Nokea
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.
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The nurse is conducting a class about antilipemic drugs. The antilipemic drug ezetimibe works by which mechanism?
- A. Inhibiting HMG-CoA reductase
- B. Preventing resorption of bile acids from the small intestines
- C. Activating lipins, which breaks down cholesterol
- D. Inhibiting cholesterol absorption in the small intestine
Correct Answer: D
Rationale: Ezetimibe selectively inhibits cholesterol absorption in the small intestine, reducing circulating cholesterol levels. It does not inhibit HMG-CoA reductase, prevent bile acid resorption, or activate lipins.
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.
A patient who has recently started therapy on a statin drug asks the nurse how long it will take until he sees an effect on his serum cholesterol. Which statement would be the nurse's best response?
- A. Blood levels return to normal within a week of beginning therapy.
- B. It takes 6 to 8 weeks to see a change in cholesterol levels.
- C. It takes at least 6 months to see a change in cholesterol levels.
- D. You will need to take this medication for almost a year to see significant results.
Correct Answer: B
Rationale: Statins typically require 6 to 8 weeks to achieve maximum lipid-lowering effects. One week is too short, and 6 months or a year is unnecessarily long for initial effects.
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 tells the nurse that he likes to eat large amounts of garlic 'to help lower his cholesterol levels naturally.' The nurse reviews his medication history and notes that which drug has a potential interaction with the garlic?
- A. Acetaminophen
- B. Warfarin
- C. Digoxin
- D. Phenytoin
Correct Answer: B
Rationale: Garlic can enhance the anticoagulant effects of warfarin, increasing bleeding risk due to its antiplatelet properties. Acetaminophen, digoxin, and phenytoin do not have significant interactions with garlic.