Nokea
A client is receiving pravastatin. The nurse understands that which of the following should be avoided with this client to prevent the risk of myopathy?
- A. Quinapril (Accupril)
- B. Niacin (Niaspan)
- C. Clarithromycin (Biaxin)
- D. Albuterol (Proventil)
- E. Verapamil (Calan)
Correct Answer: B,C,E
Rationale: Niacin, clarithromycin, and verapamil when coadministered to a client taking a statin, like pravastatin, can result in increased myopathy.
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A nurse in a health care facility is caring for a client receiving colesevelam. The nurse would anticipate administering this drug cautiously to a client with which condition?
- A. Diabetes
- B. Peptic ulcer disease
- C. Liver disease
- D. Unstable angina
Correct Answer: C
Rationale: Colesevelam is administered with caution in clients with liver disease. Fibric acid derivatives are administered with caution in clients with peptic ulcer disease and diabetes. Niacin is used with caution in clients with unstable angina.
A nurse is explaining how statin drugs help lower cholesterol, LDL, and triglycerides. Which of the following would the nurse include in the explanation?
- A. Decreased absorption of cholesterol from the GI tract
- B. Promotion of cholesterol breakdown
- C. Formation of a substance that is excreted in the feces
- D. Decreased breakdown of fat to cholesterol
- E. Inhibition of cholesterol production
Correct Answer: A,B
Rationale: Statins inhibit the manufacture of cholesterol or promote the breakdown of cholesterol. The bile acid resins bind to bile acids to form an insoluble substance that cannot be absorbed by the intestine, so it is excreted in the feces.
A client who is prescribed niacin comes to the clinic complaining of significant skin flushing and itching. The client states, 'It's really uncomfortable, so much so that I almost stopped taking the drug.' The nurse informs the primary health care provider. Which of the following would the nurse anticipate that the primary health care provider may recommend?
- A. Prednisone
- B. Aspirin
- C. Ibuprofen
- D. Hydrocortisone
Correct Answer: B
Rationale: Aspirin may be recommended before taking niacin preparations to reduce adverse reactions when niacin causes skin reactions that are severe or cause extreme discomfort.
A client is starting cholestyramine therapy for the treatment of hyperlipidemia. When teaching the client about possible adverse reactions, which of the following would the nurse include?
- A. Diarrhea
- B. Malabsorption of vitamin K
- C. Aggravation of hemorrhoids
- D. Flatulence
- E. Myopathy
Correct Answer: B,C,D
Rationale: Adverse reactions reported with the use of bile acid resins, such as cholestyramine, include constipation (that can become severe), aggravation of hemorrhoids, abdominal cramps, flatulence, nausea, increased bleeding related to vitamin K malabsorption, and vitamin A and D deficiencies.
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.