Chapter 14 Drugs for Hyperlipidemia
MULTIPLE CHOICE
1. 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 patients blood pressure is 138/72 mm Hg. The
nurse may expect the provider to order which medication for this patient? a. Amlodipine and
atorvastatin (Caduet)
b. Colestipol HCl (Colestid)
c. Fenofibrate (TriCor)
d. Niacin and lovastatin (Advicor)
ANS D
The combination drug of niacin and lovastatin is indicated for hypercholesterolemia and mixed
dyslipidemia. Niacin raises HDL, so would be helpful in this patient who has low HDL.
Combination drugs are used to enhance the antihyperlipidemic effect. Amlodipine and
atorvastatin in combination are used for patients with hyperlipidemia and elevated blood
pressure. Colestipol HCl is used to reduce cholesterol and LDL levels but has no effect on
HDL or triglycerides. Fenofibrate is used to treat type IV and V hyperlipidemia, characterized
by elevated very-low-density lipoprotein and triglycerides.
DIF COGNITIVE LEVEL Analyzing (Analysis) REF dm 666 TOP
NURSING PROCESS Assessment/Planning
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
2. 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 risk for
coronary artery disease.
b. You have a moderate 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.
DIF COGNITIVE LEVEL Applying (Application) REF dm 665 TOP
NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pathophysiology
3. 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 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.
DIF COGNITIVE LEVEL Applying (Application) REF dm 666
TOP NURSING PROCESS Evaluation/Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A patient has been taking cholestyramine (Questran) to treat hyperlipidemia type II. The
patient reports abdominal cramping and constipation. The patients serum low- density
lipoprotein (LDL) has decreased from 170 mg/dL 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 needs to
offer a preparation with fewer adverse effects. Both drugs are given twice daily.
DIF COGNITIVE LEVEL Applying (Application) REF dm 666 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. 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 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.
DIF COGNITIVE LEVEL Applying (Application) REF dm 666 TOP
NURSING PROCESS Nursing Intervention
MULTIPLE CHOICE
1. 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 patients blood pressure is 138/72 mm Hg. The
nurse may expect the provider to order which medication for this patient? a. Amlodipine and
atorvastatin (Caduet)
b. Colestipol HCl (Colestid)
c. Fenofibrate (TriCor)
d. Niacin and lovastatin (Advicor)
ANS D
The combination drug of niacin and lovastatin is indicated for hypercholesterolemia and mixed
dyslipidemia. Niacin raises HDL, so would be helpful in this patient who has low HDL.
Combination drugs are used to enhance the antihyperlipidemic effect. Amlodipine and
atorvastatin in combination are used for patients with hyperlipidemia and elevated blood
pressure. Colestipol HCl is used to reduce cholesterol and LDL levels but has no effect on
HDL or triglycerides. Fenofibrate is used to treat type IV and V hyperlipidemia, characterized
by elevated very-low-density lipoprotein and triglycerides.
DIF COGNITIVE LEVEL Analyzing (Analysis) REF dm 666 TOP
NURSING PROCESS Assessment/Planning
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
2. 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 risk for
coronary artery disease.
b. You have a moderate 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.
DIF COGNITIVE LEVEL Applying (Application) REF dm 665 TOP
NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pathophysiology
3. 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 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.
DIF COGNITIVE LEVEL Applying (Application) REF dm 666
TOP NURSING PROCESS Evaluation/Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A patient has been taking cholestyramine (Questran) to treat hyperlipidemia type II. The
patient reports abdominal cramping and constipation. The patients serum low- density
lipoprotein (LDL) has decreased from 170 mg/dL 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 needs to
offer a preparation with fewer adverse effects. Both drugs are given twice daily.
DIF COGNITIVE LEVEL Applying (Application) REF dm 666 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. 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 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.
DIF COGNITIVE LEVEL Applying (Application) REF dm 666 TOP
NURSING PROCESS Nursing Intervention
