Chapter 16: Drugs for High Blood Lipids Nursing School Test Banks

Workman: Understanding Pharmacology

Chapter 16: Drugs for High Blood Lipids

Test Bank

MULTIPLE CHOICE

1. Which statement about cholesterol is true?
a. The one source of cholesterol is from the foods a person eats.
b. Cholesterol always has harmful effects on a persons body.
c. Too much cholesterol leads to a deficit of bile acids that digest fat.
d. It is a fatty, waxy material present in cell membranes of the body.
ANS: D
Cholesterol is a fatty, waxy material that the body needs to function and is present in cell membranes everywhere in the body. There are two sources of cholesterol: food and the liver. The body needs small amounts of cholesterol for important functions including production of hormones, vitamin D, and bile acids that help digest fat. Inadequate amounts of cholesterol would lead to a deficit of bile acids.

PTS: 0 DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 295 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

2. A patient has been prescribed an antihyperlipidemic drug. Which laboratory value does the nurse report to the prescriber?
a. Total cholesterol 198 mg/dL
b. Triglycerides 135 mg/dL
c. Low density lipoprotein (LDL) 195 mg/dL
d. High density lipoprotein (HDL) 60 mg/dL
ANS: C
The total cholesterol, triglyceride, and HDL levels are all within the normal range. The LDL level is high and should be reported to the prescriber because a high level increases the patients risk for atherosclerosis.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Evaluation MSC: Client Needs Category: Physiological Integrity

3. A patient with high blood lipids asks the nurse why the lipid profile did not improve after 3 months following a low-fat diet. What is the nurses best response?
a. You may need to follow a no-fat diet to improve your lipid profile.
b. You must follow a low-fat diet for at least 6 months to see improvement.
c. You will definitely need to be prescribed a drug to see improvement.
d. You may have a genetic factor that is causing your high blood lipid levels.
ANS: D
People who do not show lipid profile improvement after following a low-fat diet for 3 months often have a genetic factor that leads to familial hyperlipidemia. This tends to run in families and requires antilipidemic drugs to lower blood lipid levels. Telling the patient that a drug is definitely required may be correct in this case, but it does not address the patients question.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

4. Which statement by a patient who has been prescribed an antilipidemic drug indicates to the nurse the need for additional teaching?
a. Once my lipid profile levels are normal, I will no longer need to take the drug.
b. Taking this drug will decrease my risk for having a heart attack.
c. My goal is to increase my HDL cholesterol and decrease my LDL cholesterol.
d. I will continue walking and watching the fat in my diet while Im taking this drug.
ANS: A
All lipid-lowering drugs reduce high blood lipid levels, but they do not cure the problem. Treatment is long term, and these drugs need to be taken even after blood fat levels are normal.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Assessment
MSC: Client Needs Category: Health Promotion and Maintenance

5. How do antihyperlipidemic drugs from the statin class lower bad cholesterol levels?
a. They act as a filter in the blood to trap bad cholesterol and allow white blood cells to destroy it.
b. They block the absorption of dietary fats through the walls of the intestinal tract.
c. They bind to cholesterol in the intestinal tract and promote its excretion in stool.
d. They decrease normal liver production of cholesterol.
ANS: D
Statins inhibit HMG CoA reductase, an enzyme that controls cholesterol production in the body. They lower blood lipid levels by slowing the production of cholesterol and increasing the ability of the liver to remove LDL cholesterol from the blood.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 298 TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Physiological Integrity

6. Which laboratory finding does the nurse report to the prescriber before giving any antihyperlipidemic drug?
a. Aspartate aminotransferase 41 IU/L
b. Alanine aminotransferase 24 IU/L
c. Alkaline phosphatase 130 IU/L
d. Gamma-glutamyltransferase 50 IU/L
ANS: A
The normal range for aspartate aminotransferase is 10 to 34 IU/L. This laboratory value is high and indicates that the patient has liver problems. One of the side effects of these drugs is liver damage. All of the other liver functions tests are within normal limits.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Evaluation MSC: Client Needs Category: Physiological Integrity

