STUVIA 2024/2025
Chapter 41: Antihyperlipidemics and Peripheral
Vasodilators
A female patient has serum lipid levels performed, which reveal a total cholesterol of 285 mg/dL,
triglycerides of 188 mg/dL, a low-density lipoprotein (LDL) of 175 mg/dL, and a high-density
lipoprotein (HDL) of 40 mg/dL. The patient's blood pressure is 138/72 mm Hg. The patient is currently
not receiving any prescription medications. Which of the following would be the most appropriate
medication (or medications) to be started at this time?
a. Amlodipine and atorvastatin (Caduet)
b. Colestipol HCl (Colestid)
c. Fenofibrate (TriCor)
d. Atorvastatin (Lipitor) - ✔✔ANS: D
Statins have actions in decreasing serum cholesterol, LDL, VLDL, and triglycerides, and they slightly
elevate HDL. Because the patient has elevated cholesterol levels, starting a statin at this time would
be appropriate and considered an appropriate first-line antihyperlipidemic therapy.
A patient has a serum cholesterol level of 270 mg/dL. The patient asks the nurse what this level
means. Which response by the nurse is correct?
%
a. "You have a high cholesterol which places you at risk for coronary artery disease."
b. "You have a moderately elevated cholesterol and risk for coronary artery disease."
c. "You have a low risk for coronary artery disease."
d. "You have no risk for coronary artery disease." - ✔✔ANS: A
A value of 270 mg/dL for serum cholesterol puts the patient at high risk.
A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal discomfort and constipation. The nurse will provide which instruction to the patient?
a. Increase fluid intake and slowly increase fiber intake.
b. Stop taking the medication immediately.
c. Take an over-the-counter laxative.
d. Take the medication on an empty stomach. - ✔✔ANS: A
Cholestyramine can cause gastrointestinal upset and constipation, and these symptoms can be
reduced with increased fluids and foods high in fiber. Stopping the medication is not indicated.
Over-the-counter laxatives are not recommended until other methods have been tried. Giving the
medication on an empty stomach will not relieve the discomfort.
stuvia
, STUVIA 2024/2025
A patient has been taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal cramping and constipation. The patient's serum low-density lipoprotein (LDL) has
decreased from 170 to 110 mg/dL, and triglycerides have not changed from 150 mg/dL since
beginning the medication. The provider changes the medication to colesevelam HCl (Welchol). The
patient asks the nurse why the medication was changed, and the nurse will explain that colesevelam
HCl is ordered for which reason?
a. It has fewer side effects.
b. It has more convenient dosing.
c. It provides greater LDL reduction.
d. It provides greater triglyceride reduction. - ✔✔ANS: A
Colesevelam is similar to cholestyramine but has fewer gastrointestinal side effects. This patient has
demonstrated good results with the bile acid sequestrant, so the provider has decided to offer a
preparation with fewer adverse effects. Both drugs are given twice daily.
A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice daily,
30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin) once daily.
The nurse will contact the provider to discuss
a. decreasing the dose of gemfibrozil.
b. giving the warfarin at noon.
%
c. increasing the dose of warfarin.
d. ordering frequent INR levels. - ✔✔ANS: D
Gemfibrozil is highly protein-bound and competes for receptor sites with drugs such as warfarin. The
anticoagulant dose should be decreased, and the international normalized ratio (INR) should be
closely monitored. Decreasing the dose of gemfibrozil is not recommended. Giving the warfarin at a
different time of day does not change this drug interaction. The warfarin dose should be decreased,
not increased.
