Nokea
A client is experiencing constipation due to an antihyperlipidemic drug. The client asks the nurse how to manage this problem. Which suggestion would be most appropriate?
- A. Stop taking the antihyperlipidemic medication
- B. Increase your fluid intake
- C. Eat foods rich in dietary fiber
- D. Be sure to exercise every day
- E. Use a stool softener
Correct Answer: B,C,D,E
Rationale: Constipation resulting from an antihyperlipidemic drug can be treated by increasing fluid intake, consuming food rich in dietary fiber, exercising daily, and using a stool softener or laxative if needed.
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A client is receiving pravastatin to reduce the risk of coronary heart disease due to hyperlipidemia. The client is also receiving amiodarone for an arrhythmia. The nurse understands that the client is at risk for which of the following based on these two drugs?
- A. Increased anticoagulant effect
- B. Increased hypoglycemic effect
- C. Increased risk of myopathy
- D. Decreased effects of pravastatin
Correct Answer: C
Rationale: When the HMG-CoA reductase inhibitor pravastatin is administered with amiodarone, the nurse should monitor the client for increased risk of myopathy as an effect of the interaction between the two drugs. Increased anticoagulant effect is observed in clients receiving warfarin along with pravastatin. Increased hypoglycemic effects are observed in clients receiving sulfonylureas with fibric acid derivatives. The interaction of pravastatin with amiodarone does not decrease the effect of pravastatin.
A nurse is preparing to administer gemfibrozil to a client. The nurse understands that this drug lowers cholesterol via which of the following mechanisms?
- A. Increases excretion of cholesterol
- B. Reduces very-low-density lipoproteins (VLDLs)
- C. Increases breakdown of VLDLs
- D. Reduces production of triglycerides
- E. Inhibits cholesterol formation
Correct Answer: A,D
Rationale: Gemfibrozil increases the excretions of cholesterol and reduces the production of triglycerides. The drug does not reduce VLDLs, increase VLDL breakdown, or inhibit cholesterol formation.
After teaching a group of nursing students about bile acids, the instructor determines that the teaching was successful when the students identify which of the following as true about bile?
- A. Bile is manufactured by the gallbladder
- B. Bile is stored in the liver
- C. Bile emulsifies fat and lipids
- D. Bile is secreted by the liver
- E. Bile is classified as a hormone
Correct Answer: C,D
Rationale: Bile is manufactured and secreted by the liver and stored in the gallbladder, it emulsifies fat and lipids, and these products pass through the intestine.
Which of the following should be included by the nurse during client teaching to improve client outcomes for a client receiving antihyperlipidemic drugs?
- A. Measures to minimize gastrointestinal upset
- B. Consultation with a dietitian for assistance with diet teaching
- C. Emphasis on the fact that drug therapy alone will significantly lower blood cholesterol levels
- D. Focus on the importance of taking drug exactly as prescribed
- E. Instruction in possible adverse reactions and signs and symptoms to report to primary health care provider
Correct Answer: A,B,D,E
Rationale: Client teaching includes measures to minimize gastrointestinal upset, consultation with a dietician to assist with diet planning and teaching, focus on the need to take the drug exactly as prescribed, and information about possible adverse reactions including those that need to be reported to the primary health care provider. The nurse should emphasize that drug therapy alone will NOT significantly lower blood cholesterol levels.
A nurse is caring for a client who has been prescribed colestipol granules. Which of the following would the nurse do when administering the drug to the client?
- A. Mix the granules in 2 to 6 fluid ounces of water
- B. Take care not to crush the granules
- C. Give the granules once or twice daily with meals
- D. Mix the drug in 90 mL of liquid
Correct Answer: D
Rationale: The nurse should mix the drug in 90 mL of liquid, soups, cereals, carbonated drinks, or pulpy fruits when administering the colestipol granules to the client. Cholestyramine powder is mixed in 2 to 6 fluid ounces of water. Colestipol tablets are not crushed. Colesevelam tablets are taken once or twice daily with meals.