LPN LPN
LPN Pharmacology Assessment A
1. A client with a history of myocardial infarction (MI) is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse reinforce?
- A. Store the tablets in a cool, dry place away from light.
- B. Take a tablet every 5 minutes if chest pain occurs.
- C. Place the tablets under the tongue for sublingual absorption.
- D. Take the tablets without water for faster effect.
Correct answer: A
Rationale: The correct answer is A. Nitroglycerin tablets are light and moisture-sensitive, so they should be stored in a cool, dry place away from light to maintain their effectiveness. Option B advises taking a tablet every 5 minutes, which may lead to overdose as this frequency is too high. Option C emphasizes the correct administration route for sublingual tablets. Option D is incorrect as water is not needed for the tablets to take effect.
2. The client with a history of heart failure is receiving digoxin (Lanoxin). Which electrolyte imbalance increases the risk of digoxin toxicity?
- A. Hypernatremia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hypomagnesemia
Correct answer: C
Rationale: Hypokalemia increases the risk of digoxin toxicity as low potassium levels enhance the effects of digoxin on the heart, leading to toxicity and potential adverse effects. Hypernatremia (Choice A) is not directly associated with an increased risk of digoxin toxicity. Hypercalcemia (Choice B) does not increase the risk of digoxin toxicity. Hypomagnesemia (Choice D) can contribute to digoxin toxicity, but hypokalemia has a more significant impact on increasing the risk.
3. The client is receiving anticoagulant therapy for atrial fibrillation. Which laboratory test should be monitored to determine the effectiveness of the therapy?
- A. Prothrombin time (PT) and international normalized ratio (INR)
- B. Activated partial thromboplastin time (aPTT)
- C. Platelet count
- D. Erythrocyte sedimentation rate (ESR)
Correct answer: A
Rationale: Prothrombin time (PT) and international normalized ratio (INR) are essential laboratory tests to monitor the effectiveness of anticoagulant therapy in clients with atrial fibrillation. These tests help ensure that the client is within the therapeutic range and are commonly used to assess the clotting ability of the blood. Monitoring PT and INR levels allows healthcare providers to adjust anticoagulant dosages as needed to prevent complications such as bleeding or thrombosis. Activated partial thromboplastin time (aPTT) is more commonly used to monitor heparin therapy, not anticoagulant therapy for atrial fibrillation. Platelet count assesses the number of platelets in the blood and is not a direct indicator of anticoagulant therapy effectiveness. Erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not used to monitor anticoagulant therapy.
4. A client with a diagnosis of heart failure is being discharged. What information should the nurse emphasize to the client regarding the use of a daily weight log?
- A. Report any weight gain of more than 2 pounds in a day
- B. Weigh yourself after eating breakfast each morning
- C. Use the same scale each day to check your weight
- D. Record your weight daily and report any changes
Correct answer: A
Rationale: The correct answer is A: 'Report any weight gain of more than 2 pounds in a day.' Sudden weight gain of more than 2 pounds in a day may indicate fluid retention and worsening heart failure. This information is crucial for early intervention and monitoring of the client's condition. Weighing after eating breakfast (choice B) may not provide consistent results due to varying food and fluid intake. Using the same scale each day (choice C) ensures accuracy and consistency in weight measurements. Recording weight daily (choice D) is more frequent than necessary and may not be practical for all clients. It is essential to focus on significant weight changes to prevent unnecessary alarm or confusion.
5. The nurse is teaching a client about lifestyle changes to manage hypertension. Which dietary change should the nurse recommend?
- A. Increase intake of red meat
- B. Use salt substitutes liberally
- C. Limit sodium intake to 2 grams per day
- D. Increase intake of processed foods
Correct answer: C
Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' This recommendation is crucial in managing hypertension because excessive sodium intake can lead to elevated blood pressure. Reducing sodium intake helps the body regulate fluid balance and lower blood pressure. Choices A, B, and D are incorrect. Increasing red meat intake can worsen hypertension due to its high saturated fat content. Using salt substitutes liberally can also be harmful as they often contain high amounts of potassium, which can be problematic for individuals with certain health conditions. Increasing processed foods consumption is generally discouraged in hypertension management due to their high sodium content and low nutritional value.
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