Nokea
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.
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While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely for the development of which problem?
- A. Neutropenia
- B. Pulmonary problems
- C. Vitamin C deficiency
- D. Liver dysfunction
Correct Answer: D
Rationale: Antilipemic drugs, particularly statins and niacin, can cause liver dysfunction, requiring regular monitoring of liver function tests. Neutropenia, pulmonary problems, and vitamin C deficiency are not associated with antilipemic therapy.
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.
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 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.
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.