Chapter 47: Lipid-Lowering Agents
A pt has been diagnosed with hyperlipidemia and has been prescribed Niacin 1.5 g PO daily in two divided doses. How many 500 mg tablets should the nurse administer for each dose?
1.5 tablets
A pt with a complex medical history has been taking Cholestyramine for several months following diagnosis with hyperlipidemia. The pt's most recent blood work reveals increased blood urea nitrogen and creatinine levels. What is the nurse's best interpretation of this finding? A) This is likely unrelated to Cholestyramine use and will not likely affect future therapy B) The pt is experiencing common adverse effects of Cholestyramine C) The pt's Cholestyramine should be discontinued promptly by the care provider D) The pt's excretion of Cholestyramine will be impaired
A
A pt with hyperlipidemia began taking Atorvastatin several weeks ago and has phoned to report muscle pain, brown-tinged urine and nausea. What is the nurse's best action? A) Tell the pt to present to the emergency department promptly B) Reassure the pt that these adverse effects of Atorvastatin will decrease with time C) Encourage the pt to increase fluid intake while taking Atorvastatin D) Ask the pt what time of day he is taking the medication
A
The nurse has completed an assessment of a female pt. What assessment finding meets the criteria for metabolic syndrome? A) Triglyceride level 159 mg/dL B) Fasting blood glucose 99 mg/dL C) Waist measurement 34 inches D) BP below 128/81 mm Hg
A
The nurse is describing the metabolism of fats to a pt who has recently been diagnosed with hyperlipidemia. The nurse should described what role of bile acids? A) Facilitating the absorption of fats into the small intestine B) Active transport of fat molecules into muscle cells C) Preventing the accumulation of cholesterol in the blood vessel lumen D) Active transport of dietary fat molecules into adipose tissue
A
What LDL-lowering medication would the nurse identify as inhibiting triglyceride synthesis in the liver? A) Fenofibrate B) Niacin C) Fenofibric acid D) Gemfibrozil
A
What does the nurse describe a as a carrier for small units of fats? A) Chylomicrons B) Cholesterol C) Micelles D) Bile acids
A
When administering a lipid-lowering agent, the nurse would anticipate administering the drug by which route? A) Oral B) Sublingual C) Intravenous D) Intramuscular
A
When describing the action of Atorvastatin, the nurse includes what important descriptor? A) Blocking the enzyme that is involved in cholesterol synthesis B) Decreasing dietary cholesterol absorption from the small intestine C) Binding with bile acids to form an insoluble complex that is excreted D) Stimulating the breakdown of lipoproteins from the tissues
A
When reviewing the pts' admission orders, what prescription should the nurse identify as being safest and most effective? A) Administer Ezetimibe 10 mg PO daily and Atorvastatin 20 mg PO daily B) Administer Atorvastatin 20 mg PO daily and Niacin 500 mg t.i.d. PO C) Adminiser Rosuvastatin 10 mg PO daily to be taken with grapefruit juice D) Administer Atorvastatin 20 mg PO daily and Erythromycin 400 mg q.i.d
A
SATA. The nurse teaches the pt to mix Cholestyramine with what liquids? A) Fruit juices B) Cereals C) Water D) Soups E) Seltzer water
A B C D
SATA. Teaching a pt who is prescribed an HMG-CoA reductase inhibitor to treat high cholesterol and high lipid levels should include which of the following? A) The importance of exercise B) The need for dietary changes to alter cholesterol levels C) That taking a statin will allow a full, unrestricted diet D) That drug therapy is always needed when these levels are elevated E) The importance of controlling BP and blood glucose levels F) That stopping smoking may also help to lower lipid levels
A B E F
SATA. A bile acid sequestrant is the drug of choice for a pt who has which of the following? A) A high LDL concentration B) A high triglyceride concentration C) Biliary obstruction D) Vitamin K deficiency E) A high HDL concentration F) Intolerance to statins
A B F
SATA. After reviewing the various agents used to lower lipid levels, the nurse should identify which agents as stimulating the breakdown of lipoproteins from the tissues and their removal from the plasma? A) Gemfibrozil B) Cholestyramine C) Niacin D) Atorvastatin E) Fenofibrate
A E
A pt with atrial fibrillation is receiving Warfarin therapy. The pt is also prescribed Ezetimibe. The nurse would instruct the pt to watch for what? A) Yellowing of the skin B) Blood in urine or stool C) Abdominal pain D) Blurred vision
B
After describing to a community group the ways in which the body uses cholesterol, which of the following, if stated by the group as such as a way, indicates successful teaching? A) The production of water-soluble vitamins B) The formation of steroid hormones C) The mineralization of bones D) The development of dental plaques
B
HMG-CoA reductase inhibitors work in the: A) Process of bile secretion B) Process of cholesterol formation in the cell C) Intestinal wall to book fat absorption D) Kidney to block fat excretion
