LPN LPN
LPN Pharmacology Assessment A
1. A client with a history of deep vein thrombosis (DVT) is prescribed warfarin (Coumadin). The nurse should include which instruction in the discharge teaching?
- A. Take the medication at the same time each day
- B. Avoid green leafy vegetables in your diet
- C. Increase your intake of vitamin K-rich foods
- D. Stop the medication if you notice any bruising
Correct answer: A
Rationale: Taking warfarin at the same time each day is crucial to maintain consistent blood levels and ensure the effectiveness of the medication in preventing clot formation. Consistent timing helps in monitoring and adjusting the dosage as needed to keep the international normalized ratio (INR) within the therapeutic range to prevent clotting events or excessive bleeding. Choices B, C, and D are incorrect. Avoiding green leafy vegetables is a misconception; while they are high in vitamin K which antagonizes warfarin, they should not be avoided but consumed in moderation. Increasing vitamin K-rich foods can interfere with warfarin's effectiveness. Stopping the medication due to bruising can be dangerous as it may indicate a clotting problem that the medication is intended to prevent.
2. The nurse is preparing to administer a scheduled dose of enalapril (Vasotec) to a client with hypertension. Before administering the medication, the nurse should check which priority assessment?
- A. Heart rate
- B. Blood pressure
- C. Respiratory rate
- D. Temperature
Correct answer: B
Rationale: Before administering enalapril, an antihypertensive medication, the nurse should prioritize checking the client's blood pressure. Monitoring blood pressure helps ensure it is at an acceptable level before giving the medication, as enalapril can further lower blood pressure. This assessment is crucial in preventing potential hypotensive episodes and adverse effects associated with excessive blood pressure reduction. Heart rate, respiratory rate, and temperature are important assessments but are not the priority before administering enalapril, which primarily affects blood pressure levels.
3. A client is admitted to the emergency department with a suspected myocardial infarction (MI). The nurse should prepare the client for which immediate diagnostic test?
- A. Chest x-ray
- B. Electrocardiogram (ECG)
- C. Echocardiogram
- D. Coronary angiography
Correct answer: B
Rationale: An Electrocardiogram (ECG) is the most immediate and essential test to diagnose a myocardial infarction (MI) and assess the extent of heart damage. An ECG can quickly identify changes in the heart's electrical activity, allowing prompt initiation of appropriate interventions. A chest x-ray (Choice A) may show other conditions affecting the heart, but it is not the immediate test of choice for diagnosing an MI. An echocardiogram (Choice C) and coronary angiography (Choice D) are valuable in further assessing cardiac function and anatomy post-MI but are not the first-line diagnostic tests due to their time-consuming nature compared to an ECG.
4. A client with a diagnosis of hypertension is prescribed atenolol (Tenormin). The nurse should monitor the client for which common side effect of this medication?
- A. Tachycardia
- B. Dry mouth
- C. Hypotension
- D. Increased appetite
Correct answer: C
Rationale: Corrected Rationale: Atenolol is a beta-blocker that commonly causes hypotension by lowering blood pressure. Therefore, monitoring for hypotension is crucial to prevent potential complications in the client receiving this medication. The other options are incorrect: A) Tachycardia is not a common side effect of atenolol as it typically reduces heart rate, B) Dry mouth is not a typical side effect of atenolol, and D) Increased appetite is not commonly associated with atenolol use.
5. The client with a history of left-sided heart failure is exhibiting increasing shortness of breath and frothy sputum. What is the priority nursing action?
- A. Administer oxygen
- B. Encourage coughing and deep breathing
- C. Place the client in a supine position
- D. Notify the healthcare provider immediately
Correct answer: A
Rationale: Shortness of breath and frothy sputum are indicative of pulmonary edema, a serious condition that requires immediate intervention to improve oxygenation. Administering oxygen is the priority action to support the client's respiratory function and prevent further deterioration. Oxygen therapy helps increase the oxygen levels in the blood, alleviate respiratory distress, and support vital organ function. Prompt intervention with oxygen can help stabilize the client while further assessments and treatments are initiated. Encouraging coughing and deep breathing may worsen the client's condition by increasing respiratory effort. Placing the client in a supine position can further compromise breathing in a client with pulmonary edema. Notifying the healthcare provider is important but not the priority when the client's respiratory status is deteriorating.
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