Chapter 46: Antihyperlipidemics and Peripheral Vasodilators

Chapter 46: Antihyperlipidemics and Peripheral Vasodilators

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A female patient has serum lipid levels performed, which reveal a total cholesterol of 285 mg/dL, triglycerides of 188 mg/dL, a low-density lipoprotein (LDL) of 175 mg/dL, and a high-density lipoprotein (HDL) of 40 mg/dL. The patient’s blood pressure is 138/72 mm Hg. The nurse may expect the provider to order which medication for this patient?

a.	Amlodipine and atorvastatin (Caduet)
b.	Colestipol HCl (Colestid)
c.	Fenofibrate (TriCor)
d.	Niacin and lovastatin (Advicor)

 

 

ANS:  D

The combination drug of niacin and lovastatin is indicated for hypercholesterolemia and mixed dyslipidemia. Niacin raises HDL, so would be helpful in this patient who has low HDL. Combination drugs are used to enhance the antihyperlipidemic effect. Amlodipine and atorvastatin in combination are used for patients with hyperlipidemia and elevated blood pressure. Colestipol HCl is used to reduce cholesterol and LDL levels but has no effect on HDL or triglycerides. Fenofibrate is used to treat type IV and V hyperlipidemia, characterized by elevated very-low-density lipoprotein and triglycerides.

 

DIF:    COGNITIVE LEVEL: Analyzing (Analysis)                     REF:   Page 666

TOP:   NURSING PROCESS: Assessment/Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient has a serum cholesterol level of 270 mg/dL. The patient asks the nurse what this level means. Which response by the nurse is correct?

a.	“You have a high risk for coronary artery disease.”
b.	“You have a moderate risk for coronary artery disease.”
c.	“You have a low risk for coronary artery disease.”
d.	“You have no risk for coronary artery disease.”

 

 

ANS:  A

A value of 270 mg/dL for serum cholesterol puts the patient at high risk.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 665

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pathophysiology

 

3. A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports abdominal discomfort and constipation. The nurse will provide which instruction to the patient?

a.	Increase fluid and slowly increase fiber intake.
b.	Stop taking the medication immediately.
c.	Take an over-the-counter laxative.
d.	Take the medication on an empty stomach.

 

 

ANS:  A

Cholestyramine can cause gastrointestinal upset and constipation, and these symptoms can be reduced with increased fluids and foods high in fiber. Stopping the medication is not indicated. Over-the-counter laxatives are not recommended until other methods have been tried. Giving the medication on an empty stomach will not relieve the discomfort.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 666

TOP:   NURSING PROCESS: Evaluation/Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient has been taking cholestyramine (Questran) to treat hyperlipidemia type II. The patient reports abdominal cramping and constipation. The patient’s serum low- density lipoprotein (LDL) has decreased from 170 mg/dL to 110 mg/dL, and triglycerides have not changed from 150 mg/dL since beginning the medication. The provider changes the medication to colesevelam HCl (Welchol).The patient asks the nurse why the medication was changed, and the nurse will explain that colesevelam HCl is ordered for which reason?

a.	It has fewer side effects.
b.	It has more convenient dosing.
c.	It provides greater LDL reduction.
d.	It provides greater triglyceride reduction.

 

 

ANS:  A

Colesevelam is similar to cholestyramine but has fewer gastrointestinal side effects. This patient has demonstrated good results with the bile acid sequestrant, so the provider needs to offer a preparation with fewer adverse effects. Both drugs are given twice daily.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 666

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies