Question 1

The nurse is providing group education about lipids to clients who have been diagnosed with hyperlipidemia. What does the best instruction include?

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?

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?

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?

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?

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.

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?

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?

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.

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). When assessing for side effects, what will be the primary focus of the nurse?

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?

Accepted Answer

Grilled chicken is a lean protein option, rice and broccoli are healthy side dishes, the salad includes walnuts for a healthy fat source and sliced apples for added fiber, the whole-wheat bread is a complex carbohydrate, and low-fat chocolate pudding is a healthier dessert option.

Question 12

The client says to the nurse "My doctor says I have heart disease and I need to decrease cholesterol in my diet. How did this happen?" What is the best response by the nurse?

Accepted Answer

Choice A is the best response because it directly and simply explains the reason behind the client's heart disease. It also provides a basis for the importance of decreasing LDL cholesterol in the client's diet. Choice B is not entirely accurate, as LDL cholesterol is not converted to saturated fat. Choice C may confuse the client and does not provide a clear explanation. Choice D is not entirely accurate either, as LDL cholesterol specifically narrows the arteries around the heart.

Question 13

The client is receiving atorvastatin (Lipitor). Which new medication order would the nurse validate with the physician?

Accepted Answer

Atorvastatin is metabolized by the CYP3A4 enzyme, and ketoconazole is a potent inhibitor of this enzyme. Co-administration of atorvastatin and ketoconazole can increase the levels of atorvastatin in the body, leading to an increased risk of adverse effects such as muscle damage. Therefore, the nurse should validate the order of ketoconazole with the physician before administering it to the client taking atorvastatin. Pioglitazone, fluoxetine, and propranolol do not have significant interactions with atorvastatin, and their administration would not require validation with the physician in this case.

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?

Accepted Answer

An increase in CPK levels can indicate muscle damage or injury, which is a potential side effect of statin drugs. Holding the drug and notifying the physician allows for further evaluation and management of the possible adverse reaction. Continuing to administer the drug without addressing the elevated CPK levels can lead to further harm to the patient. Obtaining another CPK level later may be necessary but is not the priority action at this time.

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?

Accepted Answer

Bisacodyl (Ducolax) should be administered four hours after cholestryamine (Novo -Cholamine,PMS -Cholestyramine) to prevent the two drugs from interacting and reducing the effectiveness of the cholestryamine.

Quiz 22: Drugs for Lipid Disorders

The nurse is providing group education about lipids to clients who have been diagnosed with hyperlipidemia. What does the best instruction include?

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?

The client is receiving a statin drug. Which assessment data would be a priority for the nurse to report to the physician?

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?

The client is taking a statin drug. Which assessment data would be a priority for the nurse to report immediately to the physician?

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.

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?

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?

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.

The client is receiving cholestryamine (Novo -Cholamine,PMS -Cholestyramine) . When assessing for side effects, what will be the primary focus of the nurse?

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?

The client says to the nurse "My doctor says I have heart disease and I need to decrease cholesterol in my diet. How did this happen?" What is the best response by the nurse?

The client is receiving atorvastatin (Lipitor) . Which new medication order would the nurse validate with the physician?

The client is receiving a statin drug. The nurse notes an increase in creatine phosphokinase (CPK) levels. What is the nurse's priority action?

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?