Pharm: Chp 47: Lipid-Lowering Agents (PrepU)
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
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. Cholestyramine B. Atorvastatin C. Fenofibrate D. Niacin
D. Niacin
A nurse is responsible for patient education for a 48-year-old woman who has been prescribed colestipol. The nurse will instruct the patient to take the medication A. at bedtime. B. two hours before a meal. C. after a meal. D. before a meal.
D. before a meal.
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? A. Exercise B. Diet C. Medications D. Kidneys
B. Diet
A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? A. Frequently monitor blood cholesterol. B. Obtain reports of fasting blood sugar levels. C. Take a dietary history of the patient. D. Inspect skin and eyelids for evidence of xanthomas
A. Frequently monitor blood cholesterol.
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. increased thirst. C. pruritus (itching) D. dry mouth.
A. muscle pain.
The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug? A. "The more serious side effects of atorvastatin involve a risk of bleeding." B. "The most common side effects of atorvastatin include some mild gastrointestinal upset." C. "Some clients experience mild chest pain initially." D. "Most people who experience side effects from atorvastatin report stiffness in their joints."
B. "The most common side effects of atorvastatin include some mild gastrointestinal upset."
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 sedentary lifestyle B. His dietary intake of saturated fat C. His alcohol intake D. His waist size
B. His dietary intake of saturated fat
A client appears to be a candidate for statin therapy. What laboratory value should be assessed prior to initiating therapy? A. BUN B. LFT C. aPTT D. CBC
B. LFT
What is the most serious side effect of lovastatin? A. Headache B. Rhabdomyolysis C. Muscle aches D. Liver damage
B. Rhabdomyolysis
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement? A. "I should report any problems with muscle pain or weakness." B. "I should take the dose around bedtime." C. "I can take the drug with grapefruit juice." D. "I need to be careful when I'm out in the sun."
C. "I can take the drug with grapefruit juice."
After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic? A. Waist measurement over 35 inches in men B. Fasting blood glucose below 110 mg/dL C. Triglyceride level above 150 mg/dL D. Blood pressure below 130/85 mm Hg
C. Triglyceride level above 150 mg/dL
A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime? A. Calcium carbonate B. Digoxin C. Vitamin D D. Cholestyramine
D. Cholestyramine
A male client takes cholesterol absorption inhibitors as a monotherapy without statins. He develops mild hepatic insufficiency. What would the nurse expect the health care provider to do? A. Maintain the current dosage of his medication B. Increase the dosage of his medication C. Discontinue his medication D. Decrease the dosage of his medication
D. Decrease the dosage of his medication
The nurse instructs a client to take the prescribed pravastatin at bedtime based on understanding that: A. Adverse effects are less likely during the night. B. Lack of dietary intake during sleep increases absorption. C. Compliance is enhanced with nighttime administration. D. Greater drug effectiveness is achieved at this time.
D. Greater drug effectiveness is achieved at this time.
Recommended treatments for clients with dyslipidemia are made according to their blood levels of total and low-density lipoproteins (LDL) cholesterol and risk factors for cardiovascular disease. What does the impact of existing cardiovascular disease have on recommendations? A. has no effect on either LDL or HDL levels B. decreases target serum triglyceride level C. increases target serum high-density lipoproteins (HDL) level D. decreases target serum LDL level
D. decreases target serum LDL level
What factor determines the "preferred" density of the cholesterol? A. higher amount of carbohydrates B. higher amount of lipids C. higher amount of plasma D. higher amount of protein
D. higher amount of protein
A patient with metabolic syndrome usually has increased plasminogen activator levels. True False
True
Strong evidence exists that atheroma development occurs more quickly in patients with elevated cholesterol and lipid levels. True False
True
The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include? A. "Some people get very flushed skin when they take this medication." B. "You're likely to have some nausea when you begin taking the drug, but this will dissipate with time." C. "Sometimes this causes a full body rash when you first take it, but that doesn't necessarily mean you're allergic to it." D. "It's important to avoid eating shellfish and to tell your care provider before having any diagnostic imaging tests."
A. "Some people get very flushed skin when they take this medication."
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. High B. Desirable C. Optimal D. Very high
A. High
The nurse is providing education to a client who has been prescribed atorvastatin. In what way will the nurse describe how the drug achieves its desired therapeutic effect? A. reduces the amount of cholesterol synthesized by the liver B. inhibits the absorption of dietary cholesterol in the small intestine C. increases the direct administration rate of renal excretion of LDL D. binds with LDL molecules and eliminating their potential for atherosclerosis
A. reduces the amount of cholesterol synthesized by the liver
After teaching a group of students about drugs used to treat hyperlipidemia, the instructor determines that the teaching was successful when the students identify which of the following? Select all that apply. A. Calcium channel blockers B. Fibric acid derivatives C. Bile acid resins D. Angiotensin II receptor blockers E. HMG-CoA reductase inhibitors
B. Fibric acid derivatives C. Bile acid resins E. HMG-CoA reductase inhibitors
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 first and then take the diuretic a half hour later." B. "Take the thiazide diuretic about 4 hours before the colestipol." C. "Take the thiazide diuretic about 1 hour before the colestipol." D. "Take the colestipol at the same time as the thiazide diuretic."
