Chapter 23 + 24

The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information? (3) 1) "I will maintain an optimal weight." 2) "I will implement a medically supervised exercise plan." 3) "I will increase saturated fat in my diet." 4) "I will increase insoluble fiber in my diet." 5) "I will eliminate tobacco use."

1) "I will maintain an optimal weight." 2) "I will implement a medically supervised exercise plan." 5) "I will eliminate tobacco use."

Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider? 1) "My calves hurt, and I had a hard time walking to the bathroom." 2) "I know I just started this medicine yesterday, but my stomach really is upset." 3) "Will you call my healthcare provider? I have a really bad headache." 4) "My heart rate really went up this morning."

1) "My calves hurt, and I had a hard time walking to the bathroom."

The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client? 1) "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them." 2) "Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries." 3) "It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet." 4) "Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy."

1) "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment? (3) 1) Blood glucose 2) Liver enzymes 3) Potassium 4) Hemoglobin and hematocrit 5) Urinalysis

1) Blood glucose 2) Liver enzymes 4) Hemoglobin and hematocrit

The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education? 1) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver. 2) High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup. 3) High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein [LDL]), and promotes excretion of it through the kidneys. 4) High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

1) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.

The nurse reviewing a client's serum cholesterol levels notes the following: Low density lipoprotein (LDL) = 105 mg/dl High density lipoprotein (HDL) = 37 mg/dl Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1 Which should the nurse identify as the priority outcome in the client's plan of care? 1) Maintenance of normal lipid levels without the use of pharmacotherapy 2) Education about diet and exercise 3) Validate that the client understands the importance of lifestyle changes 4) The client's achievement of normal lipid levels through compliance with medications

1) Maintenance of normal lipid levels without the use of pharmacotherapy

The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion? (3) 1) Sardines 2) Shrimp 3) Almonds 4) Olive oil 5) Carrots

1) Sardines 3) Almonds 4) Olive oil

The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents? (2) 1) Tricor 2) Zetia 3) Lopid 4) Colestid 5) Zocor

1) Tricor 3) Lopid

The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation? (3) 1) Triglycerides 2) Phospholipids 3) Steroids 4) Lecithins 5) Bile acids

1) Triglycerides 2) Phospholipids 3) Steroids

A client asks the nurse how fat is carried in the blood. Which response should the nurse provide? 1) "Fats in your blood are carried inside small molecules called phospholipids." 2) "Fats travel in the blood on little proteins called lipoproteins." 3) "Fats are free floating in your circulatory system." 4) "Fats are encapsulated inside little bags known as lecithin."

2) "Fats travel in the blood on little proteins called lipoproteins."

The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information? 1) "I should take this medication on an empty stomach to help it absorb better." 2) "I must take this medication with food or I can have heartburn." 3) "My physician said it really doesn't matter how I take this medication." 4) "Taking this medication with yogurt will help it to absorb better."

2) "I must take this medication with food or I can have heartburn."

Which information about the dietary intake of lipids should the nurse provide a client? (4) 1) "Phospholipids will help prevent Alzheimer's disease." 2) "Phospholipids are essential to building plasma membranes." 3) "Cholesterol is a building block for estrogen and testosterone." 4) "Triglycerides are the major form of fat in the body." 5) "Cholesterol in the diet is unnecessary as the liver synthesizes it."

2) "Phospholipids are essential to building plasma membranes." 3) "Cholesterol is a building block for estrogen and testosterone." 4) "Triglycerides are the major form of fat in the body." 5) "Cholesterol in the diet is unnecessary as the liver synthesizes it."

Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels? 1) "Be sure to take your niacin on an empty stomach as soon as you arise." 2) "Take one aspirin 30 minutes before you take your niacin." 3) "Take your niacin tablet with food and at least one full glass of water." 4) "It may be time to ask your healthcare provider about switching to another drug."

2) "Take one aspirin 30 minutes before you take your niacin."

Which assessment is a nursing priority for a client receiving cholestyramine (Questran)? 1) Auscultation of heart sounds 2) Auscultation of bowel sounds in all four abdominal quadrants 3) Assessment of 24-hour urine output 4) Palpation for peripheral edema in the lower extremities

2) Auscultation of bowel sounds in all four abdominal quadrants

The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets? 1) The drugs can be administered together. 2) Four hours after administration of cholestyramine (Questran). 3) Bisacodyl (Dulcolax) can be given any time but must be taken with food. 4) One hour after administration of cholestyramine (Questran).

2) Four hours after administration of cholestyramine (Questran).

Which type of lipoprotein is often referred to as "the good type?" 1) Triglycerides 2) HDL 3) LDL 4) VLDL

2) HDL

Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol? 1) HDL and LDL monitoring is less expensive than measuring total cholesterol. 2) Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol. 3) HDL and LDL measurements are more general and frequently used to assess clients that are not at risk for heart disease. 4) Total cholesterol measurements are often inaccurate and not as reliable as HDL and LDL.

2) Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.

Which type of lipid serves as fuel for the body when energy is needed? 1) Phospholipids 2) Triglycerides 3) Steroids 4) Lecithins

2) Triglycerides

A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client? (3) 1) "The best drugs to raise the high density lipoprotein (HDL) levels are the fibric acid drugs." 2) "The statin drugs are good but will cause a lot of flushing if you swallow them with warm fluids." 3) "The bile resins keep cholesterol from being absorbed but have some side effects." 4) "The statin drugs inhibit the making of cholesterol and are considered the best choice." 5) "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

3) "The bile resins keep cholesterol from being absorbed but have some side effects." 4) "The statin drugs inhibit the making of cholesterol and are considered the best choice." 5) "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching? 1) Beef tenderloin with gravy and noodles, fruit salad with apples and grapefruit, slice of rye bread, and apple pie 2) Grilled chicken salad with strawberries and pecans, baked macaroni and cheese, and low-fat brownie 3) Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding 4) Low-fat hamburger with whole-wheat bun, tossed salad with walnuts and olive oil, and raisin-oatmeal cookie

3) Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding

The nurse is preparing to provide education for a client prescribed a statin. Which serious adverse effects should the nurse include in the teaching? (2) 1) Headache 2) Abdominal pain 3) Myopathy 4) Muscle or joint pain 5) Rhabdomyolysis

3) Myopathy 5) Rhabdomyolysis

Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels? 1) Works primarily by lowering LDL and HDL levels. 2) Due to adverse effects, niacin should not be used with statins. 3) Niacin may also reduce triglyceride levels. 4) High doses of 25-30 mg per day are often necessary.

3) Niacin may also reduce triglyceride levels.

Which lipid type is associated with the highest risk for the development of atherosclerosis? 1) Phospholipids 2) Lecithins 3) Steroids 4) Triglycerides

3) Steroids

The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease? 1) Total 200, LDL 104, HDL 30 2) Total 210, LDL 135, HDL 58 3) Total 220, LDL 162, HDL 20 4) Total 186, LDL 125, HDL 54

3) Total 220, LDL 162, HDL 20

Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider? 1) Bowel sounds markedly increased in all four quadrants of the abdomen 2) Urine output of 200 mL/hour 3) Urine output of 20 mL/hour 4) Moderate elevation in liver function tests (LFTs)

3) Urine output of 20 mL/hour

Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels? 1) Hold the prescription and obtain another creatine kinase (CK) level in 6 hours. 2) Administer the prescription and continue to assess for muscle pain. 3) Administer the prescription and obtain another creatine kinase (CK) level in 6 hours. 4) Hold the prescription and notify the healthcare provider.

4) Hold the prescription and notify the healthcare provider.

Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels? 1) Binds exogenous cholesterol and excreting it in the feces 2) Increases excretion by activating enzymes within the hepatic system 3) Prevents dietary absorption within the GI tract 4) Inhibits an enzyme that is essential for cholesterol synthesis

4) Inhibits an enzyme that is essential for cholesterol synthesis

Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol? 1) Stomach 2) Gallbladder 3) Liver 4) Jejunum

4) Jejunum

Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol? 1) Most clients are not compliant with the dietary restriction. 2) Cholesterol is found in nearly all foods, and it is not possible to eliminate it from the diet. 3) Cholesterol is made within the body and cannot be absorbed via external sources. 4) The liver reacts to a low-cholesterol diet by making more cholesterol.

4) The liver reacts to a low-cholesterol diet by making more cholesterol.

Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop​ diuretic? A. Bananas B. Cheese C. Meat D. Yogurt

A. Bananas

Which should the nurse recognize a client with acute renal failure cannot effectively​ regulate? (4) A. Fluid balance B. Electrolyte balance C. The pH of body fluids D. Heart rate E. Blood pressure

A. Fluid balance B. Electrolyte balance C. The pH of body fluids E. Blood pressure

Which conditions should the nurse anticipate the healthcare provider to possibly prescribe a​ diuretic? (3) A. Heart failure B. Hypertension C. Ketoacidosis D. Acute kidney injury E. Cerebrovascular accident

A. Heart failure B. Hypertension D. Acute kidney injury

Which is the client at risk for that is receiving spironolactone​ (Aldactone)? A. Hyperkalemia B. Hyponatremia C. Pancytopenia D. Aplastic anemia

A. Hyperkalemia

Which should the nurse recognize is associated with chronic kidney disease​ (CKD)? (2) A. Hypertension B. Inflammation C. Diabetes D. Hypoperfusion E. Sepsis

A. Hypertension C. Diabetes

The nurse suspects a client receiving chlorothiazide​ (Diuril) is experiencing side effects from the prescription. Which assessment finding supports the​ nurse's suspicion? A. Serum potassium level of 3.0​ mEq/L and low blood pressure B. Mental confusion and dependent edema C. Ataxia and frequent diarrhea D. Serum sodium level of 160​ mEq/L and headaches

A. Serum potassium level of 3.0​ mEq/L and low blood pressure

Which should the nurse recognize are important safety precautions when administering a prescription to a client with renal​ failure? (3) A. The client will require lower dosages. B. Some prescriptions increase fluid retention. C. Measure hourly intake and output. D. Some prescriptions are nephrotoxic. E. Some prescriptions are bound to plasma proteins.

A. The client will require lower dosages. C. Measure hourly intake and output. D. Some prescriptions are nephrotoxic.

The nurse is preparing to provide education on daily​ self-monitoring for a client with congestive heart failure prescribed a diuretic. Which information should the nurse plan to include in the​ teaching? (3) A. Weight B. Pulse C. Temperature D. Blood pressure E. Respiratory rate

A. Weight B. Pulse D. Blood pressure

The nurse has provided education for a client with diabetes type I prescribed hydrochlorothiazide​ (Microzide) Which statement made by the client indicates an understanding of the​ information? A. ​"I expect my blood glucose to be​ elevated." B. ​"I anticipate to monitor my blood glucose more​ frequently." C. ​"I can expect my hemoglobin A1C to be​ elevated." D. ​"I expect I will need more insulin to help control my​ glucose."

A. ​"I expect my blood glucose to be​ elevated."

The nurse has provided dietary education for a client prescribed furosemide​ (Lasix). Which statement made by the client indicates an understanding of the​ information? A. ​"I will increase my consumption of​ green, leafy​ vegetables." B. ​"I will increase my consumption of​ poultry." C. ​"I will try and eat an orange​ daily." D. ​"I will try and incorporate more grains in my​ diet."

A. ​"I will increase my consumption of​ green, leafy​ vegetables."

The nurse has provided client education about the function of renal system. Which statements made by the client indicate an understanding of the​ teaching? (3) A. ​"Kidneys help the heart by balancing​ potassium." B. ​"Kidneys balance the fluid and electrolytes in my​ body." C. ​"Kidneys keep blood pressure from getting too​ low." D. ​"Kidneys help decrease infections by excreting​ bacteria." E. ​"Kidneys help regulate the oxygen levels in my​ blood."

A. ​"Kidneys help the heart by balancing​ potassium." B. ​"Kidneys balance the fluid and electrolytes in my​ body." C. ​"Kidneys keep blood pressure from getting too​ low."

A client prescribed spironolactone​ (Aldactone) asks the nurse which fluids they should drink to prevent dehydration. Which response should the nurse​ provide? A. ​"Plain water is really the​ best." B. ​"Any kind of fluid is​ okay, but avoid​ alcohol." C. ​"Electrolyte-replacement drinks like sports​ drinks." D. ​"Citrus juices are very good for​ rehydration."

A. ​"Plain water is really the​ best."

The educator is reviewing the physiology of the renal system with a nurse. Which statement made by the nurse indicates further teaching is​ required? A. ​"The kidneys stimulate white blood cell​ production." B. ​"The kidneys produce the active form of vitamin​ D." C. ​"The kidneys regulate the acid-base balance of body​ fluids." D. ​"The kidneys help regulate blood​ pressure."

A. ​"The kidneys stimulate white blood cell​ production."

Which prescription is nephrotoxic if an overdose​ occurs? A. Lorazepam​ (Ativan) B. Ibuprofen​ (Advil) C. Amitriptyline​ (Elavil) D. Quetiapine​ (Seroquel)

B. Ibuprofen​ (Advil)

Which vital signs should the nurse assess prior to the administration of a​ diuretic? (2) A. Temperature B. Pulse C. Respirations D. Blood pressure E. Pain

B. Pulse D. Blood pressure

Which diuretic is most effective in reducing the mortality of a client with heart​ failure? A. Chlorothiazide​ (Diuril) B. Spironolactone​ (Aldactone) C. Acetazolamide​ (Diamox) D. Furosemide​ (Lasix)

B. Spironolactone​ (Aldactone)

The nurse has completed the dietary teaching for a client prescribed spironolactone​ (Aldactone). Which statement made by the client indicates further teaching is​ required? A. ​"I usually eat an apple a day to stay​ regular." B. ​"I can still have my orange juice and bananas for​ breakfast." C. ​"I love to eat eggs and toast in the​ morning." D. ​"I am really happy that I can have my cranberry​ juice."

