NUR 354 Exam 3 Study Guide:
Hyperlipidemia and Cardiovascular
Medications | 2026/27 Update Complete.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
145 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This exam assesses knowledge of hyperlipidemia management and cardiovascular medications, including
lipid-lowering agents, antihypertensives, antianginals, and heart failure drugs. Emphasis is on mechanism of
action, monitoring parameters, patient education, and adverse effect management. Questions reflect current
guidelines and nursing best practices.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75%.
HIGHP - Page 1 of 46
,1. A patient with hyperlipidemia is prescribed atorvastatin. Which laboratory test should
the nurse monitor to assess for a rare but serious adverse effect?
[ ] A. Serum creatinine
[ ] B. Creatine kinase (CK)
[ ] C. Serum potassium
[ ] D. Platelet count
CORRECT: B. Creatine kinase (CK)
Statins can cause myopathy and rhabdomyolysis, which are detected by elevated CK levels. Serum
creatinine, potassium, and platelet count are not specific for statin-induced muscle injury.
2. Which instruction is most important for a patient taking cholestyramine?
[ ] A. Take with meals to enhance absorption.
[ ] B. Increase dietary fiber to prevent constipation.
[ ] C. Avoid grapefruit juice.
[ ] D. Monitor for hyperkalemia.
CORRECT: B. Increase dietary fiber to prevent constipation.
Cholestyramine is a bile acid sequestrant that commonly causes constipation; increasing dietary fiber helps
manage this. It should be taken before meals, not with other medications, and does not interact with
grapefruit juice or cause hyperkalemia.
3. A patient on lisinopril develops a persistent dry cough. Which action should the nurse
anticipate?
[ ] A. Administer an antitussive.
[ ] B. Discontinue the medication and switch to an ARB.
[ ] C. Reduce the dose by half.
[ ] D. Add a diuretic.
CORRECT: B. Discontinue the medication and switch to an ARB.
ACE inhibitors like lisinopril commonly cause a dry cough due to bradykinin accumulation; switching to an
ARB is the standard approach. Antitussives are ineffective, and dose reduction or adding a diuretic does not
address the cause.
4. Which statement by a patient taking nitroglycerin sublingual indicates correct
understanding of teaching?
[ ] A. I should swallow the tablet with water.
[ ] B. I can take up to three tablets, 5 minutes apart, for chest pain.
[ ] C. I should lie down immediately after taking it.
[ ] D. I should store the tablets in a clear plastic bag.
HIGHP - Page 2 of 46
, CORRECT: B. I can take up to three tablets, 5 minutes apart, for chest pain.
Sublingual nitroglycerin should be taken at 5-minute intervals up to three doses for chest pain. It should be
placed under the tongue, not swallowed, and stored in a dark glass container to prevent degradation. Lying
down is not required but may help with dizziness.
5. A patient is prescribed digoxin. Which assessment finding requires immediate
intervention?
[ ] A. Heart rate of 58 beats per minute
[ ] B. Serum potassium of 3.2 mEq/L
[ ] C. Nausea and vomiting
[ ] D. Visual disturbances
CORRECT: D. Visual disturbances
Visual disturbances such as yellow-green halos are a sign of digoxin toxicity and require immediate
intervention. Bradycardia, hypokalemia, and nausea can also be signs but are less specific; visual changes
are a classic toxicity indicator.
6. Which patient teaching is essential for a patient starting ezetimibe?
[ ] A. Take the medication with a high-fat meal.
[ ] B. Report any muscle pain or weakness.
[ ] C. Avoid all dairy products.
[ ] D. Expect a rapid decrease in LDL within 1 week.
CORRECT: B. Report any muscle pain or weakness.
Ezetimibe can rarely cause myopathy, so patients should report muscle pain. It can be taken with or without
food, does not require avoiding dairy, and LDL reduction occurs over several weeks.
7. A patient on warfarin is prescribed a new medication. Which drug interaction is most
concerning?
[ ] A. Acetaminophen
[ ] B. Amiodarone
[ ] C. Omeprazole
[ ] D. Metformin
CORRECT: B. Amiodarone
Amiodarone inhibits warfarin metabolism, significantly increasing INR and bleeding risk. Acetaminophen,
omeprazole, and metformin have lesser or no significant interactions with warfarin.
