High-density lipoprotein carries excess cholesterol from tissues back toward the liver, and a low HDL level is a recognized cardiovascular risk factor.
Correct Answer
True
True. HDL collects cholesterol from tissues and artery walls and returns it toward the liver, which is why it is called good cholesterol. A low HDL level counts as a risk factor for cardiovascular disease, although drugs that simply raise HDL have not been shown to prevent heart attacks.
Category: Lipoproteins and Lipids
Question 2
LDL is cleared from the blood mainly by LDL receptors located on kidney cells.
Correct Answer
False
False. LDL receptors on liver cells remove most LDL from the circulation. Several drug classes, including statins, PCSK9 inhibitors and bile acid sequestrants, lower LDL by increasing the number of these liver receptors.
Category: Lipoproteins and Lipids
Question 3
Atorvastatin must be taken at bedtime because its short half-life means it works only when taken at night.
Correct Answer
False
False. Atorvastatin and rosuvastatin have long half-lives, so they can be taken at any time of day. Bedtime dosing matters for shorter-acting statins, because the liver makes most of its cholesterol at night.
Category: Statins
Question 4
Statin-induced rhabdomyolysis can damage the kidneys because breakdown products released from injured muscle are toxic to them.
Correct Answer
True
True. In rhabdomyolysis, damaged muscle releases myoglobin and other contents that can cause acute kidney injury, which can be fatal. Patients are taught to report unexplained muscle pain or weakness promptly.
Category: Statins
Question 5
A statin is usually continued without change when a patient becomes pregnant.
Correct Answer
False
False. Labeling advises stopping the statin once pregnancy is recognized, because statins block cholesterol synthesis, which the developing fetus relies on, although a provider may weigh continuing it for a patient at very high cardiovascular risk. The patient tells the provider as soon as pregnancy is known.
Category: Statins
Question 6
A patient who is breastfeeding is advised not to take a statin.
Correct Answer
True
True. Statins can pass into breast milk and could affect the infant's lipid metabolism, so breastfeeding is not recommended during statin therapy. The patient and provider decide whether to pause the statin or to use another feeding method.
Category: Statins
Question 7
Injection-site reactions are among the most common adverse effects of PCSK9 inhibitors.
Correct Answer
True
True. Redness, pain or bruising at the injection site is common and usually mild with alirocumab and evolocumab. Patients rotate sites and avoid skin that is tender, bruised, red or hard, and they report signs of a hypersensitivity reaction.
Category: PCSK9-Targeting Drugs
Question 8
Inclisiran is self-injected by the patient at home after training.
Correct Answer
False
False. Inclisiran is given as a subcutaneous injection by a health care professional, at long intervals, so the nurse helps the patient schedule and keep those appointments. The PCSK9 monoclonal antibodies are the ones patients self-inject.
Category: PCSK9-Targeting Drugs
Question 9
Bile acid sequestrants can raise serum triglyceride levels.
Correct Answer
True
True. Sequestrants can increase triglycerides, usually mildly but sometimes markedly in patients who already have high levels, so they are avoided in hypertriglyceridemia and in patients with a history of pancreatitis from high triglycerides.
Category: Bile Acid Sequestrants
Question 10
Bile acid sequestrants are well absorbed into the bloodstream and act directly on the liver.
Correct Answer
False
False. Sequestrants are resins that stay in the intestine and are not absorbed. Because they bind substances in the gut, they can also reduce the absorption of other drugs and fat-soluble vitamins.
Category: Bile Acid Sequestrants
Question 11
Bile acid sequestrants are usually used when a statin alone does not lower LDL enough or cannot be tolerated.
Correct Answer
True
True. Statins are the main LDL-lowering drugs, and sequestrants are second-line agents because they lower LDL less, must be taken often, cause gastrointestinal effects and bind many other drugs. They are added to a statin or used in its place when the statin is not enough or not tolerated.
Category: Bile Acid Sequestrants
Question 12
Fenofibrate is a safe choice for a patient who receives dialysis.
Correct Answer
False
False. Severe kidney impairment, including dialysis, is a contraindication to fenofibrate. The drug is cleared by the kidneys and can raise serum creatinine, so kidney function is checked before and during therapy.
Category: Fibrates
Question 13
Gemfibrozil can increase the anticoagulant effect of warfarin, so the INR is monitored closely after the fibrate is started.
Correct Answer
True
True. Fibrates, including gemfibrozil and fenofibrate, can enhance warfarin's effect and raise the risk of bleeding. The INR is checked frequently until it is stable, and the warfarin dose may need to be lowered.
Category: Fibrates
Question 14
Fenofibrate products from different manufacturers can be substituted for one another milligram for milligram.
Correct Answer
False
False. Fenofibrate and fenofibric acid products differ in formulation and are not bioequivalent, so one cannot be swapped for another at the same milligram strength. The nurse confirms the exact product before giving or substituting it.
Category: Fibrates
Question 15
Combining a fibrate with colchicine raises the risk of myopathy.
Correct Answer
True
True. Colchicine can damage muscle on its own, and adding a fibrate increases the risk of myopathy and rhabdomyolysis. Patients taking this combination are monitored for muscle pain and weakness.
Category: Fibrates
Question 16
The flushing caused by niacin results from histamine release by mast cells.
Correct Answer
False
False. Niacin flushing is caused by prostaglandin-mediated dilation of blood vessels in the skin. That is why an NSAID such as aspirin taken before the dose can reduce it, and extended-release products cause less flushing than immediate-release ones.
Category: Niacin
Question 17
Niacin has no effect on the risk of muscle injury when it is added to a statin.
Correct Answer
False
False. Adding lipid-modifying doses of niacin to a statin increases the risk of myopathy and rhabdomyolysis, so the patient is taught to report unexplained muscle pain, tenderness or weakness promptly.
Category: Niacin
Question 18
Avoiding hot drinks and alcohol around the time of a niacin dose can reduce flushing.
Correct Answer
True
True. Hot beverages and alcohol dilate skin blood vessels and make niacin flushing worse. Taking the dose as directed, often at bedtime with a low-fat snack, also helps.
Category: Niacin
Question 19
Cyclosporine can raise blood levels of ezetimibe.
Correct Answer
True
True. Cyclosporine increases ezetimibe exposure, and ezetimibe can raise cyclosporine levels, so cyclosporine concentrations are monitored when the two are used together. Ezetimibe also interacts with fibrates and with cholestyramine, which reduces its absorption.
Category: Ezetimibe
Question 20
Ezetimibe is recommended for patients with moderate or severe hepatic impairment.
Correct Answer
False
False. Ezetimibe is not recommended in moderate or severe hepatic impairment, and when it is given with a statin, the statin's liver contraindications, such as acute liver failure or decompensated cirrhosis, also apply. Liver enzymes are monitored when it is combined with a statin.
Category: Ezetimibe