Chapters 47 and 48 PrepU Questions

A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:

"I will take the digoxin about an hour before the cholestyramine."

A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?

"It's a good idea to keep your intake of saturated fat to a bare minimum."

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?

"It's important that you stop taking atorvastatin before you stop using contraception."

What should the nurse teach an older adult client about the potential adverse effects of atorvastatin?

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

Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant?

"This medication will keep unnecessary clots from forming in my blood."

A client is receiving anticoagulant therapy and has an INR done. Which result would the nurse interpret as being therapeutic?

2.4

When administering tirofiban, the nurse would administer the drug intravenously over which time frame?

30 minutes

A nurse will use extreme caution when administering heparin to which patient?

A 38-year-old male with peptic ulcer disease

A nurse is caring for a patient receiving the anticoagulant drug warfarin. What pre-administration assessments should the nurse perform before administering the drug to the patient?

Assess prothrombin time (PT) and INR.

Which substance would a group of students identify as being responsible for breaking up dietary fats into smaller units?

Bile acids

A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for:

Bleeding

A 60-year-old client experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The client has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?

By inactivating clotting factors and thus stopping the coagulation cascade

A client is taking atorvastatin calcium to reduce serum cholesterol. Which aspect of client teaching is most important?

Call the health care provider if muscle pain develops.

Which would be classified as a bile acid sequestrant?

Cholestyramine

The physician is caring for a client who is a 2-year kidney transplant survivor. The nurse would expect the physician to order what drug for the client's hyperlipidemia?

Fluvastatin

A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?

Frequently monitor blood cholesterol.

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?

Garlic

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

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

To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.)

High HDL cholesterol Low triglycerides Low LDL cholesterol

Mr. Hon has been admitted to the hospital and placed on anticoagulant therapy. For what blood-related disorder is this therapy used?

Hypercoagulation

A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?

Liver disease

A 75-year-old client presents to the health care provider's office with bleeding gums and multiple bruises. When the nurse reviews the client's drug history, the nurse finds that the client is prescribed aspirin 81 mg/d. What drug may cause increased bleeding when used in conjunction with the aspirin?

NSAIDs

The nurse is providing teaching to a client who is at risk for hyperlipidemia. The nurse knows that which risk factors can be controlled or modified?

Obesity, inactivity, diet, and smoking

A client is to receive clopidogrel. The nurse would expect to administer this agent by which route?

Oral

A client is receiving heparin. Which would the nurse use to monitor the effects of the drug?

Partial thromboplastin time

HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?

Pregnancy Category X

A nurse is caring for a 64-year-old female client who is receiving IV heparin and reports bleeding from her gums. The nurse checks the client's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered?

Protamine sulfate

A client is to receive enoxaparin (Lovenox). The nurse would administer this drug by which route?

Subcutaneous injection

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

True

A client is receiving antihemophilic factor. The nurse understands that this drug is which factor?

VIII

The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will the nurse likely administer?

Vitamin K

To compensate for clopidogrel's slow onset of action, the nurse should anticipate implementing which intervention?

administering a one-time loading dose that is higher than the maintenance dose

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?

decreased absorption

In addition to being synthesized in the liver and intestine, from where are blood lipids derived?

diet

The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?

headache and flatulence.

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?

liver panel

A nurse at a long-term care facility is conducting a medication reconciliation for a man who has just moved into the facility. The man is currently taking clopidogrel. The nurse is most justified suspecting that this man has a history of:

myocardial infarction.

A client who has been treated with warfarin after cardiac surgery is found to have an INR of 9.0. Which medication will be administered to assist in the development of clotting factors?

vitamin K

A client who is receiving warfarin has blood in his urinary drainage bag. What medication will likely be prescribed by the health care provider?

vitamin K