LPN LPN
LPN Pharmacology Assessment A
1. A client with hypertension is prescribed enalapril (Vasotec). The nurse should monitor the client for which adverse effect?
- A. Hypotension
- B. Hypertension
- C. Tachycardia
- D. Hyperglycemia
Correct answer: A
Rationale: Enalapril, an ACE inhibitor, can lead to hypotension, particularly following the initial dose or dosage escalation. This effect is due to the medication's mechanism of action in dilating blood vessels, which can result in lowered blood pressure. Monitoring for hypotension is crucial to prevent complications such as dizziness, lightheadedness, or fainting in clients taking enalapril. Choices B, C, and D are incorrect because enalapril does not typically cause hypertension, tachycardia, or hyperglycemia as adverse effects.
2. 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.
3. A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor the client for which potential electrolyte imbalance?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hypocalcemia
Correct answer: C
Rationale: When a client with heart failure is prescribed furosemide, the nurse should monitor for hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, which increases the risk of hypokalemia. Hypokalemia can have serious implications such as cardiac dysrhythmias. Therefore, it is essential to closely monitor the client's serum potassium levels while on furosemide to prevent complications. Hyperkalemia (Choice A) is incorrect because furosemide leads to potassium loss, not retention. Hypernatremia (Choice B) is not typically associated with furosemide use. Hypocalcemia (Choice D) is not a common electrolyte imbalance caused by furosemide.
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. 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.
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