Nursing Pharm Exam 3 Week 11
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? Very-low-density lipoprotein (VLDL) Apolipoprotein B-100 Low-density lipoprotein (LDL) High-density lipoprotein (HDL)
Low-density lipoprotein (LDL)
The nurse is caring for a patient who has hypercholesterolemia and newly prescribed atorvastatin [Lipitor]. Which instruction will the nurse receive from the primary healthcare provider for the safe administration of the medication? "Administer 2 mg of atorvastatin [Lipitor] orally." "Administer 20 mg of atorvastatin [Lipitor] orally." "Administer 10 mg of atorvastatin [Lipitor] orally." "Administer 40 mg of atorvastatin [Lipitor] orally."
"Administer 10 mg of atorvastatin [Lipitor] orally."
When teaching the nursing student about coronary heart disease, which statement will the nurse include in the session? "Coronary heart disease occurs due to the formation of atherosclerotic plaques." "Coronary heart disease cannot be prevented by changing lifestyle modifications." "Coronary heart disease is due to decreases in the cholesterol levels to below 200 mg/dL." "Coronary heart disease is nonlethal and cannot be prevented by antilipemic medications."
"Coronary heart disease occurs due to the formation of atherosclerotic plaques."
The nurse is assessing a patient's understanding of discharge instructions regarding cholestyramine [Questran]. Which response assures the nurse that the patient has learned the instructions? "I will weigh myself weekly." "I will increase fiber in my diet." "I will have my blood pressure checked weekly." "I will take cholestyramine [Questran] 1 hour before my other
"I will increase fiber in my diet."
The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin [Mevacor]. Which response from the students indicates understanding? "It inhibits the absorption of dietary cholesterol in the small intestine." "It stimulates the biliary system to increase the excretion of dietary cholesterol." "It binds to bile in the intestinal tract forming an insoluble complex that is excreted in the feces." "It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
"It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching? "Lower your cholesterol to 300 mg/day." "Eliminate red meat and pork from your diet." "Read food labels and reduce your intake of saturated fats." "Reduce salt consumption to keep your sodium intake to 2400 mg/day."
"Read food labels and reduce your intake of saturated fats."
The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug? A patient with cardiovascular disease and elevated triglycerides A patient with elevated very-low-density lipoprotein (VLDL) levels A patient with elevated triglycerides who has not responded to dietary changes A patient with history of gallstones and elevated triglycerides
A patient with history of gallstones and elevated triglycerides
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 veggies D. Consume no more than 1L/day of fluid
A. Take this medication in the evening
Which are positive risk factors for atherosclerotic cardiovascular disease (ASCVD)? (select all) African American race Blood pressure of 130/85 mm Hg Blood pressure higher than 140/90 mm Hg High-density lipoprotein is 60 mg/dL or higher Serum triglyceride level of 150 mg/dL or more
African American race Blood pressure higher than 140/90 mm Hg
A patient with an elevated triglyceride level is prescribed a sustained-release form of nicotinic acid [Slo-Niacin]. Which laboratory value is most important for the nurse to monitor for in this patient? Blood urea nitrogen (BUN) Complete blood count (CBC) Alanine aminotransferase (ALT) Creatine kinase (CK)
Alanine aminotransferase (ALT)
Which drug is the most effective for lowering LDL cholesterol? Atorvastatin [Lipitor] Cholestyramine [Questran] Gemfibrozil [Lopid] Ezetimibe [Zetia]
Atorvastatin [Lipitor]
Which drug is the most effective for lowering low-density lipoprotein (LDL) cholesterol? Gemfibrozil Ezetimibe [Zetia] Atorvastatin [Lipitor] Cholestyramine [Questran]
Atorvastatin [Lipitor]
A patient with a serum cholesterol level of 275 mg/dL is prescribed simvastatin [Zocor]. What instructions should the nurse provide to the patient? "Avoid taking the drug with grapefruit juice." "Notify your healthcare provider if your urine becomes discolored." "Notify your healthcare provider if muscle pain occurs within 1 day." "Notify your healthcare provider if muscle pain occurs after 3 days." "Take aspirin [Ecotrin] 30 minutes before taking simvastatin [Zocor]."
