Nokea
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.'
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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.
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.
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.
Antilipemic drug therapy is prescribed for a patient, and the nurse is providing instructions to the patient about the medication. Which instructions will the nurse include? (Select all that apply.)
- A. Limit fluid intake to prevent fluid overload.
- B. Eat extra servings of raw vegetables and fruit.
- C. Report abnormal or unusual bleeding or yellow discoloration of the skin.
- D. Report the occurrence of muscle pain immediately.
- E. Drug interactions are rare with antilipemics.
- F. Take the drug 1 hour before or 2 hours after meals to maximize absorption.
Correct Answer: B,C,D
Rationale: Instructions include eating raw vegetables and fruit to prevent constipation, reporting bleeding or jaundice (indicating liver issues), and reporting muscle pain (potential myopathy). Antilipemics have frequent drug interactions, and fluid intake should be encouraged, not limited. Taking with food may reduce GI distress, not before/after meals.