Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 22

Question 1 Type: MCSA The patient says to the nurse, "My doctor says I have heart disease and I need to decrease cholesterol in my diet. How did this happen?" What is the est response y the nurse? 1. "The arteries around your heart are narrowed y low density lipoprotein !"#"$ cholesterol uildup in them." 2. ""ow density lipoprotein !"#"$ cholesterol is converted to saturated %at, which is stored in your coronary arteries." 3. "It is a &ood idea to decrease low density lipoprotein !"#"$ cholesterol in your diet, althou&h current research has not proven a correlation yet." 4. "Too much low density lipoprotein !"#"$ cholesterol narrows all the arteries in your ody so your heart does not receive enou&h lood to e healthy." Correct Answer: ' Rationa e 1( Stora&e o% cholesterol in the linin& o% coronary lood vessels contri utes to pla)ue uildup and atherosclerosis* this contri utes si&ni%icantly to coronary artery disease. "ow density lipoprotein !"#"$ cholesterol is not converted to saturated %at and stored in the coronary arteries. Coronary artery disease is caused y pla)ue uild+up in the coronary arteries, not the peripheral arteries. ,or several years, research has demonstrated a correlation etween hi&h low density lipoprotein !"#"$ levels and coronary artery disease. Rationa e 2( Stora&e o% cholesterol in the linin& o% coronary lood vessels contri utes to pla)ue uildup and atherosclerosis* this contri utes si&ni%icantly to coronary artery disease. "ow density lipoprotein !"#"$ cholesterol is not converted to saturated %at and stored in the coronary arteries. Coronary artery disease is caused y pla)ue uild+up in the coronary arteries, not the peripheral arteries. ,or several years, research has demonstrated a correlation etween hi&h low density lipoprotein !"#"$ levels and coronary artery disease. Rationa e 3( Stora&e o% cholesterol in the linin& o% coronary lood vessels contri utes to pla)ue uildup and atherosclerosis* this contri utes si&ni%icantly to coronary artery disease. "ow density lipoprotein !"#"$ cholesterol is not converted to saturated %at and stored in the coronary arteries. Coronary artery disease is caused y pla)ue uild+up in the coronary arteries, not the peripheral arteries. ,or several years, research has demonstrated a correlation etween hi&h low density lipoprotein !"#"$ levels and coronary artery disease. Rationa e 4( Stora&e o% cholesterol in the linin& o% coronary lood vessels contri utes to pla)ue uildup and atherosclerosis* this contri utes si&ni%icantly to coronary artery disease. "ow density lipoprotein !"#"$ cholesterol is not converted to saturated %at and stored in the coronary arteries. Coronary artery disease is caused y pla)ue uild+up in the coronary arteries, not the peripheral arteries. ,or several years, research has demonstrated a correlation etween hi&h low density lipoprotein !"#"$ levels and coronary artery disease. ! o"a Rationa e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+' Question 2 Type: MCSA The nurse is providin& &roup education a out lipids to patients who have een dia&nosed with hyperlipidemia. What does the est instruction include? 1. Hi&h density lipoprotein !H#"$ is called &ood cholesterol ecause it removes cholesterol %rom the ody and &ets rid o% it in the liver. 2. Hi&h density lipoprotein !H#"$ is called &ood cholesterol ecause it increases the o4y&en content in the arteries and reduces the amount o% pla)ue uild+up. 3. Hi&h density lipoprotein !H#"$ decreases the ad cholesterol !low density lipoprotein 5"#"6$, and promotes e4cretion o% it throu&h the 7idneys. 4. Hi&h density lipoprotein !H#"$ decreases low density lipoprotein !"#"$ and prevents it %rom convertin& to very low density lipoprotein !8#9"$, which is the worst 7ind o% cholesterol in the ody. Correct Answer: ' Rationa e 1( Hi&h density lipoprotein !H#"$ assists in the transport o% cholesterol away %rom ody tissues and ac7 to the liver in a process called reverse cholesterol transport. Hi&h density lipoprotein !H#"$ does not reduce low density lipoprotein !"#"$, which is e4creted in the %eces, not the 7idneys. Hi&h density lipoprotein !H#"$ does not increase o4y&en content in the arteries. 8ery low density lipoprotein !8#9"$ reduces to ecome low density lipoprotein !"#"$. Rationa e 2( Hi&h density lipoprotein !H#"$ assists in the transport o% cholesterol away %rom ody tissues and ac7 to the liver in a process called reverse cholesterol transport. Hi&h density lipoprotein !H#"$ does not reduce low density lipoprotein !"#"$, which is e4creted in the %eces, not the 7idneys. Hi&h density lipoprotein !H#"$ does not increase o4y&en content in the arteries. 8ery low density lipoprotein !8#9"$ reduces to ecome low density lipoprotein !"#"$. Rationa e 3( Hi&h density lipoprotein !H#"$ assists in the transport o% cholesterol away %rom ody tissues and ac7 to the liver in a process called reverse cholesterol transport. Hi&h density lipoprotein !H#"$ does not reduce low density lipoprotein !"#"$, which is e4creted in the %eces, not the 7idneys. Hi&h density lipoprotein !H#"$ does not increase o4y&en content in the arteries. 8ery low density lipoprotein !8#9"$ reduces to ecome low density lipoprotein !"#"$. Rationa e 4( Hi&h density lipoprotein !H#"$ assists in the transport o% cholesterol away %rom ody tissues and ac7 to the liver in a process called reverse cholesterol transport. Hi&h density lipoprotein !H#"$ does not reduce low density lipoprotein !"#"$, which is e4creted in the %eces, not the 7idneys. Hi&h density lipoprotein !H#"$
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

