Chapter 47: Lipid-Loweing Agents

A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating: a)"I will take the digoxin about an hour before the cholestyramine." b)"I need to take both drugs at the same time of the day." c)"I'll take the cholestyramine at 8 AM and the digoxin at 9 AM." d)"I'll take the digoxin about 15 minutes before the cholestyramine."

a)"I will take the digoxin about an hour before the cholestyramine."

To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.) a)Low triglycerides b)High HDL cholesterol c)Low LDL cholesterol d)High total cholesterol

a)Low triglycerides b)High HDL cholesterol c)Low LDL cholesterol

Which agent would the nurse identify as inhibiting the release of free fatty acids from adipose tissue? a)Niacin b)Fenofibrate c)Gemfibrozil d)Fenofibric acid

a)Niacin

What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia? a)Therapeutic lifestyle changes are the preferred method for lowering blood lipids. b)Continued therapeutic lifestyle changes during drug therapy will guarantee success. c)Therapeutic lifestyle changes are easier to comply with than medication therapies. d)Nonpharmacologic interventions are cheaper than using medications.

a)Therapeutic lifestyle changes are the preferred method for lowering blood lipids.

How does the nurse providing medication education describe how the drug atorvastatin achieves its desired therapeutic effect? a)increasing the direct administrationrate of renal excretion of LDL b)reducing the amount of cholesterol synthesized by the liver c)inhibiting the absorption of dietary cholesterol in the small intestine d)binding with LDL molecules and eliminating their potential for atherosclerosis

b)reducing the amount of cholesterol synthesized by the liver

A client is taking cholestyramine. The nurse will assess for which common adverse effect of the drug? a)Abdominal pain b)Headache c)Constipation d)Indigestion

c)Constipation

A client is being prescribed fluvastatin. The nurse reviews the client's medical record to ensure that the client has attempted lifestyle changes for at least a minimum of which amount of time? a)2 weeks b)4 weeks c)8 weeks d)12 weeks

d)12 weeks

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for: a)Abdominal pain b)Cataract development c)Liver failure d)Bleeding

d)Bleeding

When describing the action of atorvastatin, which would the nurse include? a)Blocking the enzyme that is involved in cholesterol synthesis b)Binding with bile acids to form an insoluble complex that is excreted c)Stimulating the breakdown of lipoproteins from the tissues d)Decreasing dietary cholesterol absorption from the small intestine

a)Blocking the enzyme that is involved in cholesterol synthesis

What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism? a)His dietary intake of saturated fat b)His sedentary lifestyle c)His waist size d)His alcohol intake

a)His dietary intake of saturated fat

Which single class drug is known to be most effective in reducing the major types of dyslipidemia? a)statins b)bile acid sequestrants c)fibrates d)niacin

a)statins

Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drug achieves its therapeutic effect by: a)binding LDL to HDL. b)mitigating the harmful effects of atherosclerosis by promoting vasodilation. c)inhibiting the synthesis of HMG-CoA reductase required for hepatic synthesis of cholesterol. d)oxidizing cholesterol to bile acids.

d)oxidizing cholesterol to bile acids.

After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify what as the storage location of bile acids? a)Liver b)Gallbladder c)Small intestine d)Stomach

b)Gallbladder

The nurse is caring for a client who takes fluvastatin (Lescol). Which laboratory value should be assessed regularly in this client? a)BUN b)CBC c)aPTT d)LFT

d)LFT

A patient with atrial fibrillation is receiving warfarin therapy. The patient is also prescribed ezetimibe. The nurse would instruct the patient to watch for: a)Blood in urine or stool b)Abdominal pain c)Yellowing of the skin d)Blurred vision

a)Blood in urine or stool

After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic? a)Triglyceride level above 150 mg/dL b)Blood pressure below 130/85 mm Hg c)Fasting blood glucose below 110 mg/dL d)Waist measurement over 40 inches in women

