Nokea
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.
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Which of the following would the nurse include in the client teaching about HMG-CoA reductase inhibitors (statins)?
- A. Photosensitivity can occur
- B. The drug should be continued even if the client feels better
- C. Muscle pain and weakness are normal
- D. Juices other than grapefruit juice are okay to use
- E. Statins should be administered in the evening
Correct Answer: A,B,D,E
Rationale: When teaching about statins, the nurse should include information about the possibility of photosensitivity, the need to continue the drug even if feeling better, juices other than grapefruit juice as appropriate, and administration in the evening. MusclePain and weakness should be reported to the client's physician as soon as they occur.
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 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.
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 client is prescribed a bile acid resin and has been taking this therapy long term. The primary health care provider has prescribed vitamins A and D in waterHIV/AIDS water-soluble form. Which nursing diagnosis would be most likely?
- A. Risk for Impaired Skin Integrity
- B. Constipation
- C. Risk for Injury
- D. Risk for Imbalanced Nutrition: Less Than Body Requirements
Correct Answer: D
Rationale: Bile acid resins may interfere with the digestion of fats and prevent the absorption of the fat-soluble vitamins (vitamins A, D, E, and K) and folic acid. Therefore, the nursing diagnosis of Risk for Imbalanced Nutrition: Less Than Body Requirements would be most appropriate. Adverse reactions associated with nicotinic acid such as flushing would suggest a risk for impaired skin integrity. Constipation would be associated with statin therapy. Risk for injury may be appropriate for clients taking fibrates or statins.