LPN LPN
LPN Pharmacology
1. A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which typical characteristic?
- A. Dark pink base
- B. Deep and painful
- C. Accompanied by very slight pain
- D. Brown pigmentation of surrounding skin
Correct answer: B
Rationale: Arterial ischemic ulcers are typically characterized by being deep and painful, often with a pale or necrotic base. The lack of adequate blood flow leads to tissue damage, resulting in these ulcers having a deep appearance and causing significant pain to the individual. The other options are not commonly associated with arterial ischemic ulcers; a dark pink base, very slight pain, or brown pigmentation of surrounding skin are not typical features of this type of ulcer.
2. The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which intervention should the nurse implement when providing care for the client?
- A. Take daily weights and monitor trends.
- B. Encourage fluid intake to improve hydration.
- C. Elevate the legs above the level of the heart.
- D. Position the client supine with the head of the bed at 30 degrees.
Correct answer: A
Rationale: Elevated BNP levels are indicative of heart failure, which often causes fluid retention and weight gain. Taking daily weights and monitoring trends allows the nurse to assess for changes in fluid status. This intervention helps in evaluating the effectiveness of the treatment plan and identifying worsening heart failure symptoms early. Encouraging fluid intake (Choice B) might exacerbate fluid overload in a client with elevated BNP levels. Elevating the legs (Choice C) and positioning the client supine with the head of the bed at 30 degrees (Choice D) are interventions more suitable for clients with hypotension, not specifically indicated for managing elevated BNP levels.
3. A hypertensive client who has been taking metoprolol (Lopressor) has been prescribed to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could affect the client in which way?
- A. Result in hypoglycemia
- B. Give the client insomnia
- C. Precipitate rebound hypertension
- D. Cause enhanced side effects of other prescribed medications
Correct answer: C
Rationale: Abruptly stopping metoprolol can lead to rebound hypertension, causing a sudden increase in blood pressure due to the sudden withdrawal of the medication. Gradually tapering the dose helps the body adjust and reduces the risk of this adverse effect. Choices A, B, and D are incorrect. Stopping metoprolol suddenly is not known to result in hypoglycemia, insomnia, or enhanced side effects of other medications.
4. A client receives discharge teaching for a new prescription of lithium. Which instruction should be included?
- A. Take the medication with food.
- B. Increase your intake of sodium.
- C. Monitor for signs of hypercalcemia.
- D. Avoid consuming dairy products.
Correct answer: B
Rationale: The correct instruction to include when a client receives discharge teaching for a new prescription of lithium is to increase their intake of sodium. Lithium can lead to decreased sodium levels, putting the individual at risk of developing hyponatremia. By increasing sodium intake, the client can counteract this risk, maintain a proper sodium balance, and prevent complications. Choices A, C, and D are incorrect because taking lithium with food, monitoring for signs of hypercalcemia, and avoiding dairy products are not directly related to managing the side effects or risks associated with lithium therapy.
5. 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.
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