LPN LPN
LPN Pharmacology
1. The healthcare provider is monitoring a client with left-sided heart failure. Which assessment finding indicates that the client's condition is worsening?
- A. Clear lung sounds
- B. Increased peripheral pulses
- C. Bibasilar crackles
- D. Improved activity tolerance
Correct answer: C
Rationale: Bibasilar crackles are abnormal lung sounds that indicate fluid accumulation in the lungs, a sign that left-sided heart failure is worsening. This finding suggests that the client's condition is deteriorating and requires prompt intervention to prevent further complications. Clear lung sounds (Choice A) are normal and would not indicate worsening heart failure. Increased peripheral pulses (Choice B) may be seen in conditions like anxiety or exercise, but not specifically in worsening left-sided heart failure. Improved activity tolerance (Choice D) would be a positive sign, not an indicator of worsening heart failure.
2. 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.
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 nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. What intervention should the nurse do to effectively accomplish this goal?
- A. Provide a quiet and low-stimulus environment.
- B. Encourage the family to visit very frequently.
- C. Encourage the client to call friends and relatives each day.
- D. Recommend that the client watch TV as a constant diversion.
Correct answer: A
Rationale: The correct answer is A: Provide a quiet and low-stimulus environment. A calm and quiet environment can help reduce stress, which is beneficial in preventing the occurrence of chest pain in clients with angina. Choice B is incorrect because excessive or frequent visitations may lead to increased stress and agitation for the client. Choice C is incorrect as it may not always contribute to a calm environment and could potentially increase the client's stress levels. Choice D is inappropriate as watching TV constantly may not promote a quiet and low-stimulus environment, which is essential in managing angina pectoris.
5. 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.
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