A patient begins taking nicotinic acid (Niacin) and reports dizziness and flushing of the skin. The
nurse will perform which action?
a. Recommend that the patient take a baby aspirin with their niacin dose.
b. Counsel the patient to increase fluid intake.
c. Request an order for renal function tests.
d. Schedule the medication to be taken with meals. - ✔✔ANS: A
Flushing of the skin and dizziness are common side effects of nicotinic acid, but with careful drug
titration and concomitant use of aspirin, these effects can be minimized. Increasing fluid intake or
taking with food does not alter these adverse effects. Nicotinic acid can affect liver enzymes not renal
function.
stuvia
Chapter 41: Antihyperlipidemics and Peripheral
Vasodilators
A female patient has serum lipid levels performed, which reveal a total cholesterol of 285 mg/dL,
triglycerides of 188 mg/dL, a low-density lipoprotein (LDL) of 175 mg/dL, and a high-density
lipoprotein (HDL) of 40 mg/dL. The patient's blood pressure is 138/72 mm Hg. The patient is currently
not receiving any prescription medications. Which of the following would be the most appropriate
medication (or medications) to be started at this time?
a. Amlodipine and atorvastatin (Caduet)
b. Colestipol HCl (Colestid)
c. Fenofibrate (TriCor)
d. Atorvastatin (Lipitor) - ✔✔ANS: D
Statins have actions in decreasing serum cholesterol, LDL, VLDL, and triglycerides, and they slightly
elevate HDL. Because the patient has elevated cholesterol levels, starting a statin at this time would
be appropriate and considered an appropriate first-line antihyperlipidemic therapy.
A patient has a serum cholesterol level of 270 mg/dL. The patient asks the nurse what this level
means. Which response by the nurse is correct?
%
a. "You have a high cholesterol which places you at risk for coronary artery disease."
b. "You have a moderately elevated cholesterol and risk for coronary artery disease."
c. "You have a low risk for coronary artery disease."
d. "You have no risk for coronary artery disease." - ✔✔ANS: A
A value of 270 mg/dL for serum cholesterol puts the patient at high risk.
A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal discomfort and constipation. The nurse will provide which instruction to the patient?
a. Increase fluid intake and slowly increase fiber intake.
b. Stop taking the medication immediately.
c. Take an over-the-counter laxative.
d. Take the medication on an empty stomach. - ✔✔ANS: A
Cholestyramine can cause gastrointestinal upset and constipation, and these symptoms can be
reduced with increased fluids and foods high in fiber. Stopping the medication is not indicated.
Over-the-counter laxatives are not recommended until other methods have been tried. Giving the
medication on an empty stomach will not relieve the discomfort.
stuvia
, STUVIA 2024/2025
A patient has been taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal cramping and constipation. The patient's serum low-density lipoprotein (LDL) has
decreased from 170 to 110 mg/dL, and triglycerides have not changed from 150 mg/dL since
beginning the medication. The provider changes the medication to colesevelam HCl (Welchol). The
patient asks the nurse why the medication was changed, and the nurse will explain that colesevelam
HCl is ordered for which reason?
a. It has fewer side effects.
b. It has more convenient dosing.
c. It provides greater LDL reduction.
d. It provides greater triglyceride reduction. - ✔✔ANS: A
Colesevelam is similar to cholestyramine but has fewer gastrointestinal side effects. This patient has
demonstrated good results with the bile acid sequestrant, so the provider has decided to offer a
preparation with fewer adverse effects. Both drugs are given twice daily.
A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice daily,
30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin) once daily.
The nurse will contact the provider to discuss
a. decreasing the dose of gemfibrozil.
b. giving the warfarin at noon.
%
c. increasing the dose of warfarin.
d. ordering frequent INR levels. - ✔✔ANS: D
Gemfibrozil is highly protein-bound and competes for receptor sites with drugs such as warfarin. The
anticoagulant dose should be decreased, and the international normalized ratio (INR) should be
closely monitored. Decreasing the dose of gemfibrozil is not recommended. Giving the warfarin at a
different time of day does not change this drug interaction. The warfarin dose should be decreased,
not increased.
A patient begins taking nicotinic acid (Niacin) and reports dizziness and flushing of the skin. The
nurse will perform which action?
a. Recommend that the patient take a baby aspirin with their niacin dose.
b. Counsel the patient to increase fluid intake.
c. Request an order for renal function tests.
d. Schedule the medication to be taken with meals. - ✔✔ANS: A
Flushing of the skin and dizziness are common side effects of nicotinic acid, but with careful drug
titration and concomitant use of aspirin, these effects can be minimized. Increasing fluid intake or
taking with food does not alter these adverse effects. Nicotinic acid can affect liver enzymes not renal
function.
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