Nokea
A patient calls the clinic office saying that the cholestyramine powder he started yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what method for mixing this medication for administration?
- A. Mix the powder in a carbonated soda drink to dissolve it faster.
- B. Add the powder to any liquid, and stir vigorously to dissolve it quickly.
- C. Mix the powder with food or fruit, or at least 4 to 6 ounces of fluid.
- D. Sprinkle the powder into a spoon and take it dry, followed by a glass of water.
Correct Answer: C
Rationale: Cholestyramine powder should be mixed with 4 to 6 ounces of fluid or food to ensure proper administration and prevent clumping. It should not be taken dry, and carbonated drinks or vigorous stirring alone are not recommended.
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A patient with coronary artery disease asks the nurse about the 'good cholesterol' laboratory values. The nurse knows that 'good cholesterol' refers to which lipids?
- A. Triglycerides
- B. Low-density lipoproteins (LDLs)
- C. Very-low-density lipoproteins (VLDLs)
- D. High-density lipoproteins (HDLs)
Correct Answer: D
Rationale: High-density lipoproteins (HDLs) are considered 'good cholesterol' due to their cardioprotective role in cholesterol recycling. LDLs and VLDLs are associated with increased cardiovascular risk, and triglycerides are not classified as 'good cholesterol.'
A patient is concerned about the adverse effects of the fibric acid derivative she is taking to lower her cholesterol level. Which is an adverse effect of this class of medication?
- A. Constipation
- B. Diarrhea
- C. Joint pain
- D. Dry mouth
Correct Answer: B
Rationale: Fibric acid derivatives, such as gemfibrozil, commonly cause gastrointestinal side effects like diarrhea. Constipation, joint pain, and dry mouth are not typical adverse effects of this class.
While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely for the development of which problem?
- A. Neutropenia
- B. Pulmonary problems
- C. Vitamin C deficiency
- D. Liver dysfunction
Correct Answer: D
Rationale: Antilipemic drugs, particularly statins and niacin, can cause liver dysfunction, requiring regular monitoring of liver function tests. Neutropenia, pulmonary problems, and vitamin C deficiency are not associated with antilipemic therapy.
The nurse will monitor for myopathy (muscle pain) when a patient is taking which class of antilipemic drugs?
- A. Niacin
- B. HMG-CoA reductase inhibitors
- C. Fibric acid derivatives
- D. Bile acid sequestrants
Correct Answer: B
Rationale: HMG-CoA reductase inhibitors (statins) can cause myopathy, including muscle pain, which may progress to rhabdomyolysis. Patients should report unexplained muscle pain immediately. Other classes do not commonly cause myopathy.
A patient reports having adverse effects with niacin. The prescriber has recommended which action to minimize these undesirable effects?
- A. Take the drug on an empty stomach.
- B. Take the medication every other day until the effects subside.
- C. Take an aspirin tablet 30 minutes before taking the drug.
- D. Take the drug with large amounts of fiber.
Correct Answer: C
Rationale: Taking aspirin 30 minutes before niacin can reduce cutaneous flushing by counteracting prostaglandin-mediated vasodilation. Taking niacin with meals, not on an empty stomach, and maintaining consistent dosing, not skipping days, are recommended. Fiber does not reduce niacin's adverse effects.