does not increase o4y&en content in the arteries. 8ery low density lipoprotein !8#9"$ reduces to ecome low density lipoprotein !"#"$. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+Question 3 Type: MCMA The patient tells the nurse she is con%used a out what she has een readin& a out lipids. What is !are$ the est response!s$ y the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. :2hospholipids will help prevent Al;heimer<s disease.= 2. :2hospholipids are essential to uildin& plasma mem ranes.= 3. :Cholesterol is a uildin& loc7 %or estro&en and testosterone.= 4. :Tri&lycerides are the ma>or %orm o% %at in the ody.= +. :Cholesterol in the diet is unnecessary as the liver synthesi;es it.= Correct Answer: 0,?,-,@ Rationa e 1( Tri&lycerides are the ma>or %orm o% %at in the ody, phospholipids are essential to uildin& plasma mem ranes, cholesterol is a uildin& loc7 %or estro&en and testosterone, and cholesterol is not needed in the diet as the liver synthesi;es ade)uate amounts %rom other chemicals. There is no evidence to support that phospholipids will prevent Al;heimer<s disease. Rationa e 2( Tri&lycerides are the ma>or %orm o% %at in the ody, phospholipids are essential to uildin& plasma mem ranes, cholesterol is a uildin& loc7 %or estro&en and testosterone, and cholesterol is not needed in the diet as the liver synthesi;es ade)uate amounts %rom other chemicals. There is no evidence to support that phospholipids will prevent Al;heimer<s disease. Rationa e 3( Tri&lycerides are the ma>or %orm o% %at in the ody, phospholipids are essential to uildin& plasma mem ranes, cholesterol is a uildin& loc7 %or estro&en and testosterone, and cholesterol is not needed in the diet as the liver synthesi;es ade)uate amounts %rom other chemicals. There is no evidence to support that phospholipids will prevent Al;heimer<s disease.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Rationa e 4( Tri&lycerides are the ma>or %orm o% %at in the ody, phospholipids are essential to uildin& plasma mem ranes, cholesterol is a uildin& loc7 %or estro&en and testosterone, and cholesterol is not needed in the diet as the liver synthesi;es ade)uate amounts %rom other chemicals. There is no evidence to support that phospholipids will prevent Al;heimer<s disease. Rationa e +( Tri&lycerides are the ma>or %orm o% %at in the ody, phospholipids are essential to uildin& plasma mem ranes, cholesterol is a uildin& loc7 %or estro&en and testosterone, and cholesterol is not needed in the diet as the liver synthesi;es ade)uate amounts %rom other chemicals. There is no evidence to support that phospholipids will prevent Al;heimer<s disease. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+0 Question 4 Type: MCSA The patient has serum cholesterol levels o% the %ollowin&( "ow density lipoprotein !"#"$ A '1@m&.dl Hi&h density lipoprotein !H#"$ A ?Bm&.dl "ow density lipoprotein !"#"$.hi&h density lipoprotein !H#"$ ratio A -.' In plannin& care with this patient, what is the est outcome? 1. The patient will maintain normal lipid levels without the use o% medications. 2. The nurse will educate the patient a out diet and e4ercise. 3. The nurse will validate that the patient understands the importance o% li%estyle chan&es. 4. The patient will achieve normal lipid levels throu&h compliance with medications. Correct Answer: ' Rationa e 1( The patient has orderline la oratory levels* patients with orderline la oratory values can control their dyslipidemia entirely throu&h nonpharmacolo&ical means. To the e4tent possi le, maintainin& normal lipid values without pharmacotherapy should e a therapeutic &oal as all medications have side e%%ects. The nurse educatin& the patient a out diet and e4ercise is a nursin& intervention, not a patient outcome. The est outcome with orderline serum lipids is to maintain normal levels without the use o% medications. The nurse validatin& that the patient understands the importance o% li%estyle chan&es is a nursin& intervention, not a patient outcome. Rationa e 2( The patient has orderline la oratory levels* patients with orderline la oratory values can control their dyslipidemia entirely throu&h nonpharmacolo&ical means. To the e4tent possi le, maintainin& normal lipid values without pharmacotherapy should e a therapeutic &oal as all medications have side e%%ects. The nurse
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

educatin& the patient a out diet and e4ercise is a nursin& intervention, not a patient outcome. The est outcome with orderline serum lipids is to maintain normal levels without the use o% medications. The nurse validatin& that the patient understands the importance o% li%estyle chan&es is a nursin& intervention, not a patient outcome. Rationa e 3( The patient has orderline la oratory levels* patients with orderline la oratory values can control their dyslipidemia entirely throu&h nonpharmacolo&ical means. To the e4tent possi le, maintainin& normal lipid values without pharmacotherapy should e a therapeutic &oal as all medications have side e%%ects. The nurse educatin& the patient a out diet and e4ercise is a nursin& intervention, not a patient outcome. The est outcome with orderline serum lipids is to maintain normal levels without the use o% medications. The nurse validatin& that the patient understands the importance o% li%estyle chan&es is a nursin& intervention, not a patient outcome. Rationa e 4( The patient has orderline la oratory levels* patients with orderline la oratory values can control their dyslipidemia entirely throu&h nonpharmacolo&ical means. To the e4tent possi le, maintainin& normal lipid values without pharmacotherapy should e a therapeutic &oal as all medications have side e%%ects. The nurse educatin& the patient a out diet and e4ercise is a nursin& intervention, not a patient outcome. The est outcome with orderline serum lipids is to maintain normal levels without the use o% medications. The nurse validatin& that the patient understands the importance o% li%estyle chan&es is a nursin& intervention, not a patient outcome. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( 2lannin& %earnin# )utcome: 00+@ Question + Type: MCSA The nurse has completed nutritional teachin& with the patient who has a hi&h low density lipoprotein !"#"$ level. The nurse reco&ni;es that teachin& has een e%%ective when the patient ma7es which menu choice? 1. Cee% tenderloin with &ravy and noodles, %ruit salad with apples and &rape%ruit, slice o% rye read, and apple pie 2. Drilled chic7en salad with straw erries and pecans, a7ed macaroni and cheese, and low+%at rownie 3. Drilled chic7en with rice and roccoli, tossed salad with walnuts and sliced apples, slice o% whole+wheat read, and low+%at chocolate puddin& 4. "ow+%at ham ur&er with whole+wheat un, tossed salad with walnuts and olive oil, and raisin+oatmeal coo7ie Correct Answer: ? Rationa e 1( A lipid+reducin& diet should include solu le %i er, plant sterols, and stanols in the diet. The est menu choice includes rice, roccoli, walnuts, apples, and whole+wheat read. The menu that includes ee% tenderloin has some healthy choices, ut the &ravy is too hi&h in %at, as is the apple pie. The menu that includes low+%at ham ur&er has some healthy choices, ut the low+%at ham ur&er is too hi&h in %at, as is a raisin+oatmeal
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

coo7ie. The menu that includes the &rilled chic7en salad has no healthy choices e4cept %or the pecans* the a7ed macaroni and cheese would e hi&h in %at. Rationa e 2( A lipid+reducin& diet should include solu le %i er, plant sterols, and stanols in the diet. The est menu choice includes rice, roccoli, walnuts, apples, and whole+wheat read. The menu that includes ee% tenderloin has some healthy choices, ut the &ravy is too hi&h in %at, as is the apple pie. The menu that includes low+%at ham ur&er has some healthy choices, ut the low+%at ham ur&er is too hi&h in %at, as is a raisin+oatmeal coo7ie. The menu that includes the &rilled chic7en salad has no healthy choices e4cept %or the pecans* the a7ed macaroni and cheese would e hi&h in %at. Rationa e 3( A lipid+reducin& diet should include solu le %i er, plant sterols, and stanols in the diet. The est menu choice includes rice, roccoli, walnuts, apples, and whole+wheat read. The menu that includes ee% tenderloin has some healthy choices, ut the &ravy is too hi&h in %at, as is the apple pie. The menu that includes low+%at ham ur&er has some healthy choices, ut the low+%at ham ur&er is too hi&h in %at, as is a raisin+oatmeal coo7ie. The menu that includes the &rilled chic7en salad has no healthy choices e4cept %or the pecans* the a7ed macaroni and cheese would e hi&h in %at. Rationa e 4( A lipid+reducin& diet should include solu le %i er, plant sterols, and stanols in the diet. The est menu choice includes rice, roccoli, walnuts, apples, and whole+wheat read. The menu that includes ee% tenderloin has some healthy choices, ut the &ravy is too hi&h in %at, as is the apple pie. The menu that includes low+%at ham ur&er has some healthy choices, ut the low+%at ham ur&er is too hi&h in %at, as is a raisin+oatmeal coo7ie. The menu that includes the &rilled chic7en salad has no healthy choices e4cept %or the pecans* the a7ed macaroni and cheese would e hi&h in %at. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+@ Question , Type: MCSA The patient is receivin& cholestryamine !Euestran$, and complains o% constipation. The physician orders isacodyl !#ucola4$ ta lets. When is the est time %or the nurse to administer the isacodyl !#ucola4$ ta lets? 1. The dru&s can e administered to&ether. 2. ,our hours a%ter administration o% cholestryamine !Euestran$ 3. Cisacodyl !#ucola4$ can e &iven any time, ut must e ta7en with %ood. 4. Fne hour a%ter administration o% cholestryamine !Euestran$ Correct Answer: 0
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Rationa e 1( Fther dru&s must e administered more than 0 hours e%ore, or - hours a%ter, the patient ta7es cholestryamine !Euestran$ ecause it can ind to other dru&s and inter%ere with their a sorption. These dru&s cannot e administered to&ether ecause cholestryamine !Euestran$ can ind to other dru&s and inter%ere with their a sorption. A minimum o% - hours administration time etween dru&s is needed to e sure cholestryamine !Euestran$ does not inter%ere with a sorption o% other dru&s. Cisacodyl !#ucola4$ cannot e administered with cholestryamine !Euestran$ as it will not e a sor ed* Cisacodyl !#ucola4$ does not need to e &iven with %ood. Rationa e 2( Fther dru&s must e administered more than 0 hours e%ore, or - hours a%ter, the patient ta7es cholestryamine !Euestran$ ecause it can ind to other dru&s and inter%ere with their a sorption. These dru&s cannot e administered to&ether ecause cholestryamine !Euestran$ can ind to other dru&s and inter%ere with their a sorption. A minimum o% - hours administration time etween dru&s is needed to e sure cholestryamine !Euestran$ does not inter%ere with a sorption o% other dru&s. Cisacodyl !#ucola4$ cannot e administered with cholestryamine !Euestran$ as it will not e a sor ed* Cisacodyl !#ucola4$ does not need to e &iven with %ood. Rationa e 3( Fther dru&s must e administered more than two hours e%ore, or %our hours a%ter, the patient ta7es cholestryamine !Euestran$ ecause it can ind to other dru&s and inter%ere with their a sorption. These dru&s cannot e administered to&ether ecause cholestryamine !Euestran$ can ind to other dru&s and inter%ere with their a sorption. A minimum o% %our hours administration time etween dru&s is needed to e sure cholestryamine !Euestran$ does not inter%ere with a sorption o% other dru&s. Cisacodyl !#ucola4$ cannot e administered with cholestryamine !Euestran$ as it will not e a sor ed* Cisacodyl !#ucola4$ does not need to e &iven with %ood. Rationa e 4( Fther dru&s must e administered more than two hours e%ore, or %our hours a%ter, the patient ta7es cholestryamine !Euestran$ ecause it can ind to other dru&s and inter%ere with their a sorption. These dru&s cannot e administered to&ether ecause cholestryamine !Euestran$ can ind to other dru&s and inter%ere with their a sorption. A minimum o% %our hours administration time etween dru&s is needed to e sure cholestryamine !Euestran$ does not inter%ere with a sorption o% other dru&s. Cisacodyl !#ucola4$ cannot e administered with cholestryamine !Euestran$ as it will not e a sor ed* Cisacodyl !#ucola4$ does not need to e &iven with %ood. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+G Question Type: MCSA The patient is receivin& &em%i ro;il !"opid$. The nurse has completed dischar&e instructions a out this medication. The nurse reco&ni;es that teachin& has een e%%ective when the patient ma7es which statement? 1. "I should ta7e this medication on an empty stomach to help it a sor 2. "I must ta7e this medication with %ood or I can have heart urn." 3. "My doctor said it really doesn<t matter how I ta7e this medication."
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

etter."

4. "Ta7in& this medication with yo&urt will help it to a sor Correct Answer: 0

etter."

Rationa e 1( Dem%i ro;il !"opid$ should e administered with %ood to decrease &astrointestinal !DI$ distress. Ta7in& &em%i ro;il !"opid$ on an empty stomach can cause &astrointestinal !DI$ distress* %ood will decrease the &astrointestinal !DI$ distress. Dem%i ro;il !"opid$ should not e ta7en with yo&urt ecause %atty %oods may decrease the e%%icacy o% &em%i ro;il !"opid$. It is hi&hly unli7ely the physician would say that it doesn<t matter how the medication is ta7en* the medication must e ta7en with %ood to decrease &astrointestinal !DI$ distress. Rationa e 2( Dem%i ro;il !"opid$ should e administered with %ood to decrease &astrointestinal !DI$ distress. Ta7in& &em%i ro;il !"opid$ on an empty stomach can cause &astrointestinal !DI$ distress* %ood will decrease the &astrointestinal !DI$ distress. Dem%i ro;il !"opid$ should not e ta7en with yo&urt ecause %atty %oods may decrease the e%%icacy o% &em%i ro;il !"opid$. It is hi&hly unli7ely the physician would say that it doesn<t matter how the medication is ta7en* the medication must e ta7en with %ood to decrease &astrointestinal !DI$ distress. Rationa e 3( Dem%i ro;il !"opid$ should e administered with %ood to decrease &astrointestinal !DI$ distress. Ta7in& &em%i ro;il !"opid$ on an empty stomach can cause &astrointestinal !DI$ distress* %ood will decrease the &astrointestinal !DI$ distress. Dem%i ro;il !"opid$ should not e ta7en with yo&urt ecause %atty %oods may decrease the e%%icacy o% &em%i ro;il !"opid$. It is hi&hly unli7ely the physician would say that it doesn<t matter how the medication is ta7en* the medication must e ta7en with %ood to decrease &astrointestinal !DI$ distress. Rationa e 4( Dem%i ro;il !"opid$ should e administered with %ood to decrease &astrointestinal !DI$ distress. Ta7in& &em%i ro;il !"opid$ on an empty stomach can cause &astrointestinal !DI$ distress* %ood will decrease the &astrointestinal !DI$ distress. Dem%i ro;il !"opid$ should not e ta7en with yo&urt ecause %atty %oods may decrease the e%%icacy o% &em%i ro;il !"opid$. It is hi&hly unli7ely the physician would say that it doesn<t matter how the medication is ta7en* the medication must e ta7en with %ood to decrease &astrointestinal !DI$ distress. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+H Question . Type: MCMA The patient tells the nurse that his doctor wants him to ta7e a medication %or his hi&h cholesterol, ut he doesn<t 7now which one would e est. What is !are$ the est response!s$ y the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. "The est dru&s to raise your hi&h density lipoprotein !H#"$ levels are the %i ric acid dru&s."
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

2. "The statin dru&s are &ood, ut will cause a lot o% %lushin& i% you swallow them with warm %luids." 3. "The ile resins 7eep cholesterol %rom ein& a sor ed, ut have some side e%%ects." 4. "The statin dru&s inhi it the ma7in& o% cholesterol and are considered the est choice." +. ",i ric acid dru&s will decrease tri&lycerides, ut your low density lipoprotein !"#"$ will still e hi&h." Correct Answer: ?,-,@ Rationa e 1( ,i ric acid a&ents are e%%ective, ut will not reduce low density lipoprotein !"#"$ levels. Statin dru&s inhi it HMD+CoA reductase which is necessary %or the iosynthesis o% cholesterol and are the dru&s o% %irst choice in reducin& serum lipid levels. Cile resins are e%%ective, ut numerous side e%%ects limit their use%ulness. 3iacin, not statins, will cause %lushin&, which is worse with warm %luids. The est dru&s to raise hi&h density lipoprotein !H#"$ levels are statins, not %i ric acid dru&s. Rationa e 2( ,i ric acid a&ents are e%%ective, ut will not reduce low density lipoprotein !"#"$ levels. Statin dru&s inhi it HMD+CoA reductase which is necessary %or the iosynthesis o% cholesterol and are the dru&s o% %irst choice in reducin& serum lipid levels. Cile resins are e%%ective, ut numerous side e%%ects limit their use%ulness. 3iacin, not statins, will cause %lushin&, which is worse with warm %luids. The est dru&s to raise hi&h density lipoprotein !H#"$ levels are statins, not %i ric acid dru&s. Rationa e 3( ,i ric acid a&ents are e%%ective, ut will not reduce low density lipoprotein !"#"$ levels. Statin dru&s inhi it HMD+CoA reductase which is necessary %or the iosynthesis o% cholesterol and are the dru&s o% %irst choice in reducin& serum lipid levels. Cile resins are e%%ective, ut numerous side e%%ects limit their use%ulness. 3iacin, not statins, will cause %lushin&, which is worse with warm %luids. The est dru&s to raise hi&h density lipoprotein !H#"$ levels are statins, not %i ric acid dru&s. Rationa e 4( ,i ric acid a&ents are e%%ective, ut will not reduce low density lipoprotein !"#"$ levels. Statin dru&s inhi it HMD+CoA reductase which is necessary %or the iosynthesis o% cholesterol and are the dru&s o% %irst choice in reducin& serum lipid levels. Cile resins are e%%ective, ut numerous side e%%ects limit their use%ulness. 3iacin, not statins, will cause %lushin&, which is worse with warm %luids. The est dru&s to raise hi&h density lipoprotein !H#"$ levels are statins, not %i ric acid dru&s. Rationa e +( ,i ric acid a&ents are e%%ective, ut will not reduce low density lipoprotein !"#"$ levels. Statin dru&s inhi it HMD+CoA reductase which is necessary %or the iosynthesis o% cholesterol and are the dru&s o% %irst choice in reducin& serum lipid levels. Cile resins are e%%ective, ut numerous side e%%ects limit their use%ulness. 3iacin, not statins, will cause %lushin&, which is worse with warm %luids. The est dru&s to raise hi&h density lipoprotein !H#"$ levels are statins, not %i ric acid dru&s. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+B
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Question / Type: MCSA The patient tells the nurse, "My doctor says I have hi&h levels o% %at in my lood. Is that li7e i& pieces o% %at %loatin& around?" What is the est response y the nurse? 1. "3o, %ats in your lood are carried inside small molecules called phospholipids." 2. "3o, actually %ats travel in the lood on little proteins called lipoproteins." 3. "3o, that is not a &ood description o% %at transport* as7 your doctor a&ain." 4. "3o, the %ats are encapsulated inside little a&s 7nown as lecithins." Correct Answer: 0 Rationa e 1( "ipids are carried throu&h the lood as lipoproteins. 2hospholipids are a class o% lipids that is essential to uildin& plasma mem ranes. "ecithins are phospholipids %ound in e&& yol7s and soy eans. The nurse can answer this )uestion* it does not need to e re%erred to the physician. Rationa e 2( "ipids are carried throu&h the lood as lipoproteins. 2hospholipids are a class o% lipids that is essential to uildin& plasma mem ranes. "ecithins are phospholipids %ound in e&& yol7s and soy eans. The nurse can answer this )uestion* it does not need to e re%erred to the physician. Rationa e 3( "ipids are carried throu&h the lood as lipoproteins. 2hospholipids are a class o% lipids that is essential to uildin& plasma mem ranes. "ecithins are phospholipids %ound in e&& yol7s and soy eans. The nurse can answer this )uestion* it does not need to e re%erred to the physician. Rationa e 4( "ipids are carried throu&h the lood as lipoproteins. 2hospholipids are a class o% lipids that is essential to uildin& plasma mem ranes. "ecithins are phospholipids %ound in e&& yol7s and soy eans. The nurse can answer this )uestion* it does not need to e re%erred to the physician. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+? Question 10 Type: MCSA The patient is ta7in& a statin dru&. Which assessment data would e a priority %or the nurse to report immediately to the physician? 1. "My calves hurt, and I had a hard time wal7in& to the athroom."
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

2. "I 7now I >ust started this medicine yesterday, ut my stomach really is upset." 3. "Will you call my doctor? I have a really ad headache." 4. "My heart rate really went up this mornin&." Correct Answer: ' Rationa e 1( The nurse must assess %or complaints o% muscle pain, tenderness, and wea7ness as this could indicate a type o% myopathy 7nown as rha domyolysis. The statin dru&s do not a%%ect heart rate. Dastrointestinal !DI$ distress is a common occurrence with the statin dru&s and is easily remedied y ta7in& the dru& with %ood. Headache is considered a minor side e%%ect and is easily remedied y anal&esic medications. Rationa e 2( The nurse must assess %or complaints o% muscle pain, tenderness, and wea7ness as this could indicate a type o% myopathy 7nown as rha domyolysis. The statin dru&s do not a%%ect heart rate. Dastrointestinal !DI$ distress is a common occurrence with the statin dru&s and is easily remedied y ta7in& the dru& with %ood. Headache is considered a minor side e%%ect and is easily remedied y anal&esic medications. Rationa e 3( The nurse must assess %or complaints o% muscle pain, tenderness, and wea7ness as this could indicate a type o% myopathy 7nown as rha domyolysis. The statin dru&s do not a%%ect heart rate. Dastrointestinal !DI$ distress is a common occurrence with the statin dru&s and is easily remedied y ta7in& the dru& with %ood. Headache is considered a minor side e%%ect and is easily remedied y anal&esic medications. Rationa e 4( The nurse must assess %or complaints o% muscle pain, tenderness, and wea7ness as this could indicate a type o% myopathy 7nown as rha domyolysis. The statin dru&s do not a%%ect heart rate. Dastrointestinal !DI$ distress is a common occurrence with the statin dru&s and is easily remedied y ta7in& the dru& with %ood. Headache is considered a minor side e%%ect and is easily remedied y anal&esic medications. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+I Question 11 Type: MCSA The patient is receivin& a statin dru&. Which assessment data would e a priority %or the nurse to report to the physician? 1. Cowel sounds mar7edly increased in all %our )uadrants o% the a domen 2. Jrine output o% 011 m".hour 3. Jrine output o% 01 m".hour
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

