Pharm Adap Quiz: Ch. 27 Antilipemic Drugs

The nurse is caring for a patient who has hypercholesterolemia and who has been prescribed atorvastatin. Which instruction will the nurse receive from the primary health care provider for the safe administration of the medication?

"Administer 10 mg of atorvastatin orally."

A patient with a serum cholesterol level of 275 mg/dL is prescribed simvastatin. What instructions should the nurse provide to the patient? Select all that apply.

"Avoid taking the drug with grapefruit juice." "Notify your health care provider if your urine becomes discolored." "Notify your health care provider if muscle pain occurs after 3 days."

The nurse is caring for a patient with hypercholesterolemia who is taking 20 mg of simvastatin as prescribed. After a few days, the patient's urinalysis reports indicate the presence of myoglobin. What instruction would the nurse receive from the primary health care provider?

"Discontinue administering the medication."

The nurse teaches the nursing student about statin drugs. Which statements by the student indicate effective learning? Select all that apply.

"Fluvastatin with warfarin increases the risk of bleeding." "Pravastatin is not as effective as simvastatin for the inhibition of CYP3A4."

Which patient's statement indicates a need for further medication instruction about colestipol?

"I should mix the powder in a small amount of fluid to maintain potency of the medication."

Which statement made by the patient demonstrates deficient knowledge regarding colestipol?

"I should sprinkle the powder on food to promote absorption but avoid overmixing."

The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin. Which response from the students indicates effective learning?

"It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."

The nurse is assessing a patient who has been prescribed atorvastatin. What instruction should the nurse provide for the patient to ensure proper administration of the medication?

"Take the drug in the evening."

What should the nurse instruct the patient with high serum cholesterol who has been on treatment with antilipemics for six months to do to ensure safe drug administration?

"You should include fiber-rich foods in your diet."

The nursing instructor is teaching nursing students about niacin therapy for the treatment of different types of hyperlipidemia. What will the nursing instructor include in this teaching? Select all that apply.

Always check the patient's medical history for gout. Always check the patient's medical history for diabetes. It is always preferable to give the extended-release dosage form of the drug to the patient.

On assessment of a patient with hyperlipidemia, the nurse learns that the patient has recently undergone a liver transplantation. Which antihyperlipidemic drug does the nurse expect to be excluded from the patient's prescription?

Atorvastatin

A patient is receiving clofibrate. A careful adjustment of the dosage of warfarin is required for patients taking this medication because of the risk of which condition?

Bleeding

The nurse knows that simvastatin exerts its action by doing what?

By inhibiting the enzyme HMG-CoA reductase

Which medication is found to be beneficial to the patient who is taking erythromycin for a throat infection and has liver disease?

Cholestyramine

The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemic drug would be most beneficial for the patient?

Colesevelam

A patient with hyperlipidemia is prescribed atorvastatin; however, the patient does not want to take a pill and prefers powder form. What alternative medication available in powder form would be most beneficial for the patient?

Colestipol

The nurse is assessing a patient who has hyperlipidemia and who is treated with antihyperlipidemic medications. During the assessment, the patient tells the nurse, "These days, my urine has a burnt odor." Which medications prescribed for the patient may be responsible for such an adverse effect? Select all that apply.

Colestipol & Cholestyramine. Urine with a burnt odor is an adverse effect of bile acid sequestrants such as colestipol and cholestyramine.

Which is a side effect of cholestyramine?

Constipation

Which assessment finding in a patient taking a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor will the nurse act on immediately?

Elevated liver function tests

Which antilipemic medication reduces serum cholesterol by inhibiting its absorption in the small intestine?

Ezetimibe

Which are positive risk factors for coronary heart disease (CHD)? Select all that apply.

Family history of premature CHD & Blood pressure higher than 140/90 mm Hg

What should the nurse tell the patient who is on atorvastatin in preparation for a lipid profile?

Fast for 12 hours before the sample collection.

Which adverse effect does the nurse expect to find in a patient who is taking antilipemic drugs?

Flushing

The nurse is caring for a patient who has elevated triglyceride levels and is unresponsive to HMG-CoA reductase inhibitors. What does the nurse expect the primary health care provider to prescribe to the patient?

Gemfibrozil

The nurse would question an order for colesevelam if the patient has which condition in the medical history?

Impaction

What are the common side effects of fenofibrate, a fibric acid derivative? Select all that apply.

Impotence, nausea & abdominal pain, and increase in gallstone formation

The nurse is caring for a patient who is on atorvastatin medication. For what should the nurse monitor?

Increase in liver enzyme levels

A patient with hypercholesterolemia has been prescribed simvastatin. Which action should the nurse perform while caring for the patient?

