Answer to Question 1
Correct Answer: 2
Rationale: Taking one aspirin tablet 30 minutes prior to niacin administration can reduce uncomfortable flushing in many patients because aspirin decreases the prostaglandin release that may cause a flushing effect. Taking niacin with food and water will not have any effect on flushing. Taking niacin on an empty stomach early in the morning will not have any effect on flushing. Switching to another drug is premature, because the niacin is effective.
Answer to Question 2
Correct Answer: 3
Rationale: Rhabdomyolysis is a rare, but serious side effect of statin drugs. Contents of muscle cells spill into the systemic circulation causing potentially fatal, acute renal failure. Urine output of less than 30 mL/hour is considered renal failure. A urine output of 200 mL/hour does not indicate renal failure, which occurs with rhabdomyolysis. Elevation of liver function tests (LFTs) may occur during statin therapy, but this is not as high a priority as acute renal failure. Increased bowel sounds will be heard with diarrhea, but diarrhea is a common side effect of statin therapy and is not considered a serious side effect initially.
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