LPN LPN
LPN Pharmacology
1. Before administering digoxin (Lanoxin) to a client diagnosed with heart failure, the nurse should perform which assessment?
- A. Check the blood pressure.
- B. Obtain an electrocardiogram (ECG).
- C. Assess the apical pulse.
- D. Review the latest electrolyte levels.
Correct answer: C
Rationale: Assessing the apical pulse is crucial before administering digoxin because the medication can lead to bradycardia. Monitoring the apical pulse helps determine the heart rate, and digoxin is typically withheld if the pulse is below 60 beats per minute. This assessment is essential to prevent potential adverse effects associated with digoxin administration. Checking the blood pressure (Choice A) is important but not specific to digoxin administration. Obtaining an electrocardiogram (ECG) (Choice B) may provide valuable information but is not the primary assessment needed before administering digoxin. Reviewing the latest electrolyte levels (Choice D) is important for assessing the overall condition but is not the immediate assessment required before administering digoxin.
2. The healthcare provider is preparing to assist in the care of a client who has just returned from coronary artery bypass graft (CABG) surgery. Which is the priority action?
- A. Monitor the client's urine output.
- B. Check the client's surgical dressing.
- C. Measure the client's blood pressure.
- D. Assess the client's level of consciousness.
Correct answer: D
Rationale: Assessing the client's level of consciousness is the priority action post-CABG surgery to monitor for signs of cerebral hypoxia or other complications that require immediate intervention. Changes in the client's level of consciousness can indicate neurological deterioration, which is critical to address promptly in this postoperative period. Monitoring urine output, checking surgical dressing, and measuring blood pressure are important aspects of postoperative care but assessing the client's level of consciousness takes precedence as it provides crucial information about the client's neurological status and the need for urgent intervention.
3. After returning the client to bed following a cardiac catheterization procedure with the left femoral vessel as the access site, the nurse places a sign above the bed instructing the client to remain on bed rest and in which position?
- A. In semi-Fowler's position
- B. With the head of the bed elevated 45 degrees
- C. With the head of the bed elevated no more than 15 degrees
- D. With the foot of the bed elevated as much as tolerated by the client
Correct answer: C
Rationale: After cardiac catheterization via the femoral vessel, it is crucial to keep the head of the bed elevated no more than 15 degrees to prevent bleeding at the access site. This position helps maintain pressure on the femoral artery, reducing the risk of bleeding and complications post-procedure. Choices A, B, and D are incorrect because they do not provide the necessary pressure on the femoral artery to prevent bleeding, which is essential after a cardiac catheterization procedure with a femoral access site.
4. A client is admitted to the hospital with a venous stasis leg ulcer. The nurse inspects the ulcer expecting to note which observation?
- A. The ulcer has a pale-colored base.
- B. The ulcer is deep, with even edges.
- C. The ulcer has little granulation tissue.
- D. The ulcer has a brownish or 'brawny' appearance.
Correct answer: D
Rationale: When assessing a venous stasis leg ulcer, the nurse should expect to note a brownish or 'brawny' appearance. This discoloration is often due to hemosiderin deposits. The correct answer is not A because venous stasis ulcers typically do not have a pale-colored base. Choice B is incorrect as venous stasis ulcers usually have irregular, shallow edges, not deep and even edges. Choice C is incorrect as venous stasis ulcers often have excess granulation tissue, not little granulation tissue. Recognizing the brownish or 'brawny' appearance is crucial for accurate diagnosis and appropriate treatment of venous stasis leg ulcers.
5. The nurse is informed during shift report that a client is experiencing occasional ventricular dysrhythmias. The nurse reviews the client's laboratory results, recalling that which electrolyte imbalance could be responsible for this development?
- A. Hypokalemia
- B. Hypernatremia
- C. Hypochloremia
- D. Hypercalcemia
Correct answer: A
Rationale: Hypokalemia, which is low potassium levels, can disrupt the normal electrical activity of the heart and lead to ventricular dysrhythmias. Potassium plays a crucial role in maintaining the heart's rhythm, and a deficiency can result in dangerous heart rhythm abnormalities. Hypernatremia (Choice B), which is high sodium levels, does not directly impact heart rhythm. Hypochloremia (Choice C), which is low chloride levels, is not typically associated with ventricular dysrhythmias. Hypercalcemia (Choice D), which is high calcium levels, is not a common cause of ventricular dysrhythmias.
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