a)Triglyceride level above 150 mg/dL

A nurse is preparing to administer a prescribed bile acid resin to a client with hyperlipidemia. The nurse understands that this class of drugs can decrease serum levels of several medications, primarily via which mechanism? a)Decreased gastrointestinal absorption b)Inhibition of hepatic enzymes c)Induction of hepatic enzymes d)Increased renal excretion

a)Decreased gastrointestinal absorption

What factor determines the "preferred" density of the cholesterol? a)higher amount of protein b)higher amount of plasma c)higher amount of lipids d)higher amount of carbohydrates

a)higher amount of protein

A client who is receiving colestipol is also taking a thiazide diuretic. Which instruction would be most appropriate for the nurse to give? a)"Take the colestipol at the same time as the thiazide diuretic." b)"Take the thiazide diuretic about 4 hours before the colestipol." c)"Take the colestipol first and then take the diuretic a half hour later." d)"Take the thiazide diuretic about 1 hour before the colestipol."

d)"Take the thiazide diuretic about 1 hour before the colestipol."

A client appears to be a candidate for statin therapy. What laboratory value should be assessed prior to initiating therapy? a)BUN b)CBC c)aPTT d)LFT

d)LFT

What information would be included in a lipoprotein profile? Select all that apply: a)Total cholesterol b)Triglycerides c)LDL d)ALT e)AST

a)Total cholesterol b)Triglycerides c)LDL

The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which? a)pruritis. b)rhabdomyolysis. c)cholelithiasis. d)cholecystitis.

b)rhabdomyolysis.

The nurse is evaluating the effectiveness of drug therapy in a client with hyperlipidemia. Effective therapy is best demonstrated by which laboratory values? a)HDL 58 LDL 96 Cholesterol 178 b)HDL 58 LDL 115 Cholesterol 210 c)HDL 78 LDL 115 Cholesterol 189 d)HDL 82 LDL 96 Cholesterol 240

a)HDL 58 LDL 96 Cholesterol 178

The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs? a)HMG-CoA reductase inhibitors b)Bile acid sequestrants c)Fibrates d)Niacin

a)HMG-CoA reductase inhibitors

The client wants to know the difference between triglycerides and cholesterol. Which response by the nurse would be correct? a)"Triglycerides are found in your blood. Cholesterol is found in the gallbladder." b)"Triglycerides are found in your blood. Cholesterol is how the fat is transported." c)"Triglycerides and cholesterol are fatlike substances found in your blood." d)"Triglycerides transport cholesterol throughout the body."

c)"Triglycerides and cholesterol are fatlike substances found in your blood." (page 812)

A client with a diagnosis of cardiovascular disease is taking atorvastatin calcium to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium? a)100 to 115 mg/dL (2.59 to 2.98 mmol/L) b)75 to 85 mg/dL (1.94 to 2.20 mmol/L) c)less than 60 mg/dL (1.55 mmol/L) d)less than 130 mg/dL (3.37 mmol/L)

d)less than 130 mg/dL (3.37 mmol/L) (page 812)

A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client? a)"It's a good idea to keep your intake of saturated fat to a bare minimum." b)"I'll give you the names of some salt substitutes that you can start using to season your food." c)"A low-fat diet is a good idea, and the animal sources of fat are always preferable to plant sources." d)"Try to get most of your food energy from protein sources rather than carbohydrates."

a)"It's a good idea to keep your intake of saturated fat to a bare minimum."

