Nursing 552: Exam 3 Practice Q&A

Which statement by a patient should alert you to a serious issue related to the patient's use of Atorvastatin? A) "I've been feeling really down lately." B) "My urine has been a lot darker than usual." C) "I've been having issues with blurry vision lately" D) "My heart feels like it beats really fast sometimes." - Answer- Answer: B. Rhabdomylosis is a rare but serious side effect of statin medications. Reference: Chapter 39 An 66 year old male has been taking Simvastatin for three years. The Nurse Practitioner should be concerned about which new medication prescribed for this patient in combination with Simvastatin: A) Metoprolol B) Multivitamin C) Azithromycin D) Tylenol - Answer- Answer: C. Antitbiotics, specifically macrolide antibiotics put elderly patients at high risk for muscle toxicity when mixed with statin medications. Reference: Chapter 39 Which medication is absolutely contraindicated for a new 23 year old pregnant patient who presents with hyperlipidemia not responsive to lifestyle modifications? A) Rosuvastatin B) Nicotinic Acid C) Fenofibrate D) Gemfibrozil - Answer- Answer: A. Statins are pregnancy category X. Reference: Chapter 39 Which drug to treat hyperlipidemia acts by inhibiting the mobilization of free fatty acids (FFA) from peripheral adipose tissue to the liver? A) Statins B) Fibric Acids C) Niacin (Nicotinic Acid) D) Bile acid-binding Resins E) Ezetimibe - Answer- Answer: C. The mobilization of FFA from peripheral adipose tissue to the liver is inhibited by nicotinic acid. The conversion of VLDL to LDL is decreased as a consequence of this decrease or an additional hepatic effect via nicotinic acid and the synthesis and secretion of VLDLs are reduced. Although the mechanism is unknown, nicotinic acid also increases serum HDL cholesterol concentrations by up to 30%.