Chapter 50: Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

Chapter 50: Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient?

a.	“Ask your provider about taking an immediate-release form of the medication.”
b.	“Ask your provider about assessing your serum uric acid levels which may be elevated.”
c.	“You should stop taking the Niacin immediately since this is a serious adverse effect.”
d.	“You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect.”

 

 

ANS:  D

Intense flushing of the face, neck, and ears occurs in practically all patients taking nicotinic acid in pharmacologic doses. Patients should be advised to take 325 mg of ASA 30 minutes prior to each dose to minimize this effect or to use an extended-release form of the drug. Serum uric acid levels may increase with Niacin use, but flushing does not indicate elevated levels. This side effect is not serious and does not warrant discontinuation of the drug.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 572

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis?

a.	Elevated cholesterol
b.	Elevated high-density lipoprotein
c.	Elevated low-density lipoprotein
d.	Elevated very-low-density lipoprotein

 

 

ANS:  C

Elevated LDL levels make the greatest contribution to coronary atherosclerosis with the probability of developing coronary heart disease (CHD) directly related to the LDL level in the blood. Total cholesterol levels do not have the same direct link. HDL levels cause increased risk when they are low. The relation between elevated very-low-density lipoprotein levels and CHD is not clear.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   pp. 557-558

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

3. A patient who is taking simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of:

a.	nausea.
b.	tiredness.
c.	muscle pain.
d.	headache.

 

 

ANS:  C

Statins can injure muscle tissue, causing muscle aches and pain known as myopathy/rhabdomyolysis. Daptomycin also can cause myopathy and therefore should be used with caution in patients concurrently taking simvastatin. Nausea, tiredness, and headache would not cause the nurse as much concern as the likelihood of myopathy.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 569

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A patient who recently started therapy with an HMG-COA reductase inhibitor asks the nurse, “How long will it take until I see an effect on my LDL cholesterol?” The nurse gives which correct answer?

a.	“It will take 6 months to see a change.”
b.	“A reduction usually is seen within 2 weeks.”
c.	“Blood levels normalize immediately after the drug is started.”
d.	“Cholesterol will not be affected, but triglycerides will fall within the first week.”

 

 

ANS:  B

Reductions in LDL cholesterol are significant within 2 weeks and maximal within 4 to 6 weeks. It does not take 6 months to see a change. The blood level of LDL cholesterol is not reduced immediately upon starting the drug; a reduction is seen within 2 weeks. Blood cholesterol is affected, specifically LDL cholesterol, not triglycerides.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   pp. 566-567

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance