Review Practice Exercise 2

Drugs Used to Treat Dyslipidemias > Pharmacology

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Practice Exercise 2

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Total Questions : 3

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Question 1:

A nurse is providing teaching to a client who is starting simvastatin (Zocor). Which of the following should the nurse include in the teaching?

A. Take this medication in the evening. B. Change position slowly when rising from a chair. C. Maintain a steady intake of green leafy vegetables. D. Consume no more than 1 L of fluid/day.

Answer and Explanation

Choice A:

Take this medication in the evening:Simvastatin works by inhibiting HMG-CoA reductase, an enzyme involved in cholesterol synthesis. Because the body synthesizes the majority of cholesterol during nighttime hours, administering simvastatin in the evening maximizes its therapeutic effect. This timing helps achieve better lipid-lowering results.Rationales for incorrect answers:

Choice B:

Change position slowly when rising from a chair:This teaching applies to antihypertensives or medications that cause orthostatic hypotension. Statins are not associated with postural blood pressure changes.

Choice C:

Maintain a steady intake of green leafy vegetables:This instruction is relevant for clients taking warfarin, because vitamin K intake affects anticoagulation levels. Simvastatin does not interact with vitamin K–rich foods, so this teaching is unnecessary.

Choice D:

Consume no more than 1 L of fluid/day:This is an instruction for clients with fluid restrictions (such as in heart failure or renal disease), not for those taking simvastatin. Statins do not require fluid limitation.

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Question 2:

Which point will the nurse emphasize to a patient who is taking an antilipemic medication in the statin class?

A. The drug must be taken on an empty stomach before meals. B. A low-fat diet is not necessary while taking these medications. C. It is important to report muscle pain immediately. D. Improved cholesterol levels will be evident within 2 weeks.

Answer and Explanation

Choice A:

The drug must be taken on an empty stomach before meals:
Statins are typically taken in the evening (when cholesterol synthesis is highest) and can be taken with or without food. Fasting before meals is not required.

Choice B:

A low-fat diet is not necessary while taking these medications:Dietary modification is still essential. Statins are an adjunct to, not a replacement for, a low-fat, heart-healthy diet.

Choice C:

It is important to report muscle pain immediately:Muscle pain may indicate statin-induced myopathy, which in severe cases can progress to rhabdomyolysis, a life-threatening breakdown of muscle tissue leading to kidney damage. Prompt reporting allows the healthcare provider to evaluate whether the medication should be discontinued or adjusted. This is the most important teaching point when starting statins.Rationales for incorrect answers:

Choice D:

Improved cholesterol levels will be evident within 2 weeks:
Although some changes may appear within 2 weeks, the full therapeutic effect usually takes 4–6 weeks. Clients should not expect immediate results.

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Question 3:

A patient has been taking simvastatin (Zocor) for 6 months. Today he received a call that he needs to come to the office for a “laboratory check.” The nurse expects which laboratory studies to be ordered at this time? Select all that apply

A. PT/INR B. Total cholesterol C. Triglycerides D. Liver function studies E. Complete blood count F. HDL and LDL levels

Answer and Explanation

Choice A:

PT/INR: PT/INR assesses blood clotting and is typically monitored in patients on anticoagulants like warfarin. It is not affected by statins and is not relevant in routine statin monitoring.

Choice B:

Total cholesterol: Measuring total cholesterol helps determine whether simvastatin is effective in reducing overall cholesterol. Since the drug’s primary goal is to lower LDL and total cholesterol to reduce cardiovascular risk, this is a key test.

Choice C:

Triglycerides: Statins can modestly lower triglyceride levels in addition to lowering LDL. Monitoring triglycerides provides further information on the patient’s response to therapy and overall risk of atherosclerosis.

Choice D:

Liver function studies: Statins carry a risk of hepatotoxicity, so monitoring liver enzymes such as AST and ALT is crucial. Elevations may indicate liver injury, requiring dose adjustment or discontinuation of the drug.

Choice E:

Complete blood count (CBC): A CBC provides information about red and white blood cells and platelets. Statins do not commonly affect bone marrow or blood cell production, so a CBC is not routinely ordered in follow-up care for simvastatin.

Choice F:

HDL and LDL levels: These are central targets of statin therapy. LDL should decrease significantly, while HDL should increase or remain stable. Tracking these values confirms the effectiveness of treatment and guides further management.Rationales for incorrect answers:

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Practice Exercise 2

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