Chapter 49: Prophylaxis of Coronary Heart Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

Chapter 49: Prophylaxis of Coronary Heart Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A patient with a history of angina and hypertension is being started on nicotinic acid (Niacin). The nurse is providing patient education. What statement made by the patient demonstrates a need for further teaching?

a.	“I will take aspirin with my medication to reduce the inflammatory effects.”
b.	“I will be cautious taking this medication because I have mild liver damage.”
c.	“I will take an aspirin 30 minutes before my niacin to reduce the flushing to my face.”
d.	“This medication will lower my triglyceride levels.”

 

 

ANS:   A

Intense flushing of the face, neck, and ears occurs in practically all patients taking nicotinic acid in pharmacologic doses. However, the 325 mg of aspirin must be taken 30 minutes before the nicotinic acid for the aspirin to be effective. No further teaching is necessary.

The flushing reaction diminishes in several weeks and can be attenuated by taking 325 mg of aspirin 30 minutes before each dose; this statement shows that further teaching is required.

Nicotinic acid is hepatotoxic, therefore the patient should be taught to have the liver enzymes checked and self-monitor for signs and symptoms; this statement shows that no further teaching is required.

Nicotinic acid reduces low-density lipoprotein (LDL) and triglyceride (TG) levels; this statement shows that no further teaching is required.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 571

TOP:    Nursing Process: Evaluation

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

 

2. The prescriber has ordered rosuvastatin (Crestor) for a patient with non-alcoholic-related cirrhosis. Which intervention would be most appropriate for the nurse prior to administration?

a.	Question the order, because rosuvastatin is contraindicated in patients with liver disease.
b.	Administer the drug as ordered.
c.	Review the baseline liver function test results.
d.	Assess the patient for liver disease.

 

 

ANS:   C

Prior to administration, the nurse should obtain the results of the baseline liver function tests.

Statins can be used by patients with liver disease, but not by those with alcoholic or viral hepatitis.

Administration of the drug prior to obtaining a baseline would not allow for an accurate baseline liver function test (LFT).

The patient clearly already has liver disease.

 

DIF:    Cognitive Level: Application             REF:    p. 569

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient with malaise has been taking daptomycin (Cubicin) for an infection and is concurrently taking simvastatin (Zocor). 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.

 

DIF:    Cognitive Level: Analysis                  REF:    pp. 568-569

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies