high risk.

Question 3

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 muscle aches and pain.

Accepted Answer

Simvastatin is given in the evening.Laboratory tests are performed every 3 to 6 months,not annually.Statins do not cause postural hypotension.Patients taking statins should report muscle aches and weakness immediately.

Question 4

A patient,who has intermittent claudication,has been taking 400 mg of pentoxifylline (Trental)three times daily with meals for 2 weeks.The patient calls the clinic and reports mild flushing,occasional gastrointestinal upset,and continued pain in both legs.How will the nurse advise the patient?

A)"Expect side effects to diminish as drug effects increase in several weeks."
B)"Notify the provider of the continued pain and request increasing the dose."
C)"Take a daily aspirin tablet to enhance the effects of pentoxifylline."
D)"Take the medication 1 hour before or 2 hours after a meal."

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Accepted Answer

Patients should be counseled that the desired therapeutic effects may take 1   1/2 to 3 months.This patient's side effects are mild and therefore do not warrant discontinuing the drug.This patient is receiving the maximum recommended dose.Aspirin is not indicated.Taking the medication with meals and not on an empty stomach minimizes gastrointestinal effects.

Question 5

A patient begins taking nicotinic acid (Niacin)and reports dizziness and flushing of the skin.The nurse will perform which action?&#10;A)Contact the provider to discuss decreasing the 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

Flushing of the skin and dizziness are common side effects of nicotinic acid,but with careful drug titration and concomitant use of aspirin,these effects can be minimized.Increasing fluid intake or taking with food does not alter these adverse effects.Nicotinic acid can affect liver enzymes not renal function.

Question 6

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 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 gastrointestinal upset and constipation,and these symptoms can be reduced with increased fluids and foods high in fiber.Stopping the medication is not indicated.Over-the-counter laxatives are not recommended until other methods have been tried.Giving the medication on an empty stomach will not relieve the discomfort.

Question 7

A patient with high cholesterol is ordered to take atorvastatin (Lipitor).What information will be included in the patient teaching? (Select all that apply.)&#10;A)Dietary management is not a priority with this medication.&#10;B)The medication should be taken on an empty stomach.&#10;C)The medicine should be taken with a full glass of water.&#10;D)The patient should watch for body aches or gastrointestinal upset as side effects.&#10;E) The patient should have renal function tests frequently.&#10;F) The patient should have liver function tests frequently.

Accepted Answer

This medication is most effective with careful monitoring of diet.Atorvastatin does not affect renal function.

Question 8

A patient has been taking atorvastatin (Lipitor)for several months to treat hyperlipidemia.The patient reports muscle weakness and tenderness.The nurse will counsel the patient to&#10;A)ask the provider about switching to simvastatin.&#10;B)contact the provider to report these symptoms.&#10;C)start taking ibuprofen to combat these effects.&#10;D)stop taking the medication immediately.

Accepted Answer

Patients taking statins should report immediately any muscle aches or weakness,which can lead to rhabdomyolysis,a muscle disintegration that can become fatal.All statins carry this risk,so changing to another statin is not indicated.Ibuprofen may be useful,but notifying the provider is essential.Patients should not abruptly discontinue statins without discussing this with the provider.

Question 9

A patient has been taking cholestyramine (Questran)to treat hyperlipidemia type II.The patient reports abdominal cramping and constipation.The patient's serum low- density lipoprotein (LDL)has decreased from 170 mg/dL 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.

Accepted Answer

Colesevelam is similar to cholestyramine but has fewer gastrointestinal side effects.This patient has demonstrated good results with the bile acid sequestrant,so the provider needs to offer a preparation with fewer adverse effects.Both drugs are given twice daily.

Question 10

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

Gemfibrozil is highly protein-bound and competes for receptor sites with drugs such as warfarin.The anticoagulant dose should be decreased,and the INR should be closely monitored.Decreasing the dose of gemfibrozil is not recommended.Giving the warfarin at a different time of day does not change this drug interaction.The warfarin dose should be decreased not increased.

Question 11

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 nurse may expect the provider to order which medication for this patient?

A)Amlodipine and atorvastatin (Caduet)
B)Colestipol HCl (Colestid)
C)Fenofibrate (TriCor)
D)Niacin and lovastatin (Advicor)

Accepted Answer

The answer of A female patient has serum lipid levels...

Question 12

A patient will begin taking rosuvastatin calcium (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 calcium...

Deck 46: Antihyperlipidemics and Peripheral Vasodilators