LPN LPN
LPN Pharmacology
1. A client diagnosed with angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?
- A. I am considering cutting my workload.
- B. I need to cut down on cigarette smoking.
- C. I am so relieved that my heart is repaired.
- D. I need to adhere to my dietary restrictions.
Correct answer: B
Rationale: The correct answer is B because cutting down on cigarette smoking is crucial for improving heart health after angioplasty. Smoking cessation helps in reducing the risk of complications and promotes better outcomes. Choices A and C are not directly related to post-angioplasty care. While reducing workload may be beneficial, it is not specifically related to the client's cardiac health. Feeling relieved that the heart is repaired is a positive emotional response but does not reflect understanding of the necessary measures. Adhering to dietary restrictions is important, but in this scenario, smoking cessation takes higher priority due to its immediate impact on heart health.
2. The nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is available for emergency use?
- A. Surgical tourniquet
- B. Dry sterile dressings
- C. Incentive spirometer
- D. Over-the-bed trapeze
Correct answer: A
Rationale: In the case of an above-the-knee amputation, the priority item that should be available for emergency use is a surgical tourniquet. This is crucial to control severe bleeding that may occur post-operatively. Dry sterile dressings (choice B) are important for wound care but not for immediate post-operative emergencies like bleeding. An incentive spirometer (choice C) is used for respiratory exercises and not directly related to emergency management post-amputation. An over-the-bed trapeze (choice D) is used for assisting clients with mobility and positioning, not for emergency situations involving bleeding.
3. The LPN/LVN is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia?
- A. Tall, peaked T waves
- B. ST-segment depression
- C. Prolonged P-R interval
- D. Widening of the QRS complex
Correct answer: B
Rationale: ST-segment depression can indicate hypokalemia, affecting the heart's electrical conduction. Hypokalemia leads to alterations in the repolarization phase of the cardiac action potential, resulting in ST-segment depression on the ECG. Tall, peaked T waves are indicative of hyperkalemia, not hypokalemia. A prolonged P-R interval is more commonly associated with first-degree heart block. Widening of the QRS complex is typically seen in conditions like bundle branch blocks or ventricular tachycardia, not specifically in hypokalemia.
4. The client admitted to the hospital with pulmonary edema is preparing for discharge. The client should be reminded of the importance of complying with which measure to prevent a recurrence?
- A. Weigh oneself every morning before breakfast.
- B. Sleep with the head elevated on multiple pillows.
- C. Adjust diuretic dose without healthcare provider guidance.
- D. Take additional digoxin (Lanoxin) as a preventive measure.
Correct answer: A
Rationale: Monitoring weight daily, especially in the morning before breakfast, is crucial in detecting fluid retention early and preventing pulmonary edema. Sudden weight gain can indicate fluid accumulation, prompting timely intervention to prevent complications. Choice A is the correct answer because daily weight monitoring is a key component in managing heart failure and preventing pulmonary edema recurrence. Choices B and D are not directly related to preventing fluid retention or pulmonary edema recurrence. Choice C is unsafe as adjusting diuretic doses without healthcare provider guidance can lead to electrolyte imbalances and worsening of the condition.
5. 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.
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