Nokea
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.
You may also like to solve these questions
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.
The nurse is reviewing a client's medical record for predisposing factors for myopathy requiring that the client be started on low doses of statins and titrated as tolerated or until cholesterol goals are met. Which of the following would the nurse identify as one of these factors?
- A. Asian descent
- B. Severe renal insufficiency
- C. Use of antihistamines
- D. Use of cyclosporine
- E. Cigarette smoking
Correct Answer: A,B,D
Rationale: Predisposing factors for myopathy with statin therapy include Asian descent, severe renal insufficiency, and use of cyclosporine.
A client with hypercholesterolemia is prescribed lovastatin. When instructing the client how to take the drug, which of the following would the nurse include?
- A. Taking the drug with his evening meal
- B. Combining the drug with the artificial sweetener aspartame
- C. Mixing the drug with highly fluid soups or pulpy fruits
- D. Taking the drug with grapefruit juice
Correct Answer: A
Rationale: For the self-administration of lovastatin, the nurse should suggest the client take the drug with his evening meal. Cholestyramine powder is mixed with highly fluid soups or pulpy fruits. Cholestyramine is available combined with the artificial sweetener aspartame. The client should not drink grapefruit juice when taking lovastatin.
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 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).