7. A patient prescribed atorvastatin (Lipitor) reports all of the following problems or changes since starting this drug. Which problem or change does the nurse report to the prescriber?
a. Abdominal cramps and bloating
b. Muscle aches and weakness
c. Urinating more at night
d. Loss of taste for sweets
ANS: B
Atorvastatin can cause the adverse reaction of rhabdomyolysis, which is the destruction of skeletal muscle. The symptoms of this problem are muscle aches and weakness. When a patient develops this problem, the drug should be stopped.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Assessment MSC: Client Needs Category: Physiological Integrity

8. A patient who is prescribed atorvastatin (Lipitor) reports experiencing some muscle pain and weakness. What is the nurses best action?
a. Administer ordered acetaminophen (Tylenol) as needed.
b. Document the finding as the only action.
c. Reassure the patient that this is an expected side effect.
d. Hold the drug and notify the prescriber.
ANS: D
Atorvastatin is an HMG-CoA reductase inhibitor (statin) drug. Patients may develop rhabdomyolysis (muscle breakdown) as an adverse effect of these drugs. Signs and symptoms include general muscle soreness, muscle pain, and weakness. The drug should be held and the prescriber notified. The patient will need to be prescribed another antihyperlipidemic drug.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

9. A patient who has been prescribed lovastatin (Mevacor) asks the nurse why all urine must be saved for intake and output measurements. What is the nurses best response?
a. All patients on this unit have orders for strict intake and output measurements.
b. Intake and output measurements are important indicators of how well your kidneys are functioning.
c. A side effect of this drug can be blockage of urine flow through the kidneys and decreased urine output.
d. Sometimes this drug can cause the kidneys to make extra urine resulting in increased urine output and dehydration.
ANS: C
Renal failure can occur if rhabdomyolysis (muscle breakdown) happens as an adverse effect of statin drugs. The protein released from broken-down muscle can block urine flow through the kidneys leading to decreased urine output. Telling the patient that intake and output measurement is an important assessment of kidney function is essentially correct, but it does not fully address the patients question.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

10. A patient who is prescribed simvastatin (Zocor) asks the nurse why liver function tests must be drawn every 6 months. What is the nurses best response?
a. They are important because early liver problems do not cause symptoms.
b. They help your prescriber decide what your dose of simvastatin should be.
c. They tell your prescriber how well your body is responding to the therapy.
d. They indicate how much cholesterol is being produced by your liver.
ANS: A
Simvastatin is a statin drug. These drugs may cause decreased liver function. Because of this, the prescriber orders liver function tests every 3 to 6 months. The tests are essential and important because early or mild liver problems may not cause symptoms.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

11. Which statement made by a patient who has been prescribed simvastatin (Zocor) indicates the need for more teaching?
a. I have been taking this drug every night at bedtime.
b. I have stopped using butter when I cook and have been using olive oil instead.
c. My LDL cholesterol level today is 101 mg/dL so the drug has cured my cholesterol problem.
d. I hope that by reducing my fatty food intake, I might not have to take medications to manage my cholesterol problem.
ANS: C
Statin drugs can help control LDL cholesterol levels but do not cure hyperlipidemia. For some people, lifestyle changes and reduced intake of cholesterol and saturated fats can lower cholesterol levels; however, no one is considered cured of hyperlipidemia based on a single test of blood cholesterol level. The fact that this patients LDL cholesterol is in the normal range is likely a response to the drug. Continuing to have a normal LDL level is most likely to require continued therapy with simvastatin.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

12. A hospitalized patient who is prescribed lovastatin (Mevacor) 80 mg orally looks at the four tablets the nurse provides and says At home, I only take two pills for 80 mg. I think this is too many pills. What is the nurses best action?
a. Hold the dose and contact the prescriber.
b. Remind the patient that the prescriber knows what is best for his or her particular health problem.
c. Explain that each tablet contains 20 mg of the drug instead of 40 mg, and that four 20-mg tablets are the same dosage as two 40-mg tablets.
d. Explain to the patient that while at home a lower dosage of the drug may have been prescribed than what is required while being hospitalized.
ANS: C
There are many different dosage strengths for this drug, including both 20-mg tablets and 40-mg tablets. The patient is right to question a dose that seems different from what is taken at home. The nurse, who knows that the drug available on the hospital unit is available as lovastatin 20-mg tablets, reassures the patient by explaining the differences in tablet content. If further evidence is needed to completely reassure the patient, the nurse can provide the drug container.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Psychosocial Integrity

