NURS 1002 Pharmacology Chapter 27 Quiz: Antipilemic Drugs

To decrease skin flushing, which is an adverse effect reaction of niacin (nicotinic acid), which action should the nurse take? A. Administer niacin with a liquid antacid B. Administer aspirin 30 minutes before each dose C. Give niacin with all other morning medications D. Apply cold compresses to the head and neck

B. Administer aspirin 30 minutes before each dose

Which antilipemic medication reduces serum cholesterol by inhibiting its absorption in the small intestine? A. Niacin (Niaspan) B. Ezetimibe (Zetia) C. Rosuvastatin (Crestor) D. Cholestyramine (Questran)

B. Ezetimibe (Zetia) Ezetimibe, the only cholesterol-absorption inhibitor on the U.S. market, is effective in lowering total cholesterol, LDL-C, apolipoprotein B, and triglyceride levels. Niacin is a vitamin administered in large doses to lower serum cholesterol levels. Rosuvastatin is an HMG-CoA reductase inhibitor that lowers serum cholesterol levels. Cholestyramine is a bile acid sequestrant.

The nurse provides discharge instructions to a patient prescribed cholestyramine (Questran). Which statement by the patient indicates teaching about this drug was effective? A. "I will increase fiber in my diet and drink more fluids." B. "This drug can cause flushing and gastrointestinal upset." C. "I will take Questran 1 hour before my other medications." D. "I will notify my health care provider if I have muscle pain."

A. "I will increase fiber in my diet and drink more fluids."

Which statement by the patient indicates a need for further instruction about colestipol (Colestid) from the nurse? A. "I will mix and stir the powder thoroughly with at least 1 to 2 oz of fluid." B. "I should take this medication 1 hour after or 4 hours before my other medications." C. "The potential adverse effects of this drug are rash and itching." D. "I might need to take fat-soluble vitamins to supplement my diet."

A. "I will mix and stir the powder thoroughly with at least 1 to 2 oz of fluid."

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are generally administered at which time of day? A. Evening B. 12:00 noon C. Afternoon D. Morning

A. Evening

Which action does atorvastatin (Lipitor) decrease lipid levels? A. Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver B. Decreasing the amount of triglycerides produced by the liver and increasing the removal of triglycerides by the liver C. Binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces D. Stimulating the gallbladder and biliary system to increase excretion of dietary cholesterol

A. Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver

The nurse is providing discharge teaching for a patient about potential serious adverse effects to simvastatin (Zocor). Which symptom may indicate the patient is experiencing a serious adverse effect to this medication? A. Muscle pain B. Itching C. Headache D. Weight loss

A. Muscle pain

A patient with elevated triglyceride levels unresponsive to HMG-CoA reductase inhibitors will most likely be prescribed which drug? A. Colestipol (Colestid) B. Gemfibrozil (Lopid) C. Simvastatin (Zocor) D. Cholestyramine (Questran)

B. Gemfibrozil (Lopid)

What is the mechanism of action of ezetimibe (Zetia)? A. Binds to bile acids in the intestine, inhibiting its reabsorption into the blood B. Inhibits absorption of dietary and biliary cholesterol in the small intestine C. Decreases the adhesion of cholesterol in the arteries D. Inhibits the biosynthesis of cholesterol in the liver

B. Inhibits absorption of dietary and biliary cholesterol in the small intestine

Which discharge instruction should the nurse include for a patient prescribed an antilipemic medication? A. "It is important to take a double dose to make up for a missed dose." B. "Stop taking the medication if it causes nausea and vomiting." C. "Continue your exercise program and maintain a low-fat diet." D. "Lifestyle changes are no longer necessary when taking this medication."

C. "Continue your exercise program and maintain a low-fat diet."

Which statement by the nurse explains to the patient the action of cholestyramine (Questran) to decrease blood lipid levels? A. Inhibits lipolysis in adipose tissue and decreases the hepatic synthesis of triglycerides in the liver. B. Stimulates the biliary system to increase excretion of dietary cholesterol. C. Binds to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces. D. Inhibits absorption of dietary cholesterol in the small and large intestines.

C. Binds to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces.

The nurse would question a prescription for simvastatin (Zocor) in a patient with which condition? A. Hepatic disease B. Diabetes C. Leukemia D. Heart failure

C. Leukemia

To assess for a potentially serious adverse effect to HMG-CoA reductase inhibitors, the nurse should monitor which laboratory results? A. Serum electrolytes B. Urine specific gravity C. Liver function studies D. Complete blood count

C. Liver function studies

Before the nurse administers simvastatin (Zocor), which baseline data should be collected to help prevent adverse effects of therapy? (Select all that apply.) A. Uric acid B. Potassium C. Muscle pain D. Liver enzymes E. Renal function F. Gastric distress

C. Muscle pain D. Liver enzymes E. Renal function F. Gastric distress Simvastatin is a 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitor, or statin, which is used to decrease the serum low-density lipoprotein cholesterol by decreasing its synthesis in the liver. The nurse assesses the liver enzymes and checks the patient for muscle pain because adverse effects of statin therapy include myositis, rhabdomyolysis, and liver dysfunction. The nurse assesses renal function because serious adverse effects of therapy involving the muscles can result in renal dysfunction. Gastric distress is also assessed to establish baseline data about nausea and vomiting, potential adverse effects of a statin. Assessment of the serum uric acid and serum potassium levels are reasonable nursing interventions before the administration of medication; however, these parameters are unrelated to the adverse effects of statin therapy.

A patient with metabolic syndrome requires antilipemic therapy after a myocardial infarction. Which antilipemic medication is the best choice for the nurse to administer to reach treatment goals in this patient? A. Ezetimibe (Zetia) B. Pravastatin (Pravachol) C. Nicotinic acid (Niaspan) D. Cholestyramine (Questran)

C. Nicotinic acid (Niaspan) Metabolic syndrome is a set of risk factors that includes hypertriglyceridemia and a low concentration of high-density lipoprotein. Nicotinic acid is the best choice to decrease serum triglyceride levels and to increase HDL levels in this patient because it decreases triglycerides by 30% to 70% and increases HDLs by 20% to 35%. The only antilipemic agent that affects the triglycerides and HDLs more favorably than nicotinic acid is a fibric acid derivative such as gemfibrozil (Lopid). Ezetimibe and pravastatin are indicated to lower serum concentrations of low-density lipoprotein cholesterol (LDL-C) and triglycerides. Cholestyramine is indicated to reduce the serum LDL-C level but is likely to increase serum triglyceride levels.

The nurse prepares a patient who will take atorvastatin (Lipitor) at home with the use of teaching approved by the provider. Which patient teaching is most directly related to maintenance of the antilipemic medication dosage at the lowest level possible? A. Take atorvastatin at bedtime. B. Adhere to the blood test schedule. C. Avoid all alcoholic beverages. D. Engage in moderate exercise.

D. Engage in moderate exercise. The nurse instructs the patient to engage in moderate-intensity exercise to improve cardiovascular conditioning. Exercise helps increase metabolism and promote collateral circulation. Taking atorvastatin at bedtime, adhering to the blood test schedule, and avoiding alcoholic beverages all help manage adverse effects and aid in the early detection of serious adverse effects; however, these reasonable nursing interventions for patient teaching are less likely to affect the dosage of atorvastatin.