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  • August 11, 2024
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  • 2024/2025
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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 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.

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



stuvia

, STUVIA 2024/2025
taking with food does not alter these adverse effects. Nicotinic acid can affect liver enzymes not renal
function.

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 has been prescribed cilostazol. Which statement by the client indicates the need for further
teaching?
a. "I can take the medication with food if it causes nausea."
b. "This medication is used to improve blood flow."
c. "I can continue to take ginkgo biloba to improve my memory."
d. "I should be cautious when standing." - ✔✔ANS: C

Cilostazol should not be taken with ginkgo biloba because bleeding time can be prolonged. It can
%

cause nausea so the nurse should recommend taking the medication with food. Cilostazol does
cause vasodilation and improves blood flow which can also cause peripheral edema. Caution should
be taken when standing for long periods.

A patient has been taking atorvastatin (Lipitor) for several months to treat hyperlipidemia. The patient
reports severe muscle weakness and tenderness. The nurse will counsel the patient to do which of
the following?
a. ask the provider about switching to simvastatin.
b. contact the provider to report these symptoms.
c. start taking ibuprofen to combat these effects.
d. stop taking the medication immediately. - ✔✔ANS: B

Patients taking statins should report immediately any muscle aches or weakness, which can lead to
rhabdomyolysis, a muscle disintegration that can become fatal. All statins carry this risk, so changing
to another statin is not indicated. Ibuprofen may be useful, but notifying the provider is essential.
Patients should not abruptly discontinue statins without discussing this with the provider.

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


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