LPN LPN
Pharmacology for LPN
1. The LPN/LVN is assisting with the care of a client who has been diagnosed with a myocardial infarction (MI). Which laboratory test result would the nurse expect to see elevated within the first 24 hours of the client's admission?
- A. Serum troponin
- B. Serum creatinine
- C. Serum sodium
- D. Serum albumin
Correct answer: A
Rationale: Elevated serum troponin levels are indicative of myocardial damage and are commonly used as a diagnostic marker for myocardial infarction. Troponin levels typically rise within a few hours of an MI and remain elevated for several days, making it a crucial test for early detection and monitoring of cardiac injury. Serum creatinine is not typically elevated in the acute phase of a myocardial infarction. Serum sodium and serum albumin levels are not directly associated with myocardial infarction and are unlikely to be elevated in the first 24 hours following an MI.
2. A client with hypertension is prescribed a thiazide diuretic. What instruction should the nurse reinforce to the client?
- A. Take the medication in the morning.
- B. Increase potassium intake in the diet.
- C. Weigh yourself daily.
- D. Limit fluid intake to 2 liters per day.
Correct answer: C
Rationale: The correct answer is to weigh oneself daily. This instruction is important as daily weights help monitor fluid loss and are crucial for detecting early signs of fluid imbalance when taking a diuretic. Weighing daily allows for timely adjustments in treatment and helps prevent complications associated with fluid imbalance. Choice A is not directly related to the client's need for monitoring fluid balance. Choice B, although important for some diuretics, is not specific to thiazide diuretics. Choice D is not appropriate as limiting fluid intake without proper monitoring can lead to dehydration, especially when taking diuretics.
3. The nurse is assisting with the care of a client who is on a continuous heparin infusion for deep vein thrombosis (DVT). Which laboratory test should the nurse monitor to evaluate the effectiveness of the therapy?
- A. Prothrombin time (PT)
- B. Activated partial thromboplastin time (aPTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct answer: B
Rationale: To evaluate the effectiveness of heparin therapy in a client with DVT, the nurse should monitor the activated partial thromboplastin time (aPTT). The aPTT test helps ensure that the dose of heparin is within the therapeutic range, which is essential for preventing clot formation or excessive bleeding. Monitoring aPTT is crucial in managing patients on heparin therapy to maintain the delicate balance between preventing thrombosis and avoiding hemorrhage. Prothrombin time (PT) and International normalized ratio (INR) are more indicative of warfarin therapy effectiveness, not heparin. Platelet count assesses platelet levels and function, not the effectiveness of heparin therapy for DVT.
4. The client is receiving digoxin (Lanoxin) for heart failure. Which symptom would indicate digoxin toxicity?
- A. Increased appetite
- B. Yellow or blurred vision
- C. Increased urination
- D. Diarrhea
Correct answer: B
Rationale: Yellow or blurred vision can be a sign of digoxin toxicity. These visual disturbances are concerning as they indicate a potential adverse reaction to the medication. Recognizing this symptom promptly is crucial to prevent serious complications. Increased appetite, increased urination, and diarrhea are not typically associated with digoxin toxicity. Therefore, option B is the correct choice in this scenario.
5. The client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin. Which action should the nurse take next?
- A. Administer another dose of nitroglycerin.
- B. Notify the healthcare provider immediately.
- C. Have the client lie down and rest.
- D. Encourage the client to take deep breaths.
Correct answer: B
Rationale: When a client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin, it may indicate a myocardial infarction, also known as a heart attack. In this situation, the nurse should immediately notify the healthcare provider to ensure prompt evaluation and appropriate intervention. Delay in seeking medical attention for chest pain unrelieved by nitroglycerin can be life-threatening, as it might be a sign of a more serious cardiac event. Administering another dose of nitroglycerin (Choice A) without further evaluation can be risky, as the client's condition may require a different intervention. Having the client lie down and rest (Choice C) or encouraging deep breaths (Choice D) are not appropriate actions in this scenario where a more serious cardiac event needs to be ruled out.
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