Pharm Chapter 33: Antihyperlipidemic Drugs

5. A client taking niacin reports flushing after each dose of the niacin. Which of the following drugs would the nurse expect to be prescribed to help alleviate the flushing? meperidine (Demerol) aspirin vitamin K diphenhydramine (Benadryl)

aspirin

6. When assessing a client taking cholestyramine for vitamin K deficiency, the nurse would _________. check the client for bruising keep a record of the client's intake and output monitor the client for myalgia keep a dietary record of foods eaten

check the client for bruising

4. Lovastatin is best taken _________. once daily, preferably with the evening meal three times daily with meals at least 1 hour before or 2 hours after meals twice daily without regard to meals

once daily, preferably with the evening meal

8. As the client makes breakfast selections for tomorrow, which of the following items should the nurse recognize as a potential problem food? Scrambled eggs Oatmeal with cream and sugar Stewed prunes Grapefruit juice

Grapefruit juice

22. The health care provider has prescribed pravastatin for a client. The nurse should question this order if the client is currently prescribed which additional medication (s)? Select all that apply. Quinapril Niacin Clarithromycin Albuterol Verapamil

Niacin Clarithromycin Verapamil Rationale: Niacin, clarithromycin, and verapamil when coadministered to a client taking a statin, like pravastatin, can result in increased myopathy.

9. A client taking bile acid resins can become vitamin deficient in which of the following? Select all that apply. Vitamin A Vitamin B Vitamin C Vitamin D Vitamin E

Vitamin A Vitamin D Vitamin E

3. Select the most common adverse reaction in a client taking a bile acid resin: anorexia vomiting constipation headache

constipation

2. Antihyperlipidemia drugs work to: reduce fat in dietary intake. decrease cholesterol and triglycerides. remove plaque from arterioles. lessen gallbladder stones.

decrease cholesterol and triglycerides.

16. The nurse is preparing to teach a client with hyperlipidemia about the prescribed cholestyramine. Which instruction should the nurse prioritize for the client? "Eat foods high in dietary fiber." "Follow a complete liquid diet." "Be sure to stay on complete bed rest." "Take the water-soluble form of vitamin D."

"Eat foods high in dietary fiber." Rationale: The nurse should instruct the client taking cholestyramine to eat foods high in dietary fiber to prevent constipation.

18. A client prescribed niacin reports significant skin flushing and itching, stating, "I almost stopped taking the drug." The nurse anticipates the health care provider will prescribe which drug to address this issue? Prednisone Aspirin Ibuprofen Hydrocortisone

Aspirin

28. The nurse is conducting a preadministration assessment on a client prescribed simvastatin. Which factor(s) should the nurse prioritize? Select all that apply. Dietary history Vital signs Blood glucose Weight Input and output

Dietary history Vital signs Weight Rationale: Before administering an antihyperlipidemic drug, the nurse would assess a lipid profile, liver function tests, dietary history, vital signs, and weight and inspect for xanthomas. Blood glucose would be important for clients with diabetes.

26. The nursing instructor has completed a teaching session on bile acids with a group of nursing students. The instructor determines the session is successful when the students correctly choose which facts) as true about bile? Select all that apply. Manufactured by the gallbladder Stored in the liver Emulsifies fat and lipids Secreted by the liver Classified as a hormone

Emulsifies fats and lipids Secreted by the liver Rationale: Bile is manufactured and secreted by the liver and stored in the gallbladder; it emulsifies fat and lipids, and these products pass through the intestine. It is not considered a hormone.

12. The health care provider has prescribed ezetimibe for a client diagnosed with hyperlipidemia. The nurse is prepared to prioritize which assessment to evaluate the drug's effectiveness? Taking a dietary history of the client Inspecting skin and eyelids for evidence of xanthomas Obtaining reports of fasting blood sugar levels Frequently monitoring blood cholesterol

Frequently monitoring blood cholesterol

21. The nurse has administered atorvastatin to a client. Which assessment finding(s) should the nurse prioritize? Select all that apply. Headache Sedation Insomnia Diarrhea Constipation

Headache Insomnia Constipation Rationale: Atorvastatin is an HMG-CoA reductase inhibitor (statin). Adverse reactions of statins include headache, dizziness, insomnia (not sedation), flatulence, abdominal pain, cramping, constipation (not diarrhea), and nausea.