13. What does the nurse include in a teaching plan for a woman of childbearing age who is prescribed a statin drug?
a. These drugs should not be taken during pregnancy, but are safe to use when breastfeeding.
b. Statins are pregnancy category X drugs and should not be taken while pregnant or breastfeeding.
c. Because these drugs control fats produced by the liver, they will help control weight gain during pregnancy.
d. You can take these drugs during pregnancy as long as you do not have a history of muscle or liver problems.
ANS: B
Statin drugs are pregnancy category X and should not be taken by women who plan to become pregnant, are pregnant, or are breastfeeding. These drugs decrease the amount of fat in the body. Fat is essential to brain development in the fetus and infant. When there is not enough fat in the body during pregnancy and infancy, the results can be poor brain development and mental retardation.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Health Promotion and Maintenance

14. Why do the most common side effects of any bile acid sequestrant include bloating, abdominal discomfort, and constipation?
a. Many patients are lactose intolerant and these drugs contain lactose.
b. Bile acid sequestrants exert their effects directly in the intestinal tract.
c. The action of bile acid sequestrants on the liver releases bile into the intestinal tract.
d. The drugs inhibit the absorption of dietary fiber, increasing its concentration and effects in the intestinal tract.
ANS: B
Bile acid sequestrants are taken by mouth and work directly on dietary fats in the intestinal tract. They bind with cholesterol in the intestine, preventing fats from being absorbed into the blood. This action then eliminates the cholesterol from the body through the stool and also is likely to change the general activity of the intestinal tract, leading to intestinal side effects.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 300 TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Physiological Integrity

15. A patient who is prescribed cholestyramine (Questran) tablets reports experiencing bloating, nausea, and gas. What is the nurses best action?
a. Hold the drug and notify the prescriber.
b. Document the finding as the only action.
c. Administer the drug before meals to avoid nausea.
d. Teach the patient to drink 12 to 16 ounces of water with the drug.
ANS: D
GI symptoms including constipation, bloating, nausea, vomiting, and gas are common side effects of bile acid sequestrants such as cholestyramine. The drug should not be held. The nurse should teach the patient to take the tablet form of this drug with at least 12 to 16 ounces of water to prevent stomach and intestinal problems such as bowel obstruction. Administering the drug with meals can help to decrease GI symptoms and aids their action, which is to bind with cholesterol in the intestines.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

16. Which laboratory blood value is more important for the nurse to monitor with a patient who is prescribed both colestipol (Colestid) and warfarin (Coumadin)?
a. Hematocrit
b. Hemoglobin
c. Red blood cell (RBC) count
d. International normalized ratio (INR)
ANS: D
Colestipol can change the action of the anticoagulant warfarin in two ways. They can decrease the absorption of vitamin K, which would intensify the effects of warfarin and increase the risk for bleeding (as evidenced by a high INR). Bile acid sequestrants can also directly bind warfarin in the intestinal tract and cause its rapid elimination. This action would inactivate warfarin activity and increase the risk for clot formation (as evidenced by an INR level that is lower than the therapeutic range). Although all of the above laboratory blood values can help diagnose a bleeding problem, the most sensitive test is the INR.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Evaluation
MSC: Client Needs Category: Safe and Effective Care Environment

17. A patient who is prescribed ezetimibe (Zetia) has developed swelling around the eyes, nose, and lips. What is the nurses priority action at this time?
a. Elevate the head of the bed.
b. Notify the prescriber.
c. Assess the patients airway.
d. Check the patients blood pressure.
ANS: C
Swelling under the skin, usually around the eyes, nose, and lips are symptoms of angioedema, a rare adverse effect of ezetimibe. It is caused by blood vessel dilation and may be life-threatening when it affects the airways.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

18. A patient who has been taking niacin (Niacor) daily for 1 week reports intense itching. What is the nurses best response?
a. This is a common side effect and many people can control it by taking aspirin.
b. Stop taking the drug and talk with your prescriber as soon as possible.
c. Unless your skin forms blisters or peels, continue to take the drug.
d. Do you have any other drug allergies?
ANS: A
Niacin causes a mild systemic inflammatory response with vasodilation that can result in the sensation of itching. This is not an allergy but can be very distressing to the patient. Often, taking aspirin reduces the inflammatory response and eliminates the itchiness. If the patient has no other health problems that would be worsened by aspirin, this should be tried first.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

