ATI LPN
Pharmacology for LPN
1. The nurse is assisting in the care of a client with a history of chronic obstructive pulmonary disease (COPD) who is on oxygen therapy. Which action should the nurse take to ensure the client's safety?
- A. Set the oxygen flow rate to 4 liters per minute.
- B. Remove oxygen while the client is eating.
- C. Ensure the client wears a nasal cannula instead of a face mask.
- D. Maintain the oxygen flow rate at the lowest level that relieves hypoxia.
Correct answer: D
Rationale: For clients with COPD, too much oxygen can suppress their drive to breathe, leading to hypoventilation. Therefore, the nurse should maintain the oxygen flow rate at the lowest level that relieves hypoxia to prevent complications while ensuring adequate oxygenation. Setting the oxygen flow rate too high (Choice A) can be detrimental for the client with COPD. Removing oxygen while the client is eating (Choice B) can compromise oxygenation, which is essential even during meals. While nasal cannulas are commonly used, the choice of oxygen delivery device depends on the client's needs; there may be situations where a face mask (Choice C) is more appropriate.
2. The client is taking interferon alfa-2a (Roferon-A) and ribavirin (Virazole) combination therapy for hepatitis C and reports overwhelming feelings of depression. Which action should the nurse implement first?
- A. Recommend mental health counseling.
- B. Review the medication actions and interactions.
- C. Assess the client's daily activity level.
- D. Provide information about a support group.
Correct answer: B
Rationale: The priority action for the nurse is to review the medication actions and interactions. Interferon alfa-2a and ribavirin combination therapy for hepatitis C can lead to neuropsychiatric side effects, including depression. By assessing the medication actions and interactions, the nurse can identify if the depression is a known side effect of the medications, and further intervention or adjustment of the treatment plan may be required to address the client's emotional well-being. Recommending mental health counseling (choice A) may be necessary but should come after ensuring that the depression is not solely caused by medication side effects. Assessing the client's daily activity level (choice C) and providing information about a support group (choice D) are important interventions but addressing the medication's potential contribution to the depression takes precedence.
3. A client has a new prescription for metoprolol. Which of the following instructions should the nurse include?
- A. Monitor your blood pressure daily.
- B. Take the medication with food.
- C. Increase your intake of potassium-rich foods.
- D. Avoid consuming grapefruit juice.
Correct answer: A
Rationale: The correct answer is A, 'Monitor your blood pressure daily.' When a client is prescribed metoprolol, it is important to monitor blood pressure daily because the medication can cause hypotension, leading to low blood pressure. Regular monitoring allows for the early detection of any potential issues and adjustment of treatment if necessary. Choices B, C, and D are incorrect. Taking metoprolol with food is not necessary, increasing potassium-rich foods is not directly related to metoprolol therapy, and avoiding grapefruit juice is more relevant for certain other medications that interact with grapefruit.
4. The nurse is assisting in the care of a client with a history of angina pectoris who is receiving nitroglycerin patches. Which instruction should the nurse reinforce with the client?
- A. Apply the patch to a different site each time.
- B. Remove the patch at night to prevent tolerance.
- C. Use more than one patch if chest pain occurs.
- D. Shower with caution while wearing the patch.
Correct answer: B
Rationale: Removing the nitroglycerin patch at night is crucial to prevent the development of tolerance. Tolerance can occur when the body becomes accustomed to a constant level of the medication, reducing its effectiveness. By removing the patch at night, the client experiences a drug-free period, which helps prevent tolerance and maintains the effectiveness of the nitroglycerin for angina relief. Choices A, C, and D are incorrect because applying the patch to a different site each time helps prevent skin irritation, using more than one patch is not recommended unless instructed by the healthcare provider, and showering with caution is important to prevent dislodging the patch, but it is not the most critical instruction to prevent tolerance development.
5. 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 hypoglycemia.
- C. Increase fluid intake.
- D. Expect a metallic taste in the mouth.
Correct answer: C
Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.
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