C. "Take the thiazide diuretic about 1 hour before the colestipol."
A client is taking cholestyramine. The nurse will assess for which common adverse effect of the drug? A. Headache B. Abdominal pain C. Constipation D. Indigestion
C. Constipation
Which category of blood lipids is involved in the formation of atherosclerotic plaques? A. triglycerides B. phospholipids C. cholesterol D. nitroglycerin
C. cholesterol
A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client? A. A female client who had a laparoscopic cholecystectomy (gall bladder removal) earlier this year B. A resident of a long-term care facility whose Alzheimer disease is being treated with donepezil (Aricept) C. A 72-year-old man who has emphysema and a long history of cigarette smoking D. An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
D. An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
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 82 LDL 96 Cholesterol 240 B. HDL 78 LDL 115 Cholesterol 189 C. HDL 58 LDL 115 Cholesterol 210 D. HDL 58 LDL 96 Cholesterol 178
D. HDL 58 LDL 96 Cholesterol 178
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. Electrolyte panel B. Fibrate level C. CBC D. LFTs
D. LFTs
An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy? A. INR and aPTT B. Reticulocyte count C. Complete blood count (CBC) E. Liver panel
E. Liver panel
A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for: A. Bleeding B. Liver failure C. Abdominal pain D. Cataract development
A. Bleeding
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition? A. Heart disease B. Diabetes C. Hypertension D. Glaucoma
A. Heart disease
What information would be included in a lipoprotein profile? Select all that apply: A. Total cholesterol B. ALT C. LDL D. AST E. Triglycerides
A. Total cholesterol C. LDL E. Triglycerides
A nurse is caring for several clients. Which client would have the greatest chance of developing CAD as determined by total cholesterol? A. a 62-year-old White client with total cholesterol of 260 mg/dl B. a 32-year-old Asian American with total cholesterol of 120 mg/dl C. a 26-year-old Native American client with total cholesterol of 150 mg/dl D. a 48-year-old Black client with total cholesterol of 198 mg/dl
A. a 62-year-old White client with total cholesterol of 260 mg/dl
A patient is receiving atorvastatin. The nurse would anticipate that the maximum effectiveness of the drug would occur within which time frame? A. 4 to 5 hours B. 1 to 2 hours C. 2 to 3 hours D. 3 to 4 hours
B. 1 to 2 hours
To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.) A. High VLDL cholesterol B. Low triglycerides C. High total cholesterol D. Low LDL cholesterol E. High HDL cholesterol
B. Low triglycerides D. Low LDL cholesterol E. High HDL cholesterol
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. Bile acid sequestrants B. Niacin C. HMG-CoA reductase inhibitors D. Fibrates
C. HMG-CoA reductase inhibitors
A client is taking cholestyramine (Questran) and ezetimibe (Zetia). What administration guideline is most important for the nurse to teach this client? A. The two medications should be taken together. B. The ezetimibe inhibits cholesterol in the liver. C. The administration of ezetimibe (Zetia) is four hours after cholestyramine. D. The cholestyramine (Questran) is administered one hour before ezetimibe.
C. The administration of ezetimibe (Zetia) is four hours after cholestyramine.
What drug or drug class inhibits mobilization of free fatty acids from peripheral tissues? A. Fibrate B. Cholesterol absorption inhibitor C. Statin D. Niacin
D. Niacin
Niacin is prescribed to a client to increase HDL levels. What are the most common adverse effects of this therapy? Select all that apply. A. Nausea B. Flushing of the face C. Vomiting D. Headache E. Diarrhea
A. Nausea B. Flushing of the face C. Vomiting
A client is taking lovastatin. Which are noted as the most common adverse effects? A. Nausea, flatulence, and constipation B. Hiccups, nasal congestion, and dizziness C. Increased appetite and blood pressure D. Fatigue and mental disorientation
A. Nausea, flatulence, and constipation
A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client? A. "Atorvastatin is approved to be taken during pregnancy, but you would have to stop taking it if you chose to breastfeed." B. "There's no evidence that atorvastatin is either safe or unsafe during pregnancy, so it's best to err on the side of caution." C. "Atorvastatin can be taken safely throughout your pregnancy since it does not cross through the placenta." D. "It's important that you stop taking atorvastatin before you stop using contraception."
