Family Nurse Practitioner Exam

What is the best initial intervention for a patient with a triglyceride level of 650 mg/dL?

1. Educate the patient about lifestyle changes that will help lower cholesterol levels

2. Initiate a prescription of pravastatin (Pravachol)

3. Recommend that the patient exercise and avoid eating fatty foods

4. Initiate a prescription of nicotinic acid (Niacin, Niaspan)

The correct answer is: Initiate a prescription of nicotinic acid (Niacin, Niaspan)

The best initial intervention for a patient with a triglyceride level of 650 mg/dL is to initiate a prescription of nicotinic acid (Niacin, Niaspan). When triglyceride levels are markedly elevated, as in this scenario, pharmacological intervention is often necessary to reduce the risk of pancreatitis and other complications associated with very high triglyceride levels. Niacin is specifically effective in lowering triglyceride levels and can also raise HDL (high-density lipoprotein) cholesterol. While educating the patient about lifestyle changes and recommending exercise or dietary modifications are indeed important components of managing elevated triglycerides, they may not be sufficient on their own when faced with such significantly high levels. In cases where triglycerides exceed 500 mg/dL, immediate treatment is often warranted, as lifestyle changes alone may take time to yield results and are unlikely to quickly bring down dangerously high levels. By comparison, pravastatin and other statins primarily target LDL cholesterol and may not adequately address triglyceride levels on their own in this situation. Therefore, starting with nicotinic acid can lead to a more immediate reduction in triglycerides while additional strategies can be implemented concurrently.