LPN LPN
LPN Pharmacology Assessment A
1. In monitoring the effectiveness of warfarin therapy for a client with a history of atrial fibrillation, which laboratory value should the nurse monitor?
- A. Activated partial thromboplastin time (aPTT)
- B. Prothrombin time (PT) and international normalized ratio (INR)
- C. Platelet count
- D. Erythrocyte sedimentation rate (ESR)
Correct answer: B
Rationale: Prothrombin time (PT) and international normalized ratio (INR) are crucial laboratory values to monitor the effectiveness of warfarin therapy in clients with atrial fibrillation. These values help ensure that the client is within the therapeutic range and that the anticoagulant effect of warfarin is appropriate. Monitoring aPTT, platelet count, or ESR is not directly related to assessing the effectiveness of warfarin therapy in these cases.
2. The client with a history of coronary artery disease (CAD) is scheduled for a stress test. What instruction should the nurse provide to the client before the test?
- A. Continue taking your usual dose of beta-blockers
- B. Refrain from eating or drinking anything for 4 hours before the test
- C. Wear loose, comfortable clothing and walking shoes
- D. Avoid any physical activity for 24 hours before the test
Correct answer: C
Rationale: Before a stress test, the nurse should instruct the client to wear loose, comfortable clothing and walking shoes. This is essential as the stress test involves physical exercise, and the client should be ready for the activity involved. Continuing beta-blockers should be based on healthcare provider's instructions; adjustments may be needed. Fasting before the test is usually not necessary. Avoiding physical activity for 24 hours before the test is not recommended as it may affect the accuracy of the test results by not providing a true reflection of the client's exercise capacity.
3. A client with a diagnosis of angina pectoris is prescribed nitroglycerin tablets. How should the nurse instruct the client to take the medication?
- A. Swallow the tablet whole with water
- B. Place the tablet under the tongue and let it dissolve
- C. Chew the tablet and then swallow
- D. Place the tablet between the cheek and gum
Correct answer: B
Rationale: Nitroglycerin is most effective when administered sublingually (under the tongue) as it is rapidly absorbed into the bloodstream. Placing the tablet under the tongue allows for quick absorption and faster relief of angina symptoms. Chewing the tablet, swallowing it, or placing it between the cheek and gum would not provide the same rapid onset of action needed during an angina episode. Therefore, the correct instruction for the client is to place the nitroglycerin tablet under the tongue and let it dissolve for optimal effectiveness.
4. A client with a diagnosis of acute myocardial infarction (MI) is receiving thrombolytic therapy. The nurse monitors the client for which potential complication associated with this therapy?
- A. Hypertension
- B. Bleeding
- C. Hyperkalemia
- D. Hypoglycemia
Correct answer: B
Rationale: Thrombolytic therapy is associated with an increased risk of bleeding due to its mechanism of action in dissolving blood clots. Therefore, the nurse should closely monitor the client for any signs of hemorrhage, such as unexplained bruising, bleeding gums, or blood in the urine or stools. Hypertension is not a common complication of thrombolytic therapy. Hyperkalemia and hypoglycemia are also not typically associated with this therapy.
5. 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.
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