LPN LPN
LPN Pharmacology Assessment A
1. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?
- A. Take one tablet daily with breakfast
- B. Take one tablet every 5 minutes as needed, up to three times
- C. Take one tablet every hour until pain subsides
- D. Take one tablet only if pain does not subside after 30 minutes
Correct answer: B
Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.
2. The healthcare provider is teaching a client about the use of nitroglycerin patches for angina pectoris. Which instruction should the healthcare provider include?
- A. Apply the patch to the same site each day
- B. Remove the patch at bedtime to prevent tolerance
- C. Cover the patch with a bandage to keep it in place
- D. Rotate the application site every 24 hours
Correct answer: D
Rationale: Rotating the application site every 24 hours is crucial when using nitroglycerin patches to prevent skin irritation and ensure consistent absorption of the medication. By rotating the site, the risk of local skin reactions is reduced, and the effectiveness of the nitroglycerin patch is maintained. Applying the patch to the same site each day (Choice A) can lead to skin irritation. Removing the patch at bedtime (Choice B) is not necessary as long as the prescribed wearing schedule is followed. Covering the patch with a bandage (Choice C) is not recommended as it may interfere with proper absorption.
3. The nurse is assisting in the care of a client with a history of angina pectoris who is receiving nitroglycerin patches. Which instruction should the nurse reinforce with the client?
- A. Apply the patch to a different site each time.
- B. Remove the patch at night to prevent tolerance.
- C. Use more than one patch if chest pain occurs.
- D. Shower with caution while wearing the patch.
Correct answer: B
Rationale: Removing the nitroglycerin patch at night is crucial to prevent the development of tolerance. Tolerance can occur when the body becomes accustomed to a constant level of the medication, reducing its effectiveness. By removing the patch at night, the client experiences a drug-free period, which helps prevent tolerance and maintains the effectiveness of the nitroglycerin for angina relief. Choices A, C, and D are incorrect because applying the patch to a different site each time helps prevent skin irritation, using more than one patch is not recommended unless instructed by the healthcare provider, and showering with caution is important to prevent dislodging the patch, but it is not the most critical instruction to prevent tolerance development.
4. The LPN/LVN is assisting in the care of a client with a diagnosis of heart failure who is receiving digoxin (Lanoxin). Which laboratory result should the nurse monitor closely?
- A. Serum sodium
- B. Serum potassium
- C. Serum calcium
- D. Serum glucose
Correct answer: B
Rationale: The correct answer is serum potassium. Monitoring serum potassium levels is crucial when a client is receiving digoxin (Lanoxin) because low potassium levels can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac complications, such as arrhythmias. Therefore, close monitoring of serum potassium is essential to prevent adverse effects and ensure the safe administration of digoxin in clients with heart failure. Serum sodium, serum calcium, and serum glucose levels are also important laboratory values to monitor in clients with heart failure, but they are not directly associated with the risk of digoxin toxicity. Monitoring these values helps in assessing overall health status, fluid balance, and metabolic functions in the client.
5. A client is scheduled for a coronary artery bypass graft (CABG) surgery. The nurse should prepare the client by reinforcing information about which post-operative care measure?
- A. You will be on bed rest for the first 48 hours after surgery.
- B. You will be encouraged to cough and deep breathe frequently.
- C. You will be discharged within 24 hours if no complications arise.
- D. You will not be able to eat or drink for 24 hours after surgery.
Correct answer: B
Rationale: Encouraging the client to cough and deep breathe frequently is essential post-operative care to prevent respiratory complications such as atelectasis and pneumonia after CABG surgery. Choices A, C, and D are incorrect because post-CABG surgery, early mobilization is encouraged to prevent complications such as deep vein thrombosis (DVT) and pneumonia. Discharge within 24 hours is unlikely after CABG surgery, and early oral intake is encouraged to promote recovery and prevent complications.
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