Nokea
The nurse is reviewing a client's medical record for predisposing factors for myopathy requiring that the client be started on low doses of statins and titrated as tolerated or until cholesterol goals are met. Which of the following would the nurse identify as one of these factors?
- A. Asian descent
- B. Severe renal insufficiency
- C. Use of antihistamines
- D. Use of cyclosporine
- E. Cigarette smoking
Correct Answer: A,B,D
Rationale: Predisposing factors for myopathy with statin therapy include Asian descent, severe renal insufficiency, and use of cyclosporine.
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A nurse is preparing to administer gemfibrozil to a client. The nurse understands that this drug lowers cholesterol via which of the following mechanisms?
- A. Increases excretion of cholesterol
- B. Reduces very-low-density lipoproteins (VLDLs)
- C. Increases breakdown of VLDLs
- D. Reduces production of triglycerides
- E. Inhibits cholesterol formation
Correct Answer: A,D
Rationale: Gemfibrozil increases the excretions of cholesterol and reduces the production of triglycerides. The drug does not reduce VLDLs, increase VLDL breakdown, or inhibit cholesterol formation.
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.
A client with hypercholesterolemia is prescribed lovastatin. When instructing the client how to take the drug, which of the following would the nurse include?
- A. Taking the drug with his evening meal
- B. Combining the drug with the artificial sweetener aspartame
- C. Mixing the drug with highly fluid soups or pulpy fruits
- D. Taking the drug with grapefruit juice
Correct Answer: A
Rationale: For the self-administration of lovastatin, the nurse should suggest the client take the drug with his evening meal. Cholestyramine powder is mixed with highly fluid soups or pulpy fruits. Cholestyramine is available combined with the artificial sweetener aspartame. The client should not drink grapefruit juice when taking lovastatin.
A nurse is caring for a client receiving gemfibrozil. Which of the following would the nurse include in the teaching plan for this client?
- A. Take the drug along with meals
- B. Observe caution while driving
- C. Take a single dose once daily in the evening
- D. Be alert for mild to severe facial flushing
Correct Answer: B
Rationale: When preparing a teaching plan for the client receiving the fibric acid derivative gemfibrozil, the nurse should instruct the client to observe caution while driving. Rosuvastatin calcium is taken as a single dose once daily in the evening. The nurse instructs a client prescribed nicotinic acid to take it along with meals; it may also cause mild to severe facial flushing.
The nurse is preparing a client for discharge. The client is prescribed antihyperlipidemic drug therapy. The nurse would include which of the following in the discharge teaching?
- A. Reason for taking the prescribed drug
- B. Drug name
- C. Correct dose
- D. Frequency of administration
- E. Dosage form
Correct Answer: A,B,C,D,E
Rationale: The nurse should review the reasons for the drug and prescribed therapy, including drug name, form and method of preparation, correct dose, and frequency of administration, as part of a client's discharge counseling.