D. "It's important that you stop taking atorvastatin before you stop using contraception."
What drug or drug class decreases the delivery of intestinal cholesterol to the liver? A. Cholesterol absorption inhibitor B Fibrate C. Bile acid sequestrant D. Statin
A. Cholesterol absorption inhibitor
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. Gallbladder B. Small intestine C. Liver D. Stomach
A. Gallbladder
What should the nurse suggest to assist a client to improve his cholesterol levels? A. Smoking cessation B. Limit exercise to the weekends C. Diet high in polysaturated fats D. Weight lifting
A. Smoking cessation
When describing the action of atorvastatin, which would the nurse include? A. Binding with bile acids to form an insoluble complex that is excreted B. Blocking the enzyme that is involved in cholesterol synthesis C. Stimulating the breakdown of lipoproteins from the tissues D. Decreasing dietary cholesterol absorption from the small intestine
B. Blocking the enzyme that is involved in cholesterol synthesis
Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Which category of blood lipids is involved in the formation of atherosclerotic plaques? A. Cholesterol B. Phospholipids C. Nitroglycerin D. Triglycerides
A. Cholesterol
A nurse is caring for a client receiving cholestyramine to improve his blood lipid profile at a home care setting. What adverse reactions to cholestyramine should the nurse monitor in the client? A. Constipation B. Cholelithiasis C. Rash D. Vertigo
A. Constipation
A nurse is preparing a teaching plan for a client who is prescribed cholestyramine. Which information would the nurse include as a possible adverse reaction associated with this drug? Select all that apply. A. Constipation B. Bruising C. Dizziness D. Abdominal cramping E. Memory problems
A. Constipation B. Bruising D. Abdominal cramping
The nurse instructs a patient to take his prescribed simvastatin at bedtime to promote: A. Increase absorption of the drug B. A decreased risk for adverse effects C. Enhanced drug effectiveness D. Improved compliance with therapy
C. Enhanced drug effectiveness
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. Inhibition of hepatic enzymes B. Induction of hepatic enzymes C. Increased renal excretion E. Decreased gastrointestinal absorption
E. Decreased gastrointestinal absorption
A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client? A. Decrease in serum cholesterol and LDL levels B. Decrease in sitosterol and serum cholesterol C. Decrease in campesterol and LDL levels D. Decrease in serum cholesterol only
A. Decrease in serum cholesterol and LDL levels
Which of the following best reflects the action of ezetimibe? A. Decreases the absorption of dietary cholesterol from the small intestine B. Stimulates the breakdown of lipoproteins from tissues C. Blocks the enzyme involved in cholesterol synthesis D. Binds with bile acids to form an insoluble complex for excretion
A. Decreases the absorption of dietary cholesterol from the small intestine
As part of a routine physical examination, a 60-year-old client's primary care provider has ordered blood work that includes cholesterol levels. What result would strongly suggest the need for an antihyperlipidemic drug? A. Elevated LDL levels B. Low VLDL levels C. A high ratio of HDL to LDL D. Elevated HDL levels
A. Elevated LDL levels
What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.) A. Frequency of administration B. Correct dose C. Drug name D. Reason for taking the prescribed drug E. Dosage form
A. Frequency of administration B. Correct dose C. Drug name D. Reason for taking the prescribed drug E. Dosage form
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)? A. Gemfibrozil B. Ezetimibe C. Niacin D. Colesevelam
A. Gemfibrozil
A nurse is caring for a patient who is receiving lovastatin. Which assessment by the nurse would indicate that there is possible damage to the patient's skeletal muscle as a result of the drug therapy? A. Amber colored urine B. Brownish colored urine C. Reddish colored skin D. Tanned colored skin
B. Brownish colored urine
What cardiac risk factors are related to metabolic syndrome? (Select all that apply.) A. Postural hypotension B. Central adiposity C. Reduced high density lipoprotein cholesterol D. Elevated triglycerides
B. Central adiposity C. Reduced high density lipoprotein cholesterol D. Elevated triglycerides
A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility? A. Tachycardia B. Flushing of the skin C. Weakness E. Dyspnea
B. Flushing of the skin
A client's serum cholesterol is 286 mg/dL. Lovastatin (Mevacor) is prescribed. The nurse plans care based on the fact that the action of lovastatin: A. decreases absorption of cholesterol. B. inhibits the production of cholesterol. C. promotes the breakdown of HDL. D. promotes excretion of cholesterol in the feces.
B. inhibits the production of cholesterol.
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. cholecystitis. B. rhabdomyolysis. C. pruritis. D. cholelithiasis.
B. rhabdomyolysis.
The client wants information about 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."
A client is going home on cholestyramine (Questran). Client teaching should state that cholestyramine 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.
A client who had a total cholesterol-to-HDL cholesterol ratio of 5.3 has been losing weight and participating in an exercise program. His total cholesterol-to-HDL ratio is now 3.9. What LDL reading is also important to further decrease his risk of coronary artery disease? A. 140 mg/dL B. 120 mg/dL C. 95 mg/dL D. 105 mg/dL
C. 95 mg/dL
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. Yellowing of the skin B. Blurred vision C. Blood in urine or stool D. Abdominal pain
C. Blood in urine or stool
A male client presents to the health care provider's office for his annual visit. He takes statins to control his hyperlipidemia. When the provider reviews the client's laboratory results and notes that there is an unexplained elevation in the serum aspartate, what would the nurse expect the provider to do? A. Increase the dose of the statin B. Decrease the dose of the statin C. Discontinue the statin D. Maintain the current dose of the statin
C. Discontinue the statin
Prior to administering an antihyperlipidemic to a client, what information does the nurse need to gather? (Select all that apply.) A. Dietary history B. Vital signs C. Input and output D. WEIGHT E. Blood glucose
A. Dietary history B. Vital signs D. WEIGHT