Nokea
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.
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A nurse is caring for a client taking a cholestyramine drug. What instructions should the nurse give to this client to prevent constipation?
- A. Eat foods high in dietary fiber
- B. Follow a complete liquid diet
- C. Be sure to stay on complete bed rest
- D. Take the water-soluble form of vitamin A
Correct Answer: A
Rationale: The nurse should instruct the client taking a cholestyramine drug to eat foods high in dietary fiber to prevent constipation. The nurse need not instruct the client to have a complete liquid diet or complete bed rest, instead, the nurse should instruct the client to exercise to prevent constipation. Clients are asked to take a water-soluble form of vitamin A if they are experiencing impaired digestion of fats and absorption of the fat-soluble vitamins due to long-term therapy of bile acid sequestrants.
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 with hyperlipidemia has been prescribed niacin by a physician. Which of the following adverse reactions should the nurse monitor for in the client?
- A. Tingling
- B. Constipation
- C. Diarrhea
- D. Cholelithiasis
Correct Answer: A
Rationale: The nurse should monitor for tingling in the client as an adverse reaction to the drug niacin. Constipation, diarrhea, and cholelithiasis are adverse reactions to the drug fenofibrate.
A nurse is reviewing the medical record of a client who is prescribed statin therapy. The nurse understands that this class of drugs is contraindicated in clients with which of the following conditions?
- A. Kidney disease
- B. Pregnancy
- C. Serious hepatic disease
- D. Carcinoma of the breast
- E. Lactation
Correct Answer: B,C,E
Rationale: Statin drugs are contraindicated in individuals with known hypersensitivity to the drugs or serious liver disease and during pregnancy (category X) and lactation.
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.