test bank for clayton’s basic pharmacology for nurses 18th edition by willihnganz updated 2022
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Chapter 21: Drugs Used to Treat Dyslipidemias
Test Bank
MULTIPLE CHOICE
1. Which lipoprotein contributes to the development of atherosclerosis?
a. Chylomicrons
b. Very-low-density lipoprotein (VLDL)
c. Low-density lipoprotein chylomicron (LDL C)
d. High-density lipoprotein chylomicron (HDL C)
ANS: C
The probability that atherosclerosis will develop is related directly to the concentration of
LDL C. Chylomicrons are intermediate-density lipoproteins. VLDLs are not as important in
the development of atherosclerosis as low-density lipoproteins. HDLs do not contribute to the
development of atherosclerosis.
2. The nurse is preparing medications for a patient. When is the best time for the nurse to
administer lovastatin (Mevacor)?
a. 2 hours after breakfast
b. During the patient’s dinner
c. 1 hour before breakfast
d. 30 minutesbefore lunch
ANS: B
Lovastatin should be administered with food to enhance absorption, and in the evening,
because this is when the production of cholesterol is at its highest. It is not recommended that
lovastatin be taken after food but while eating to enhance absorption. Taking the medication a
half hour or an hour before eating would not benefit the patient or enhance absorption.
3. The nurse has completed an admitting patient history and notes the patient’s current
medications to be simvastatin (Zocor) and warfarin (Coumadin). What is the result of the
interaction of these drugs?
a. Abdominal distention
b. Increased INR
c. Low serum level of simvastatin
d. Hypertension
ANS: B
The combined therapy of simvastatin and warfarin may prolong the patient’s INR. Additional
nursing assessments would include monitoring for possible overcoagulation and bleeding.
Abdominal distention and a low serum level of simvastatin does not occur with the combined
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therapy of simvastatin and warfarin. Increased blood pressure is not a complication of
combining simvastatin and warfarin therapy.
DIF: Cognitive Level: ComprehensionREF: p. 353 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
4. Which deficiency may develop in patients taking cholestyramine?
a. Potassium deficiency
b. Sodium deficiency
c. Vitamin K deficiency
d. Hydrochloric acid deficiency
ANS: C
Patients on long term bile acid–sequestering resin therapy may become deficient in fat
soluble vitamins (i.e., D, E, A, K). Cholestyramine does not affect electrolyte levels or
hydrochloric acid.
5. A patient is prescribed a bile acid resin. The nurse instructs the patient to report which
adverse reaction related to vitamin K deficiency?
a. Constipation
b. Coffee ground emesis
c. Nausea
d. Changes in skin pigmentation
ANS: B
Vitamin K is essential for blood clotting. Signs and symptoms of a vitamin K deficiency include
bleeding gums, bruising, dark tarry stools, and coffee ground emesis (blood vomited from the
stomach). Constipation, nausea, and a change in skin pigmentation are not signs of vitamin K
deficiency.
DIF: Cognitive Level: Application REF: p. 347 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
6. Which vitamin has antilipemic actions?
a. C
b. A
c. D
d. B3
ANS: D
It is thought that niacin inhibits VLDL synthesis by liver cells, causing a decrease in LDL and
triglyceride production. Vitamins A, C, and D do not have an antilipemic effects.
DIF: Cognitive Level: Knowledge REF: p. 349 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
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7. Why are statins, or HMG CoA reductase inhibitors, administered at bedtime?
a. The stomach is empty.
b. Metabolic needs of the body are decreased.
c. Cholesterol production is at its peak.
d. The body temperature is increased.
ANS: C
The peak production of cholesterol is during the night. Therefore, HMG CoA reductase
inhibitors are more effective when administered at bedtime. Statins should be taken with
food, not on an empty stomach. Metabolic needs of the body and body temperature do not
affect the administration of statins.
DIF: Cognitive Level: ComprehensionREF: p. 350 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
8. What is the desired effect of any antilipemic therapy?
a. Reduced LDLs and total cholesterol levels
b. Reduced HDLs and total cholesterol levels
c. Reduced LDLs and HDLs
d. Reduced HDLs and dietary cholesterol levels
ANS: A
LDLs account for 60% to 70% of total serum cholesterol and are a major contributor to
atherosclerosis. The therapeutic outcome of antilipemic therapy is to lower the LDL and total
cholesterol levels and raise the HDL and HDL/LDL ratio. HDLs are not reduced in treating
hyperlipidemia.
DIF: Cognitive Level: ComprehensionREF: pp. 344-346 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
9. In addition to controlling hyperlipidemia, what are bile acid–binding resins prescribed to
treat?
a. Constipation secondary to excess fecal bile acids
b. Constipation related to pseudomembranous colitis
c. Pruritus secondary to biliary stasis
d. Jaundice related to cholelithiasis
ANS: C
Bile acid–binding resins may be used to treat pruritus as a result of partial biliary stasis.
Excess fecal bile acids produce diarrhea. Pseudomembranous colitis produces diarrhea. Bile
acid–binding resins are not used to treat jaundice.
DIF: Cognitive Level: ComprehensionREF: p. 348 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
10. Which antilipemic agent is most potent?
a. Niacin
b. HMG CoA reductase inhibitor
c. Bile acid–binding resin
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d. Fibric acid
ANS: B
HMG CoA reductase inhibitors are the most potent antilipemic agents available. Niacin, bile
acid–binding resins, and fibric acid are not as potent as HMG CoA reductase inhibitors.
11. The nurse is teaching a patient about statin therapy. Which statement by the patient
indicates a need for further teaching?
a. “I will take this medication at night.”
b. “This medication will reduce blood clot formation.”
c. “I will avoid drinking grapefruit juice.”
d. “If I get a headache, I will notify my health care provider.”
ANS: D
Headaches are usually mild and disappear with continued therapy. Statins are to be taken at
night. Statins reduce blood clot formation by reducing platelet aggregation and thrombin
formation. Grapefruit juice inhibits the metabolism of this medication.
12. The nurse is providing education to a patient who has recently been prescribed niacin.
Which information given by the nurse is accurate?
a. “Weigh yourself weekly because of the risk of fluid retention.”
b. “Nausea can be decreased if you take this medication with food.”
c. “Because your blood pressure may increase while taking this drug, have it checked
monthly.”
d. “You should not take aspirin while on this medication.”
ANS: B
Niacin is administered with food to decrease gastrointestinal (GI) upset. Fluid retention and
increased blood pressure are not adverse effects of niacin. Aspirin can minimize adverse
effects and is safe to take.
13. The nurse is assessing a patient who is being evaluated for hyperlipidemia. Which
assessment will most increase the risk of coronary artery disease (CAD)?
a. Blood pressure, 168/90 mm Hg
b. Hemoglobin A1c, 6%
c. Walks 3 miles briskly, usually 4 days a week
d. Eats five servings of fruits and vegetables daily
ANS: A
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