19. A patient who is prescribed niacin (Niacor) reports experiencing flushing and hot flashes. What is the nurses best action?
a. Hold the drug and notify the prescriber.
b. Give the niacin at least 1 hour before meals.
c. Reassure the patient that this is an expected side effect.
d. Administer the ordered nonsteroidal anti-inflammatory drug (NSAID) 30 minutes before the niacin.
ANS: D
Flushing (redness) and hot flashes can be reduced by the use of aspirin or an NSAID 30 minutes before the niacin, or by giving the niacin during or after meals. While reassuring the patient that flushing and hot flashes are expected side effects is correct, it does not address the patients discomfort.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

20. A patient prescribed niacin extended action (Niaspan) reports all of the following new onset problems. For which problem does the nurse notify the prescriber?
a. Moderate itchiness, especially at night
b. Six to seven loose stools daily
c. Increased nighttime urination
d. Swollen, painful great toe
ANS: D
One adverse reaction to niacin is an increase in uric acid crystals and calcium that can precipitate in joints and cause gout. The great toe is one of the most common sites of gout. The condition is painful and reduces mobility. Usually, the patient can continue the niacin therapy along with another drug that reduces uric acid production. Drinking plenty of water can also reduce the precipitation of uric acid.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

21. A patient is prescribed niacin (Niaspan). The pharmacy sends niacin (Niacor). What is the nurses best action?
a. Hold the drug and contact the prescriber.
b. Administer the Niacor in place of the Niaspan.
c. Ask the pharmacy to send the patients ordered Niaspan.
d. Check the patients chart to find out if he or she takes Niacor at home.
ANS: C
Niaspan is an extended-release form of niacin that is taken once a day. Niacor is an immediate release form of niacin. Immediate release niacin should not be substituted for extended-release niacin. Additionally, extended-release niacin should be swallowed whole and never crushed or chewed because this causes immediate release of the entire drug dose and could lead to overdose.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

22. What action must the nurse be prepared to take for a diabetic patient who is prescribed niacin (Niacor)?
a. Give insulin only in the presence of food.
b. Check the blood glucose level more often.
c. Decrease the morning insulin dosage.
d. Encourage increased caloric intake.
ANS: B
Niacin may increase blood glucose levels. The nurse would check the patients blood glucose level more often. Doses of drugs used to control blood glucose may need to be increased.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

23. A patient who is prescribed gemfibrozil (Lopid) is also taking warfarin (Coumadin). What is the priority nursing action for this patient?
a. Monitor liver function tests.
b. Keep an accurate record of urine output.
c. Give the drug 30 minutes before meals.
d. Check the patient for signs of bleeding.
ANS: D
Even though all of these actions are important for a patient taking gemfibrozil, the priority action is to check the patient for signs of bleeding. Fibrate drugs such as gemfibrozil increase the effectiveness of warfarin by causing a prolonged prothrombin time, which can lead to excessive bleeding and become life threatening.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

24. Which food, drink, or herbal supplement does the nurse warn a patient who is prescribed gemfibrozil (Lopid) to avoid?
a. Caffeinated beverages
b. Grapefruit juice
c. St. Johns wort
d. Dairy products
ANS: B
The metabolism of gemfibrozil is affected by grapefruit and grapefruit juice to the extent that the drugs activity is reduced. If possible, patients should avoid grapefruit juice completely, or at least, patients should not take gemfibrozil with grapefruit juice.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

25. Which statement does the nurse plan to include in a teaching plan for a patient who has been prescribed fenofibrate (Tricor)?
a. The most common side effects of this drug are headache and muscle weakness.
b. Be sure to report any upset stomach to your prescriber immediately.
c. Take this drug 30 minutes after breakfast, lunch, and dinner.
d. Do not drink grapefruit juice while you are taking this drug.
ANS: D
Patients should not drink grapefruit juice while taking fibrate drugs such as fenofibrate, because the effectiveness of these drugs is decreased by grapefruit juice. It interferes with the metabolism (breakdown) of fibrates in the body.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Health Promotion and Maintenance