4. Moderate elevation in liver %unction tests !",Ts$ Correct Answer: ? Rationa e 1( 9ha domyolysis is a rare, ut serious side e%%ect o% statin dru&s. Contents o% muscle cells spill into the systemic circulation causin& potentially %atal, acute renal %ailure. Jrine output o% less than ?1 m".hour is considered renal %ailure. A urine output o% 011 m".hour does not indicate renal %ailure, which occurs with rha domyolysis. /levation o% liver %unction tests !",Ts$ may occur durin& statin therapy, ut this is not as hi&h a priority as acute renal %ailure. Increased owel sounds will e heard with diarrhea, ut diarrhea is a common side e%%ect o% statin therapy and is not considered a serious side e%%ect initially. Rationa e 2( 9ha domyolysis is a rare, ut serious side e%%ect o% statin dru&s. Contents o% muscle cells spill into the systemic circulation causin& potentially %atal, acute renal %ailure. Jrine output o% less than ?1 m".hour is considered renal %ailure. A urine output o% 011 m".hour does not indicate renal %ailure, which occurs with rha domyolysis. /levation o% liver %unction tests !",Ts$ may occur durin& statin therapy, ut this is not as hi&h a priority as acute renal %ailure. Increased owel sounds will e heard with diarrhea, ut diarrhea is a common side e%%ect o% statin therapy and is not considered a serious side e%%ect initially. Rationa e 3( 9ha domyolysis is a rare, ut serious side e%%ect o% statin dru&s. Contents o% muscle cells spill into the systemic circulation causin& potentially %atal, acute renal %ailure. Jrine output o% less than ?1 m".hour is considered renal %ailure. A urine output o% 011 m".hour does not indicate renal %ailure, which occurs with rha domyolysis. /levation o% liver %unction tests !",Ts$ may occur durin& statin therapy, ut this is not as hi&h a priority as acute renal %ailure. Increased owel sounds will e heard with diarrhea, ut diarrhea is a common side e%%ect o% statin therapy and is not considered a serious side e%%ect initially. Rationa e 4( 9ha domyolysis is a rare, ut serious side e%%ect o% statin dru&s. Contents o% muscle cells spill into the systemic circulation causin& potentially %atal, acute renal %ailure. Jrine output o% less than ?1 m".hour is considered renal %ailure. A urine output o% 011 m".hour does not indicate renal %ailure, which occurs with rha domyolysis. /levation o% liver %unction tests !",Ts$ may occur durin& statin therapy, ut this is not as hi&h a priority as acute renal %ailure. Increased owel sounds will e heard with diarrhea, ut diarrhea is a common side e%%ect o% statin therapy and is not considered a serious side e%%ect initially. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+G Question 12 Type: MCSA The patient is receivin& cholestryamine !Euestran$. When assessin& %or side e%%ects, what will e the primary %ocus o% the nurse? 1. Auscultation o% heart sounds
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

2. Auscultation o% owel sounds in all %our a dominal )uadrants 3. Assessment o% 0-+hour urine output 4. 2alpation %or peripheral edema in the lower e4tremities Correct Answer: 0 Rationa e 1( Assessment o% owel sounds is a priority ecause cholestryamine !Euestran$ could cause o struction o% the intestines. Cholestryamine !Euestran$ does not a%%ect cardiac status. Cholestryamine !Euestran$ does not cause peripheral edema. Cholestryamine !Euestran$ does not cause rha domyolysis, so the nurse would not assess %or 0-+hour urine output. Rationa e 2( Assessment o% owel sounds is a priority ecause cholestryamine !Euestran$ could cause o struction o% the intestines. Cholestryamine !Euestran$ does not a%%ect cardiac status. Cholestryamine !Euestran$ does not cause peripheral edema. Cholestryamine !Euestran$ does not cause rha domyolysis, so the nurse would not assess %or 0-+hour urine output. Rationa e 3( Assessment o% owel sounds is a priority ecause cholestryamine !Euestran$ could cause o struction o% the intestines. Cholestryamine !Euestran$ does not a%%ect cardiac status. Cholestryamine !Euestran$ does not cause peripheral edema. Cholestryamine !Euestran$ does not cause rha domyolysis, so the nurse would not assess %or 0-+hour urine output. Rationa e 4( Assessment o% owel sounds is a priority ecause cholestryamine !Euestran$ could cause o struction o% the intestines. Cholestryamine !Euestran$ does not a%%ect cardiac status. Cholestryamine !Euestran$ does not cause peripheral edema. Cholestryamine !Euestran$ does not cause rha domyolysis, so the nurse would not assess %or 0-+hour urine output. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+I Question 13 Type: MCSA The patient is receivin& niacin. Althou&h this dru& is e%%ective in lowerin& lipid levels, the patient complains o% uncom%orta le %lushin&. What is the est education y the nurse? 1. "Ce sure to ta7e your niacin on an empty stomach as soon as you arise." 2. "Ta7e one aspirin ?1 minutes e%ore you ta7e your niacin." 3. "Ta7e your niacin ta let with %ood and at least one %ull &lass o% water."
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

