Chapter 46: Antihyperlipidemics and Peripheral Vasodilators Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 46: Antihyperlipidemics and Peripheral Vasodilators

Test Bank

MULTIPLE CHOICE

1. A clients serum cholesterol level is 268 mg/dl. Lovastatin (Mevacor) is prescribed. A positive outcome of treatment with the medication is ________ of cholesterol.

a.

inhibition of hepatic synthesis

b.

stimulation of hepatic synthesis

c.

an increase in renal excretion

d.

an increase in fecal excretion

ANS: A

Lovastatin (Mevacor) should result in inhibition of the hepatic synthesis of cholesterol.

DIF: Cognitive Level: Application REF: p. 686

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The level of risk for coronary artery disease for a client with a serum cholesterol level of 270 mg/dl is _____ risk.

a.

low

b.

moderate

c.

high

d.

no

ANS: C

A value of 270 for serum cholesterol puts the client at high risk.

DIF: Cognitive Level: Analysis REF: p. 685

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

3. The nurse assesses a client for side effects of lovastatin (Mevacor). Which symptom would be least likely to be associated with Mevacor?

a.

Headache

b.

Tachycardia

c.

Gastrointestinal (GI) disturbances

d.

Dizziness

ANS: B

Tachycardia is not an associated side effect of lovastatin. Headache, GI disturbance, and dizziness are associated with this medication.

DIF: Cognitive Level: Application REF: pp. 686

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. Which laboratory test would be highest priority for the nurse to monitor while a client receives treatment with the statin medications?

a.

CBC

b.

Electrolytes

c.

Liver enzymes

d.

Urinalysis

ANS: C

The statin medications are hepatotoxic.

DIF: Cognitive Level: Application REF: p. 688

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. Which symptom would be highest priority for the nurse to monitor while the client is being treated with peripheral vasodilators?

a.

Bradycardia

b.

Dizziness

c.

Headache

d.

Pallor

ANS: B

Peripheral vasodilators cause a decrease in blood pressure, which can cause dizziness.

DIF: Cognitive Level: Application REF: p. 692

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A client is receiving atorvastatin (Lipitor) for high blood cholesterol level. Which sign warrants the clients immediate contacting of the healthcare provider?

a.

Muscle tenderness

b.

Gastrointestinal distress

c.

Constipation

d.

Flushing of the skin

ANS: A

Muscle tenderness may be an early sign of a serious condition known as rhabdomyolysis that affects some users of Lipitor.

DIF: Cognitive Level: Application REF: pp. 688-689

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. A nurse is teaching a client about the treatment of hyperlipidemia and use of statin drugs. What do the instructions include?

a.

This treatment is only temporary.

b.

Diet and exercise are secondary to treatment.

c.

Annual eye examinations are recommended.

d.

Diarrhea is a common side effect.

ANS: C

The use of statins may lead to cataracts; therefore, regular eye examinations are ordered.

DIF: Cognitive Level: Application REF: p. 686

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A nurse is monitoring a client after the client has received pentoxifylline (Trental) for treatment of intermittent claudication. Which effect indicates a positive response to the medication?

a.

Increased claudication

b.

Bradycardia

c.

Decrease in pain

d.

Orthostatic hypotension

ANS: C

Pentoxifylline is a hemorrheologic agent that improves microcirculation and tissue perfusion. It is has been approved by the U.S. Food and Drug Administration for clients with intermittent claudication. A decrease in pain is a positive response.

DIF: Cognitive Level: Application REF: p. 692

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A client is to receive simvastatin (Zocor) to reduce serum cholesterol levels. The nurse recommends to the client that the best time to take this medication is:

a.

before breakfast.

b.

during meals.

c.

in the mid-afternoon.

d.

in the evening.

ANS: D

Most cholesterol is manufactured at night, so taking simvastatin (Zocor) at night is most effective.

DIF: Cognitive Level: Application REF: pp. 687-688

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A client diagnosed with hyperlipidemia has been prescribed cholestyramine (Questran). Which of the following instructions will the nurse include in the clients teaching plan?

a.

Mix powder sparingly with fluid.

b.

Eat a low-fiber diet.

c.

Mix powder well with fluid.

d.

Take an antidiarrheal agent if diarrhea occurs.

ANS: C

Cholestyramine should be mixed well in fluid for proper absorption. Fluids and a high-fiber diet should be encouraged as this drug may cause constipation. Cholestyramine may cause GI upset and can be taken with food.

DIF: Cognitive Level: Application REF: p. 686

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The client is being treated with Atorvastatin (Lipitor). He tells the nurse that he has been self-medicating at home with antacids. The nurse anticipates that the interaction of the two drugs will produce a(n) _____ effect from the _____.

a.

increased; Atorvastatin (Lipitor)

b.

decreased; Atorvastatin (Lipitor)

c.

increased; antacids

d.

decrease; antacids

ANS: B

The interaction of Atorvastatin and antacids will produce a decreased effect from the Atorvastatin.

DIF: Cognitive Level: Application REF: p. 689

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The client is being treated with ergoloid mesylates (Hydergine). The nurse determines that the medication is producing a positive outcome for the client when the client is noted to be exhibiting a(n):

a.

improvement in mood.

b.

decrease in blood pressure.

c.

decrease in serum cholesterol.

d.

change in GI functioning.

ANS: A

Treatment with ergoloid mesylates (Hydergine) should improve cognitive skills, self-care, and mood. GI distress and orthostatic hypotension are side effects of the drug.

DIF: Cognitive Level: Analysis REF: p. 692

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The client is taking fenofibrate (Tricor). The highest priority nursing intervention with this medication is to monitor serum:

a.

potassium.

b.

glucose.

c.

creatinine.

d.

sodium.

ANS: C

Treatment with this medication can produce changes in the clients serum creatinine level.

DIF: Cognitive Level: Analysis REF: pp. 687-688

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. The client is scheduled to begin treatment with Isoxsuprine. In preparing the teaching plan for the client, the nurse anticipates that the client will be taking the drug _____ daily.

a.

once

b.

1 to 2 times

c.

2 to 3 times

d.

3 to 4 times

ANS: D

Because of its half-life, Isoxsuprine should be given 3 to 4 times daily.

DIF: Cognitive Level: Application REF: p. 691

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. A client with high cholesterol is ordered to take atorvastatin (Lipitor). What information should be included in the client teaching? (Select all that apply.)

a.

Dietary management is not a priority with this medication.

b.

The medication should be taken on an empty stomach.

c.

The medicine should be taken with a full glass of water.

d.

The client should watch for body aches or GI upset as side effects.

e.

The client should have renal function tests frequently.

f.

The client should have liver function tests frequently.

ANS: C, D, F

This medication is most effective with careful monitoring of diet and does not affect renal function.

DIF: Cognitive Level: Application REF: p. 690

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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