Pharm Lilley Ch. 27
1. A patient with elevated lipid levels has a new prescription for nicotinic acid (niacin). The nurse
informs the patient that which adverse effects may occur with this medication?
a. Pruritus, cutaneous flushing
b. Tinnitus, urine with a burnt odor
c. Myalgia, fatigue
d. Blurred vision, headaches - ANSANS: A
Possible adverse effects of nicotinic acid include pruritus, cutaneous flushing, and
gastrointestinal distress. Tinnitus, urine with a burnt odor, and headaches are possible adverse
effects of bile acid sequestrants. Headaches are also possible adverse effects of HMG-CoA
reductase inhibitors, as are myalgia and fatigue.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 444
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient reports having adverse effects with nicotinic acid (niacin). The nurse can suggest
performing which action to minimize these undesirable effects?
a. Take the drug on an empty stomach.
b. Take the medication every other day until the effects subside.
c. Take an aspirin tablet 30 minutes before taking the drug.
d. Take the drug with large amounts of fiber. - ANSANS: C
The undesirable effects of nicotinic acid can be minimized by starting with a low initial dose,
taking the drug with meals, and taking small doses of aspirin with the drug to minimize
cutaneous flushing. Fiber intake has no effect on niacin's adverse effects, and it is not within the
nurse's scope of practice to suggest a change of medication dosage.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 444
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient calls the clinic office saying that the cholestyramine (Questran) powder he started
yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what
method for mixing this medication for administration?
a. Mix the powder in a carbonated soda drink to dissolve it faster.
b. Add the powder to any liquid, and stir vigorously to dissolve it quickly.
c. Mix the powder with food or fruit, or at least 4 to 6 ounces of fluid.
d. Sprinkle the powder into a spoon and take it dry, followed by a glass of water. - ANSANS: C
Mix the powder with food or at least 4 to 6 ounces of fluid. The powder may not mix completely
at first, but patients should be sure to mix the dose as much as possible and then dilute any
, undissolved portion with additional fluid. The powder should be dissolved for at least 1 full
minute. Powder and granule dosages are never to be taken in dry form.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 447
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient is concerned about the adverse effects of the fibric acid derivative she is taking to
lower her cholesterol level. Which is an adverse effect of this class of medication?
a. Constipation
b. Diarrhea
c. Joint pain
d. Dry mouth - ANSANS: B
Fibric acid derivatives may cause nausea, vomiting, diarrhea, drowsiness, and dizziness. Other
effects are listed in Table 27-8. The other options are not adverse effects of fibric acid
derivatives.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 445
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely
for the development of which problem?
a. Neutropenia
b. Pulmonary problems
c. Vitamin C deficiency
d. Liver dysfunction - ANSANS: D
Antilipemic drugs may adversely affect liver function; therefore, liver function studies need to be
closely monitored. The other options do not reflect problems that may occur with antilipemic
drugs.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 446
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. A patient tells the nurse that he likes to eat large amounts of garlic "to help lower his
cholesterol levels naturally." The nurse reviews his medication history and notes that which drug
has a potential interaction with the garlic?
a. Acetaminophen (Tylenol)
b. Warfarin (Coumadin)
c. Digoxin (Lanoxin)
d. Phenytoin (Dilantin) - ANSANS: B
When using garlic, it is recommended to avoid any other drugs that may interfere with platelet
and clotting function. These drugs include antiplatelet drugs, anticoagulants, nonsteroidal
1. A patient with elevated lipid levels has a new prescription for nicotinic acid (niacin). The nurse
informs the patient that which adverse effects may occur with this medication?
a. Pruritus, cutaneous flushing
b. Tinnitus, urine with a burnt odor
c. Myalgia, fatigue
d. Blurred vision, headaches - ANSANS: A
Possible adverse effects of nicotinic acid include pruritus, cutaneous flushing, and
gastrointestinal distress. Tinnitus, urine with a burnt odor, and headaches are possible adverse
effects of bile acid sequestrants. Headaches are also possible adverse effects of HMG-CoA
reductase inhibitors, as are myalgia and fatigue.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 444
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient reports having adverse effects with nicotinic acid (niacin). The nurse can suggest
performing which action to minimize these undesirable effects?
a. Take the drug on an empty stomach.
b. Take the medication every other day until the effects subside.
c. Take an aspirin tablet 30 minutes before taking the drug.
d. Take the drug with large amounts of fiber. - ANSANS: C
The undesirable effects of nicotinic acid can be minimized by starting with a low initial dose,
taking the drug with meals, and taking small doses of aspirin with the drug to minimize
cutaneous flushing. Fiber intake has no effect on niacin's adverse effects, and it is not within the
nurse's scope of practice to suggest a change of medication dosage.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 444
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient calls the clinic office saying that the cholestyramine (Questran) powder he started
yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what
method for mixing this medication for administration?
a. Mix the powder in a carbonated soda drink to dissolve it faster.
b. Add the powder to any liquid, and stir vigorously to dissolve it quickly.
c. Mix the powder with food or fruit, or at least 4 to 6 ounces of fluid.
d. Sprinkle the powder into a spoon and take it dry, followed by a glass of water. - ANSANS: C
Mix the powder with food or at least 4 to 6 ounces of fluid. The powder may not mix completely
at first, but patients should be sure to mix the dose as much as possible and then dilute any
, undissolved portion with additional fluid. The powder should be dissolved for at least 1 full
minute. Powder and granule dosages are never to be taken in dry form.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 447
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient is concerned about the adverse effects of the fibric acid derivative she is taking to
lower her cholesterol level. Which is an adverse effect of this class of medication?
a. Constipation
b. Diarrhea
c. Joint pain
d. Dry mouth - ANSANS: B
Fibric acid derivatives may cause nausea, vomiting, diarrhea, drowsiness, and dizziness. Other
effects are listed in Table 27-8. The other options are not adverse effects of fibric acid
derivatives.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 445
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely
for the development of which problem?
a. Neutropenia
b. Pulmonary problems
c. Vitamin C deficiency
d. Liver dysfunction - ANSANS: D
Antilipemic drugs may adversely affect liver function; therefore, liver function studies need to be
closely monitored. The other options do not reflect problems that may occur with antilipemic
drugs.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 446
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. A patient tells the nurse that he likes to eat large amounts of garlic "to help lower his
cholesterol levels naturally." The nurse reviews his medication history and notes that which drug
has a potential interaction with the garlic?
a. Acetaminophen (Tylenol)
b. Warfarin (Coumadin)
c. Digoxin (Lanoxin)
d. Phenytoin (Dilantin) - ANSANS: B
When using garlic, it is recommended to avoid any other drugs that may interfere with platelet
and clotting function. These drugs include antiplatelet drugs, anticoagulants, nonsteroidal