4. "It may e time to as7 your doctor a out switchin& to another dru&." Correct Answer: 0 Rationa e 1( Ta7in& one aspirin ta let ?1 minutes prior to niacin administration can reduce uncom%orta le %lushin& in many patients ecause aspirin decreases the prosta&landin release that may cause a %lushin& e%%ect. Ta7in& niacin with %ood and water will not have any e%%ect on %lushin&. Ta7in& niacin on an empty stomach early in the mornin& will not have any e%%ect on %lushin&. Switchin& to another dru& is premature, ecause the niacin is e%%ective. Rationa e 2( Ta7in& one aspirin ta let ?1 minutes prior to niacin administration can reduce uncom%orta le %lushin& in many patients ecause aspirin decreases the prosta&landin release that may cause a %lushin& e%%ect. Ta7in& niacin with %ood and water will not have any e%%ect on %lushin&. Ta7in& niacin on an empty stomach early in the mornin& will not have any e%%ect on %lushin&. Switchin& to another dru& is premature, ecause the niacin is e%%ective. Rationa e 3( Ta7in& one aspirin ta let ?1 minutes prior to niacin administration can reduce uncom%orta le %lushin& in many patients ecause aspirin decreases the prosta&landin release that may cause a %lushin& e%%ect. Ta7in& niacin with %ood and water will not have any e%%ect on %lushin&. Ta7in& niacin on an empty stomach early in the mornin& will not have any e%%ect on %lushin&. Switchin& to another dru& is premature, ecause the niacin is e%%ective. Rationa e 4( Ta7in& one aspirin ta let ?1 minutes prior to niacin administration can reduce uncom%orta le %lushin& in many patients ecause aspirin decreases the prosta&landin release that may cause a %lushin& e%%ect. Ta7in& niacin with %ood and water will not have any e%%ect on %lushin&. Ta7in& niacin on an empty stomach early in the mornin& will not have any e%%ect on %lushin&. Switchin& to another dru& is premature, ecause the niacin is e%%ective. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+G Question 14 Type: MCSA The patient is receivin& a statin dru&. The nurse notes an increase in creatine phospho7inase !C2K$ levels. What is the nurse<s priority action? 1. Hold the dru& and o tain another creatine phospho7inase !C2K$ level in H hours. 2. Administer the dru& and continue to assess %or muscle pain. 3. Administer the dru& and o tain another creatine phospho7inase !C2K$ level in H hours.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

4. Hold the dru& and noti%y the physician. Correct Answer: Rationa e 1( /levated creatine phospho7inase !C2K$ levels could indicate myopathy* i% this is suspected, hold the dru& and noti%y the physician. The physician must e noti%ied when myopathy is suspected, so the nurse would not hold the dru& and o tain another creatine phospho7inase !C2K$ level. I% myopathy is suspected, the dru& must e held, not administered, and the physician noti%ied. The nurse should not administer the dru&, the physician must e noti%ied. Rationa e 2( /levated creatine phospho7inase !C2K$ levels could indicate myopathy* i% this is suspected, hold the dru& and noti%y the physician. The physician must e noti%ied when myopathy is suspected, so the nurse would not hold the dru& and o tain another creatine phospho7inase !C2K$ level. I% myopathy is suspected, the dru& must e held, not administered, and the physician noti%ied. The nurse should not administer the dru&, the physician must e noti%ied. Rationa e 3( /levated creatine phospho7inase !C2K$ levels could indicate myopathy* i% this is suspected, hold the dru& and noti%y the physician. The physician must e noti%ied when myopathy is suspected, so the nurse would not hold the dru& and o tain another creatine phospho7inase !C2K$ level. I% myopathy is suspected, the dru& must e held, not administered, and the physician noti%ied. The nurse should not administer the dru&, the physician must e noti%ied. Rationa e 4( /levated creatine phospho7inase !C2K$ levels could indicate myopathy* i% this is suspected, hold the dru& and noti%y the physician. The physician must e noti%ied when myopathy is suspected, so the nurse would not hold the dru& and o tain another creatine phospho7inase !C2K$ level. I% myopathy is suspected, the dru& must e held, not administered, and the physician noti%ied. The nurse should not administer the dru&, the physician must e noti%ied. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Implementation %earnin# )utcome: 00+I Question 1+ Type: MCSA Which lipid type is associated with the hi&hest ris7 o% atherosclerosis development? 1. 2hospholipids 2. "ecithins 3. Steroids 4. Tri&lycerides
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Correct Answer: ? Rationa e 1( Cholesterol is a steroid, and is 7nown %or its role in promotin& atherosclerosis. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. Rationa e 2( Cholesterol is a steroid, and is 7nown %or its role in promotin& atherosclerosis. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. Rationa e 3( Cholesterol is a steroid, and is 7nown %or its role in promotin& atherosclerosis. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. Rationa e 4( Cholesterol is a steroid, and is 7nown %or its role in promotin& atherosclerosis. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. ! o"a Rationa e: Co#niti$e %e$e : 9emem erin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+' and 00+0 Question 1, Type: MCSA Which type o% lipid serves as %uel %or the ody when ener&y is needed? 1. 2hospholipids 2. Tri&lycerides 3. Steroids 4. "ecithins Correct Answer: 0 Rationa e 1( Tri&lycerides account %or G1L o% the lipids in the ody, and serve as an important ener&y source. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. Rationa e 2( Tri&lycerides account %or G1L o% the lipids in the ody, and serve as an important ener&y source. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. Rationa e 3( Tri&lycerides account %or G1L o% the lipids in the ody, and serve as an important ener&y source. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Rationa e 4( Tri&lycerides account %or G1L o% the lipids in the ody, and serve as an important ener&y source. There are three types o% lipids important %or humans( tri&lycerides, phospholipids, and steroids. "ecithins are a phospholipid. ! o"a Rationa e: Co#niti$e %e$e : 9emem erin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+' and 00+0 Question 1Type: MCSA Which type o% lipoprotein is o%ten re%erred to as :the &ood type,= and why? 1. Tri&lycerides are &ood ecause they are used %or ener&y. 2. H#" is &ood, ecause it carries cholesterol away %rom tissues and to the liver %or meta olism and e4cretion. 3. "#" is &ood ecause it contains the most cholesterol that will e e4creted in the %eces. 4. 8"#" is &ood ecause it contains the lowest amount o% cholesterol. Correct Answer: 0 Rationa e 1( H#" is considered &ood ecause it carries cholesterol away %rom tissues and to the liver %or meta olism and e4cretion. Hi&h levels o% H#" are use%ul %or lowerin& the ris7 o% heart disease. Tri&lycerides are not lipoproteins* they ma7e up lipoproteins. "#" does contain the most cholesterol, ut it does not carry it to the liver %or e4cretion. Throu&h several steps, 8"#" is converted to "#". Rationa e 2( H#" is considered &ood ecause it carries cholesterol away %rom tissues and to the liver %or meta olism and e4cretion. Hi&h levels o% H#" are use%ul %or lowerin& the ris7 o% heart disease. Tri&lycerides are not lipoproteins* they ma7e up lipoproteins. "#" does contain the most cholesterol, ut it does not carry it to the liver %or e4cretion. Throu&h several steps, 8"#" is converted to "#". Rationa e 3( H#" is considered &ood ecause it carries cholesterol away %rom tissues and to the liver %or meta olism and e4cretion. Hi&h levels o% H#" are use%ul %or lowerin& the ris7 o% heart disease. Tri&lycerides are not lipoproteins* they ma7e up lipoproteins. "#" does contain the most cholesterol, ut it does not carry it to the liver %or e4cretion. Throu&h several steps, 8"#" is converted to "#". Rationa e 4( H#" is considered &ood ecause it carries cholesterol away %rom tissues and to the liver %or meta olism and e4cretion. Hi&h levels o% H#" are use%ul %or lowerin& the ris7 o% heart disease. Tri&lycerides are not lipoproteins* they ma7e up lipoproteins. "#" does contain the most cholesterol, ut it does not carry it to the liver %or e4cretion. Throu&h several steps, 8"#" is converted to "#". ! o"a Rationa e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Co#niti$e %e$e : Jnderstandin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+Question 1. Type: MCSA Which statement provides the est rationale %or monitorin& H#" and "#" as opposed to total cholesterol? 1. H#" and "#" monitorin& is much cheaper than measurin& total cholesterol. 2. Total cholesterol measurements include cholesterol that will e destroyed as well as transported to tissues and stored. 3. H#" and "#" measurements are more &eneral, and %re)uently are used in patients not at ris7 %or heart disease. 4. Total cholesterol measurements are o%ten inaccurate and not as relia le as H#" and "#". Correct Answer: 0 Rationa e 1( Total cholesterol tests include the :&ood= and : ad= cholesterol, the &ood ein& the type that is destroyed and e4creted while the ad is the type stored inside lood vessels. Total, "#", and H#" tests are as accurate as the e)uipment and technicians that complete them. H#" and "#" are more speci%ic tests, not more &eneral. Dainin& more speci%ic in%ormation, not associated costs, is the primary reason %or monitorin& the H#" and "#". Rationa e 2( Total cholesterol tests include the :&ood= and : ad= cholesterol, the &ood ein& the type that is destroyed and e4creted while the ad is the type stored inside lood vessels. Total, "#", and H#" tests are as accurate as the e)uipment and technicians that complete them. H#" and "#" are more speci%ic tests, not more &eneral. Dainin& more speci%ic in%ormation, not associated costs, is the primary reason %or monitorin& the H#" and "#". Rationa e 3( Total cholesterol tests include the :&ood= and : ad= cholesterol, the &ood ein& the type that is destroyed and e4creted while the ad is the type stored inside lood vessels. Total, "#", and H#" tests are as accurate as the e)uipment and technicians that complete them. H#" and "#" are more speci%ic tests, not more &eneral. Dainin& more speci%ic in%ormation, not associated costs, is the primary reason %or monitorin& the H#" and "#". Rationa e 4( Total cholesterol tests include the :&ood= and : ad= cholesterol, the &ood ein& the type that is destroyed and e4creted while the ad is the type stored inside lood vessels. Total, "#", and H#" tests are as accurate as the e)uipment and technicians that complete them. H#" and "#" are more speci%ic tests, not more &eneral. Dainin& more speci%ic in%ormation, not associated costs, is the primary reason %or monitorin& the H#" and "#". ! o"a Rationa e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Co#niti$e %e$e : Jnderstandin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+@ Question 1/ Type: MCSA Which o% the %ollowin& patients would e at the &reatest ris7 o% developin& heart disease? 1. Total 011, "#" '-1, H#" ?1 2. Total 001, "#" '?@, H#" HI 3. Total 'GI, "#" 'H0, H#" 01 4. Total 'IH, "#" '0@, H#" @Correct Answer: ? Rationa e 1( A patient with these cholesterol levels would e at the &reatest ris7 o% developin& heart disease. Rationa e 2( A patient with these cholesterol levels would e at the &reatest ris7 o% developin& heart disease. Rationa e 3( A patient with these cholesterol levels would e at the &reatest ris7 o% developin& heart disease. Rationa e 4( A patient with these cholesterol levels would e at the &reatest ris7 o% developin& heart disease. ! o"a Rationa e: Co#niti$e %e$e : 9emem erin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+Question 20 Type: MCSA Which statement correctly identi%ies why simply restrictin& dietary inta7e o% cholesterol &enerally will not result in a si&ni%icant reduction o% lood cholesterol? 1. Most people are not compliant with the dietary restriction. 2. Cholesterol is %ound in nearly all %oods, and it is not possi le to eliminate it %rom the diet.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

