PHARMA: Chapter 10 (DYSLIPIDEMIA)
The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse prioritize related to the safe use of this drug? You Selected:
"How many alcoholic drinks do you have in a typical day or week?"
The nurse is preparing a client for discharge who will receive a prescription for a hydroxymethylglutaryl-coenzyme A (HMG-CoA) inhibitor. What statement by the client demonstrates a clear understanding of the teaching provided by the nurse? You Selected:
"I should plan to take this drug before bedtime, because my body makes lipids mostly at night."
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? You Selected:
"Some people get very flushed skin when they take this medication."
A client is going home on cholestyramine (Questran). Client teaching should state that this medication should be administered: You Selected:
1 hour after other medication
Antihyperlipidemics
Agents used to lower abnormally high levels of lipids when other treatments fail
The nurse explains to a client the action of a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. What enzyme does the nurse state this drug inhibits? You Selected:
An enzyme that controls the production of cellular 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? You Selected:
An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
What drug or drug class decreases the delivery of intestinal cholesterol to the liver? You Selected:
Cholesterol absorption inhibitor
A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client? You Selected:
Decrease in serum cholesterol and LDL levels
Coronary Artery Disease (CAD)
Decrease the flow of oxygenated blood to heart and organs.
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? You Selected:
Diet
After reviewing the various agents used to lower lipid levels, the students demonstrate understanding of the information when they identify which agents as stimulating the breakdown of lipoproteins from the tissues and their removal from the plasma? (Select all that apply.) You Selected:
Fenofibrate Gemfibrozil
A client asks the nurse about herbal products that can help to lower serum cholesterol and triglycerides. Which herbal product would the nurse include in the response? You Selected:
Garlic
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)? You Selected:
Gemfibrozil
A client taking atorvastatin presents to the clinic reporting acute muscle pain not associated with exercise or injury. The nurse asks questions to determine if this client has been taking what contraindicated substance? You Selected:
Grapefruit juice
Dyslipidemia contributes to
HTN, CAD
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? You Selected: Hypertension Correct response:
Heart disease
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? You Selected:
High
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? You Selected:
LFTs
The nurse is caring for a client taking ezetimibe and monitors the client for what common adverse effects? You Selected:
Mild abdominal pain and diarrhea
Which of the following should not be administered to a client taking pravastatin (Pravachol) due to increased risk of myopathy? Select all that apply: You Selected:
Niacin (Niaspan) Verapamil (Calan)
Which agent would the nurse identify as inhibiting the release of free fatty acids from adipose tissue? You Selected:
Niacin (PU)
A patient with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. In which of the following categories of patients is the use of clofibrate contraindicated? You Selected:
Patients with primary biliary cirrhosis
Saturated fats
Solid at room temp Raises LDL levels Accumulates in the walls of blood vessels
The nurse should discuss the benefit of adding a statin drug to a client's medication regimen. Statin drugs can reduce the risk of death from which of the following? Select all that apply: You Selected:
Stroke Transient ischemic attack
______ the most effective drug for increasing the concentration of HDL cholesterol, is most helpful in preventing heart disease when used in combination with another dyslipidemic drug such as a bile acid sequestrant or a fibrate. a. Niacin b. Statins
a. Niacin
Dyslipidemia:
abnormal lipid levels in the blood
A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication: You Selected:
at bedtime.
The nurse has completed a comprehensive assessment of a new client. What assessment findings would support a diagnosis of metabolic syndrome? Select all that apply. You Selected:
blood pressure 148/93 mm Hg fasting blood glucose 7.2 mmol/L (121 mg/dL) waist measurement 107 cm (42 in) high-density lipoprotein (HDL) 1.29 mmol/L (50 mg/dL)
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? You Selected:
headache and flatulence.
The nurse should be cognizant that niacin therapy is the most effective method of achieving which cardiac-related goal? You Selected:
increased concentration of HDL cholesterol
Statins can injure muscle tissue, resulting in
muscle ache, pain, or weakness.
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? You Selected:
Cholesterol abnormalities and hypertension
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? You Selected: Liver Correct response:
Gallbladder
What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism? You Selected: His sedentary lifestyle Correct response:
His dietary intake of saturated fat
What information would be included in a lipoprotein profile? Select all that apply: You Selected:
LDL Triglycerides Total cholesterol
Which lipid level would the nurse interpret as being high? You Selected:
LDL cholesterol of 190 mg/dL
A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale? You Selected:
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
The ______ are the most effective dyslipidemic agents for primary and secondary prevention of cardiovascular disease. a. diuretics b. beta blockers c. statins
c. statins
A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed? You Selected:
decreased absorption
Cholestyramine should be mixed with _________, so the nurse now recognizes the need for medication teaching and chooses the nursing diagnosis related to deficient knowledge.
water or other noncarbonated fluids
The nurse is teaching a 45-year-old client about ways to lower cholesterol level. What effects of exercise does the nurse describe? You Selected:
Increases high-density lipoproteins (HDLs) and decreases low-density lipoproteins (LDL)