PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
CHAPTER 47:
1. When planning patient care the nurse recognizes what patient is at greatest risk of developing
coronary artery disease?
A) A 32-year-old Asian American with total cholesterol of 120 mg/dL
B) A 62-year-old white American with total cholesterol of 260 mg/dL
C) A 48-year-old African American with total cholesterol of 198 mg/dL
D) A 26-year-old Native American with total cholesterol of 150 mg/dL
Ans: B Feedback: White Americans have the highest incidence of coronary artery disease (CAD). This
patient has total cholesterol of 260 mg/dL, which is considered high according to the Third Report of the
National Cholesterol Education Program Expert Panel. The other three patients could be at risk due to
cultural risk factors such as hypertension, diabetes, high (HDL) and low density lipoprotein (LDL) levels,
and HDL level to cholesterol ratio. However, their total cholesterol levels fall within normal or desirable
range.
2. The nurse is assessing a patient who reports taking cholestyramine (Questran) mixed with diet
cola twice per day. What is an appropriate nursing diagnosis for this patient?
A) Acute pain related to central nervous system and GI effects
B) Constipation related to GI effects
C) Noncompliance related to how the drug is taken
D) Deficient knowledge regarding drug therapy
Ans: D Feedback: Cholestyramine should be mixed with water or other noncarbonated fluids so the
nurse now recognizes the need for medication teaching and chooses the nursing diagnosis related to
deficient knowledge. Nothing in this question indicates that the patient is experiencing any adverse
effects from the drug so that pain and constipation would not be optimal nursing diagnoses. Until the
nurse assesses the patient’s understanding of how to take the drug, it would be incorrect to assume
noncompliance when it may actually be lack of understanding.
3. The patient asks the nurse what atorvastatin (Lipitor), newly prescribed, will do. What expected
outcome will the nurse describe?
A) Decrease in serum cholesterol only
B) Decrease in serum cholesterol and low density lipoprotein (LDL) levels
C) Decrease in sitosterol and serum cholesterol
,PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
D) Decrease in campesterol and LDL levels
Ans: B Feedback: Atorvastatin is a beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitor and
should lower serum cholesterol and LDL levels as well as prevention of a first myocardial infarction and
slow the progression of coronary artery disease. A decrease in serum cholesterol alone would result
from the use of a bile acid sequestrant. A cholesterol absorption inhibitor would also decrease sitosterol
and campesterol levels as well as decrease levels of serum cholesterol and LDL.
4. The nurse is taking a health history on a 38-year-old man who is taking atorvastatin (Lipitor) for high
cholesterol. What will the nurse question specifically related to the safe use of this drug?
A) Alcohol
B) Nicotine
C) Caffeine
D) Herbal therapy
Ans: A Feedback: Beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are
contraindicated with active liver disease or a history of alcohol-related liver disease so it is important for
the nurse to ask about the patient’s use of alcohol. Nicotine, caffeine, and herbal therapies are usually
not identified as producing any drugdrug interactions with atorvastatin.
5. The nurse is caring for a patient taking ezetimibe (Zetia) and monitors the patient for what common
adverse effects?
A) Bloating and flank pain
B) Neuropathy and flatulence
C) Mild abdominal pain and diarrhea
D) Constipation and flank pain
Ans: C Feedback: The most common adverse effects of ezetimibe are mild abdominal pain and diarrhea.
Bloating and flatulence are associated with bile acid sequestrants and the fibrates. Constipation is
usually associated with bile acid sequestrants. Neuropathy and flank pain are usually not associated with
lipid-lowering agents.
6. A patient taking atorvastatin (Lipitor) comes to the clinic with complaints of acute muscle pain not
associated with exercise or injury. The nurse will ask questions to determine if this patient has been
taking what contraindicated substance?
A) Over-the-counter (OTC) medications
B) Ginseng
C) Grapefruit juice
,PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
D) Saw palmetto
Ans: C
Feedback:
Grapefruit juice can decrease the breakdown of atorvastatin, leading to increased serum levels and toxic
adverse effects, including rhabdomyolysis. Patients on this drug should be cautioned to avoid drinking
grapefruit juice. OTC drugs, ginseng, and saw palmetto are not associated with increased toxicity.