B. ​"I can still have my orange juice and bananas for​ breakfast."

An older adult receiving ethacrynic acid​ (Edecrin) tells the nurse he or she​ doesn't hear as well as he or she used to. Which statement should the nurse include in the​ response? A. ​"You may be​ dehydrated; are you drinking enough​ fluid?" B. ​"I will let your healthcare provider know about​ this; it could be a side effect of your​ medication." C. ​"How long have you been having difficulty​ hearing?" D. ​"I will schedule a hearing​ exam; this could be a side effect of your​ medication."

B. ​"I will let your healthcare provider know about​ this; it could be a side effect of your​ medication."

The educator is preparing to review the diuretics that do not require potassium supplements with a nurse. Which diuretics should the educator​ include? (2) A. Furosemide​ (Lasix) B. Chlorothiazide​ (Diuril) C. Amiloride​ (Midamor) D. Mannitol​ (Osmitrol) E. Spironolactone​ (Aldactone)

C. Amiloride​ (Midamor) E. Spironolactone​ (Aldactone)

The nurse is preparing the education for a client prescribed chlorothiazide​ (Diuril). Which information should the nurse include in the​ teaching? A. Assessment of blood glucose daily B. Daily weights with a report of a gain of more than 1 pound in 24 hours C. Consumption of foods high in potassium D. Report change in hearing

C. Consumption of foods high in potassium

A patient receiving chlorothiazide​ (Diuril) has developed hypokalemia. Which assessment findings support the​ diagnosis? A. Hyperglycemia B. Diarrhea C. Heart palpitations D. Increased urine output

C. Heart palpitations

Which is the primary functional unit of the​ kidney? A. ​Bowman's capsule B. Distal tubule C. Nephron D. Loop of Henle

C. Nephron

Which general adverse effect is associated with the use of​ diuretics? A. Constipation B. Hypertension C. Orthostatic hypotension D. Weight gain

C. Orthostatic hypotension

Which should the nurse suspect after reviewing noting the presence of protein on a routine​ analysis? A. Chronic kidney injury B. Acute kidney injury C. Structural damage D. Kidney infection

C. Structural damage

The nurse is reviewing the laboratory reports for a client with chronic kidney failure. Which lab should then nurse understand reflects the progression of the kidney​ disease? A. Serum creatinine B. Urinalysis C. Blood urea nitrogen​ (BUN) D. Glomerular filtration rate​ (GFR)

D. Glomerular filtration rate​ (GFR)

The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide​ (Microzide). Which condition should the nurse be concerned​ about? A. Hypothyroidism B. Asthma C. Gout D. Hypertension

D. Hypertension

Which initial treatment prescribed should the nurse anticipate for the client that has overdosed on​ hydrochlorothiazide? A. Intravenous normal saline B. Furosemide​ (Lasix) C. Electrolyte replacement D. Vasopressor

D. Vasopressor

The healthcare provider has prescribed hydrochlorothiazide​ (HCTZ) for a client with chronic renal failure. Which assessment finding indicates the treatment is​ ineffective? A. Hypotension B. Weak pulses C. Poor skin turgor D. Wheezing

D. Wheezing

Which information should the nurse include when providing education for an older client prescribed chlorothiazide​ (Diuril)? A. ​"Take the medication on an empty​ stomach." B. ​"Avoid foods that are high in​ potassium." C. ​"It is alright to have a glass of wine with this​ medication." D. ​"Take the medication early in the​ morning."

D. ​"Take the medication early in the​ morning."

A client prescribed bumetanide​ (Bumex) asks the nurse how the drug works. Which response should the nurse provide the​ client? A. ​"This prescription causes your kidneys to reabsorb​ sodium." B. ​"This prescription causes your kidneys to reabsorb​ potassium." C. ​"This prescription causes your kidneys to reabsorb​ chloride." D. ​"This prescription causes your kidneys to reabsorb​ calcium."

D. ​"This prescription causes your kidneys to reabsorb​ calcium."