NURSING 6005 CHAPTER 50: PROPHYLAXIS OF CORONARY HEART DISEASE: Drugs That Help Normalize Cholesterol and Triglyceride Levels

NURSING 6005 CHAPTER 50: PROPHYLAXIS OF CORONARY HEART DISEASE: Drugs That Help Normalize Cholesterol and Triglyceride Levels Test Bank MULTIPLE CHOICE 1. A patient with a history of angina and hypertension is being started on nicotinic acid (Niacin). The nurse is providing patient education. What statement made by the patient demonstrates a need for further teaching? a. “I will take Tylenol with my medication to reduce the inflammatory effects.” b. “I will be cautious taking this medication, because I have mild liver damage.” c. “I will take an aspirin 30 minutes before my niacin to reduce flushing.” d. “This medication will lower my triglyceride levels.” ANS: A Intense flushing of the face, neck, and ears occurs in practically all patients taking nicotinic acid in pharmacologic doses. Tylenol will not reduce the flushing or inflammatory effects of the medication; further patient teaching is required. The flushing reaction diminishes in several weeks and can be attenuated by taking 325 mg of aspirin 30 minutes before each dose. Nicotinic acid is hepatotoxic; therefore, the patient should be taught to have the liver enzymes checked and to self-monitor for signs and symptoms. Nicotinic acid reduces low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels. DIF: Cognitive Level: Analysis REF: Nicotinic Acid (Niacin) | Adverse Effects TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 2. A prescriber has ordered rosuvastatin (Crestor) for a patient with non–alcoholic-related cirrhosis. Which intervention would be most appropriate for the nurse before administration of this drug? a. Question the order, because rosuvastatin is contraindicated in patients with liver disease. b. No intervention is necessary; just administer the drug as ordered. c. Review the baseline liver function test results. d. Assess the patient for liver disease. ANS: C Before administering rosuvastatin, the nurse should review the results of the baseline liver function tests (LFTs). Statins can be used by patients with liver disease but not by those with alcoholic or viral hepatitis. Administering the drug before obtaining baseline LFT results would not allow for an accurate baseline. The patient clearly already has liver disease. DIF: Cognitive Level: Application REF: HMG-CoA Reductase Inhibitors (Statins) | Adverse Effects | Hepatotoxicity TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 3. A patient with malaise has been taking daptomycin (Cubicin) for an infection and is concurrently taking simvastatin (Zocor). The nurse should be concerned if the patient complains of: