LPN LPN
LPN Pharmacology
1. 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.
2. The LPN/LVN is assisting in caring for a client in the telemetry unit who is receiving an intravenous infusion of 1000 mL of 5% dextrose with 40 mEq of potassium chloride. Which occurrence observed on the cardiac monitor indicates the presence of hyperkalemia?
- A. Tall, peaked T waves
- B. ST segment depressions
- C. Shortened P-R intervals
- D. Shortening of the QRS complex
Correct answer: A
Rationale: In hyperkalemia, tall, peaked T waves are a distinct ECG finding. These T waves can be seen as a result of increased serum potassium levels, affecting the repolarization phase of the cardiac action potential. It is crucial for healthcare providers to recognize this ECG change promptly as hyperkalemia can lead to serious cardiac arrhythmias and complications. ST segment depressions, shortened P-R intervals, and shortening of the QRS complex are not typically associated with hyperkalemia. ST segment depressions are more indicative of myocardial ischemia or infarction. Shortened P-R intervals may be seen in conditions like Wolff-Parkinson-White syndrome. Shortening of the QRS complex is associated with conditions affecting the conduction system of the heart, such as bundle branch blocks.
3. The client is scheduled to undergo a treadmill stress test. Which instruction should the client be reinforced with?
- A. Eat a light meal before the test.
- B. Wear comfortable shoes and clothing.
- C. Avoid all physical activity the morning of the test.
- D. Take prescribed medications right before the test.
Correct answer: B
Rationale: The correct answer is B: 'Wear comfortable shoes and clothing.' Wearing comfortable shoes and clothing is crucial for the client undergoing a treadmill stress test to ensure they can complete the test without discomfort. The right attire will help the client move freely and reduce the risk of any hindrance during the test, which requires physical activity. Choices A, C, and D are incorrect. A light meal before the test may be recommended, but it's not as crucial as wearing suitable attire. Avoiding physical activity the morning of the test is not necessary as the test requires physical activity. Taking prescribed medications right before the test instructions should be followed as per the healthcare provider's advice and not as a general rule for all clients undergoing the test.
4. A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). Which statement indicates an initial understanding of lifestyle alterations?
- A. I should take daily medication for life.
- B. I should eat a diet that is low in fat and cholesterol.
- C. I should continue to smoke to keep the metabolic rate high.
- D. I should begin to exercise if the diet is not sufficient to achieve weight loss.
Correct answer: B
Rationale: Choosing a diet that is low in fat and cholesterol is crucial for managing and preventing the progression of coronary artery disease (CAD). This dietary change can help reduce the risk of further complications associated with CAD, such as plaque buildup in the arteries. It is a fundamental lifestyle alteration that can positively impact the client's heart health. Option A is incorrect as relying solely on medication without lifestyle changes may not address the root cause of CAD. Option C is incorrect as smoking is harmful and worsens CAD. Option D is incorrect because exercise is a crucial part of a healthy lifestyle, but dietary changes should come first in managing CAD.
5. A client being seen in the emergency department for complaints of chest pain confides in the nurse about regular use of cocaine as a recreational drug. The nurse takes which important action in delivering holistic nursing care to this client?
- A. Reports the client to the police for illegal drug use
- B. Explains to the client the damage that cocaine does to the heart
- C. Tells the client it is imperative to stop before myocardial infarction occurs
- D. Teaches about the effects of cocaine on the heart and offers a referral for further help
Correct answer: D
Rationale: In this scenario, the nurse should prioritize educating the client about the effects of cocaine on the heart and provide a referral for further help. This approach is crucial in addressing the root cause of the client's health issues and supporting them in making informed decisions about their health. Reporting the client to the police is not appropriate in this situation as the focus should be on the client's health and well-being. Simply explaining the damage without offering solutions may not effectively address the client's needs or promote holistic care. Telling the client to stop without providing support or education may not be as effective as teaching about the effects of cocaine and offering help for cessation. Therefore, educating about the effects and providing a referral for further assistance is the best course of action for holistic nursing care.
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