LPN LPN
LPN Pharmacology
1. A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action?
- A. Assist the client to get back into bed.
- B. Report the chest pain episode to the healthcare provider.
- C. Tell the client to stand still and take the client's blood pressure.
- D. Give a nitroglycerin (Nitrostat) tablet and assist the client to the bathroom.
Correct answer: A
Rationale: In a client with myocardial infarction experiencing chest pain during activity, the priority action is to stop the activity immediately to reduce the heart's workload and oxygen demand. Assisting the client back to bed helps in reducing stress on the heart and can prevent worsening of the condition. Reporting the chest pain episode to the healthcare provider is important but should not delay taking immediate action to alleviate symptoms. Taking the client's blood pressure and administering nitroglycerin are secondary actions after ensuring the client's safety and comfort. Therefore, the correct action is to assist the client back into bed.
2. The client is receiving intravenous heparin for the treatment of a pulmonary embolism. Which medication should the nurse ensure is readily available?
- A. Protamine sulfate
- B. Vitamin K
- C. Calcium gluconate
- D. Magnesium sulfate
Correct answer: A
Rationale: Protamine sulfate is the antidote for heparin, used to reverse its anticoagulant effects. It should be readily available in case of bleeding complications, as it can rapidly neutralize the effects of heparin and prevent excessive bleeding. Vitamin K is used to reverse the effects of warfarin, not heparin (Choice B). Calcium gluconate is used to treat calcium deficiencies, not indicated for heparin therapy (Choice C). Magnesium sulfate is used for conditions like preeclampsia and eclampsia, not for reversing heparin effects (Choice D).
3. 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.
4. The healthcare provider is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The provider should place the highest priority on making sure that which is available at the bedside?
- A. Bedside commode
- B. Rolling shower chair
- C. Oxygen tubing and flowmeter
- D. Twelve-lead electrocardiogram (ECG) machine
Correct answer: C
Rationale: In a client with coronary artery disease (CAD), ensuring the availability of oxygen and a flowmeter at the bedside is crucial. Oxygen is essential for adequate oxygenation, which helps prevent myocardial ischemia, a common complication in CAD. The other options, such as a bedside commode and rolling shower chair, are important for patient comfort and mobility but are not as critical as ensuring proper oxygen supply in a client with CAD. While having an ECG machine available is important for ongoing monitoring, ensuring oxygen availability takes precedence in this scenario.
5. The client with Raynaud's phenomenon is being taught by the nurse about preventing episodes. Which instruction should the nurse reinforce?
- A. Wear gloves in cold weather.
- B. Avoid caffeine and chocolate.
- C. Increase intake of vitamin C.
- D. Use a heating pad for warmth.
Correct answer: A
Rationale: The correct answer is A: 'Wear gloves in cold weather.' Wearing gloves in cold weather is essential for preventing vasoconstriction and subsequent episodes of Raynaud's phenomenon. Cold temperatures can trigger vasospasms in individuals with Raynaud's, and wearing gloves helps maintain warmth and prevent the constriction of blood vessels in the extremities, reducing the likelihood of an episode. Choices B, C, and D are incorrect because while avoiding caffeine and chocolate, increasing vitamin C intake, and using a heating pad for warmth can be beneficial for overall health, they are not specifically targeted at preventing Raynaud's phenomenon episodes triggered by cold weather.
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