Chapter 33: Antihyperlipidemic Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. The nurse is preparing to administer niacin to a client with hyperlipidemia. Which adverse reaction should the nurse prioritize on ongoing assessment? a. Tingling b. Constipation c. Diarrhea d. Cholelithiasis Answer: A Rationale: The nurse should monitor for tingling in the client as an adverse reaction to the drug niacin. Constipation, diarrhea, and cholelithiasis are adverse reactions to the drug fenofibrate. Question format: Multiple Choice Chapter: 33 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 421, Miscellaneous Antihyperlipidemic Drugs 2. 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? a. Take the drug along with meals. b. Observe caution while driving. c. Take a single dose once daily in the evening. d. Be alert for mild to severe facial flushing. Answer: B Rationale: When preparing a teaching plan for the client receiving the fibric acid derivative gemfibrozil, the nurse should instruct the client to observe caution while driving. Rosuvastatin calcium is taken as a single dose once daily in the evening. The nurse instructs a client prescribed nicotinic acid to take it along with meals; it may also cause mild to severe facial flushing. Question format: Multiple Choice Chapter: 33 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 425, Fibric Acid Derivatives 3. 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? a. Taking a dietary history of the client b. Inspecting skin and eyelids for evidence of xanthomas c. Obtaining reports of fasting blood sugar levels d. Frequently monitoring blood cholesterol Answer: D Rationale: The nurse should frequently monitor blood cholesterol as part of the ongoing assessment for a client receiving ezetimibe. Taking a dietary history of the client and inspecting the skin and eyelids for evidence of xanthomas are the preadministration assessments that a nurse should perform for a client receiving ezetimibe. The nurse obtains the reports of fasting blood sugar for a client with diabetes. Question format: Multiple Choice Chapter: 33 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 422, Ongoing Assessment 4. 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? a. Hypotension b. Acute infection c. Liver disease d. Unstable angina Answer: C Rationale: Bile acid resins should be used cautiously in clients with diabetes, liver, peptic ulcer or kidney disease, and during pregnancy and lactation. Colesevelam is administered with caution in clients with liver disease. Niacin is used with caution in clients with unstable angina. Statins should be used cautiously in clients with hypotension and an acute infection. Question format: Multiple Choice Chapter: 33 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 424, Bile Acid Resins 5. The nurse is administering pravastatin and amiodarone to a client with cardiac issues. Which potential interaction will the nurse carefully monitor the client for? a. Increased anticoagulant effect b. Increased hypoglycemic effect c. Increased risk of myopathy d. Decreased effects of pravastatin Answer: C 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. Increased anticoagulant effect is observed in clients receiving warfarin along with pravastatin. Increased hypoglycemic effects are observed in clients receiving sulfonylureas with fibric acid derivatives. The interaction of pravastatin with amiodarone does not decrease the effect of pravastatin. Question format: Multiple Choice Chapter: 33 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 418, Central Nervous System Reactions 6. 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? a. Endocrine disorder b. Primary biliary cirrhosis c. Arterial bleeding d. Respiratory depression