1. Which of the following blood elements has a protective property for heart disease? Cholesterol Low-density lipoproteins (LDL) High-density lipoproteins (HDL) Triglycerides

High-density lipoproteins (HDL)

32. The nurse is preparing to administer cholestyramine to a client. On preadministration assessment, the nurse discovers the client is currently taking propranolol, glipizide, and acetaminophen. Which potential interaction(s) should the nurse prioritize? Select all that apply. Hypoglycemia Decreased analgesia Increase in blood pressure Hypotension Hyperglycemia

Increase in blood pressure Hyperglycemia Rationale: The use of bile acid resins, like cholestyramine, decreases the absorption of some medications including glipizide and propranolol. This decreased absorption could result in hyperglycemia (not hypoglycemia) and an increase in blood pressure (not hypotension) for this particular client. There should not be any interaction between the acetaminophen and cholestyramine.

13. A nurse is preparing to administer colesevelam to a client with hyperlipidemia. The nurse determines cautious administration is warranted after noting which condition in the client's history? Hypotension Acute infection Liver disease Unstable angina

Liver disease Rationale: Bile acid resins should be used cautiously in clients with diabetes, liver, peptic ulcer or kidney disease, and during pregnancy and lactation.

7. Which of the following points is important for the nurse to tell the client when teaching about drug and diet therapy for hyperlipidemia? Fluids are taken in limited amounts when eating a low-fat diet. The medication should be taken at least 1 hour before meals. Medication alone will not lower cholesterol. Meat is not allowed on a low-fat diet.

Medication alone will not lower cholesterol.

17. The nurse is preparing to administer colestipol to the client. Which method should the nurse prioritize to administer this medication? Mix the granules in 2-6 fluid ounces of water. Take care not to crush the granules. Give the granules once or twice daily with meals. Mix the drug in 90 mL of liquid.

Mix the drug in 90 mL of liquid. Rationale: The nurse should mix the drug in 90 mL of liquid, soups, cereals, carbonated drinks, or pulpy fruits when administering the colestipol granules to the client.

30. The nurse is preparing to teach a client about HMG-CoA Reductase Inhibitors. The nurse should prepare to point out which instruction(s)? Select all that apply. Photosensitivity can occur. The drug should be continued even if the client feels better. Muscle pain and weakness are normal. Juices other than grapefruit juice are okay to use. Statins should be administered in the evening.

Photosensitivity can occur. The drug should be continued even if the client feels better. Muscle pain and weakness are normal. Juices other than grapefruit juice are okay to use. Statins should be administered in the evening. Rationale: When teaching about statins, the nurse should include information about the possibility of photosensitivity, the need to continue the drug even if feeling better, juices other than grapefruit juice as appropriate, and administration in the evening. Muscle pain and weakness should be reported to the client's health care provider as soon as they occur as they are early indications of rhabdomyolysis, a serious condition, which may necessitate discontinuing the drug.

19. The client presents for a routine clinic visit to evaluate the long-term use of cholestyramine. The health care provider determines vitamin A and D should be prescribed at this time. The nurse determines which nursing diagnose is most appropriate at this time? Risk for impaired skin integrity Constipation Risk for injury Risk for imbalanced nutrition: less than body requirements

Risk for imbalanced nutrition: less than body requirements Rationale: Bile acid resins may interfere with the digestion of fats and prevent the absorption of the fat-soluble vitamins (vitamins A, D, E, and K) and folic acid.

24. A client is questioning the new prescription for a statin. The nurse should point out that statin will reduce the risk of which disorder(s) for the client? Select all that apply. Stroke Transient ischemic attack Kidney disease Hepatic disease Cancer

Stroke Transient ischemic attack Rationale: The use of statins in clients with hyperlipidemia with or without clinically evident coronary heart disease can reduce the risk of death from stroke and transient ischemic attacks.