7. Which drug is most effective in reducing serum triglyceride levels?
A) Beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitors
B) Bile acid sequestrants
C) Fibrates
D) Niacin
Ans: C
Feedback:
Fibrates decrease hepatic production of triglycerides. They are the most effective drugs for reducing
serum triglycerides. The other options are incorrect.
8. A patient is being discharged on cholestyramine (Questran). Patient teaching should include what
about this medication?
A) Should be administered with other medications
B) Should be administered 1 hour before or 4 to 6 hours after other medications
C) Should be administered 1 hour after other medications
D) Should be administered on an empty stomach
Ans: B
Feedback:
Cholestyramine should be administered 1 hour before or 4 to 6 hours after other medications, because
it may prevent the absorption of other drugs. Therefore, the other options are incorrect.
9. The patient receives a prescription for a lipid lowering medication from the health care provider and,
before discharge, asks the nurse what else he or she can do to improve his or her lipid levels besides just
taking medication. What recommendation will the nurse make? (Select all that apply.)
, PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
A) Quitting smoking
B) Exercising
C) Following a low sodium diet
D) Reducing stress
E) Avoiding alcohol
Ans: A, B, D
Feedback:
Lifestyle changes including low-fat diet, exercise, smoking cessation, and stress reduction should be
tried before any antihyperlipidemic drug is used. Avoiding alcohol is not indicated as a means to lower
serum lipid levels. Although a low sodium diet is a healthy choice, it is not associated with elevating
lipid levels.
10. The nurse teaches the patient at risk for coronary artery disease (CAD) that some risk factors can
be controlled or modified. What modifiable factors would the nurse include?
A) Gender, obesity, family history, and smoking
B) Inactivity, stress, gender, and smoking
C) Obesity, inactivity, diet, and smoking
D) Stress, family history, and
obesity Ans: C
Feedback:
The risk factors for CAD that can be controlled or modified include obesity, inactivity, diet, stress, and
smoking. Gender and family history are risk factors that cannot be controlled.
11. The nurse cares for a 10-year-old child brought to the clinic for an annual checkup who is diagnosed
with hypercholesterolemia. What is the most common cause of hypercholesterolemia in children?
A) Gender
B) Diet
C) Familial connection
D) Exercise
ASSUARED SUCCESS
CHAPTER 47:
1. When planning patient care the nurse recognizes what patient is at greatest risk of developing
coronary artery disease?
A) A 32-year-old Asian American with total cholesterol of 120 mg/dL
B) A 62-year-old white American with total cholesterol of 260 mg/dL
C) A 48-year-old African American with total cholesterol of 198 mg/dL
D) A 26-year-old Native American with total cholesterol of 150 mg/dL
Ans: B Feedback: White Americans have the highest incidence of coronary artery disease (CAD). This
patient has total cholesterol of 260 mg/dL, which is considered high according to the Third Report of the
National Cholesterol Education Program Expert Panel. The other three patients could be at risk due to
cultural risk factors such as hypertension, diabetes, high (HDL) and low density lipoprotein (LDL) levels,
and HDL level to cholesterol ratio. However, their total cholesterol levels fall within normal or desirable
range.
2. The nurse is assessing a patient who reports taking cholestyramine (Questran) mixed with diet
cola twice per day. What is an appropriate nursing diagnosis for this patient?
A) Acute pain related to central nervous system and GI effects
B) Constipation related to GI effects
C) Noncompliance related to how the drug is taken
D) Deficient knowledge regarding drug therapy
Ans: D Feedback: Cholestyramine should be mixed with water or other noncarbonated fluids so the
nurse now recognizes the need for medication teaching and chooses the nursing diagnosis related to
deficient knowledge. Nothing in this question indicates that the patient is experiencing any adverse
effects from the drug so that pain and constipation would not be optimal nursing diagnoses. Until the
nurse assesses the patient’s understanding of how to take the drug, it would be incorrect to assume
noncompliance when it may actually be lack of understanding.
3. The patient asks the nurse what atorvastatin (Lipitor), newly prescribed, will do. What expected
outcome will the nurse describe?
A) Decrease in serum cholesterol only
B) Decrease in serum cholesterol and low density lipoprotein (LDL) levels
C) Decrease in sitosterol and serum cholesterol
,PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
D) Decrease in campesterol and LDL levels
Ans: B Feedback: Atorvastatin is a beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitor and
should lower serum cholesterol and LDL levels as well as prevention of a first myocardial infarction and
slow the progression of coronary artery disease. A decrease in serum cholesterol alone would result
from the use of a bile acid sequestrant. A cholesterol absorption inhibitor would also decrease sitosterol
and campesterol levels as well as decrease levels of serum cholesterol and LDL.
