Drugs for High Blood Lipids

Understanding Pharmacology Essentials for Medication Safety

Nursing
31
Questions
0
True/False
26
Choices
5
Essay
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Questions

Q1
Free

Which statement about cholesterol is true?

Multiple Choice
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A) The one source of cholesterol is from the foods a person eats.
B) Cholesterol always has harmful effects on a persons body.
C) Too much cholesterol leads to a deficit of bile acids that digest fat.
D) It is a fatty, waxy material present in cell membranes of the body.
Answer:
D) It is a fatty, waxy material present in cell membranes of the body.

Explanation:
Cholesterol is a fatty, waxy material that the body needs to function and is present in cell membranes everywhere in the body. There are two sources of cholesterol: food and the liver. The body needs small amounts of cholesterol for important functions including production of hormones, vitamin D, and bile acids that help digest fat. Inadequate amounts of cholesterol would lead to a deficit of bile acids.
Q2
Free

A patient has been prescribed an antihyperlipidemic drug. Which laboratory value does the nurse report to the prescriber?

Multiple Choice
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A) Total cholesterol 198 mg/dL
B) Triglycerides 135 mg/dL
C) Low density lipoprotein (LDL) 195 mg/dL
D) High density lipoprotein (HDL) 60 mg/dL
Answer:
C) Low density lipoprotein (LDL) 195 mg/dL

Explanation:
The total cholesterol, triglyceride, and HDL levels are all within the normal range. The LDL level is high and should be reported to the prescriber because a high level increases the patients risk for atherosclerosis.
Q3
Free

A patient with high blood lipids asks the nurse why the lipid profile did not improve after 3 months following a low-fat diet. What is the nurses best response?

Multiple Choice
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A) You may need to follow a no-fat diet to improve your lipid profile.
B) You must follow a low-fat diet for at least 6 months to see improvement.
C) You will definitely need to be prescribed a drug to see improvement.
D) You may have a genetic factor that is causing your high blood lipid levels.
Answer:
D) You may have a genetic factor that is causing your high blood lipid levels.

Explanation:
People who do not show lipid profile improvement after following a low-fat diet for 3 months often have a genetic factor that leads to familial hyperlipidemia. This tends to run in families and requires antilipidemic drugs to lower blood lipid levels. Telling the patient that a drug is definitely required may be correct in this case, but it does not address the patients question.
Q4

Which statement by a patient who has been prescribed an antilipidemic drug indicates to the nurse the need for additional teaching?

Multiple Choice
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A) Once my lipid profile levels are normal, I will no longer need to take the drug.
B) Taking this drug will decrease my risk for having a heart attack.
C) My goal is to increase my HDL cholesterol and decrease my LDL cholesterol.
D) I will continue walking and watching the fat in my diet while Im taking this drug.
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Q5

How do antihyperlipidemic drugs from the statin class lower bad cholesterol levels?

Multiple Choice
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A) They act as a filter in the blood to trap bad cholesterol and allow white blood cells to destroy it.
B) They block the absorption of dietary fats through the walls of the intestinal tract.
C) They bind to cholesterol in the intestinal tract and promote its excretion in stool.
D) They decrease normal liver production of cholesterol.
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Q6

Which laboratory finding does the nurse report to the prescriber before giving any antihyperlipidemic drug?

Multiple Choice
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A) Aspartate aminotransferase 41 IU/L
B) Alanine aminotransferase 24 IU/L
C) Alkaline phosphatase 130 IU/L
D) Gamma-glutamyltransferase 50 IU/L
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Q7

A patient prescribed atorvastatin (Lipitor) reports all of the following problems or changes since starting this drug. Which problem or change does the nurse report to the prescriber?

Multiple Choice
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A) Abdominal cramps and bloating
B) Muscle aches and weakness
C) Urinating more at night
D) Loss of taste for sweets
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Q8

A patient who is prescribed atorvastatin (Lipitor) reports experiencing some muscle pain and weakness. What is the nurses best action?

Multiple Choice
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A) Administer ordered acetaminophen (Tylenol) as needed.
B) Document the finding as the only action.
C) Reassure the patient that this is an expected side effect.
D) Hold the drug and notify the prescriber.
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Q9

A patient who has been prescribed lovastatin (Mevacor) asks the nurse why all urine must be saved for intake and output measurements. What is the nurses best response?

Multiple Choice
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A) All patients on this unit have orders for strict intake and output measurements.
B) Intake and output measurements are important indicators of how well your kidneys are functioning.
C) A side effect of this drug can be blockage of urine flow through the kidneys and decreased urine output.
D) Sometimes this drug can cause the kidneys to make extra urine resulting in increased urine output and dehydration.
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Q10

A patient who is prescribed simvastatin (Zocor) asks the nurse why liver function tests must be drawn every 6 months. What is the nurses best response?

Multiple Choice
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A) They are important because early liver problems do not cause symptoms.
B) They help your prescriber decide what your dose of simvastatin should be.
C) They tell your prescriber how well your body is responding to the therapy.
D) They indicate how much cholesterol is being produced by your liver.
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Q11

Which statement made by a patient who has been prescribed simvastatin (Zocor) indicates the need for more teaching?

Multiple Choice
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A) I have been taking this drug every night at bedtime.
B) I have stopped using butter when I cook and have been using olive oil instead.
C) My LDL cholesterol level today is 101 mg/dL so the drug has cured my cholesterol problem.
D) I hope that by reducing my fatty food intake, I might not have to take medications to manage my cholesterol problem.
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Q12

A hospitalized patient who is prescribed lovastatin (Mevacor) 80 mg orally looks at the four tablets the nurse provides and says At home, I only take two pills for 80 mg. I think this is too many pills. What is the nurses best action?

Multiple Choice
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A) Hold the dose and contact the prescriber.
B) Remind the patient that the prescriber knows what is best for his or her particular health problem.
C) Explain that each tablet contains 20 mg of the drug instead of 40 mg, and that four 20-mg tablets are the same dosage as two 40-mg tablets.
D) Explain to the patient that while at home a lower dosage of the drug may have been prescribed than what is required while being hospitalized.
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Q13

What does the nurse include in a teaching plan for a woman of childbearing age who is prescribed a statin drug?

Multiple Choice
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A) These drugs should not be taken during pregnancy, but are safe to use when breastfeeding.
B) Statins are pregnancy category X drugs and should not be taken while pregnant or breastfeeding.
C) Because these drugs control fats produced by the liver, they will help control weight gain during pregnancy.
D) You can take these drugs during pregnancy as long as you do not have a history of muscle or liver problems.
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Q14

Why do the most common side effects of any bile acid sequestrant include bloating, abdominal discomfort, and constipation?

Multiple Choice
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A) Many patients are lactose intolerant and these drugs contain lactose.
B) Bile acid sequestrants exert their effects directly in the intestinal tract.
C) The action of bile acid sequestrants on the liver releases bile into the intestinal tract.
D) The drugs inhibit the absorption of dietary fiber, increasing its concentration and effects in the intestinal tract.
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Q15

A patient who is prescribed cholestyramine (Questran) tablets reports experiencing bloating, nausea, and gas. What is the nurses best action?

Multiple Choice
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A) Hold the drug and notify the prescriber.
B) Document the finding as the only action.
C) Administer the drug before meals to avoid nausea.
D) Teach the patient to drink 12 to 16 ounces of water with the drug.
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Q16

Which laboratory blood value is more important for the nurse to monitor with a patient who is prescribed both colestipol (Colestid) and warfarin (Coumadin)?

Multiple Choice
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A) Hematocrit
B) Hemoglobin
C) Red blood cell (RBC) count
D) International normalized ratio (INR)
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Q17

A patient who is prescribed ezetimibe (Zetia) has developed swelling around the eyes, nose, and lips. What is the nurses priority action at this time?

Multiple Choice
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A) Elevate the head of the bed.
B) Notify the prescriber.
C) Assess the patients airway.
D) Check the patients blood pressure.
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Q18

A patient who has been taking niacin (Niacor) daily for 1 week reports intense itching. What is the nurses best response?

Multiple Choice
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A) This is a common side effect and many people can control it by taking aspirin.
B) Stop taking the drug and talk with your prescriber as soon as possible.
C) Unless your skin forms blisters or peels, continue to take the drug.
D) Do you have any other drug allergies?
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Q19

A patient who is prescribed niacin (Niacor) reports experiencing flushing and hot flashes. What is the nurses best action?

