Nokea
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.
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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.
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 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.
A client with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. The nurse understands that this drug would be contraindicated if the client has which condition?
- A. Endocrine disorder
- B. Primary biliary cirrhosis
- C. Arterial bleeding
- D. Respiratory depression
Correct Answer: B
Rationale: The fibric acid derivative clofibrate is contraindicated in clients with primary biliary cirrhosis. The use of clofibrate is not contraindicated in clients with an endocrine disorder. The HMG-CoA reductase inhibitors are used with caution in clients with a history of endocrine disorders. Niacin is contraindicated in clients with arterial bleeding. The fibric acid derivative clofibrate is not contraindicated in clients with respiratory depression.
A nurse is caring for a client receiving gemfibrozil. Which of the following would the nurse include in the teaching plan for this client?
- A. Take the drug along with meals
- B. Observe caution while driving
- C. Take a single dose once daily in the evening
- D. Be alert for mild to severe facial flushing
Correct Answer: B
Rationale: When preparing a teaching plan for the client receiving the fibric acid derivative gemfibrozil, the nurse should instruct the client to observe caution while driving. Rosuvastatin calcium is taken as a single dose once daily in the evening. The nurse instructs a client prescribed nicotinic acid to take it along with meals; it may also cause mild to severe facial flushing.