4. The nurse is taking a health history on a 38-year-old man who is taking atorvastatin (Lipitor) for high
cholesterol. What will the nurse question specifically related to the safe use of this drug?
A) Alcohol
B) Nicotine
C) Caffeine
D) Herbal therapy
Ans: A Feedback: Beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are
contraindicated with active liver disease or a history of alcohol-related liver disease so it is important for
the nurse to ask about the patient’s use of alcohol. Nicotine, caffeine, and herbal therapies are usually
not identified as producing any drugdrug interactions with atorvastatin.
5. The nurse is caring for a patient taking ezetimibe (Zetia) and monitors the patient for what common
adverse effects?
A) Bloating and flank pain
B) Neuropathy and flatulence
C) Mild abdominal pain and diarrhea
D) Constipation and flank pain
Ans: C Feedback: The most common adverse effects of ezetimibe are mild abdominal pain and diarrhea.
Bloating and flatulence are associated with bile acid sequestrants and the fibrates. Constipation is
usually associated with bile acid sequestrants. Neuropathy and flank pain are usually not associated with
lipid-lowering agents.
6. A patient taking atorvastatin (Lipitor) comes to the clinic with complaints of acute muscle pain not
associated with exercise or injury. The nurse will ask questions to determine if this patient has been
taking what contraindicated substance?
A) Over-the-counter (OTC) medications
B) Ginseng
C) Grapefruit juice
,PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
D) Saw palmetto
Ans: C
Feedback:
Grapefruit juice can decrease the breakdown of atorvastatin, leading to increased serum levels and toxic
adverse effects, including rhabdomyolysis. Patients on this drug should be cautioned to avoid drinking
grapefruit juice. OTC drugs, ginseng, and saw palmetto are not associated with increased toxicity.
7. Which drug is most effective in reducing serum triglyceride levels?
A) Beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitors
B) Bile acid sequestrants
C) Fibrates
D) Niacin
Ans: C
Feedback:
Fibrates decrease hepatic production of triglycerides. They are the most effective drugs for reducing
serum triglycerides. The other options are incorrect.
8. A patient is being discharged on cholestyramine (Questran). Patient teaching should include what
about this medication?
A) Should be administered with other medications
B) Should be administered 1 hour before or 4 to 6 hours after other medications
C) Should be administered 1 hour after other medications
D) Should be administered on an empty stomach
Ans: B
Feedback:
Cholestyramine should be administered 1 hour before or 4 to 6 hours after other medications, because
it may prevent the absorption of other drugs. Therefore, the other options are incorrect.
9. The patient receives a prescription for a lipid lowering medication from the health care provider and,
before discharge, asks the nurse what else he or she can do to improve his or her lipid levels besides just
taking medication. What recommendation will the nurse make? (Select all that apply.)
, PHARM MISC EXAM QUESTION WITH ANSWERS 2023 A+
ASSUARED SUCCESS
A) Quitting smoking
B) Exercising
C) Following a low sodium diet
D) Reducing stress
E) Avoiding alcohol
Ans: A, B, D
Feedback:
Lifestyle changes including low-fat diet, exercise, smoking cessation, and stress reduction should be
tried before any antihyperlipidemic drug is used. Avoiding alcohol is not indicated as a means to lower
serum lipid levels. Although a low sodium diet is a healthy choice, it is not associated with elevating
lipid levels.
10. The nurse teaches the patient at risk for coronary artery disease (CAD) that some risk factors can
be controlled or modified. What modifiable factors would the nurse include?
A) Gender, obesity, family history, and smoking
B) Inactivity, stress, gender, and smoking
C) Obesity, inactivity, diet, and smoking
D) Stress, family history, and
obesity Ans: C
Feedback:
The risk factors for CAD that can be controlled or modified include obesity, inactivity, diet, stress, and
smoking. Gender and family history are risk factors that cannot be controlled.
11. The nurse cares for a 10-year-old child brought to the clinic for an annual checkup who is diagnosed
with hypercholesterolemia. What is the most common cause of hypercholesterolemia in children?
A) Gender
B) Diet
C) Familial connection
D) Exercise