Inform the patient that this drug may cause nausea.

What is the mechanism of action of ezetimibe?

Inhibiting absorption of dietary and biliary cholesterol in the small intestine

The nurse is caring for a patient who is prescribed simvastatin. What medication in the prescription would need a replacement?

Ketoconazole

A patient is taking pravastatin sodium. Which assessment finding requires immediate action by the nurse?

Muscle Pain; as this may be indicative of rhabdomyolysis, a muscle disintegration that can become fatal.

A patient will be discharged to continue treatment with simvastatin. The nurse will teach the patient to report which symptom?

Muscle pain

Before the nurse administers simvastatin, which baseline data are collected to help prevent adverse effects of therapy? Select all that apply.

Muscle pain Renal function Liver enzymes Gastric distress

A patient with dyslipidemia has been prescribed atorvastatin. After a few days, the patient reports to the nurse that her pregnancy test is positive and that she has severe constipation. What medication does the nurse expect the provider to order for the patient?

Niacin

A patient with metabolic syndrome requires antilipemic therapy after a myocardial infarction. Which antilipemic medication is the best choice to reach this patient's treatment goals?

Nicotinic acid

The nurse is assessing a patient who has been prescribed cholestyramine. The nurse finds that the patient has bloating and decreased peristalsis. Which intervention should the nurse perform to relieve the symptoms? Select all that apply.

Provide a diet rich in fiber & Increase the intake of fluid

The nurse is assessing a patient who has hyperlipidemia and who is prescribed gemfibrozil. For which condition will the nurse assess in the patient before administering the drug? Select all that apply.

Renal dysfunction Gallbladder disease Hepatic dysfunction

The nurse assesses a patient who has hyperlipidemia and who is on antihyperlipidemic therapy and informs the primary health care provider that the patient has keratomalacia. Which drug does the nurse expect to be included in the patient's treatment regimen?

Retinol

The primary health care provider prescribes niacin (nicotinic acid) for a patient who has hyperlipidemia. For what will the nurse assess while caring for this patient?

Symptoms of pruritus

The nurse is teaching a patient about the safe administration of niacin (nicotinic acid). What instruction will the nurse give to the patient to minimize the adverse effects of the drug?

Take aspirin 30 minutes before taking the drug.

The nurse is teaching a medication regimen to a patient who has type II hyperlipoproteinemia and who has been prescribed cholestyramine. Of what will the nurse inform the patient during the teaching?

Take other medications 1 hour before the administration of cholestyramine.

A patient with hyperlipidemia is treated with atorvastatin. On the follow-up visit, the nurse discovers that the patient has had no improvement in cholesterol levels. What could be the reason for this?

The patient is taking the medication in the morning.

An older adult patient with hypertension and hyperlipidemia who has been prescribed a statin medication comes for a follow-up visit after 4 months of therapy. The patient's lab reports show elevated blood cholesterol levels, and the urine examination reveals rhabdomyolysis. What could be the reasons for this condition? Select all that apply.

The patient is taking verapamil along with statins. The patient is taking amiodarone along with statins. The patient is taking grapefruit juice along with statins.

The nurse is assessing a patient who is receiving antilipemic drug therapy. After 3 weeks of treatment, the nurse finds decreased levels of cognition, learning dysfunction, and behavioral changes in the patient. What does the nurse infer from this observation? Select all that apply.

The patient is treated with cholestyramine drug therapy. The patient has a previous history of phenylketonuria (PKU).

A patient with congestive heart failure has a serum low-density lipoprotein (LDL) level of 140 mg/dL. The health care provider prescribes extended-release niacin tablets to the patient. During the follow-up visit, the serum cholesterol concentration is found to be 120 mg/dL. What changes will the nurse expect in the patient's prescription?

The same dose of niacin will be continued.

Laboratory reports indicate that a patient's serum cholesterol concentration is 250 mg/dL and triglyceride levels are 450 mg/dL. The health care provider prescribes gemfibrozil to lower cholesterol levels. What is the desired effect of the drug on the patient's lipoprotein levels?

There would be an increase in low-density lipoprotein (LDL) levels.

A patient eats large amounts of garlic for its cardiovascular benefits. Which drug in the patient's medication history would prompt the nurse to ask the patient to stop consuming garlic?

Warfarin

A patient is prescribed simvastatin. During medication reconciliation, the presence of which drug(s) in the prescription should raise concern? Select all that apply.

Warfarin Gemfibrozil Cyclosporine Erythromycin

A patient with hyperlipidemia has been prescribed simvastatin. The nurse instructs the patient to undergo a liver function test and kidney function test every 3 to 6 months. Which drug therapy-related complication in the patient is the nurse trying to prevent?

rhabdomyolysis