26. A patient is prescribed colesevalam (WelChol) 1875 mg twice a day. Available tablets are 625 mg each. How many tablets does the nurse administer to the patient?
a. 2
b. 3
c. 4
d. 5
ANS: B
Need 1875 mg/X tablets; Have 625 mg/1 tablet. 1875/625 = 3 tablets.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

MULTIPLE RESPONSE

1. Which health problems does the nurse teach a patient can be caused by chronic hyperlipidemia? (Select all that apply.)
a. Hypertension
b. Pancreatitis
c. Peptic ulcer disease
d. Xanthoma
e. Diabetes mellitus
ANS: A, B, D
Chronic hyperlipidemia contributes to development of narrowed arteries. It can cause health problems including atherosclerosis, coronary artery disease (angina, heart attack), hypertension, pancreatitis, peripheral vascular disease, stroke, and xanthomas (skin atheromas or abnormal fat deposits).

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 295 TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

2. The risk for which health problems can be reduced when blood levels of low-density lipoprotein (LDL) cholesterol are controlled within the normal range? (Select all that apply.)
a. Angina
b. Asthma
c. Colitis
d. Heart attack
e. High blood pressure
f. Parkinson disease
g. Stroke
ANS: A, D, E, G
Excessive LDL cholesterol levels cause plaques to form in blood vessels and narrow the area where blood flows through these vessels. This results in reduced blood flow and vital organs may not be well oxygenated. As a result, the risk for angina and stroke is increased. The same narrowing of blood vessels increases the resistance in the arterial system and raises blood pressure, leading to hypertension. With hypertension, the heart has to work much harder and may have less blood feeding the heart from the coronary arteries. These two conditions increase the risk for a heart attack. High LDL levels are not associated with an increased risk for asthma, colitis, or Parkinson disease.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 297 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

3. Which teaching points does the nurse include in a teaching plan for a patient prescribed an antihyperlipidemic drug? (Select all that apply.)
a. Continue to follow a low-fat diet.
b. Be sure to exercise regularly.
c. Always take these drugs with food.
d. Fast for at least 8 hours before your lipid levels are drawn.
e. You will need follow-up laboratory tests once a year.
ANS: A, B, D
Patients taking antihyperlipidemic drugs should be taught to continue lifestyle changes such as low-fat diets, exercise, and weight loss while taking the drugs. Some, but not all, are best taken with food. Follow-up laboratory specimens must be drawn every 3 to 6 months and the patient should fast for at least 8 hours before the blood is taken because test results can be changed by some substances in food or fluids.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 297 TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Health Promotion and Maintenance

4. Which are symptoms of late liver disease? (Select all that apply.)
a. Yellowing of the skin
b. Light-colored diluted urine
c. Pale gray-colored stools
d. Pain on the right side just below the ribs
e. Reddened mucous membranes in the mouth
ANS: A, C, D
Late symptoms of liver disease include yellowing (jaundice) of the skin, the whites of the eyes, and the roof of the mouth; pain over the liver on the right side just below the ribs; darkened urine; and pale gray-colored stools. The bile and bilirubin made by the liver usually leave the body in the stool, giving it a medium to dark brown color. When the liver is not working well, these products do not reach the stool, so it is a light gray or green color instead of brown. Bilirubin enters the urine and turns it dark, and gets into the skin and mucous membranes, making them yellow.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 299 TOP: Nursing Process Step: Assessment
MSC: Client Needs Category: Physiological Integrity

5. Which actions are important when a patient is prescribed a bile acid sequestrant drug? (Select all that apply.)
a. Administer a daily multivitamin.
b. Give other medications at least an hour before this drug.
c. Schedule the drug for one hour before meals.
d. Ask the patient about symptoms of constipation.
e. Mix powdered forms of the drug with 2 ounces of juice or water.
ANS: A, B, D
Bile acid sequestrants decrease the bodys ability to absorb oral drugs. Give other drugs at least an hour before these drugs. They also inhibit fat-soluble vitamins (A, D, E, K), so patients may need to take a daily vitamin supplement. Giving the drugs with meals facilitates the drugs action and decreases common GI side effects including constipation. Powdered forms should be mixed with 4 to 6 ounces of juice or water.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 301 TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

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