*NURSING > EXAM > NR 508 NR508 ADVANCED PHARM POSSIBLE MIDTERM QUESTIONS AND ANSWERS EXAM 2022 (All)

NR 508 NR508 ADVANCED PHARM POSSIBLE MIDTERM QUESTIONS AND ANSWERS EXAM 2022

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A patient who has primary hyperlipidemia and who takes atorvastatin (Lipitor) continues to have LDL cholesterol of 140 mg/dL after 3 months of therapy. The primary care NP increases the dose from 10 m... g daily to 20 mg daily. The patient reports headache and dizziness a few weeks after the dose increase. The NP should: change the atorvastatin dose to 15 mg twice daily. change the patient’s medication to cholestyramine (Questran). add ezetimibe (Zetia) and lower the atorvastatin to 10 mg daily. recommend supplements of omega3 along with the atorvastatin. When used in combination with a lowdose statin, ezetimibe has been noted to produce an additional 18% reduction in LDL. Because this patient continues to have elevated LDL along with side effects of the statin, the NP should resume the lower dose of the statin and add ezetimibe. Atorvastatin is given once daily. Cholestyramine and omega 3 supplements are not indicated. A patient who has hyperlipidemia has been taking atorvastatin (Lipitor) 60 mg daily for 6 months. The patient’s initial lipid profile showed LDL of 180 mg/dL, HDL of 45 mg/dL, and triglycerides of 160 mg/dL. The primary care NP orders a lipid profile today that shows LDL of 105 mg/dL, HDL of 50 mg/dL, and triglycerides of 120 mg/dL. The patient reports muscle pain and weakness. The NP should: order liver function tests (LFTs). order a creatine kinaseMM (CKMM) level. change atorvastatin to twicedaily dosing. add gemfibrozil (Lopid) to the patient’s medication regimen. Hepatotoxicity and muscle toxicity are the two primary adverse effects of greatest concern with statin use. Patients who report muscle discomfort or weakness should have a CKMM level drawn. LFTs are indicated with signs of hepatotoxicity. It is not correct to change the dosing schedule. Gemfibrozil is not indicated. [Show More]

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