3. Cholesterol is made within the ody, and cannot e a sor ed via e4ternal sources. 4. The liver reacts to a low+cholesterol diet y ma7in& more cholesterol. Correct Answer: Rationa e 1( 2atients wishin& to lower their lood cholesterol levels should restrict their inta7e o% cholesterol and saturated %ats. The liver will react to a low+cholesterol diet y ma7in& more cholesterol when saturated %ats are present. Rationa e 2( 2atients wishin& to lower their lood cholesterol levels should restrict their inta7e o% cholesterol and saturated %ats. The liver will react to a low+cholesterol diet y ma7in& more cholesterol when saturated %ats are present. Rationa e 3( 2atients wishin& to lower their lood cholesterol levels should restrict their inta7e o% cholesterol and saturated %ats. The liver will react to a low+cholesterol diet y ma7in& more cholesterol when saturated %ats are present. Rationa e 4( 2atients wishin& to lower their lood cholesterol levels should restrict their inta7e o% cholesterol and saturated %ats. The liver will react to a low+cholesterol diet y ma7in& more cholesterol when saturated %ats are present. ! o"a Rationa e: Co#niti$e %e$e : 9emem erin& C ient &eed: 2sychosocial Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+@ Question 21 Type: MCSA Atorvastatin !"ipitor$ is a statin that can e used to lower lood cholesterol levels y 1. indin& e4o&enous cholesterol and e4cretin& it in the %eces. 2. increasin& e4cretion y activatin& en;ymes within the hepatic system. 3. preventin& dietary a sorption within the DI tract. 4. inhi itin& an en;yme that is essential %or cholesterol synthesis. Correct Answer: Rationa e 1( Statins wor7 y inhi itin& the en;yme HMD+CoA reductase. HMD+CoA reductase is essential %or cholesterol iosynthesis. Cile acid resins ind cholesterol and promote its e4cretion in the %eces.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Rationa e 2( Statins wor7 y inhi itin& the en;yme HMD+CoA reductase. HMD+CoA reductase is essential %or cholesterol iosynthesis. Cile acid resins ind cholesterol and promote its e4cretion in the %eces. Rationa e 3( Statins wor7 y inhi itin& the en;yme HMD+CoA reductase. HMD+CoA reductase is essential %or cholesterol iosynthesis. Cile acid resins ind cholesterol and promote its e4cretion in the %eces. Rationa e 4( Statins wor7 y inhi itin& the en;yme HMD+CoA reductase. HMD+CoA reductase is essential %or cholesterol iosynthesis. Cile acid resins ind cholesterol and promote its e4cretion in the %eces. ! o"a Rationa e: Co#niti$e %e$e : 9emem erin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( 2lannin& %earnin# )utcome: 01+H Question 22 Type: MCSA Which statement is accurate re&ardin& the use o% nicotinic acid !3iacin$ %or lowerin& lood cholesterol levels? 1. It wor7s primarily y lowerin& "#" and H#" levels. 2. #ue to adverse e%%ects, niacin should not e used with statins. 3. Hot %lashes are a common side e%%ect when niacin is used in hi&h doses. 4. Hi&h doses o% 0@M?1 m& per day are o%ten necessary. Correct Answer: ? Rationa e 1( 3iacin is used as a vitamin supplement in doses o% 0@ m&.day. The usual dose o% 0M? &rams.day %or lowerin& lood cholesterol levels o%ten results in hot %lashes. 3iacin lowers "#" levels and increases H#" levels. It is o%ten used with other dru&s li7e the statins. Rationa e 2( 3iacin is used as a vitamin supplement in doses o% 0@ m&.day. The usual dose o% 0M? &rams.day %or lowerin& lood cholesterol levels o%ten results in hot %lashes. 3iacin lowers "#" levels and increases H#" levels. It is o%ten used with other dru&s li7e the statins. Rationa e 3( 3iacin is used as a vitamin supplement in doses o% 0@ m&.day. The usual dose o% 0M? &rams.day %or lowerin& lood cholesterol levels o%ten results in hot %lashes. 3iacin lowers "#" levels and increases H#" levels. It is o%ten used with other dru&s li7e the statins. Rationa e 4( 3iacin is used as a vitamin supplement in doses o% 0@ m&.day. The usual dose o% 0M? &rams.day %or lowerin& lood cholesterol levels o%ten results in hot %lashes. 3iacin lowers "#" levels and increases H#" levels. It is o%ten used with other dru&s li7e the statins.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

