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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.
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A patient with elevated lipid levels has a new prescription for niacin. The nurse informs the patient that which adverse effects may occur with this medication?
- A. Pruritus, cutaneous flushing
- B. Tinnitus, urine with a burnt odor
- C. Myalgia, fatigue
- D. Blurred vision, headaches
Correct Answer: A
Rationale: Niacin commonly causes pruritus and cutaneous flushing due to its vasodilatory effects. Tinnitus and urine odor are associated with bile acid sequestrants, myalgia and fatigue with statins, and blurred vision and headaches are not typical niacin adverse effects.
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.
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.
When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?
- A. Bran muffins
- B. Grapefruit juice
- C. Licorice
- D. Dairy products
Correct Answer: B
Rationale: Grapefruit juice inhibits CYP3A4, which metabolizes statins, potentially increasing statin levels and toxicity risk, including rhabdomyolysis. Bran, licorice, and dairy products do not significantly interact with antilipemic drugs.
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.