Chapter 47 Lipid-Lowering Agents

Chapter 47  Lipid-Lowering Agents

Complete Chapter Questions And Answers
 

Sample Questions

1.
When planning patient care the nurse recognizes what patient is at greatest risk of developing coronary artery disease?
A)
A 32-year-old Asian American with total cholesterol of 120 mg/dL
B)
A 62-year-old white American with total cholesterol of 260 mg/dL
C)
A 48-year-old African American with total cholesterol of 198 mg/dL
D)
A 26-year-old Native American with total cholesterol of 150 mg/dL
Ans:
B

Feedback:

White Americans have the highest incidence of coronary artery disease (CAD). This patient has total cholesterol of 260 mg/dL, which is considered high according to the Third Report of the National Cholesterol Education Program Expert Panel. The other three patients could be at risk due to cultural risk factors such as hypertension, diabetes, high (HDL) and low density lipoprotein (LDL) levels, and HDL level to cholesterol ratio. However, their total cholesterol levels fall within normal or desirable range.

2.
The nurse is assessing a patient who reports taking cholestyramine (Questran) mixed with diet cola twice per day. What is an appropriate nursing diagnosis for this patient?
A)
Acute pain related to central nervous system and GI effects
B)
Constipation related to GI effects
C)
Noncompliance related to how the drug is taken
D)
Deficient knowledge regarding drug therapy
Ans:
D

Feedback:

Cholestyramine should be mixed with water or other noncarbonated fluids so the nurse now recognizes the need for medication teaching and chooses the nursing diagnosis related to deficient knowledge. Nothing in this question indicates that the patient is experiencing any adverse effects from the drug so that pain and constipation would not be optimal nursing diagnoses. Until the nurse assesses the patient’s understanding of how to take the drug, it would be incorrect to assume noncompliance when it may actually be lack of understanding.

3.
A patient tells the nurse he has had an exacerbation of hemorrhoidal irritation. What drug would the nurse suspect is most likely to contribute to this adverse effect?
A)
Bile acid sequestrants
B)
Beta-hydroxy-beta-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors
C)
Cholesterol absorption inhibitor
D)
Fibrates
Ans:
A

Feedback:

Direct gastrointestinal (GI) irritation, including nausea, constipation that may progress to fecal impaction, and aggravation of hemorrhoids, may occur with use of bile acid sequestrants. GI irritation, and specifically irritation of hemorrhoids is not associated with use of HMG-CoA reductase inhibitors, cholesterol absorption inhibitors, or fibrates.

4.
The nurse is engaged in patient teaching about a newly prescribed bile acid sequestrant that may be mixed with a carbonated beverage. What bile acid sequestrant is the nurse describing?
A)
Cholestyramine (Questran)
B)
Colesevelam (Welchol)
C)
Colestipol (Colestid)
D)
Ezetimibe (Zetia)
Ans:
C

Feedback:

Colestipol can be mixed with a carbonated beverage. The mixture should be stirred and all of the liquid should be swallowed. Ezetimibe is a cholesterol absorption inhibitor and comes in tablet form. The other two options are bile acid sequestrants, but should not be taken with carbonated beverages. The carbonation interferes with the absorption of the drug.

5.
The patient asks the nurse what atorvastatin (Lipitor), newly prescribed, will do. What expected outcome will the nurse describe?
A)
Decrease in serum cholesterol only
B)
Decrease in serum cholesterol and low density lipoprotein (LDL) levels
C)
Decrease in sitosterol and serum cholesterol
D)
Decrease in campesterol and LDL levels
Ans:
B

Feedback:

Atorvastatin is a beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitor and should lower serum cholesterol and LDL levels as well as prevention of a first myocardial infarction and slow the progression of coronary artery disease. A decrease in serum cholesterol alone would result from the use of a bile acid sequestrant. A cholesterol absorption inhibitor would also decrease sitosterol and campesterol levels as well as decrease levels of serum cholesterol and LDL.