LPN LPN
LPN Pharmacology Assessment A
1. 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.
2. 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.
3. The nurse is teaching a client with coronary artery disease (CAD) about the risk factors for the disease. Which modifiable risk factor should the nurse emphasize?
- A. Family history
- B. Age
- C. Cigarette smoking
- D. Gender
Correct answer: C
Rationale: Cigarette smoking is a modifiable risk factor for coronary artery disease (CAD) as it can be changed or controlled to reduce the risk of developing CAD. Family history, age, and gender are non-modifiable risk factors that cannot be changed. Emphasizing the importance of quitting smoking can help the client reduce their risk of CAD and improve their overall cardiovascular health. Therefore, the correct answer is C. Choice A (Family history), B (Age), and D (Gender) are non-modifiable risk factors and not the focus of modifiable risk reduction strategies in CAD prevention.
4. The client with a diagnosis of heart failure is receiving furosemide (Lasix). Which laboratory value is most important for the nurse to monitor?
- A. Blood glucose
- B. Serum sodium
- C. Serum potassium
- D. Blood urea nitrogen (BUN)
Correct answer: C
Rationale: The correct answer is C: Serum potassium. When a client is receiving furosemide, a loop diuretic, it can lead to potassium loss. Monitoring the serum potassium levels is crucial to prevent life-threatening complications such as cardiac arrhythmias. Blood glucose (Choice A) is not directly impacted by furosemide. Serum sodium (Choice B) may be affected, but monitoring potassium is more critical due to the risk of arrhythmias. Blood urea nitrogen (BUN) (Choice D) is important for assessing kidney function but is not the most crucial value to monitor in a client taking furosemide.
5. A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the LPN/LVN expect to assist with first?
- A. Administer a diuretic as prescribed.
- B. Place the client in a high Fowler's position.
- C. Prepare the client for intubation.
- D. Insert an indwelling urinary catheter.
Correct answer: B
Rationale: In a client with pulmonary edema, placing them in a high Fowler's position is the priority intervention. This position helps to improve ventilation and oxygenation by decreasing venous return, reducing the workload on the heart, and facilitating fluid redistribution from the lungs. It is crucial to optimize respiratory function and oxygenation before considering other interventions like administering medications, preparing for intubation, or inserting a urinary catheter. Administering a diuretic, preparing for intubation, or inserting a urinary catheter may be necessary but should follow the priority of improving oxygenation through positioning.
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