LPN LPN
LPN Pharmacology Assessment A
1. The nurse is caring for a client receiving anticoagulant therapy. Which instruction should the nurse reinforce with the client to prevent bleeding complications?
- A. Use a soft-bristle toothbrush and electric razor.
- B. Increase your intake of vitamin K-rich foods.
- C. Take aspirin if you have a headache.
- D. Avoid using ice packs for injuries.
Correct answer: A
Rationale: The correct instruction to prevent bleeding complications in a client on anticoagulant therapy is to use a soft-bristle toothbrush and an electric razor. These implements help reduce the risk of bleeding by being gentle on the skin and reducing the chances of cuts or abrasions that could lead to bleeding in individuals on anticoagulants. Choice B is incorrect because increasing intake of vitamin K-rich foods can interfere with the action of anticoagulants. Choice C is incorrect as aspirin is a blood thinner and can increase the risk of bleeding when combined with anticoagulant therapy. Choice D is incorrect as ice packs can help reduce bleeding and swelling in injuries, but in a client on anticoagulant therapy, it is important to avoid potential trauma to the skin that could lead to bleeding.
2. A client who had a myocardial infarction (MI) two days ago reports chest pain radiating to the left arm. What should the nurse do immediately?
- A. Administer morphine
- B. Obtain an electrocardiogram (ECG)
- C. Apply oxygen via nasal cannula
- D. Administer sublingual nitroglycerin
Correct answer: B
Rationale: Obtaining an ECG is crucial in this situation because it helps in assessing for potential complications, such as a recurrent MI or ongoing ischemia. This diagnostic test provides valuable information to guide further interventions and treatment. Administering morphine, oxygen, or nitroglycerin may be necessary but obtaining an ECG takes precedence to evaluate the cardiac status and determine the appropriate course of action. Administering morphine without assessing the current cardiac status through an ECG can mask important diagnostic clues. Applying oxygen and administering nitroglycerin are supportive measures that can follow the ECG to address potential hypoxia and ischemic pain relief, respectively.
3. A client with peripheral artery disease (PAD) complains of pain in the legs while walking. Which instruction should the LPN/LVN reinforce to help alleviate the client's symptoms?
- A. Walk until the pain becomes severe, then rest.
- B. Perform leg exercises while sitting.
- C. Elevate the legs on pillows while resting.
- D. Take frequent breaks and walk shorter distances.
Correct answer: D
Rationale: The correct answer is to take frequent breaks and walk shorter distances. This instruction helps alleviate symptoms in clients with peripheral artery disease (PAD) by allowing them to manage pain and discomfort more effectively. Option A is incorrect as waiting for the pain to become severe before resting can exacerbate symptoms. Option B, performing leg exercises while sitting, may not directly address the issue of pain during walking. Option C, elevating the legs on pillows while resting, is beneficial for other conditions like edema but may not specifically help alleviate pain while walking in PAD clients.
4. A client with chronic heart failure is being discharged with a prescription for digoxin (Lanoxin). Which instruction should the nurse reinforce?
- A. Take the medication at the same time each day.
- B. Avoid foods high in potassium.
- C. Skip a dose if you feel well.
- D. Take the medication on an empty stomach.
Correct answer: A
Rationale: Taking digoxin at the same time each day is essential to maintain a consistent blood level of the medication. This consistency helps optimize the therapeutic effects of digoxin in managing chronic heart failure. Deviating from the scheduled time could lead to fluctuations in drug levels, affecting its effectiveness and potentially causing harm. Choices B, C, and D are incorrect because avoiding potassium-rich foods, skipping doses when feeling well, and taking the medication on an empty stomach are not relevant or appropriate instructions for a client prescribed digoxin.
5. The client with a history of coronary artery disease (CAD) is scheduled for a stress test. What instruction should the nurse provide to the client before the test?
- A. Continue taking your usual dose of beta-blockers
- B. Refrain from eating or drinking anything for 4 hours before the test
- C. Wear loose, comfortable clothing and walking shoes
- D. Avoid any physical activity for 24 hours before the test
Correct answer: C
Rationale: Before a stress test, the nurse should instruct the client to wear loose, comfortable clothing and walking shoes. This is essential as the stress test involves physical exercise, and the client should be ready for the activity involved. Continuing beta-blockers should be based on healthcare provider's instructions; adjustments may be needed. Fasting before the test is usually not necessary. Avoiding physical activity for 24 hours before the test is not recommended as it may affect the accuracy of the test results by not providing a true reflection of the client's exercise capacity.
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