Nokea
The nurse discusses the benefit of adding a statin drug to a client's medication regimen based on the understanding that this group of drugs can reduce the risk of death from which of the following?
- A. Stroke
- B. Transient ischemic attack
- C. Kidney disease
- D. Hepatic disease
- E. Cancer
Correct Answer: A,B
Rationale: The use of statins in clients with hyperlipidemia with or without clinically evident coronary heart disease can reduce the risk of death from stroke and transient ischemic attacks.
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A nurse is reviewing the medical record of a client who is prescribed statin therapy. The nurse understands that this class of drugs is contraindicated in clients with which of the following conditions?
- A. Kidney disease
- B. Pregnancy
- C. Serious hepatic disease
- D. Carcinoma of the breast
- E. Lactation
Correct Answer: B,C,E
Rationale: Statin drugs are contraindicated in individuals with known hypersensitivity to the drugs or serious liver disease and during pregnancy (category X) and lactation.
A nurse is reviewing a client's laboratory test results after being on statin therapy for several months. Which of the following would the nurse interpret as indicating effectiveness of the drug?
- A. Total cholesterol 220 mg/dL
- B. LDL cholesterol 80 mg/dL
- C. HDL cholesterol 30 mg/dL
- D. LDL cholesterol 165 mg/dL
- E. HDL cholesterol 60 mg/dL
Correct Answer: B,E
Rationale: Effectiveness of therapy would be indicated by values that are low or optimal. This would include a total cholesterol below 200 mg/dL, LDL less than 100 mg/dL, and HDL greater than 40 mg/dL.
A client is receiving atorvastatin. The nurse would be alert to client complaints of which of the following?
- A. Headache
- B. Sedation
- C. Insomnia
- D. Diarrhea
- E. Constipation
Correct Answer: A,C,E
Rationale: Atorvastatin is an HMG-CoA reductase inhibitor (statin). Adverse reactions of statins include headache, dizziness, insomnia, flatulence, abdominal pain, cramping, constipation, and nausea.
Which of the following should be included by the nurse during client teaching to improve client outcomes for a client receiving antihyperlipidemic drugs?
- A. Measures to minimize gastrointestinal upset
- B. Consultation with a dietitian for assistance with diet teaching
- C. Emphasis on the fact that drug therapy alone will significantly lower blood cholesterol levels
- D. Focus on the importance of taking drug exactly as prescribed
- E. Instruction in possible adverse reactions and signs and symptoms to report to primary health care provider
Correct Answer: A,B,D,E
Rationale: Client teaching includes measures to minimize gastrointestinal upset, consultation with a dietician to assist with diet planning and teaching, focus on the need to take the drug exactly as prescribed, and information about possible adverse reactions including those that need to be reported to the primary health care provider. The nurse should emphasize that drug therapy alone will NOT significantly lower blood cholesterol levels.
A client is receiving pravastatin. The nurse understands that which of the following should be avoided with this client to prevent the risk of myopathy?
- A. Quinapril (Accupril)
- B. Niacin (Niaspan)
- C. Clarithromycin (Biaxin)
- D. Albuterol (Proventil)
- E. Verapamil (Calan)
Correct Answer: B,C,E
Rationale: Niacin, clarithromycin, and verapamil when coadministered to a client taking a statin, like pravastatin, can result in increased myopathy.