Nokea
A client is receiving warfarin therapy as part of the treatment plan for atrial fibrillation. The client is also to begin therapy with cholestyramine. When assessing the client, the nurse would be alert for which of the following?
- A. Bruising
- B. Blood in the stool
- C. Subtherapeutic INR
- D. Supratherapeutic INR
- E. Calf pain and warmth
Correct Answer: C,E
Rationale: Coadministration of warfarin and cholestyramine can result in a decreased anticoagulant effect, leading to subtherapeutic INR and increased chance of clotting (signs and symptoms of DVT or PE).
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After administering an antihyperlipidemic drug, the nurse continues to assess which of the following?
- A. Blood glucose
- B. Vital signs
- C. Assessment of bowel function
- D. Input and output
- E. Stool sample
Correct Answer: B,C
Rationale: Clients on antihyperlipidemic medications should have vital signs checked and bowel function assessed because an adverse reaction to these drugs is constipation. Constipation may become serious if not treated early in the medication regimen.
A client is receiving atorvastatin. The nurse would be alert to client complaints of which of the following?
- A. Headache
- B. Sedation
- C. Insomnia
- D. Diarrhea
- E. Constipation
Correct Answer: A,C,E
Rationale: Atorvastatin is an HMG-CoA reductase inhibitor (statin). Adverse reactions of statins include headache, dizziness, insomnia, flatulence, abdominal pain, cramping, constipation, and nausea.
A nurse is reviewing a client's laboratory test results after being on statin therapy for several months. Which of the following would the nurse interpret as indicating effectiveness of the drug?
- A. Total cholesterol 220 mg/dL
- B. LDL cholesterol 80 mg/dL
- C. HDL cholesterol 30 mg/dL
- D. LDL cholesterol 165 mg/dL
- E. HDL cholesterol 60 mg/dL
Correct Answer: B,E
Rationale: Effectiveness of therapy would be indicated by values that are low or optimal. This would include a total cholesterol below 200 mg/dL, LDL less than 100 mg/dL, and HDL greater than 40 mg/dL.
A nurse is conducting a community presentation on heart disease, cholesterol, and risk factors. The nurse determines that the class has been successful when the class identifies which of the following as true?
- A. Low-fat diet raises LDL cholesterol levels
- B. Being overweight causes HDL levels to go up
- C. Physical activity raises HDL cholesterol levels
- D. Excess body weight causes LDL cholesterol to go down
Correct Answer: C
Rationale: Saturated fat and cholesterol in the food raises total and LDL cholesterol levels. Being overweight can make LDL cholesterol levels go up and HDL levels go down. Increased physical activity helps to lower LDL cholesterol and raise HDL cholesterol levels.
The nurse discusses the benefit of adding a statin drug to a client's medication regimen based on the understanding that this group of drugs can reduce the risk of death from which of the following?
- A. Stroke
- B. Transient ischemic attack
- C. Kidney disease
- D. Hepatic disease
- E. Cancer
Correct Answer: A,B
Rationale: The use of statins in clients with hyperlipidemia with or without clinically evident coronary heart disease can reduce the risk of death from stroke and transient ischemic attacks.