Avoid taking the drug with grapefruit juice." "Notify your healthcare provider if your urine becomes discolored." "Notify your healthcare provider if muscle pain occurs after 3 days."
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) A. Muscle aches B. Hyperglycemia C. Hearing loss D. Flushing of the skin E. Jaundice
B. Hyperglycemia D. Flushing of the skin E. Jaundice
How does simvastatin [Zocor] exert its action? By inhibiting lipolysis in the adipose tissue By preventing the reabsorption of bile acids By activating the lipoprotein lipase enzyme By inhibiting the enzyme HMG-CoA reductase
By inhibiting the enzyme HMG-CoA reductase
A nurse is completing an nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as contraindicated to adding ezetimibe to the client's medications? A. History of sever constipation B. History of HTN C. Active Hep C D. Type 2 diabetes
C. Active Hep 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 change B. Tremor C. Jaundice D. Pneumonia
C. Jaundice
The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects? Simvastatin [Zocor] Colesevelam [Welchol] Nicotinic acid [Niaspan] Gemfibrozil [Lopid]
Colesevelam [Welchol]
A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? A. Take digoxin with your morning dose of colesevelam B. You sodium and potassium levels will be monitored periodically while taking colesevelam C. Watch for bleeding or bruising while taking D. take with food and at least one glass of water
D. take with food and at least one glass of water
The nurse provides teaching to a patient who will take atorvastatin [Lipitor] at home. Which patient teaching is most likely to help maintain the anti-lipemic medication dosage at the lowest level possible? Avoid all alcoholic beverages. Engage in moderate exercise. Adhere to the blood test schedule. Take atorvastatin [Lipitor] at bedtime.
Engage in moderate exercise.
The nurse is caring for a patient who has elevated triglyceride levels and is unresponsive to HMG-CoA reductase inhibitors. What does the nurse expect the primary healthcare provider to prescribe to the patient? Gemfibrozil [Lopid] Simvastatin [Zocor] Colestipol [Colestid] Cholestyramine [Questran]
Gemfibrozil [Lopid]
Which discharge instructions should the nurse include for a patient prescribed cholestyramine [Questran]? Mix the drug with water or juice. Take with all other morning medications. Take 325 mg of aspirin 30 minutes before each dose. Notify the healthcare provider if upper abdominal discomfort occurs.
Mix the drug with water or juice.
A patient is taking pravastatin sodium [Pravachol]. Which assessment finding requires immediate action by the nurse? Fatigue Headache Muscle pain Slight nausea
Muscle pain
Before the nurse administers simvastatin [Zocor], which baseline data are collected to help prevent adverse effects of therapy? (Select all) Uric acid Potassium Muscle pain Liver enzymes Renal function Gastric distress
Muscle pain Liver enzymes Renal function Gastric distress
A patient with cardiovascular disease is taking rosuvastatin [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug? Blood pressure of 140/90 mm Hg Wheezing and shortness of breath Platelet count of 100 × 103/mm3 Muscle pain and tenderness
Muscle pain and tenderness
A patient with hyperlipidemia has been prescribed simvastatin [Zocor]. While caring for the patient, the nurse unknowingly administers niacin [Nicobid] along with simvastatin [Zocor]. Which complication may the patient have due to the drugs' interaction? Myopathy Blurred vision Bowel obstruction Hepatic dysfunction
Myopathy
Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? (Select all that apply.) Reduction of LDLs Elevation of HDLs Stabilization of the plaque in coronary arteries Reduction of risk of cardiovascular events Improvement of liver function
Reduction of LDLs Elevation of HDLs Stabilization of the plaque in coronary arteries Reduction of risk of cardiovascular events
The nurse is teaching a medication regimen to a patient who has type II hyperlipoproteinemia and who has been prescribed cholestyramine [Questran]. Of what will the nurse inform the patient during the teaching? Include milk in the diet while taking this medication. Avoid taking vitamin A supplements while taking the medication. Avoid doing deep breathing exercises after taking the medication. Take other medications 1 hour before or 4 hours after the administration of cholestyramine.
Take other medications 1 hour before or 4 hours after the administration of cholestyramine.
