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The medication order reads, 'Give simvastatin 30 mg daily at bedtime, PO.' The medication is available in 20-mg tablets. Identify how many tablets the nurse will administer to the patient.
Correct Answer: 1.5
Rationale: To calculate: 20 mg/1 tablet = 30 mg/x tablets. Cross-multiply: (20 * x) = (1 * 30); 20x = 30; x = 30/20 = 1.5 tablets.
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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 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.
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 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.
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.