Chapter 50 Evolve Questions (Pharm)
The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? (Select all that apply.)
"Do not start any new medications without first talking to your healthcare provider" "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes" "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains"
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching?
"Read food labels and reduce your intake of saturated fats"
The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug?
A patient with history of gallstones and elevated triglycerides - Gemfibrozil is indicated to reduce elevated triglycerides and very-low-density lipoprotein levels primarily in patients who have not responded adequately to diet modification; increases the risk of gallstone formation
A patient with an elevated triglyceride level is prescribed a sustained-release form of nicotinic acid [Slo-Niacin]. Which laboratory value is most important for the nurse to monitor for in this patient?
Alanine aminotransferase (ALT) - nicotinic acid is hepatotoxic and severe liver injury has been reported
Which drug is the most effective for lowering LDL cholesterol?
Atorvastatin [Lipitor] - statin drugs are most effective for lowering LDL cholesterol; better tolerated, fewer adverse effects, and produce better clinical outcomes
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?
Low-density lipoprotein (LDL) - LDLs are most significant contributors to coronary atherosclerosis - when pharmacologic agents are used to lower cholesterol, the primary goal is to reduce elevated LDL levels
Which discharge instructions should the nurse include for a patient prescribed cholestyramine [Questran]?
Mix the drug with water or juice - is supplied in powder form; mix it with liquids because swallowing it can cause esophageal irritation
A patient with cardiovascular disease is taking rosuvastatin [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug?
Muscle pain and tenderness - myopathy and rhabdomyolysis in rare cases can be adverse effect; unexplained muscle pain and tenderness develop, the prescriber should be notified
Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? (Select all that apply.)
Reduction of LDLs Elevation of HDLs Stabilization of the plaque in coronary arteries Reduction of risk of cardiovascular effects
The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects?
Colesevelam [Welchol] - non-absorbable resin that works directly in the GI tract; does not have systemic effects because not absorbed