CH 10 Drugs for Dyslipidemia (E3)
A 48-year-old man visits his health care provider for his annual checkup. He is otherwise in good health, but assessment findings reveal the new onset of a slight increase in blood pressure and a total serum cholesterol of 240 mg/dL. What can the nurse anticipate as the preferred treatment for this patient? A) a low-lipid diet and an exercise program B) a low-lipid diet and a cholesterol synthesis inhibitor C) an exercise program and a fibrate D) a low-lipid diet and an exercise program
A
A client has been reading about the use of flax seed to lower cholesterol. What should the client be taught about the use of oat bran and cholestyramine? A) Cholestyramine absorption will be increased with oat bran. B) Cholestyramine absorption will be decreased with oat bran. C) Bleeding will be increased with oat bran and cholestyramine. D) Hypoglycemia will result from oat bran and cholestyramine.
A
A 66-year-old woman's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The woman is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin. The nurse should anticipate what order? A) "atorvastatin 150 mg PO BID" B) "atorvastatin 10 mg PO OD" C) "atorvastatin 50 mg PO TID with meals" D) "atorvastatin 75 mg PO BID"
B
A client is scheduled to have serum triglyceride level assessed. How long should the client be without food or fluids prior to the serum triglyceride test? A) 6 hours B) 8 to 10 hours C) 12 hours D) 24 hours
C
A client who has been taking a statin has seen an improvement in cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medication regimen? A) digoxin B) vitamin D C) cholestyramine D) calcium carbonate
C
A nurse is collecting data from a client who is taking gemfibrozil Which of the following assessment findings should the nurse identify as an adverse reaction to the medication? A) Mental status changes B) Tremor C) Jaundice D) Pneumonia
C
A client has begun taking cholestyramine. Which are noted as the most common adverse effects? A) nausea, flatulence, and constipation B) increased appetite and blood pressure C) fatigue and mental disorientation D) hiccups, nasal congestion, and dizziness
A
A client is taking atorvastatin to reduce serum cholesterol. Which aspect of client teaching is most important? A) Call the health care provider if muscle pain develops. B) It is unacceptable to eat dietary fats. C) Decrease the dose if lethargy occurs. D) Eat two eggs per day to increase protein stores.
A
A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication? A) digoxin B) ibuprofen C) aspirin D) acetaminophen
A
A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: A) muscle pain. B) dry mouth. C) pruritus (itching). D) increased thirst.
A
A man has not been able to decrease his low-density lipoprotein (LDL) cholesterol levels with lifestyle management, and his nurse practitioner has prescribed atorvastatin, a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. The nurse explains to him that atorvastatin is best administered A) without regard for time of day B) at noon, taken with grapefruit juice C) with a snack in the early afternoon D) every other day with a dose of red yeast rice
A
A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? A) Take this medication in the evening. B) Change position slowly when rising from a chair. C) Maintain a steady intake of green leafy vegetables. D) Consume no more than 1 L/day of fluid.
A
The primary focus for prevention and management of metabolic syndrome and its sequelae is A) elevated high-density lipoprotein (HDL) cholesterol, depressed low-density lipoprotein (LDL) cholesterol, and low total cholesterol B) low HDL cholesterol, low LDL cholesterol, and low total cholesterol C) low triglycerides D) high HDL cholesterol, low LDL cholesterol, and low triglycerides
A
Which single drug class is known to be most effective in reducing the major types of dyslipidemia? A) statins B) bile acid sequestrants C) fibrates D) niacin
A
The nurse practitioner adds cholestyramine to statin therapy in a patient with markedly elevated serum levels of LDL cholesterol. Which of the following if stated by the patient indicates that patient teaching has been successful? SELECT ALL THAT APPLY. A) "I need to mix the powder with water or other fluids before I take it." B) "I should wait 1 hour after I eat to take the medication." C) "I need to maintain good oral hygiene as the medication can damage my teeth." D) "If I notice an increased bleeding tendency, I need to notify the nurse practitioner." E) "I might have some GI effects, including constipation or abdominal pain."
A, C, E
A client has an elevated total serum cholesterol of 260 mg/dL. Which aspect of client teaching of lifestyle changes is most important for the client? A) Eat organic foods. B) Stop smoking. C) Increase rest periods. D) Drink whole milk.
B
A client is prescribed fenofibrate. When providing client teaching, which accurately describes the action of fenofibrate? A) It binds to bile acids in the intestinal lumen. B) It increases oxidation of fatty acids in the liver. C) It inhibits an enzyme required for hepatic synthesis. D) It inhibits mobilization of free fatty acids from peripheral tissues.
B
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? A) complete blood count (CBC) B) liver panel C) INR and aPTT D) reticulocyte count
B
An obese client who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by the primary care provider. What do these data suggest in this client? A) the development of arthritic syndrome B) the development of metabolic syndrome C) the development of Reye's syndrome D) the development of Tay-Sachs disease
B
A male client has been diagnosed with moderately increased LDL, and his primary care provider wishes to begin him on a statin. What is a potential disadvantage of statins that the care provider should consider? SELECT ALL THAT APPLY. A) Statins are nephrotoxic. B) Statins are expensive. C) Statins are contraindicated in clients with a history of myocardial infarction. D) Statins require regularly scheduled blood work. E) Statins have an immunosuppressive effect.
B, D
A nurse is caring for a client who has a new prescription for niacin to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of niacin? SELECT ALL THAT APPLY. A) Muscle aches B) Hyperglycemia C) Hearing loss D) Flushing of the skin E) Jaundice
B, D, E
A nurse is caring for a client who has a new prescription for alirocumab to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of this drug? SELECT ALL THAT APPLY. A) Muscle aches B) Vasculitis C) Hearing loss D) Urticaria E) Jaundice
B, E
A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A) History of severe constipation B) History of hypertension C) Active hepatitis C D) Type 2 diabetes mellitus
C
An older adult client is being treated in the hospital for a stroke and is undergoing an extended stay on a rehabilitation unit. The client's spouse has been participating actively in the client's care and performs much of the feeding and hygiene needs. This evening, the spouse has brought in a number of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes simvastatin, the nurse would remove which item? A) purple grapes B) cranberry cocktail C) grapefruit juice D) trail mix (salted nuts and seeds)
C
Which herbal and dietary supplement has shown proven success in lowering LDL and total cholesterol in research studies? A) soy B) flaxseed oil C) red yeast rice D) garlic
C
A 36-year-old woman has been taking atorvastatin 20 mg PO daily for 6 months to treat mild dyslipidemia. At a clinic appointment, she tells the nurse she is 6 weeks pregnant. The nurse counsels the patient that it is likely that her midwife will counsel her A) to increase the dose of prenatal vitamins B) to reduce the dosage of her lovastatin to 20 mg PO daily C) to increase the dosage to 40 mg PO twice daily D) about discontinuing the drug during pregnancy
D
A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy? A) reduction in triglycerides B) reduction in total serum cholesterol levels C) increase in HDL levels D) reduction in LDL cholesterol levels
D
A client is taking cholestyramine and ezetimibe. What administration guideline is most important to teach this client? A) The two medications should be taken together. B) The ezetimibe inhibits cholesterol in the liver. C) The cholestyramine is administered 1 hour after ezetimibe. D) The administration of ezetimibe is 1 hour before cholestyramine.
D
A client with a diagnosis of cardiovascular disease is taking atorvastatin to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium? A) 100 to 115 mg/dL B) 75 to 85 mg/dL C) less than 60 mg/dL D) less than 130 mg/dL
D
A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of following instructions should nurse include in the teaching? A) "Take digoxin with your morning dose of colesnvelam B) "Your sodium and potassium levels will be monitored periodically while taking colesevelam. C) "Watch for bleeding or bruising while taking colesnvelam. D) "Take colesevelam with food at least one glass of water.
D
A person with type 1 diabetes mellitus and hypertension has the following lipid profile: total serum cholesterol 288 mg/dL, low-density lipoprotein (LDL) cholesterol 200 mg/dL, high-density lipoprotein (HDL) cholesterol 48 mg/dL, and triglycerides 200 mg/dL. How would you evaluate the results of the lipid profile? SELECT ALL THAT APPLY. A) LDL cholesterol is elevated. B) HDL cholesterol is within normal limits. C) Triglyceride level is elevated. D) Total cholesterol is within normal limits.
D
An older adult client, who leads a sedentary lifestyle, has recently been diagnosed with dyslipidemia. The client is disappointed to learn about this condition, stating, "First it was the diabetes and then the arthritis, now this." The nurse has performed health education with the client and has described metabolic syndrome. In addition to the elevated cholesterol levels, what aspect of the client's health is congruent with a diagnosis of metabolic syndrome? A) sedentary lifestyle B) age over 65 C) arthritis D) diabetes mellitus
D
John Jones, a 47-year-old teacher, now takes cholestyramine, and the nurse teaches him about the medication and its use. The nurse should be concerned if, after the teaching session, Mr. Jones states A) "I should take the medicine with a full glass of water when I take my other medications" B) "I am taking this medication to decrease my LDL cholesterol level" C) "I should swallow the tablets whole" D) "I may need to supplement my intake of the fat-soluble vitamins A, D, E, and K"
D
Karen James, a 32-year-old accountant with type 1 diabetes mellitus, is taking gemfibrozil to reduce her serum triglyceride level. She asks why she could not take niacin, as her husband does. The nurse responds A) "Either drug reduces triglycerides. Why don't you ask your nurse practitioner if the drug therapy could be changed?" B) "Gemfibrozil is the only drug recommended for use to lower cholesterol" C) "Niacin therapy is not recommended for use in women" D) "Niacin increases blood glucose levels and is not preferred for people with diabetes"
D