The nurse is caring for a patient who has hyperlipidemia and who has been prescribed gemfibrozil [Lopid]. On reviewing the medical history of the patient, the nurse learns that the patient is taking warfarin [Coumadin]. What does the nurse anticipate after reviewing the patient's medical history? The patient has an increased risk of infection. The patient has an increased risk of bleeding. The patient has an increased risk of vitamin K toxicity. The patient has an increased risk of bowel obstruction.
The patient has an increased risk of bleeding.
A patient with congestive heart failure has a serum low-density lipoprotein (LDL) level of 140 mg/dL. The healthcare provider prescribes extended-release niacin [Nicobid] tablets to the patient. During the follow-up visit, the serum cholesterol concentration is found to be 120 mg/dL. What changes will the nurse expect in the patient's prescription? The dose of niacin [Nicobid] will be increased. The dose of niacin [Nicobid] will be decreased. The same dose of niacin [Nicobid] will be continued. The drug therapy with niacin [Nicobid] will be stopped.
The same dose of niacin [Nicobid] will be continued.
Which statement made by the patient indicates to the nurse that understanding of the discharge instructions on antihyperlipidemic medications has occurred? "I will stop taking the medication if it causes nausea and vomiting." "It is important to double my dose if I miss one in order to maintain therapeutic blood levels." "I will continue to modify my diet and keep exercising to help increase my high-density lipoprotein serum levels." "Antihyperlipidemic medications will replace the other interventions I have been doing to try to decrease my cholesterol."
"I will continue to modify my diet and keep exercising to help increase my high-density lipoprotein serum levels."
The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? (Select all that apply.) "Do not start any new medications without first talking to your healthcare provider." "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." "Take your medication in the morning, with a full glass of water for best results." "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
"Do not start any new medications without first talking to your healthcare provider." "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
The nurse teaches the nursing student about statin drugs. Which statements by the student indicate effective learning? "Statins can be used along with gemfibrozil [Lopid]." "Simvastatin [Zocor] is the less potent inhibitor of CYP3A4 enzyme." "Fluvastatin [Lescol] with warfarin [Coumadin] increases the risk of bleeding." "Pravastatin [Pravachol] is not as effective as simvastatin [Zocor] for the inhibition of CYP3A4." "Atorvastatin [Lipitor] with cyclosporine [Gengraf] decreases the risk of rhabdomyolysis."
"Fluvastatin [Lescol] with warfarin [Coumadin] increases the risk of bleeding." "Pravastatin [Pravachol] is not as effective as simvastatin [Zocor] for the inhibition of CYP3A4."
Which patient's statement indicates a need for further medication instruction about colestipol [Colestid]? "I might need to take fat-soluble vitamins to supplement my diet." "I should take this medication 1 hour after or 4 hours before my other medications." "The medication may cause constipation, so I will increase fluid and fiber in my diet." "I should stir the powder in as small an amount of fluid as possible to maintain potency of the medication."
"I should stir the powder in as small an amount of fluid as possible to maintain potency of the medication."
A patient comes to the clinic and is diagnosed with gouty arthritis. When the nurse looks over the patient's medication list, what medication could have caused this adverse effect? Ezetimibe [Zetia] Gemfibrozil [Lopid] Niacin (nicotinic acid) Colesevelam [Welchol]
Niacin (nicotinic acid)
The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemic drug would be most beneficial for the patient? Fluvastatin [Lescol] Cyclosporin [Gengraf] Colesevelam [Welchol] Cholestyramine [Questran]
Colesevelam [Welchol]
The nurse would question an order for colesevelam [Welchol] if the patient has which condition in the medical history? Glaucoma Constipation Renal disease Hepatic disease
Constipation
What are the common side effects of fenofibrate [Tricor], a fibric acid derivative? Impotence Constipation Cutaneous flushing Nausea and abdominal pain Increase in gallstone formation
Impotence Nausea and abdominal pain Increase in gallstone formation
A patient with dyslipidemia has been prescribed atorvastatin [Lipitor]. After a few days, the patient reports to the nurse that her pregnancy test is positive and that she has severe constipation. What medication does the nurse expect the provider to order for the patient? Ezetimibe [Zetia] Simvastatin [Zocor] Niacin (nicotinic acid) Cholestyramine [Questran]
Niacin (nicotinic acid)