HIGHP - Page 3 of 46
, 8. Which finding indicates that a patient with heart failure is responding positively to
sacubitril/valsartan?
[ ] A. Decreased serum potassium
[ ] B. Improved ejection fraction on echocardiogram
[ ] C. Increased blood pressure
[ ] D. Weight gain of 2 kg in 2 days
CORRECT: B. Improved ejection fraction on echocardiogram
Sacubitril/valsartan improves cardiac function and can increase ejection fraction. Decreased potassium,
increased blood pressure, and weight gain are not indicators of positive response and may signal worsening
condition.
9. A nurse is reviewing discharge instructions for a patient on spironolactone. Which
dietary advice is appropriate?
[ ] A. Increase intake of potassium-rich foods.
[ ] B. Avoid salt substitutes containing potassium.
[ ] C. Limit fluid intake to 1 liter per day.
[ ] D. Take the medication on an empty stomach.
CORRECT: B. Avoid salt substitutes containing potassium.
Spironolactone is a potassium-sparing diuretic, so patients should avoid additional potassium sources like
salt substitutes to prevent hyperkalemia. Increasing potassium-rich foods is unsafe, fluid restriction is not
routine, and it can be taken with food.
10. A patient with established ASCVD is started on a high-intensity statin. Which
laboratory parameter best reflects the statin's therapeutic efficacy in reducing
cardiovascular risk?
[ ] A. LDL-C percent reduction from baseline
[ ] B. Total cholesterol/HDL ratio
[ ] C. Serum creatine kinase level
[ ] D. Triglyceride level
CORRECT: A. LDL-C percent reduction from baseline
LDL-C lowering is the primary mechanism by which statins reduce ASCVD events, and the magnitude of
percent reduction correlates with risk reduction. Total cholesterol/HDL ratio is a secondary marker, CK
monitors muscle toxicity, and triglycerides are not the primary efficacy target for statin therapy.
11. A patient on atorvastatin 80 mg daily reports new bilateral proximal muscle weakness
and dark urine. Which is the priority nursing action?
[ ] A. Hold the statin and obtain a statin-induced myopathy workup including CK
HIGHP - Page 4 of 46
Hyperlipidemia and Cardiovascular
Medications | 2026/27 Update Complete.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
145 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This exam assesses knowledge of hyperlipidemia management and cardiovascular medications, including
lipid-lowering agents, antihypertensives, antianginals, and heart failure drugs. Emphasis is on mechanism of
action, monitoring parameters, patient education, and adverse effect management. Questions reflect current
guidelines and nursing best practices.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75%.
HIGHP - Page 1 of 46
,1. A patient with hyperlipidemia is prescribed atorvastatin. Which laboratory test should
the nurse monitor to assess for a rare but serious adverse effect?
[ ] A. Serum creatinine
[ ] B. Creatine kinase (CK)
[ ] C. Serum potassium
[ ] D. Platelet count
CORRECT: B. Creatine kinase (CK)
Statins can cause myopathy and rhabdomyolysis, which are detected by elevated CK levels. Serum
creatinine, potassium, and platelet count are not specific for statin-induced muscle injury.
2. Which instruction is most important for a patient taking cholestyramine?
[ ] A. Take with meals to enhance absorption.
[ ] B. Increase dietary fiber to prevent constipation.
[ ] C. Avoid grapefruit juice.
[ ] D. Monitor for hyperkalemia.
CORRECT: B. Increase dietary fiber to prevent constipation.
Cholestyramine is a bile acid sequestrant that commonly causes constipation; increasing dietary fiber helps
manage this. It should be taken before meals, not with other medications, and does not interact with
grapefruit juice or cause hyperkalemia.
3. A patient on lisinopril develops a persistent dry cough. Which action should the nurse
anticipate?
[ ] A. Administer an antitussive.
[ ] B. Discontinue the medication and switch to an ARB.
[ ] C. Reduce the dose by half.
[ ] D. Add a diuretic.
CORRECT: B. Discontinue the medication and switch to an ARB.
ACE inhibitors like lisinopril commonly cause a dry cough due to bradykinin accumulation; switching to an
ARB is the standard approach. Antitussives are ineffective, and dose reduction or adding a diuretic does not
address the cause.
