Nursing 552 Exam 3 Practice |45 Questions with 100% correct answers.

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: 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: 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: 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: 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%. Question from: Which antihyperlipidemic is most effective when given in combination with other drugs? A. Niacin B. Bile acid-binding resins C. Ezetimibe D. Statins E. Fibric Acid Answer: A. If a bile acid-binding resin is added, 40-60% reduction in LDL. In triple therapy with bile acid-binding resin plus a statin, it decreases LDL by 70% or more. Question from: How can you avoid some of the adverse effects seen with Niacin (dyspepsia, skin flushing, itching)? A) By taking an NSAID like Aspirin concurrently. B) By taking the medication at night. C) By taking the medication with food. D) By taking the medication on an empty stomach. E) The Adverse affects cannot be avoided. Answer: A. Question from: What conditions are worsened with Niacin (nicotinic acid)? A) Gout B) Cardiac atrial arrhythmias C) Diabetes D) Gallbladder disease E) All of the above Answer: E. Gout - see an increase in uric acid because it competes for excretion - Diabetes - glucose levels are affected - Gallbladder Disease - releases bile acids. Question from: Giving Niacin in combination with statins causes an increased risk of what disease? A) Gout. B) MI. C) Renal disease. D) Myopathy (rhabdomyolysis) E) Hepatic Failure Answer: D. Question from: What are the two drugs that are classified as fibric acid derivatives? A) Niacin and Gemfibrozil. B) Gemfibrozil and Fenofibrate. C) Fenofibrate and Ezetimibie. D) Simvastatin and Gemfibrozil. Answer: B. Question from: What do the fibric acid derivatives do? A) Enhance oxidation of FA in liver and muscle. B) Reduce rate of lipogenesis in the liver. C) Increase synthesis of Apo AI and II for more HDL. D) All of the above Answer: D. Question from: What is the principle indication for all fibrates? A) Elevation of LDLs B) Reduction of HDLs C) Elevation of VLDLs D) High blood cholesterol levels E) High blood pressure levels Answer: D. Question from: Which drug can be displaced by the fibrates, causing increased levels of the drug in the blood? A) Aspirin B) Tetracycline C) Warfarin D) Ezetimibe E) Vicodin. Answer: C. Question from: How do the Bile Acid-Binding Resins (Cholestyramine, Colestipol, and Colesevelam) function? A) By binding LDLs and removing them from circulation B) By increasing HDLs C) By attacking the plaque directly D) By cationic exchange E) By anionic exchange Answer: D Question from: What type of individual would not benefit as much from the bile acid-binding resins? A)Hemophiliacs. B) Patients suffering from gout. C) Patients genetically deficient in LDL receptors. D) Patients with a fever. E) Patient with renal disease. Answer: C. These patients would need combination therapy. Question from: If a patient is at risk for pancreatitis, which drugs would you want to avoid? A) Fibric acid derivatives B) Bile Acid-Binding Resins C) Niacin D) Statins E) Ezetimibe Answer: B. Question from: Which are the most effective antihyperlipidemics with few side effects? A) Niacin B) FIbric Acids C) Bile acid-binding resins D) Ezetimibe E) Statins Answer: E Question from: Which drugs are competitive inhibitors of hepatic HMG CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis? A) Statins B) Ezetimibe C) Fibric Acids D) Bile acid-binding resins E) Niacin Answer: A Question from: What are the benefits from statin usage? A) With less cholesterol synthesized, the amount of cholesterol in the liver is reduced. B) Serum cholesterol level is reduced due to the fact that more LDL receptors are synthesized and more LDL is removed from the blood. C) VLDL and IDL might also be removed because their ApoE component is recognized by LDL receptors. D) Reduction of inflammation by an unknown mechanism. E) All of the above Answer: D Question from: Which drug name is an example of an Ace Inhibitor (ACEI)? A) Losartan B) Lisiniopril C) Aliskiren D) Metoprolol B) Lisinopril Chapter 16 Which drug name is an example of an Angiotensin II Receptor Blocker (ARB)? A) Losartan B) Lisinopril C) Aliskiren D) Metoprolol A) Losartan Chapter 16