While a client is receiving an HMG-CoA Reductase inhibitor (statin), the nurse knows to monitor
the client closely for the development of which problem?
a. Pulmonary Problems
b. Vitamin C deficiency
c. Liver dysfunction
d. Neutropenia - ANSWER C. Liver Dysfunction
Response Feedback:
HMG-CoA reductase Inhibitors (statins) may adversely affect liver function (where cholesterol
synthesis occurs); therefore, liver function studies need to be closely monitored. The other
options do not reflect problems that may occur with HMG-CoA Reductase Inhibitors (statins).
Professor Reddington made fun of her father for experiencing what adverse effects of niacin
(nicotinic acid)?
a. Gout
b. Flatulence
c. Cutaneous flushing
d. Pruitis - ANSWER C. Cutaneous Flushing
Response Feedback:
A younger professor Reddington made fun of her father's flushed, red face from taking niacin
(nicotinic acid). Niacin (nicotinic acid). A common adverse effect of Niacin is an intense
,cutaneous flushing that can be accompanied by an itching/burning/prickly sensation. The
administration of aspirin (ASA) or an NSAID (ibuprofen) 30 mins before the administration of
niacin can help alleviate this discomfort. Pruitis is not a known adverse effect of Niacin. Gout
can occur with niacin therapy due to increased serum levels of uric acid which can predispose to
the development of gout, but was not an issue with Professor Reddington's father. GI
discomfort, such as flatulence, could occur with niacin therapy but luckily did not occur with
Professor Reddington's father.
A client calls the clinic office saying that the cholestyramine (Questran) powder he started
yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what
method for mixing this medication for administration?
a. It is recommended not to drink the whole glass if there are clumps
b. Mix the powder for at least one minute with at least 4 to 6 ounces of fluid or soft-like food
c. Mix the powder in a carbonated soda drink to dissolve it faster.
d. Sprinkle the powder into a spoon and take it dry, followed by a glass of water. - ANSWER b.
Mix the powder for at least one minute with at least 4 to 6 ounces of fluid or soft-like food
Response Feedback:
Mix the powder for at least one minute (if not more) with soft foods like applesauce or yogurt
or at least 4 to 6 ounces of fluid. The powder may not mix completely at first, but patients
should be sure to mix the dose as much as possible and then dilute any undissolved portion
with additional fluid. The powder should be dissolved for at least 1 full minute, and small
remaining clumps are okay for administration. Powder and granule dosages are never to be
taken in dry form, as the medication is activated by the liquid. Mixing in carbonated soda is not
recommended due to a reaction with the carbonation and medication.
A client on HMG-CoA reductase inhibitors (statins) therapy is complaining of muscle soreness
and dark-colored urine. What is the nurse concerned about?
a. Sick Sinus Syndrome
, b. Hypothyroidism
c. Cinchonism
d. Rhabdomyolysis - ANSWER D. Rhabdomyolysis
Response Feedback:
Taking HMG-CoA reductase inhibitors (statins) can cause a serious condition called
rhabdomyolysis, which causes a breakdown of skeletal muscle fibers that leads to acute renal
failure and death; muscle soreness and changes in urine color are early signs of rhabdomyolysis.
Cinchonism is an adverse effect of quinoline derivatives. Sick sinus syndrome is an adverse
effect seen from class IV anti-arrhythmias called calcium-channel blockers, such as Diltiazem.
Hypothyroidism is not associated with antilipemic therapy
A client with a red, swollen leg is diagnosed with a deep vein thrombosis (DVT) and is planning
to be discharged home on a "warfarin (Coumadin)-enoxaparin (Lovenox)" bridging therapy. The
nurse makes what correct statement regarding this therapy?
a. "You will discharge home on both oral warfarin (coumadin) tablets and subcutaneous low
molecular weight heparin (LMWH) enoxaparin (Lovenox) injections and will continue both
therapies until your INR becomes therapeutic; then you may discontinue the enoxaparin
(Lovenox) injections"
b. "You will be discharged home on both oral warfarin (coumadin) tablets and continuous
intravenous unfractionated heparin infusion and will continue both therapies until your INR
becomes therapeutic; then you may discontinue the heparin infusion."
c. "You will discharge home on both oral warfarin (coumadin) tablets and subcutaneous low
molecular weight heparin (LMWH) enoxaparin (Lovenox) inje - ANSWER A
Response Feedback:
The client will discharge home on both oral warfarin (coumadin) tablets and subcutaneous low
molecular weight heparin (LMWH) enoxaparin (Lovenox) injections. The client will continue
both therapies until the INR becomes therapeutic, then the enoxaparin (Lovenox) injections will
the client closely for the development of which problem?
a. Pulmonary Problems
b. Vitamin C deficiency
c. Liver dysfunction
d. Neutropenia - ANSWER C. Liver Dysfunction
Response Feedback:
HMG-CoA reductase Inhibitors (statins) may adversely affect liver function (where cholesterol
synthesis occurs); therefore, liver function studies need to be closely monitored. The other
options do not reflect problems that may occur with HMG-CoA Reductase Inhibitors (statins).