4. Which statement by a patient taking nitroglycerin sublingual indicates correct
understanding of teaching?
[ ] A. I should swallow the tablet with water.
[ ] B. I can take up to three tablets, 5 minutes apart, for chest pain.
[ ] C. I should lie down immediately after taking it.
[ ] D. I should store the tablets in a clear plastic bag.
HIGHP - Page 2 of 46
, CORRECT: B. I can take up to three tablets, 5 minutes apart, for chest pain.
Sublingual nitroglycerin should be taken at 5-minute intervals up to three doses for chest pain. It should be
placed under the tongue, not swallowed, and stored in a dark glass container to prevent degradation. Lying
down is not required but may help with dizziness.
5. A patient is prescribed digoxin. Which assessment finding requires immediate
intervention?
[ ] A. Heart rate of 58 beats per minute
[ ] B. Serum potassium of 3.2 mEq/L
[ ] C. Nausea and vomiting
[ ] D. Visual disturbances
CORRECT: D. Visual disturbances
Visual disturbances such as yellow-green halos are a sign of digoxin toxicity and require immediate
intervention. Bradycardia, hypokalemia, and nausea can also be signs but are less specific; visual changes
are a classic toxicity indicator.
6. Which patient teaching is essential for a patient starting ezetimibe?
[ ] A. Take the medication with a high-fat meal.
[ ] B. Report any muscle pain or weakness.
[ ] C. Avoid all dairy products.
[ ] D. Expect a rapid decrease in LDL within 1 week.
CORRECT: B. Report any muscle pain or weakness.
Ezetimibe can rarely cause myopathy, so patients should report muscle pain. It can be taken with or without
food, does not require avoiding dairy, and LDL reduction occurs over several weeks.
7. A patient on warfarin is prescribed a new medication. Which drug interaction is most
concerning?
[ ] A. Acetaminophen
[ ] B. Amiodarone
[ ] C. Omeprazole
[ ] D. Metformin
CORRECT: B. Amiodarone
Amiodarone inhibits warfarin metabolism, significantly increasing INR and bleeding risk. Acetaminophen,
omeprazole, and metformin have lesser or no significant interactions with warfarin.
HIGHP - Page 3 of 46
, 8. Which finding indicates that a patient with heart failure is responding positively to
sacubitril/valsartan?
[ ] A. Decreased serum potassium
[ ] B. Improved ejection fraction on echocardiogram
[ ] C. Increased blood pressure
[ ] D. Weight gain of 2 kg in 2 days
CORRECT: B. Improved ejection fraction on echocardiogram
Sacubitril/valsartan improves cardiac function and can increase ejection fraction. Decreased potassium,
increased blood pressure, and weight gain are not indicators of positive response and may signal worsening
condition.
9. A nurse is reviewing discharge instructions for a patient on spironolactone. Which
dietary advice is appropriate?
[ ] A. Increase intake of potassium-rich foods.
[ ] B. Avoid salt substitutes containing potassium.
[ ] C. Limit fluid intake to 1 liter per day.
[ ] D. Take the medication on an empty stomach.
CORRECT: B. Avoid salt substitutes containing potassium.
Spironolactone is a potassium-sparing diuretic, so patients should avoid additional potassium sources like
salt substitutes to prevent hyperkalemia. Increasing potassium-rich foods is unsafe, fluid restriction is not
routine, and it can be taken with food.
10. A patient with established ASCVD is started on a high-intensity statin. Which
laboratory parameter best reflects the statin's therapeutic efficacy in reducing
cardiovascular risk?
[ ] A. LDL-C percent reduction from baseline
[ ] B. Total cholesterol/HDL ratio
[ ] C. Serum creatine kinase level
[ ] D. Triglyceride level
CORRECT: A. LDL-C percent reduction from baseline
LDL-C lowering is the primary mechanism by which statins reduce ASCVD events, and the magnitude of
percent reduction correlates with risk reduction. Total cholesterol/HDL ratio is a secondary marker, CK
monitors muscle toxicity, and triglycerides are not the primary efficacy target for statin therapy.
11. A patient on atorvastatin 80 mg daily reports new bilateral proximal muscle weakness
and dark urine. Which is the priority nursing action?
[ ] A. Hold the statin and obtain a statin-induced myopathy workup including CK
HIGHP - Page 4 of 46
