Review Practice Exercise 6

Drugs Used to Treat Dyslipidemias > Pharmacology

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Practice Exercise 6

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Total Questions : 2

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Question 1:

A nurse is completing a nursing history for a client who currently takes simvastatin (Zocor). The provider recommends adding ezetimibe to the client’s medications. Which of the following disorders is a contraindication to adding ezetimibe (Zetia) to the client’s medications?

A. History of severe constipation B. History of hypertension C. Active hepatitis C D. Type 2 diabetes mellitus

Answer and Explanation

Choice A:

History of severe constipation:
Constipation is not a contraindication for ezetimibe. Unlike bile acid sequestrants, ezetimibe does not cause significant gastrointestinal issues and has no direct link to worsening constipation.

Choice B:

History of hypertension:Ezetimibe does not adversely affect blood pressure regulation. Clients with hypertension can safely use the medication alongside their antihypertensive therapy.

Choice C:

Active hepatitis C:Clients with active liver disease should not take ezetimibe in combination with statins because of the increased risk of liver injury. Hepatitis C already compromises liver function, and adding medications that affect the liver can worsen hepatic inflammation and elevate liver enzymes. This contraindication is based on the high risk of hepatotoxicity when combining ezetimibe with simvastatin in the presence of preexisting liver disease.Rationales for incorrect answers:

Choice D:

Type 2 diabetes mellitus:
Ezetimibe is not contraindicated in diabetes and can actually be beneficial since lowering cholesterol reduces cardiovascular risk, which is elevated in diabetic clients. No harmful interaction exists between ezetimibe and antidiabetic medications.

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Question 2:

A patient is taking ezetimibe (Zetia) and asks the nurse how it works. The nurse should explain that Ezetimibe does what?

A. Inhibits absorption of dietary cholesterol in the intestines. B. Binds with bile acids in the intestines to reduce LDL levels. C. Inhibits HMG-CoA reductase, which is necessary for cholesterol production in the liver. D. Forms insoluble complexes and reduces circulating cholesterol in the blood.

Answer and Explanation

Choice A:

Inhibits absorption of dietary cholesterol in the intestines: Ezetimibe acts on the brush border of the small intestine to block the Niemann-Pick C1-Like 1 (NPC1L1) transporter, reducing cholesterol absorption from both dietary sources and bile. This results in lower serum LDL cholesterol without significantly affecting triglycerides or HDL.Rationales for incorrect answers:

Choice B:

Binds with bile acids in the intestines to reduce LDL levels: This describes the mechanism of bile acid sequestrants (e.g., cholestyramine, colesevelam), not ezetimibe.

Choice C:

Inhibits HMG-CoA reductase, which is necessary for cholesterol production in the liver: This is the mechanism of statins (e.g., simvastatin, atorvastatin), not ezetimibe.

Choice D:

Forms insoluble complexes and reduces circulating cholesterol in the blood: This is a vague description that more closely fits bile acid sequestrants, not ezetimibe.

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Practice Exercise 6

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