Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 17

Question 1

Type: MCSA

Which client statement demonstrates understanding of the link between cardiovascular disease and high cholesterol?

1. “There is no link between cardiovascular disease and cholesterol levels.”
2. “My diet does not need to be changed to help control my cardiovascular risk.”
3. “The only people at risk for high cholesterol are those with a family history.”
4. “The greater the amount of cholesterol circulating in the blood, the greater the risk of cardiovascular disease.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 259

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-1 Summarize the roles that fats play in human nutrition, and describe the potential consequences of excessively high lipid levels.

Question 2

Type: MCSA

The nurse is educating a group of clients on how high cholesterol leads to heart disease. Which explanation regarding high cholesterol is most appropriate?

1. It interferes with the conduction system of the heart.
2. It binds to vessel walls, decreasing the amount of blood getting to the heart.
3. It thickens the blood, causing clots.
4. It damages the heart muscle.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 260

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-1 Summarize the roles that fats play in human nutrition, and describe the potential consequences of excessively high lipid levels.

Question 3

Type: MCMA

According to the nurse instructing the client, which foods contain high amounts of omega-3 fatty acids? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Green beans
2. Bananas
3. Flax seeds
4. Salmon
5. Sunflower seeds

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 259

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-2 Explain the different types of lipids and how they are transported through the body.

Question 4

Type: MCSA

The client asks which components of the lipid profile should be low. What is the most appropriate response by the nurse?

1. VLDL should be high
2. LDL should be low
3. Total cholesterol levels do not give sufficient information
4. HDL should be low

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 260

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-2 Explain the different types of lipids and how they are transported through the body.

Question 5

Type: MCSA

The client asks how the body gets rid of cholesterol. Which response by the nurse is the most appropriate?

1. Cholesterol is secreted as HDL.
2. Cholesterol is secreted through the kidneys.
3. Cholesterol is secreted in bile.
4. Cholesterol is secreted in sweat.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 260

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-2 Explain the different types of lipids and how they are transported through the body.

Question 6

Type: MCSA

The nurse is caring for a client who has high cholesterol. The client asks which type of cholesterol is the good cholesterol. Which response by the nurse is most appropriate?

1. VLDL
2. LDL
3. Triglycerides
4. HDL

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 260

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-2 Explain the different types of lipids and how they are transported through the body.

Question 7

Type: MCSA

The nurse is caring for a client who asks why LDL (low-density lipoprotein) is called the “bad” cholesterol. Which response by the nurse is most appropriate?

1. It consists of 50% cholesterol.
2. It synthesizes other steroids.
3. It is stored in the tissues.
4. It increases the risk of heart disease.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 260

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-2 Explain the different types of lipids and how they are transported through the body.

Question 8

Type: MCSA

The client has an HDL cholesterol value of 38 mg/dL. What is the most appropriate interpretation of this value by the nurse?

1. Normal
2. Borderline
3. Low
4. High

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 261

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-2 Explain the different types of lipids and how they are transported through the body.

Question 9

Type: MCMA

Which lifestyle changes should the nurse recommend to the client to lower blood lipid levels? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Increased exercise
2. Restriction of dietary unsaturated fat
3. Smoking cessation
4. Taking medication
5. Restricting dietary cholesterol

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 261

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-3 Give examples of how blood lipid levels can be controlled through therapeutic lifestyle changes.

Question 10

Type: MCSA

The client has been diagnosed with hyperlipidemia and is being educated on types of food to include in his diet. What is the most appropriate nursing diagnosis for this client?

1. Impaired health maintenance, related to effects of drug therapy
2. Deficient knowledge, related to need for altered lifestyle
3. Noncompliance, related to dietary regime
4. Self-care deficit, related to disease process

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 261

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 17-3 Give examples of how blood lipid levels can be controlled through therapeutic lifestyle changes.

Question 11

Type: MCSA

Therapeutic lifestyle changes that can control high blood cholesterol levels include what percentage of total caloric intake as saturated fat?

1. 10%
2. 6%
3. 7%
4. 2%

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 261

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-3 Give examples of how blood lipid levels can be controlled through therapeutic lifestyle changes.

Question 12

Type: MCMA

The client has been taking nicotinic acid. Which adverse effects are common with nicotinic acid? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Fever
2. Hot flashes
3. Chest heaviness
4. Flushing
5. Weight gain

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 266

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-6 Explain the role of niacin in the treatment of lipid disorders.

Question 13

Type: MCSA

What drug classification is considered the drug of choice to decrease triglyceride levels?

1. Statin
2. Fibric acid agents
3. Bile acid agents
4. HMG-CoA reductase inhibitors

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 266–267

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-7 Explain the role of fibric acid drugs in the treatment of lipid disorders.

Question 14

Type: MCSA

The client is going to be started on cholestyramine (Questran), 6 mg, three times daily. What instruction should the nurse provide to this client?

