KARCH Chapter: Chapter 47: Lipid-Lowering Agents PREP U
Which of the following classes of medications are used to treat hyperlipidemia? (Select all that apply) a) Calcium channel blockers b) Fibric acid derivatives c) Bile acid resins d) HMG-CoA reductase inhibitors e) Angiotensin II receptor blockers
• HMG-CoA reductase inhibitors • Fibric acid derivatives • Bile acid resins
A patient is taking cholestyramine (Questran) to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which of the following medications? a) Ibuprofen (Motrin) b) Acetaminophen (Tylenol) c) Aspirin d) Digoxin (Lanoxin)
Digoxin (Lanoxin)
Increased levels of low-density lipoprotein (LDL) combined with certain risk factors can lead to the development of which medical condition? (Choose one) a) Glaucoma b) Diabetes c) Heart Disease d) Hypertension
Heart Disease
HMG-CoA reductase inhibitors (statins) are in which pregnancy category? (Choose one) a) Pregnancy Category C b) Pregnancy Category B c) Pregnancy Category X d) Pregnancy Category D e) Pregnancy Category A
Pregnancy Category X
The client has been taking rosuvastatin for hyperlipidemia. She now presents with complaints of severe weakness. She states she can barely move her extremities because she is so weak. The nurse suspects the client has which of the following? a) Cholecystitis b) Cholelithiasis c) Pruritis d) Rhabdomyolysis
Rhabdomyolysis
Which of the following activities increases high-density lipoproteins? a) All of these b) Smoking cessation c) Regular aerobic exercise d) Weight loss
All of these
A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? a) A 72-year-old man who has emphysema and a 55-pack-year history of cigarette smoking b) A female client who had a laparoscopic cholecystectomy (gall bladder removal) earlier this year c) A resident of a long-term care facility whose Alzheimer disease is being treated with donepezil (Aricept) d) An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
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? a) Cholesterol b) Bile acids c) Chylomicrons d) Micelles
Bile acids
A client with atrial fibrillation who is receiving oral anticoagulant therapy is receiving atorvastatin. The nurse would monitor this client for which of the following? a) Cataract development b) Bleeding c) Abdominal pain d) Liver failure
Bleeding
Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Which category of blood lipids is involved in the formation of atherosclerotic plaques? a) Phospholipids b) Cholesterol c) None of these d) Triglycerides
Cholesterol
Which of the following would be classified as a bile acid sequestrant? a) Gemfibrozil b) Cholestyramine c) Ezetimibe d) Lovastatin
Cholestyramine
A patient who has been taking lovastatin (Mevacor) has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime? a) Cholestyramine (Questran) b) Calcium carbonate c) Vitamin D d) Digoxin (Lanoxin)
Cholestyramine (Questran)
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? a) Exercise b) Diet c) Medications d) Kidneys
Diet
Which of the following are examples of modifiable risk factors for hyperlipidemia? (Select all that apply) a) Post menopausal female b) Men older than 45 years c) Weight d) Diet e) Women older than 55 years
Diet Weight
As part of a routine physical examination, a 60-year-old patient's primary care provider has ordered blood work that includes cholesterol levels. What result would most strongly suggest the need for treatment with an antihyperlipidemic drug? a) Elevated LDL levels b) Low VLDL levels c) A high ratio of HDL to LDL d) Elevated HDL levels
Elevated LDL levels
Which agent would a nurse identify as a cholesterol absorption inhibitor? a) Fenofibrate b) Colestipol c) Simvastatin d) Ezetimibe
Ezetimibe
A nurse is caring for a patient prescribed nicotinic acid for hyperlipidemia. Which of the following are experienced by patients taking nicotinic acid? a) Dyspnea b) Weakness c) Tachycardia d) Flushing of the skin
Flushing of the skin
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? a) Lovastatin b) Fluvastatin c) Pravastatin d) Atorvastatin
Fluvastatin
After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify which of the following as the storage location of bile acids? a) Stomach b) Gallbladder c) Liver d) Small intestine
Gallbladder
The nurse instructs a client to take the prescribed pravastatin at bedtime based on the understanding about which of the following? a) Adverse effects are less likely during the night. b) Lack of dietary intake during sleep increases absorption. c) Compliance is enhanced with nighttime administration. d) Greater drug effectiveness is achieved at this time.
Greater drug effectiveness is achieved at this time.
The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which of the following drug classes would the instructor identify as the most widely used dyslipidemia drugs? a) Niacin b) HMG-CoA reductase inhibitors c) Fibrates d) Bile acid sequestrants
HMG-CoA reductase inhibitors
Which drug will be most effective in reducing the major types of dyslipidemia? a) Fibrates b) Bile acid sequestrants c) Niacin d) HMG-CoA reductase inhibitors
HMG-CoA reductase inhibitors
We frequently hear references to "good" cholesterol (HDL) and "bad" cholesterol (LDL, VLDL). What determines the "preferred" density of the cholesterol? a) None of these b) Higher amount of plasma c) Higher amount of protein d) Higher amount of lipids
Higher amount of protein
A patient is taking lovastatin (Mevacor). Which of the following is noted as the most common adverse effects? a) Hiccups, nasal congestion, and dizziness b) Nausea, flatulence, and constipation c) Fatigue and mental disorientation d) Increased appetite and blood pressure
Nausea, flatulence, and constipation
A patient who has an elevated triglyceride level and reduced high-density lipoprotein cholesterol is seen by her primary care physician. What do these laboratory tests indicate in this patient? a) The development of Reye's syndrome b) The development of metabolic syndrome c) The development of Tay-Sachs disease d) The development of arthritic syndrome
The development of metabolic syndrome
Your patient, a 37-year-old woman with moderately elevated lipid levels, requests immediate pharmacotherapy for her dyslipidemia. You explain that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered. You explain the rationale for this regimen as: a) Therapeutic lifestyle changes are the preferred method for lowering blood lipids. b) Continued therapeutic lifestyle changes during drug therapy will guarantee success. c) Therapeutic lifestyle changes work only when used in conjunction with medications. d) None of the above.
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic? a) Blood pressure below 130/85 mm Hg b) Waist measurement over 40 inches in women c) Fasting blood glucose below 110 mg/dL d) Triglyceride level above 150 mg/dL
Triglyceride level above 150 mg/dL
A patient with metabolic syndrome usually has increased plasminogen activator levels. a) False b) True
True
Cholesterol is the base unit for the formation of steroid hormones. a) False b) True
True
Strong evidence exists that atheroma development occurs more quickly in patients with elevated cholesterol and lipid levels. a) False b) True
True
A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it a) consists of a fibric acid derivative. b) is a bile-acid resin. c) is a hormone. d) inhibits cholesterol syntheses.
inhibits cholesterol syntheses.
What information would be included in a lipoprotein profile? Select all that apply: a) LDL b) AST c) Triglycerides d) ALT e) Total cholesterol
• LDL • Triglycerides • Total cholesterol
What should the nurse suggest to assist a client to improve his cholesterol levels? a) Smoking cessation b) Limit exercise to the weekends c) Weight lifting d) Diet high in polysaturated fats
Smoking cessation
A client being initiated on cholestyramine for the treatment of hyperlipidemia should be counseled that which of the following can occur? Select all that apply: a) Diarrhea b) Myopathy c) Aggravation of hemorrhoids d) Flatulence e) Malabsorption of vitamin K
• Malabsorption of vitamin K • Aggravation of hemorrhoids • Flatulence
Which of the following lipid levels would the nurse interpret as being high? a) Total cholesterol of 200 mg/dL b) HDL cholesterol of 48 mg/dL c) LDL cholesterol of 180 mg/dL d) Triglyceride level of 160 mg/dL
LDL cholesterol of 180 mg/dL
A female client presents to the physician's office with complaints of a recurrence of her "hot flashes." The nurse understands that the client is taking what drug to treat her dyslipidemia? a) Niacin b) Fenofibrate c) Atorvastatin d) Cholestyramine
Niacin
The most common adverse effects of lovastatin include which of the following? a) Hiccups, sinus congestion, and dizziness b) Increased appetite and blood pressure c) Headache and flatulence d) Fatigue and mental disorientation
Headache and flatulence
A client asks how ezetimibe will help to treat high lipid levels. The nurse explains that it does which of the following? a) Its mechanism of action is not understood. b) It reduces the production of triglycerides by the liver. c) It stimulates the breakdown of triglycerides. d) It decreases the absorption of cholesterol in the small intestine.
It decreases the absorption of cholesterol in the small intestine.
The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which of the following is a fibrate? a) Gemfibrozil b) Colestipol c) Colesevelam d) Cholestyramine
Gemfibrozil