ATI LPN
LPN Pharmacology Assessment A
1. 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.
2. A client has a new prescription for metformin. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Monitor for signs of hyperglycemia.
- C. Increase your fluid intake.
- D. Expect a sweet taste in your mouth.
Correct answer: C
Rationale: The correct instruction for a client starting metformin is to increase fluid intake. Metformin commonly causes gastrointestinal discomfort, and increasing fluid intake can help alleviate this side effect. Instructing the client to take the medication with food (Choice A) rather than on an empty stomach is recommended to reduce gastrointestinal side effects. Monitoring for signs of hyperglycemia (Choice B) is not directly related to metformin but rather to low blood sugar. Expecting a sweet taste in the mouth (Choice D) is not a common side effect of metformin.
3. When educating a client with a new prescription for nitroglycerin, which of the following instructions should the nurse include?
- A. Store the medication in a cool, dark place.
- B. Take the medication before bedtime.
- C. Take the medication with food.
- D. Take the medication at the first sign of chest pain.
Correct answer: D
Rationale: The correct instruction for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator used to relieve chest pain associated with angina. Taking it at the onset of chest pain ensures prompt relief by dilating blood vessels and increasing blood flow to the heart muscle. Storing nitroglycerin in a cool, dark place helps maintain its potency, while taking it with food can alter its absorption. Timing the medication with bedtime is not necessary, but prompt administration at the first sign of chest pain is crucial for effective management of angina. Choices A, B, and C are incorrect because storing the medication in a cool, dark place, taking it before bedtime, and taking it with food are not essential instructions for nitroglycerin use. The priority is to administer it promptly when chest pain occurs to achieve optimal therapeutic effects.
4. A client reports chest pain that is unrelieved by three doses of nitroglycerin taken 5 minutes apart. What is the nurse's next best action?
- A. Administer another dose of nitroglycerin.
- B. Call the healthcare provider immediately.
- C. Provide oxygen via nasal cannula.
- D. Place the client in a supine position.
Correct answer: B
Rationale: In the scenario described, the client's chest pain persists despite three doses of nitroglycerin, indicating a potentially severe cardiac issue like a myocardial infarction. The priority for the nurse in this situation is to involve the healthcare provider promptly. Calling the healthcare provider immediately is essential to ensure timely evaluation and appropriate intervention for the client. Administering more nitroglycerin without further assessment or instructions may not be safe and could delay necessary treatments. Providing oxygen or changing the client's position may offer some comfort but does not address the underlying potentially life-threatening condition, making these options less appropriate as the immediate next best action.
5. The client has angina pectoris and is prescribed nitroglycerin patches. What instruction should the nurse provide to the client?
- A. Apply the patch to the chest and leave it in place for 24 hours
- B. Apply the patch to a different site each time to prevent skin irritation
- C. Remove the patch before going to bed to prevent tolerance
- D. Cut the patch in half if experiencing headaches
Correct answer: B
Rationale: The correct instruction for the nurse to provide to the client is to apply the nitroglycerin patch to a different site each time to prevent skin irritation. Rotating the application site is crucial to prevent skin irritation and ensure consistent absorption of the medication. Applying the patch to the same site can lead to skin irritation and decreased effectiveness. Removing the patch before going to bed is not necessary, as the patch can typically be worn for a specific duration. Cutting the patch in half if experiencing headaches is not recommended and can alter the dose of the medication.
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