LPN LPN
LPN Pharmacology Assessment A
1. A client with heart failure is being discharged with a prescription for digoxin (Lanoxin). The nurse should include which instruction in the discharge teaching?
- A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute
- B. Increase your fluid intake to at least 3 liters per day
- C. Report any weight loss of more than 2 pounds in a week
- D. Take the medication with meals to avoid gastrointestinal upset
Correct answer: A
Rationale: The correct instruction for a client taking digoxin is to monitor the pulse before each dose and hold the medication if the pulse is below 60 beats per minute. Digoxin can cause bradycardia, so it is crucial to assess the pulse rate before administration to prevent potential complications. Choices B, C, and D are incorrect because increasing fluid intake, reporting weight loss, or taking the medication with meals are not specific instructions related to the safe use of digoxin.
2. A client with chronic heart failure is being discharged with a prescription for digoxin (Lanoxin). Which instruction should the nurse reinforce?
- A. Take the medication at the same time each day.
- B. Avoid foods high in potassium.
- C. Skip a dose if you feel well.
- D. Take the medication on an empty stomach.
Correct answer: A
Rationale: Taking digoxin at the same time each day is essential to maintain a consistent blood level of the medication. This consistency helps optimize the therapeutic effects of digoxin in managing chronic heart failure. Deviating from the scheduled time could lead to fluctuations in drug levels, affecting its effectiveness and potentially causing harm. Choices B, C, and D are incorrect because avoiding potassium-rich foods, skipping doses when feeling well, and taking the medication on an empty stomach are not relevant or appropriate instructions for a client prescribed digoxin.
3. 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.
4. 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.
5. A client with a history of coronary artery disease (CAD) is prescribed simvastatin (Zocor). The nurse should teach the client about which potential side effect?
- A. Muscle pain
- B. Dry mouth
- C. Drowsiness
- D. Diarrhea
Correct answer: A
Rationale: Muscle pain is a common side effect of statins like simvastatin and can indicate a serious condition called rhabdomyolysis. Rhabdomyolysis is a severe condition where muscle fibers break down rapidly, releasing myoglobin into the bloodstream, which can lead to kidney damage. Therefore, it's important for the nurse to educate the client about this potential side effect and to promptly report any muscle pain to the healthcare provider. Dry mouth, drowsiness, and diarrhea are not commonly associated with simvastatin use and are less concerning compared to the risk of rhabdomyolysis.
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