! o"a Rationa e: Co#niti$e %e$e : Jnderstandin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( Assessment %earnin# )utcome: 00+H Question 23 Type: MCMA A nursin& student is preparin& a presentation on the di%%erent types o% lipids. The student will include which classi%ication o% lipids in the presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. Tri&lycerides 2. 2hospholipids 3. Steroids 4. "ecithins +. Cile acids Correct Answer: ',0,? Rationa e 1( Tri&lycerides are the most common classi%ications o% lipids. Rationa e 2( 2hospholipids are a class o% lipids essential to uildin& plasma mem ranes. Rationa e 3( Steroids are a diverse classi%ication o% lipids. Rationa e 4( "ecithins are not a classi%ication o% lipids. "ecithin is the est 7nown phospholipid. Rationa e +( Cile acids are not a classi%ication o% lipids. Cholesterol is a uildin& loc7 o% ile acids. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": 2hysiolo&ical Adaptation &ursin#/(nte#rated Concepts: 3ursin& 2rocess( 2lannin& %earnin# )utcome: 00+0
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Question 24 Type: MCMA A student is discussin& lipid transport throu&h the lood with a nursin& instructor. The student as7s the educator which apoproteins are important to lipid transport. Which responses y the educator are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. A+I 2. A+II 3. A+III 4. A+I8 +. C+'11 Correct Answer: ',0,-,@ Rationa e 1( A+I is an apoprotein important to lipid transport. Rationa e 2( A+II is an apoprotein important to lipid transport. Rationa e 3( A+III is not an apoprotein important to lipid transport. Rationa e 4( A+I8 is an apoprotein important to lipid transport. Rationa e +( C+'11 is an apoprotein important to lipid transport. ! o"a Rationa e: Co#niti$e %e$e : Applyin& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": 2hysiolo&ical Adaptation &ursin#/(nte#rated Concepts: Teachin& and "earnin& %earnin# )utcome: 00+? Question 2+ Type: MCMA The nurse is teachin& a patient re&ardin& therapeutic li%estyle chan&es that can e implemented to control cholesterol levels in the lood. The nurse 7nows the patient has understood the teachin& when the patient states,
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. "I will maintain an optimal wei&ht." 2. "I will implement a medically supervised e4ercise plan." 3. "I will increase saturated %at in my diet." 4. "I will increase insolu le %i er in my diet." +. "I will eliminate to acco use." Correct Answer: ',0,@ Rationa e 1( Maintainin& an optimal wei&ht is a nonpharmcolo&ical therapeutic li%estyle chan&e that can control cholesterol levels in the lood. Rationa e 2( A medically supervised e4ercise plan is a nonpharmacolo&ical therapeutic li%estyle chan&e that can control cholesterol levels in the lood. Rationa e 3( This statement indicates that the patient re)uires %urther education, as the patient should decrease dietary saturated %ats and cholesterol in the diet. Rationa e 4( It is recommended to increase solu le %i er, not insolu le %i er, in the diet. The e4amples included are solu le %i er. Rationa e +( /liminatin& to acco use is a nonpharmacolo&ical therapeutic li%estyle chan&e that can decrease cholesterol levels in the lood. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: Health 2romotion and Maintenance C ient &eed 'u": &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+@ Question 2, Type: MCMA The nurse is reviewin& the adverse e%%ects associated with statins with a patient who has recently een started on this classi%ication o% medication to reduce lood cholesterol levels. The nurse 7nows the patient has understood the teachin& when the patient states that serious adverse e%%ects associated with statins include Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

'tandard Te*t: Select all that apply. 1. headache. 2. a dominal pain. 3. myopathy. 4. muscle or >oint pain. +. rha domyolysis. Correct Answer: ?,@ Rationa e 1( A headache is an e4ample o% a minor adverse e%%ect associated with statins. Rationa e 2( A dominal pain is an e4ample o% a minor adverse e%%ect associated with statins. Rationa e 3( Severe myopathy is a rare ut serious adverse e%%ect associated with statins. Rationa e 4( Muscle or >oint pain is an e4ample o% a minor adverse e%%ect associated with statins. Rationa e +( 9ha domyolysis is an e4ample o% a rare ut serious adverse e%%ect associated with statins. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": 2harmacolo&ical and 2arenteral Therapies &ursin#/(nte#rated Concepts: 3ursin& 2rocess( /valuation %earnin# )utcome: 00+H Question 2Type: Correct Answer: ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": 2harmacolo&ical and 2arenteral Therapies &ursin#/(nte#rated Concepts: Teachin& and "earnin& %earnin# )utcome: 00+B Question 2. Type: MCMA

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.

A seasoned nurse is reviewin& the di%%erent classi%ications o% medications that are used to decrease lood cholesterol levels with a new nurse on a medical+sur&ical unit. The seasoned nurse 7nows the new nurse has comprehended the in%ormation when she cites these medications as %i ric acid a&ents. Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. Atromid+S 2. Netia 3. "opid 4. Colestid +. Nocor Correct Answer: ',? Rationa e 1( Atromid+S is a %i ric acid a&ent used to decrease lood cholesterol levels. Rationa e 2( Netia is an unclassi%ied a&ent used to decrease lood cholesterol levels. Rationa e 3( "opid is a %i ric acid a&ent used to decrease lood cholesterol levels. Rationa e 4( Colestid is a Cile Acid Se)uestrant used to decrease lood cholesterol levels. Rationa e +( Nocor is an HMD+CoA 9eductase medication used to decrease lood cholesterol levels. ! o"a Rationa e: Co#niti$e %e$e : Analy;in& C ient &eed: 2hysiolo&ical Inte&rity C ient &eed 'u": 2harmacolo&ical and 2arenteral Therapies &ursin#/(nte#rated Concepts: Teachin& and "earnin& %earnin# )utcome: 00+B

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyri&ht 01'- y 2earson /ducation, Inc.