LPN LPN
LPN Pharmacology
1. A client with deep vein thrombosis (DVT) is receiving anticoagulant therapy. The nurse should reinforce with the client the importance of reporting which potential side effect?
- A. Nausea
- B. Headache
- C. Gingival bleeding
- D. Dizziness
Correct answer: C
Rationale: The correct answer is C, 'Gingival bleeding.' Gingival bleeding is a common side effect of anticoagulant therapy. Anticoagulants work by prolonging the time it takes for blood to clot, which can lead to bleeding issues, including gingival bleeding. Nausea, headache, and dizziness are not typically associated with anticoagulant therapy. Since bleeding, including gingival bleeding, can be a serious side effect that requires medical attention, the client should be educated on reporting it promptly to their healthcare provider.
2. Which statement indicates that a client with coronary artery disease (CAD) understands disease management?
- A. I will walk for one-half hour daily.
- B. As long as I exercise, I can eat anything I wish.
- C. My weight plays no role in this disease.
- D. My father's high cholesterol is irrelevant.
Correct answer: A
Rationale: Choice A is the correct answer because regular physical activity, such as walking for half an hour daily, is beneficial for managing coronary artery disease (CAD) and promoting heart health. Walking helps improve circulation, reduce cholesterol levels, and maintain a healthy weight, all of which are crucial for managing CAD. Choice B is incorrect because diet also plays a significant role in CAD management, not just exercise. Choice C is incorrect because weight management is essential in controlling CAD risk factors. Choice D is incorrect because family history of high cholesterol can increase the risk of CAD, making it relevant for disease management.
3. A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin 0.4 mg sublingually. Five minutes later, the client is still experiencing chest pain. What is the next appropriate nursing action?
- A. Administer another dose of nitroglycerin.
- B. Notify the healthcare provider immediately.
- C. Have the client lie down and stay calm.
- D. Give the client aspirin 325 mg to chew.
Correct answer: A
Rationale: If chest pain persists after the first dose of nitroglycerin, it is appropriate to administer a second dose while continuing to monitor the client's response. Nitroglycerin is a vasodilator commonly used to relieve angina symptoms by dilating blood vessels and increasing blood flow to the heart. Reassessing the client's response and providing a second dose may be necessary to achieve adequate pain relief and improve blood flow to the heart. Administering another dose of nitroglycerin is the next appropriate step in managing angina symptoms. Notifying the healthcare provider immediately (Choice B) may be necessary if the client's condition worsens or if there are other concerning symptoms. Having the client lie down and stay calm (Choice C) is generally recommended but addressing the ongoing chest pain takes precedence. Giving the client aspirin 325 mg to chew (Choice D) is beneficial for suspected myocardial infarction but is not the immediate action indicated for persistent angina symptoms.
4. 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.
5. The client will wear a Holter monitor for continuous cardiac monitoring over the next 24 hours. What action should the nurse take to assist the client?
- A. Shave the front of the client's chest
- B. Give the client a device holder to wear around the waist
- C. Teach the client to rest as much as possible during the next 24 hours
- D. Tell the client to cover the monitor in plastic wrap before taking a bath
Correct answer: B
Rationale: Providing the client with a device holder to wear around the waist allows them to comfortably carry the Holter monitor while engaging in normal activities throughout the 24-hour monitoring period. This approach supports the client's mobility and ensures the monitor is securely in place for accurate readings. Shaving the front of the client's chest is unnecessary and not a standard practice for Holter monitor placement. Instructing the client to rest as much as possible does not promote normal daily activities which are important for accurate monitoring. Covering the monitor in plastic wrap before bathing is not recommended as it may affect the functionality of the device.
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