14. The nurse is administering pravastatin and amiodarone to a client with cardiac issues. Which potential interaction will the nurse carefully monitor the client for? Increased anticoagulant effect Increased hypoglycemic effect Increased risk of myopathy Decreased effects of pravastatin

Increased risk of myopathy Rationale: When the HMG-CoA reductase inhibitor pravastatin is administered with amiodarone, the nurse should monitor the client for increased risk of myopathy as an effect of the interaction between the two drugs.

11. The nurse is finishing a teaching session with a client who is prescribed gemfibrozil. The nurse determines the session is successful when the client correctly chooses which instruction? Take the drug along with meals. Observe caution while driving. Take a single dose once daily in the evening. Be alert for mild to severe facial flushing.

Observe caution while driving.

10. The nurse is preparing to administer niacin to a client with hyperlipidemia. Which adverse reaction should the nurse prioritize on ongoing assessment? Tingling Constipation Diarrhea Cholelithiasis

Tingling Rationale: The nurse should monitor for tingling in the client as an adverse reaction to the drug niacin.

27. A nurse is analyzing the chemistry profile of a client diagnosed with hyperlipidemia. Which measurements) will the nurse prioritize on the lipid profile? Select all that apply. Total cholesterol Triglycerides LDL ALT AST

Total cholesterol Triglycerides LDL Rationale: A lipoprotein profile is a laboratory test that reports total cholesterol, LDL, HDL, and triglycerides. AST and ALT are values that would be reported from liver function tests.

23. A nursing instructor is teaching a class on the action of statin drugs. The instructor determines the class is successful after the students correctly choose which actions? Select all that apply. Decrease cholesterol absorption in GI tract Promote cholesterol breakdown Formation of a substance excreted in the feces Decrease breakdown of fat to cholesterol Inhibit cholesterol production

Decrease cholesterol absorption in GI tract Promote cholesterol breakdown Inhibit cholesterol production Rationale: Statins inhibit the manufacture or production of cholesterol or promote the breakdown of cholesterol.

29. The nurse has completed a teaching session with a client who is prescribed nicotinic acid. The nurse determines the session is successful when the client correctly chooses which reaction(s) as a normal response to this drug? Select all that apply. Flushing Sensations of warmth Tingling Urticaria Pustule formation

Flushing Sensations of warmth Tingling Rationale: Generalized skin flushing, a sensation of warmth, and severe itching and tingling can occur with the administration of nicotinic acid, especially at higher doses.

33. The nurse is preparing a teaching session for a client prescribed gemfibrozil. The nurse will point out the drug operates via which mechanism(s)? Select all that apply. Increases excretion of cholesterol Reduces VLDLS Increases breakdown of VLDLs Reduces production of triglycerides Inhibits cholesterol formation

Increases excretion of cholesterol Reduces production of triglycerides Rationale: Gemfibrozil increases the excretions of cholesterol and reduces the production of triglycerides.

20. A nurse is conducting a community presentation on heart disease, cholesterol, and risk factors. The nurse determines that the class has been successful when the class correctly chooses which point as true? Low-fat diet raises LDL cholesterol levels. Being overweight causes HDL levels to go up. Physical activity raises HDL cholesterol levels. Excess body weight causes LDL cholesterol to go down.

Physical activity raises HDL cholesterol levels. Rationale: Saturated fat and cholesterol in the food raises total and LDL cholesterol levels.

25. A nurse is preparing to administer lovastatin to a client. The nurse should question this order if which disorders) is noted in the client's history? Select all that apply. Kidney disease Pregnancy Serious hepatic disease Carcinoma of the breast Lactation

Pregnancy Serious hepatic disease Lactation Rationale: Statin drugs are contraindicated in individuals with known hypersensitivity to the drugs or serious liver disease and during pregnancy category X and lactation.

15. The health care provider has prescribed fenofibrate for a client discovered to have very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder? Endocrine disorder Primary biliary cirrhosis Arterial bleeding Respiratory depression

Primary biliary cirrhosis Rationale: The fibric acid derivative fenofibrate is contraindicated in clients with primary biliary cirrhosis.