LPN LPN
LPN Pharmacology
1. The client is being ambulated due to activity intolerance caused by bacterial endocarditis. How can the nurse determine that the client is best tolerating ambulation?
- A. Mild dyspnea after walking 10 feet
- B. Minimal chest pain rated 1 on a 1-to-10 pain scale
- C. Pulse rate that increases from 68 to 94 beats per minute
- D. Blood pressure that increases from 114/82 to 118/86 mm Hg
Correct answer: D
Rationale: A slight increase in blood pressure without significant symptoms indicates that the client is tolerating the activity. In this scenario, a mild increase in blood pressure without other symptoms is a positive sign of tolerance to ambulation despite the underlying condition of bacterial endocarditis. Choices A, B, and C are not the best indicators of tolerance to ambulation in this case. Mild dyspnea after walking a short distance, minimal chest pain, and an increase in pulse rate are common signs that the activity might not be well-tolerated by the client with a history of bacterial endocarditis.
2. A healthcare provider is assisting in the care of a client who is having central venous pressure (CVP) measurements taken. The healthcare provider should assist by placing the bed in which position for the reading?
- A. Flat
- B. Semi-Fowler's
- C. Trendelenburg
- D. Reverse Trendelenburg
Correct answer: A
Rationale: Central venous pressure (CVP) measurements are most accurate when the client is lying flat, as this allows for a consistent baseline. Placing the bed flat ensures that the hydrostatic pressure within the vena cava is not affected by the client's position, providing a more precise reading. Choice B (Semi-Fowler's) elevates the head of the bed at a 30-45 degree angle, which could affect the accuracy of CVP readings. Choices C (Trendelenburg) and D (Reverse Trendelenburg) involve extreme positions that would not be suitable for obtaining accurate CVP measurements.
3. A client's serum calcium level is 7.9 mg/dL. The nurse is immediately concerned, knowing that this level could lead to which complication?
- A. Stroke
- B. Cardiac arrest
- C. High blood pressure
- D. Urinary stone formation
Correct answer: B
Rationale: A serum calcium level below normal (hypocalcemia) can lead to cardiac arrhythmias and potentially cardiac arrest. Calcium plays a crucial role in cardiac muscle contractility, and low levels can disrupt normal heart function, potentially leading to fatal arrhythmias and cardiac arrest. Choices A, C, and D are incorrect as hypocalcemia is not directly associated with stroke, high blood pressure, or urinary stone formation. The immediate concern with low serum calcium levels is the risk of cardiac complications.
4. Before administering digoxin (Lanoxin) to a client diagnosed with heart failure, the nurse should perform which assessment?
- A. Check the blood pressure.
- B. Obtain an electrocardiogram (ECG).
- C. Assess the apical pulse.
- D. Review the latest electrolyte levels.
Correct answer: C
Rationale: Assessing the apical pulse is crucial before administering digoxin because the medication can lead to bradycardia. Monitoring the apical pulse helps determine the heart rate, and digoxin is typically withheld if the pulse is below 60 beats per minute. This assessment is essential to prevent potential adverse effects associated with digoxin administration. Checking the blood pressure (Choice A) is important but not specific to digoxin administration. Obtaining an electrocardiogram (ECG) (Choice B) may provide valuable information but is not the primary assessment needed before administering digoxin. Reviewing the latest electrolyte levels (Choice D) is important for assessing the overall condition but is not the immediate assessment required before administering digoxin.
5. When assisting a hospitalized client newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu, which meal should the nurse encourage the client to select?
- A. Sausage, pancakes, and toast
- B. Broccoli, buttered rice, and grilled chicken
- C. Hamburger, baked apples, and avocado salad
- D. Fresh strawberries, steamed vegetables, and baked fish
Correct answer: D
Rationale: The correct choice is D: Fresh strawberries, steamed vegetables, and baked fish. This meal is low in saturated fats and cholesterol, which is suitable for a client with CAD. It aligns with dietary recommendations to support heart health and manage CAD. Choices A, B, and C are less appropriate as they contain higher levels of saturated fats and cholesterol, which are not ideal for individuals with CAD.
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