Chapter 23 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 23 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient says to the nurse, “My doctor says I have heart disease and I need to decrease cholesterol in my diet. How did this happen?” What is the best response by the nurse?

1. “The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them.”
2. “Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries.”
3. “It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet.”
4. “Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy.”

Correct Answer: 1

Rationale 1: Storage of cholesterol in the lining of coronary blood vessels contributes to plaque buildup and atherosclerosis; this contributes significantly to coronary artery disease.

Rationale 2: Low density lipoprotein (LDL) cholesterol is not converted to saturated fat and stored in the coronary arteries.

Rationale 3: For several years, research has demonstrated a correlation between high levels of low density lipoprotein (LDL) and coronary artery disease.

Rationale 4: Coronary artery disease is caused by plaque buildup in the coronary arteries, not the peripheral arteries.

Global Rationale: Storage of cholesterol in the lining of coronary blood vessels contributes to plaque buildup and atherosclerosis; this contributes significantly to coronary artery disease. Low density lipoprotein (LDL) cholesterol is not converted to saturated fat and stored in the coronary arteries. Coronary artery disease is caused by plaque buildup in the coronary arteries, not the peripheral arteries. For several years, research has demonstrated a correlation between high levels of low density lipoprotein (LDL) and coronary artery disease.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-1 Summarize the link between high blood cholesterol, LDL levels, and cardiovascular disease.

MNL Learning Outcome: 4.4.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 327

 

Question 2

Type: MCSA

The nurse is providing group education about lipids to patients who have been diagnosed with hyperlipidemia. What does the best instruction include?

1. High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.
2. High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup.
3. High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein [LDL]), and promotes excretion of it through the kidneys.
4. High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

Correct Answer: 1

Rationale 1: High density lipoprotein (HDL) assists in the transport of cholesterol away from body tissues and back to the liver in a process called reverse cholesterol transport.

Rationale 2: High density lipoprotein (HDL) does not increase oxygen content in the arteries.

Rationale 3: High density lipoprotein (HDL) does not reduce low density lipoprotein (LDL), which is excreted in the feces, not the kidneys.

Rationale 4: Very low density lipoprotein (VDRL) reduces to become low density lipoprotein (LDL).

Global Rationale: High density lipoprotein (HDL) assists in the transport of cholesterol away from body tissues and back to the liver in a process called reverse cholesterol transport. High density lipoprotein (HDL) does not reduce low density lipoprotein (LDL), which is excreted in the feces, not the kidneys. High density lipoprotein (HDL) does not increase oxygen content in the arteries. Very low density lipoprotein (VDRL) reduces to become low density lipoprotein (LDL).

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-2 Compare and contrast the different types of lipids.

MNL Learning Outcome: 4.4.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 328

 

Question 3

Type: MCMA

The patient tells the nurse she is confused about what she has been reading about lipids. What are the best responses by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Phospholipids will help prevent Alzheimer’s disease.”
2. “Phospholipids are essential to building plasma membranes.”
3. “Cholesterol is a building block for estrogen and testosterone.”
4. “Triglycerides are the major form of fat in the body.”
5. “Cholesterol in the diet is unnecessary as the liver synthesizes it.”

Correct Answer: 2,3,4,5

Rationale 1: There is no evidence to support that phospholipids will prevent Alzheimer’s disease.

Rationale 2: Phospholipids are essential to building plasma membranes.

Rationale 3: Cholesterol is a building block for estrogen and testosterone.

Rationale 4: Triglycerides are the major form of fat in the body.

Rationale 5: Cholesterol is not needed in the diet as the liver synthesizes adequate amounts from other chemicals.

Global Rationale: Triglycerides are the major form of fat in the body, phospholipids are essential to building plasma membranes, cholesterol is a building block for estrogen and testosterone, and cholesterol is not needed in the diet as the liver synthesizes adequate amounts from other chemicals. There is no evidence to support that phospholipids will prevent Alzheimer’s disease.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-2 Compare and contrast the different types of lipids.

MNL Learning Outcome: 4.4.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 327

 

Question 4

Type: MCSA

The patient has serum cholesterol levels of the following:
Low density lipoprotein (LDL) = 105 mg/dl
High density lipoprotein (HDL) = 37 mg/dl
Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1
In planning care with this patient, what is the best outcome?

1. The patient will maintain normal lipid levels without the use of medications.
2. The nurse will educate the patient about diet and exercise.
3. The nurse will validate that the patient understands the importance of lifestyle changes.
4. The patient will achieve normal lipid levels through compliance with medications.

Correct Answer: 1

Rationale 1: The patient has borderline laboratory levels; patients with borderline laboratory values can control their dyslipidemia entirely through nonpharmacological means. To the extent possible, maintaining normal lipid values without pharmacotherapy should be a therapeutic goal as all medications have side effects.

Rationale 2: The nurse educating the patient about diet and exercise is a nursing intervention, not a patient outcome.

Rationale 3: The nurse validating that the patient understands the importance of lifestyle changes is a nursing intervention, not a patient outcome.

Rationale 4: The best outcome with borderline serum lipids is to maintain normal levels without the use of medications.

Global Rationale: The patient has borderline laboratory levels; patients with borderline laboratory values can control their dyslipidemia entirely through nonpharmacological means. To the extent possible, maintaining normal lipid values without pharmacotherapy should be a therapeutic goal as all medications have side effects. The nurse educating the patient about diet and exercise is a nursing intervention, not a patient outcome. The best outcome with borderline serum lipids is to maintain normal levels without the use of medications. The nurse validating that the patient understands the importance of lifestyle changes is a nursing intervention, not a patient outcome.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: IX.17 Develop a beginning understanding of complementary and alternative modalities and their role in health care.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 23-5 Give examples of how cholesterol and LDL levels can be controlled through nonpharmacologic means.

MNL Learning Outcome: 4.4.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 328