Professor Reddington made fun of her father for experiencing what adverse effects of niacin
(nicotinic acid)?
a. Gout
b. Flatulence
c. Cutaneous flushing
d. Pruitis - ANSWER C. Cutaneous Flushing
Response Feedback:
A younger professor Reddington made fun of her father's flushed, red face from taking niacin
(nicotinic acid). Niacin (nicotinic acid). A common adverse effect of Niacin is an intense
,cutaneous flushing that can be accompanied by an itching/burning/prickly sensation. The
administration of aspirin (ASA) or an NSAID (ibuprofen) 30 mins before the administration of
niacin can help alleviate this discomfort. Pruitis is not a known adverse effect of Niacin. Gout
can occur with niacin therapy due to increased serum levels of uric acid which can predispose to
the development of gout, but was not an issue with Professor Reddington's father. GI
discomfort, such as flatulence, could occur with niacin therapy but luckily did not occur with
Professor Reddington's father.
A client calls the clinic office saying that the cholestyramine (Questran) powder he started
yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what
method for mixing this medication for administration?
a. It is recommended not to drink the whole glass if there are clumps
b. Mix the powder for at least one minute with at least 4 to 6 ounces of fluid or soft-like food
c. Mix the powder in a carbonated soda drink to dissolve it faster.
d. Sprinkle the powder into a spoon and take it dry, followed by a glass of water. - ANSWER b.
Mix the powder for at least one minute with at least 4 to 6 ounces of fluid or soft-like food
Response Feedback:
Mix the powder for at least one minute (if not more) with soft foods like applesauce or yogurt
or at least 4 to 6 ounces of fluid. The powder may not mix completely at first, but patients
should be sure to mix the dose as much as possible and then dilute any undissolved portion
with additional fluid. The powder should be dissolved for at least 1 full minute, and small
remaining clumps are okay for administration. Powder and granule dosages are never to be
taken in dry form, as the medication is activated by the liquid. Mixing in carbonated soda is not
recommended due to a reaction with the carbonation and medication.
A client on HMG-CoA reductase inhibitors (statins) therapy is complaining of muscle soreness
and dark-colored urine. What is the nurse concerned about?
a. Sick Sinus Syndrome
, b. Hypothyroidism
c. Cinchonism
d. Rhabdomyolysis - ANSWER D. Rhabdomyolysis
Response Feedback:
Taking HMG-CoA reductase inhibitors (statins) can cause a serious condition called
rhabdomyolysis, which causes a breakdown of skeletal muscle fibers that leads to acute renal
failure and death; muscle soreness and changes in urine color are early signs of rhabdomyolysis.
Cinchonism is an adverse effect of quinoline derivatives. Sick sinus syndrome is an adverse
effect seen from class IV anti-arrhythmias called calcium-channel blockers, such as Diltiazem.
Hypothyroidism is not associated with antilipemic therapy
A client with a red, swollen leg is diagnosed with a deep vein thrombosis (DVT) and is planning
to be discharged home on a "warfarin (Coumadin)-enoxaparin (Lovenox)" bridging therapy. The
nurse makes what correct statement regarding this therapy?
a. "You will discharge home on both oral warfarin (coumadin) tablets and subcutaneous low
molecular weight heparin (LMWH) enoxaparin (Lovenox) injections and will continue both
therapies until your INR becomes therapeutic; then you may discontinue the enoxaparin
(Lovenox) injections"
b. "You will be discharged home on both oral warfarin (coumadin) tablets and continuous
intravenous unfractionated heparin infusion and will continue both therapies until your INR
becomes therapeutic; then you may discontinue the heparin infusion."
c. "You will discharge home on both oral warfarin (coumadin) tablets and subcutaneous low
molecular weight heparin (LMWH) enoxaparin (Lovenox) inje - ANSWER A
Response Feedback:
The client will discharge home on both oral warfarin (coumadin) tablets and subcutaneous low
molecular weight heparin (LMWH) enoxaparin (Lovenox) injections. The client will continue
both therapies until the INR becomes therapeutic, then the enoxaparin (Lovenox) injections will