B
The formation of atheroma in blood vessels precedes the signs and symptoms of: A) Hepatitis B) CAD C) Diabetes mellitus D) COPD
B
The nurse monitors the pt for what possible adverse effect when taking Colestipol? A) Fecal incontinence B) Increase bleeding C) Diplopia D) Jaundice
B
The nurse, teaching a class on healthy lifestyle choices, explains that elevated HDL levels are beneficial because of what action? A) Block the effects of estrogen on development of coronary artery disease B) Pick up remnants of fat and cholesterol left in the periphery by LDL breakdown C) Increase LDL metabolism and more rapid excretion in feces D) Prevent the absorption of fat in the small intestine by increasing bile secretion
B
What adverse effects would a nurse assess for in a pt taking Ezetimibe? A) Bloating B) Mild abdominal pain C) Constipation D) Flatulence
B
A nurse is caring for an obese male pt with a family history of coronary after who had a myocardial infarction at age 40. What risk factor can the pt modify? A) Male B) Family history C) Obesity D) History of MI
C
Hyperlipidemia is considered to be: A) A normal finding in adult males B) Related to stress levels C) A treatable CAD risk factor D) A side effect of cigarette smoking
C
The nurse is assessing a pt who has just been taking Atorvastatin for several months. What change in the pt's health status should the nurse most likely attribute to the use of Atorvastatin? A) Pitting edema to the lower legs and feet B) Upper respiratory infections C) Recent nausea and constipation D) Palpitations and decreased exercise tolerance
C
The obese pt is told that his lipid levels are elevated. What is the first intervention the nurse will anticipate the provider will order? A) Atorvastatin B) Niacin C) Dietary change and exercise D) Cholestyramine
C
The pt undergoing medication therapy to treat hyperlipidemia reports she just found out she is pregnant. What drug would be safe for the pt to continue while pregnant? A) Cholesterol absorption inhibitors B) Omega-3-acid ethyl esters C) Bile acid sequestrant D) HMG-CoA reductase inhibitors
C
Which agent would a nurse identify as a cholesterol absorption inhibitor? A) Simvastatin B) Colestipol C) Ezetimibe D) Fenofibrate
C
Which of the following would the nurse expect the health care provider to prescribe for a pt who has high lipid levels and cannot take vibrates or HMG-CoA reductase inhibitors? A) Nicotine B) Vitamin C C) Niacin D) Nitrates
C
Which of the following would the nurse include when teaching a pt about HMG-CoA reductase inhibitors? A) The pt will not have a heart attack B) The pt will not develop CAD C) The pt might develop cataracts as a result D) The pt might stop absorbing fat-soluble vitamins
C
SATA. What factors would the nurse anticipate assessing in the pt diagnosed with metabolic syndrome? A) High HDL B) Anemia C) High triglycerides D) Abdominal fat E) HTN
C D E
A pt is receiving Atorvastatin. The nurse would anticipate that the maximum effectiveness of the drug would occur whit which time frame? A) 4 to 5 hours B) 2 to 3 hours C) 3 to 4 hours D) 1 to 2 hours
D
A pt who is receiving Cholestyramine also take Digoxin. The nurse teaches the pt about drug administration. The pt demonstrates understanding of the teaching when he makes what statement? A) I need to take both drugs at the same time of the day B) I'll take the Digoxin about 15 minutes before the Cholestyramine C) I'll take the Cholestyramine at 0800 and the Digoxin at 0900 D) I will take the Digoxin at least an hour before taking Cholestyramine
D
The bile acids sequestrants: A) Are absorbed into the liver B) Take servile weeks to show an effect C) Have no associated adverse effects D) Prevent bile salts form being reabsorbed
D
The nurse admits a pt who has recently begun taking bile acid sequestrants in order to control serum lipid levels and reduce risk for CAD. When assessing the pt for adverse effects, what assessment should the nurse prioritize? A) Assessment of fluid balance and examination of lymphedema B) Assess tympanic membrane for inflammation or edema C) Examination for signs of tetany D) Bowel sounds and recent pattern of bowel movements
D
What education should the nurse provide to a pt who has been prescribed Simvastatin? A) Take an extra dose when a high-fat meal is anticipated B) Avoid concurrent use of antibiotics C) Take the medication three times a day, with meals D) Take the medication at bedtime
D
Which of the following would alert the nurse to suspect that a pt receiving HMG-CoA reductase inhibitors is developing rhabdomyolysis? A) Flatulence and abdominal bloating B) Increased bleeding and bruising C) The development of cataracts and blurred vision D) Muscle pain and weakness
D
SATA. The nurse is teaching a pt about Fenofibric acid. What adverse effects would the nurse discuss in the teaching plan? A) Gallstones B) Abdominal pain C) Constipation D) Respiratory infections E) Runny nose
D E