The health care provider prescribes fibrate for a client with elevated triglycerides. The client begins to self-administer niacin approximately 3 mg daily. What would the nurse expect the provider to order? a)LFTs b)CBC c)Electrolyte panel d)Fibrate level

a)LFTs (page 818)

A client is diagnosed with hyperlipidemia and is to receive drug therapy as part of the treatment plan. When reviewing the client's laboratory test results, which findings would the nurse identify as supporting the client's diagnosis? Select all that apply. a)Total cholesterol 250 mg/dL b)LDL cholesterol 165 mg/dL c)HDL cholesterol 60 mg/dL d)Total cholesterol 150 mg/dL e)LDL cholesterol 90 mg/dL

a)Total cholesterol 250 mg/dL b)LDL cholesterol 165 mg/dL

A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: a)muscle pain. b)dry mouth. c)pruritus (itching) d)increased thirst.

a)muscle pain.

An older adult client's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The woman is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin. The nurse should anticipate what prescription from the health care provider? a)"atorvastatin 150 mg PO BID" b)"atorvastatin 10 mg PO OD" c)"atorvastatin 50 mg PO TID with meals" d)"atorvastatin 75 mg PO BID"

b)"atorvastatin 10 mg PO OD"

The client has been prescribed lovastatin to treat mixed lipidemia. In addition to monitoring cholesterol levels, what other laboratory test value needs to be monitored on a routine basis during therapy? a)Glucose level b)AST and ALT c)BUN and creatinine d)TSH

b)AST and ALT

The nurse is doing teaching about cholesterol and its role in cardiovascular disease. In addition to promoting cessation of cigarette smoking and a healthy lifestyle with diet and exercise to correct cholesterol abnormalities, the nurse explains that there are two modifiable conditions that have been cited as major risk factors for CAD and its complications. What are these two conditions? a)Obesity and hypertension b)Cholesterol abnormalities and hypertension c)Bradycardia and hypertension d)Depression and hypertension

b)Cholesterol abnormalities and hypertension

The physician is caring for a client who is a 2-year kidney transplant survivor. The nurse would expect the physician to order what drug for the client's hyperlipidemia? a)Atorvastatin b)Fluvastatin c)Lovastatin d)Pravastatin

b)Fluvastatin

A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history? a)Asthma b)Liver disease c)Renal disease d)Hypertension

b)Liver disease

A client being initiated on cholestyramine for the treatment of hyperlipidemia should be counseled that what can occur? (Select all that apply.) a)Diarrhea b)Malabsorption of vitamin K c)Aggravation of hemorrhoids d)Flatulence e)Myopathy

b)Malabsorption of vitamin K c)Aggravation of hemorrhoids d)Flatulence

A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? Select all that apply. a)Statins are nephrotoxic. b)Statins are expensive. c)Statins are contraindicated in clients with a history of myocardial infarction. d)Statins require regularly scheduled blood work. e)Statins have an immunosuppressive effect.

b)Statins are expensive. d)Statins require regularly scheduled blood work.

A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have? a)Optimal b)Desirable c)High d)Very high

c)High

A female client presents to the health care provider's office with recurrence of her "hot flashes." The nurse understands that the client is taking what drug to treat her dyslipidemia? a)Fenofibrate b)Cholestyramine c)Niacin d)Atorvastatin

c)Niacin

The administration of cholestyramine (Questran) with warfarin (Coumadin) would most likely cause a client to present with which issues? (Select all that apply.) a)Bruising b)Blood in the stool c)Subtherapeutic INR d)Supratherapeutic INR e)Calf pain and warmth

c)Subtherapeutic INR e)Calf pain and warmth

A client is going home on cholestyramine (Questran). Client teaching should state that this medication should be administered: a)with other medications. b)1 hour before other medications. c)1 hour after other medications. d)on an empty stomach.

c)1 hour after other medications.

An older adult client, who leads a sedentary lifestyle, has recently been diagnosed with dyslipidemia. The client is disappointed to learn about this condition, stating, "First it was the diabetes and then the arthritis, now this." The nurse has performed health education with the client and has described metabolic syndrome. In addition to the elevated cholesterol levels, what aspect of the client's health is congruent with a diagnosis of metabolic syndrome? a)sedentary lifestyle b)age over 65 c)arthritis d)diabetes mellitus

d)diabetes mellitus