Chapter 47 questions

What should the nurse teach an older adult client about the potential adverse effects of atorvastatin? -"Some clients get some mild chest pain initially, but rest assured that this does not indicate a heart attack." -"Most people who experience side effects from atorvastatin report stiffness in their joints or calves." -"The more serious side effects of atorvastatin involve a risk of bleeding, but this is quite rare." -"The most common side effects of atorvastatin involve some mild gastrointestinal upset."

-"The most common side effects of atorvastatin involve some mild gastrointestinal upset."

The administration of cholestyramine (Questran) with warfarin (Coumadin) would most likely cause a client to present with which issues? (Select all that apply.) -Bruising -Blood in the stool -Subtherapeutic INR -Supratherapeutic INR -Calf pain and warmth

-Subtherapeutic INR -Calf pain and warmth Co-administration of warfarin and cholestyramine can result in decreased anticoagulant effect leading to subtherapeutic INR and increase chance of clotting (signs and symptoms of DVT or PE).

Which single class drug is known to be most effective in reducing the major types of dyslipidemia? -statins -bile acid sequestrants -fibrates -niacin

-statins

Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? -Diet -Medications -Exercise -Kidneys

Diet

What intervention may help the client increase HDL levels? -Smoking cessation -Leg elevation -TED hose -Exercise

Exercise

A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility? -Weakness -Flushing of the skin -Tachycardia -Dyspnea

Flushing of the skin

The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate? -Cholestyramine -Colesevelam -Colestipol -Gemfibrozil

Gemfibrozil

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? -Heart disease -Diabetes -Glaucoma -Hypertension

Heart Disease Increased levels of LDL in combination with other risk factors, such as increased weight, diet high in saturated fats, and lack of physical activity, can lead to the development of atherosclerotic heart disease. In diabetes high levels of blood glucose as well as HbA1c are seen. In clients with glaucoma, increased eye pressure causes damage to the optic nerve. Clients with hypertension left untreated can lead to kidney failure and stroke.

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? -Optimal -Desirable -High -Very high

High High is rated at >240 mg/dL (6.2064 mmol/L). The other options are incorrect.

A patient with metabolic syndrome usually has increased plasminogen activator levels. True False

True

A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply. -Weight -Diet -Gender -Age -Family history

Weight Diet

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 72-year-old man who has emphysema and a long history of cigarette smoking -An obese male client who is a heavy alcohol user and who has cirrhosis of the liver -A female client who had a laparoscopic cholecystectomy (gall bladder removal) earlier this year -A resident of a long-term care facility whose Alzheimer disease is being treated with donepezil (Aricept)

-An obese male client who is a heavy alcohol user and who has cirrhosis of the liver

Which substance would a group of students identify as being responsible for breaking up dietary fats into smaller units? -Bile acids -Cholesterol -Chylomicrons -Micelles

-Bile acids

What cardiac risk factors are related to metabolic syndrome? (Select all that apply.) -Central adiposity -Elevated triglycerides -Reduced high density lipoprotein cholesterol -Postural hypotension -Elevated fasting blood glucose

-Central adiposity -Elevated triglycerides -Reduced high density lipoprotein cholesterol -Elevated fasting blood glucose

Which would be classified as a bile acid sequestrant? -Lovastatin -Ezetimibe -Cholestyramine -Gemfibrozil

-Cholestyramine

A client asks the nurse what the atorvastatin (Lipitor) prescribed for the client will do. What is an expected outcome for this client? -Decrease in serum cholesterol only -Decrease in serum cholesterol and LDL levels -Decrease in sitosterol and serum cholesterol -Decrease in camperterol and LDL levels

-Decrease in serum cholesterol and LDL levels

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? -Elevated LDL levels -Elevated HDL levels -A high ratio of HDL to LDL -Low VLDL levels

-Elevated LDL levels

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? -Liver -Gallbladder -Small intestine -Stomach

-Gallbladder

A client is taking lovastatin (Mevacor). Which are noted as the most common adverse effects? -Nausea, flatulence, and constipation -Increased appetite and blood pressure -Fatigue and mental disorientation -Hiccups, nasal congestion, and dizziness

-Nausea, flatulence, and constipation

What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia? -Therapeutic lifestyle changes are the preferred method for lowering blood lipids. -Continued therapeutic lifestyle changes during drug therapy will guarantee success. -Therapeutic lifestyle changes are easier to comply with than medication therapies. -Nonpharmacologic interventions are cheaper than using medications.

-Therapeutic lifestyle changes are the preferred method for lowering blood lipids.