1. Take with large amounts of fluid.
2. Take in the morning.
3. Take with food.
4. Take without food.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 263

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-5 Explain the role of bile acid binding drugs in the treatment of lipid disorders.

Question 15

Type: MCSA

The physician tells the nurse an HMG-CoA reductase inhibitor has been ordered. What is another name for the type of drug?

1. A fibric acid
2. An omega-3 fatty acid
3. A statin
4. A bile acid resin

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 262

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-4 Explain the role of statins in the treatment of lipid disorders.

Question 16

Type: MCSA

What is the term for a medical condition, caused by statins, in which the muscle tissue becomes extremely inflamed, resulting in the breakdown of muscle?

1. Rhabdomyolysis
2. Spasticity
3. Multiple sclerosis
4. Dystonia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 263

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-4 Explain the role of statins in the treatment of lipid disorders.

Question 17

Type: MCSA

The nurse is providing medication instructions for a client taking colesevelam (Welchol). What should the nurse include in the teaching session?

1. Take other medications 1 hour before or 4 hours after colesevelam.
2. Take other medications 4 hours before or 1 hour after taking colesevelam.
3. Avoid all other medications for 4 hours before and after taking colesevelam.
4. Take all medications at the same time as colesevelam.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 265

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-5 Explain the role of bile acid binding drugs in the treatment of lipid disorders.

Question 18

Type: MCSA

The client asks the nurse how atorvastatin (Lipitor) will help lower cholesterol. Which response by the nurse is most appropriate?

1. Its action is not understood.
2. It makes the body excrete cholesterol quicker.
3. It binds to cholesterol and inhibits its production.
4. It interferes with how cholesterol is made.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 262

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-4 Explain the role of statins in the treatment of lipid disorders.

Question 19

Type: MCSA

The nurse is caring for a client who is taking simvastatin (Zocor). What should the nurse instruct this client to avoid while taking this medication?

1. All fruit juices
2. Coenzyme Q10 (CoQ10) supplements
3. Grapefruit juice
4. Orange juice

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 264

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-4 Explain the role of statins in the treatment of lipid disorders.

Question 20

Type: MCMA

The nurse is caring for a client who is prescribed bile acid resins. Which adverse reactions should be included in the teaching session regarding this medication? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Bloating
2. Constipation
3. Headache
4. Increased urination
5. Diarrhea

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 265

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-5 Explain the role of bile acid binding drugs in the treatment of lipid disorders.

Question 21

Type: MCSA

The nurse is caring for a client who is prescribed ezetimibe (Zetia). Which teaching by the nurse regarding this medication is the most appropriate?

1. It works in the small intestine to block absorption of dietary cholesterol.
2. It causes rhabdomyolysis.
3. It increases LDL levels.
4. It increases triglyceride levels.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 268

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-8 Explain the role of omega-3 fatty acids and other miscellaneous drugs in the treatment of lipid disorders.

Question 22

Type: MCSA

What is the best explanation for why combination drugs may improve compliance for clients on multiple medications?

1. There are no side effects to combination drugs.
2. The physician can prescribe a combination drug to prevent rhabdomyolysis.
3. The client can obtain with a prescription.
4. Taking one tablet is easier to remember.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 268

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-8 Explain the role of omega-3 fatty acids and other miscellaneous drugs in the treatment of lipid disorders.

Question 23

Type: MCSA

The nurse has just completed medication teaching regarding medications used to treat high cholesterol. Which statement made by the client indicates a need for further teaching?

1. “I can eat any food I want as long as I take my medications.”
2. “I need to call the physician if I experience severe muscle weakness.”
3. “I should take my medications every day.”
4. “A low-fat diet needs to be followed even with medications to treat high cholesterol.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 261

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-3 Give examples of how blood lipid levels can be controlled through therapeutic lifestyle changes.

Question 24

Type: MCSA

What should the nurse instruct the client to perform in order to decrease mouth irritation and constipation while taking a bile acid binding drug?

1. “Take with coffee to increase the effect of the drug.”
2. “Dissolve in water and increase fluid intake.”
3. “Decrease fluid intake.”
4. “Chew tablets.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 269

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-5 Explain the role of bile acid binding drugs in the treatment of lipid disorders.

Question 25

Type: MCSA

The client has been taking niacin. Which statement by the client describes how this medication works?

1. It decreases VLDL levels and increases HDL levels.

2. The medication works immediately.

3. It works by binding bile acid in the intestines.

4. It is a vitamin C replacement.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 266

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-6 Explain the role of niacin in the treatment of lipid disorders.

Question 26

Type: MCSA

Which drugs are often combined with statins for an enhanced lipid-lowering effect to lower triglycerides?

1. Bile acid binding drugs

2. Niacin

3. Fibric acid

4. HMG-CoA

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 266

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 17-7 Explain the role of fibric acid drugs in the treatment of lipid disorders.