LPN LPN
LPN Pharmacology
1. The client is being ambulated due to activity intolerance caused by bacterial endocarditis. How can the nurse determine that the client is best tolerating ambulation?
- A. Mild dyspnea after walking 10 feet
- B. Minimal chest pain rated 1 on a 1-to-10 pain scale
- C. Pulse rate that increases from 68 to 94 beats per minute
- D. Blood pressure that increases from 114/82 to 118/86 mm Hg
Correct answer: D
Rationale: A slight increase in blood pressure without significant symptoms indicates that the client is tolerating the activity. In this scenario, a mild increase in blood pressure without other symptoms is a positive sign of tolerance to ambulation despite the underlying condition of bacterial endocarditis. Choices A, B, and C are not the best indicators of tolerance to ambulation in this case. Mild dyspnea after walking a short distance, minimal chest pain, and an increase in pulse rate are common signs that the activity might not be well-tolerated by the client with a history of bacterial endocarditis.
2. A client is admitted to the hospital with a venous stasis leg ulcer. The nurse inspects the ulcer expecting to note which observation?
- A. The ulcer has a pale-colored base.
- B. The ulcer is deep, with even edges.
- C. The ulcer has little granulation tissue.
- D. The ulcer has a brownish or 'brawny' appearance.
Correct answer: D
Rationale: When assessing a venous stasis leg ulcer, the nurse should expect to note a brownish or 'brawny' appearance. This discoloration is often due to hemosiderin deposits. The correct answer is not A because venous stasis ulcers typically do not have a pale-colored base. Choice B is incorrect as venous stasis ulcers usually have irregular, shallow edges, not deep and even edges. Choice C is incorrect as venous stasis ulcers often have excess granulation tissue, not little granulation tissue. Recognizing the brownish or 'brawny' appearance is crucial for accurate diagnosis and appropriate treatment of venous stasis leg ulcers.
3. The nurse is informed during shift report that a client is experiencing occasional ventricular dysrhythmias. The nurse reviews the client's laboratory results, recalling that which electrolyte imbalance could be responsible for this development?
- A. Hypokalemia
- B. Hypernatremia
- C. Hypochloremia
- D. Hypercalcemia
Correct answer: A
Rationale: Hypokalemia, which is low potassium levels, can disrupt the normal electrical activity of the heart and lead to ventricular dysrhythmias. Potassium plays a crucial role in maintaining the heart's rhythm, and a deficiency can result in dangerous heart rhythm abnormalities. Hypernatremia (Choice B), which is high sodium levels, does not directly impact heart rhythm. Hypochloremia (Choice C), which is low chloride levels, is not typically associated with ventricular dysrhythmias. Hypercalcemia (Choice D), which is high calcium levels, is not a common cause of ventricular dysrhythmias.
4. The healthcare provider notes this rhythm on the client's cardiac monitor. The healthcare provider next reports that the client is experiencing which heart rhythm?
- A. Normal sinus
- B. Atrial fibrillation
- C. Sinus bradycardia
- D. Ventricular fibrillation
Correct answer: B
Rationale: The correct answer is B, Atrial fibrillation. Atrial fibrillation is characterized by an irregular and often rapid heart rate, which can lead to poor blood flow due to ineffective contractions of the atria. Sinus bradycardia (Choice C) is a regular but slow heart rhythm originating from the sinus node. Normal sinus rhythm (Choice A) refers to a regular heartbeat originating from the sinus node. Ventricular fibrillation (Choice D) is a life-threatening arrhythmia characterized by rapid, uncoordinated contractions of the ventricles.
5. 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.
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