Multiple Choice
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A) Hold the drug and notify the prescriber.
B) Give the niacin at least 1 hour before meals.
C) Reassure the patient that this is an expected side effect.
D) Administer the ordered nonsteroidal anti-inflammatory drug (NSAID) 30 minutes before the niacin.
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Q20

A patient prescribed niacin extended action (Niaspan) reports all of the following new onset problems. For which problem does the nurse notify the prescriber?

Multiple Choice
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A) Moderate itchiness, especially at night
B) Six to seven loose stools daily
C) Increased nighttime urination
D) Swollen, painful great toe
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Q21

A patient is prescribed niacin (Niaspan). The pharmacy sends niacin (Niacor). What is the nurses best action?

Multiple Choice
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A) Hold the drug and contact the prescriber.
B) Administer the Niacor in place of the Niaspan.
C) Ask the pharmacy to send the patients ordered Niaspan.
D) Check the patients chart to find out if he or she takes Niacor at home.
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Q22

What action must the nurse be prepared to take for a diabetic patient who is prescribed niacin (Niacor)?

Multiple Choice
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A) Give insulin only in the presence of food.
B) Check the blood glucose level more often.
C) Decrease the morning insulin dosage.
D) Encourage increased caloric intake.
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Q23

A patient who is prescribed gemfibrozil (Lopid) is also taking warfarin (Coumadin). What is the priority nursing action for this patient?

Multiple Choice
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A) Monitor liver function tests.
B) Keep an accurate record of urine output.
C) Give the drug 30 minutes before meals.
D) Check the patient for signs of bleeding.
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Q24

Which food, drink, or herbal supplement does the nurse warn a patient who is prescribed gemfibrozil (Lopid) to avoid?

Multiple Choice
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A) Caffeinated beverages
B) Grapefruit juice
C) St. Johns wort
D) Dairy products
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Q25

Which statement does the nurse plan to include in a teaching plan for a patient who has been prescribed fenofibrate (Tricor)?

Multiple Choice
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A) The most common side effects of this drug are headache and muscle weakness.
B) Be sure to report any upset stomach to your prescriber immediately.
C) Take this drug 30 minutes after breakfast, lunch, and dinner.
D) Do not drink grapefruit juice while you are taking this drug.
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Q26

A patient is prescribed colesevalam (WelChol) 1875 mg twice a day. Available tablets are 625 mg each. How many tablets does the nurse administer to the patient?

Multiple Choice
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A) 2
B) 3
C) 4
D) 5
Answer:

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Q27

[Multiple Response] Which health problems does the nurse teach a patient can be caused by chronic hyperlipidemia? (Select all that apply.)
a. Hypertension
b. Pancreatitis
c. Peptic ulcer disease
d. Xanthoma
e. Diabetes mellitus

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Q28

[Multiple Response] The risk for which health problems can be reduced when blood levels of low-density lipoprotein (LDL) cholesterol are controlled within the normal range? (Select all that apply.)
a. Angina
b. Asthma
c. Colitis
d. Heart attack
e. High blood pressure
f. Parkinson disease g. Stroke

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Q29

[Multiple Response] Which teaching points does the nurse include in a teaching plan for a patient prescribed an antihyperlipidemic drug? (Select all that apply.)
a. Continue to follow a low-fat diet.
b. Be sure to exercise regularly.
c. Always take these drugs with food.
d. Fast for at least 8 hours before your lipid levels are drawn.
e. You will need follow-up laboratory tests once a year.

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Q30

[Multiple Response] Which are symptoms of late liver disease? (Select all that apply.)
a. Yellowing of the skin
b. Light-colored diluted urine
c. Pale gray-colored stools
d. Pain on the right side just below the ribs
e. Reddened mucous membranes in the mouth

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Q31

[Multiple Response] Which actions are important when a patient is prescribed a bile acid sequestrant drug? (Select all that apply.)
a. Administer a daily multivitamin.
b. Give other medications at least an hour before this drug.
c. Schedule the drug for one hour before meals.
d. Ask the patient about symptoms of constipation.
e. Mix powdered forms of the drug with 2 ounces of juice or water.

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