LPN LPN
LPN Pharmacology Assessment A
1. A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the LPN/LVN expect to assist with first?
- A. Administer a diuretic as prescribed.
- B. Place the client in a high Fowler's position.
- C. Prepare the client for intubation.
- D. Insert an indwelling urinary catheter.
Correct answer: B
Rationale: In a client with pulmonary edema, placing them in a high Fowler's position is the priority intervention. This position helps to improve ventilation and oxygenation by decreasing venous return, reducing the workload on the heart, and facilitating fluid redistribution from the lungs. It is crucial to optimize respiratory function and oxygenation before considering other interventions like administering medications, preparing for intubation, or inserting a urinary catheter. Administering a diuretic, preparing for intubation, or inserting a urinary catheter may be necessary but should follow the priority of improving oxygenation through positioning.
2. The patient with a history of myocardial infarction (MI) is prescribed aspirin. What instruction should the nurse include in the discharge teaching?
- A. Take the aspirin with food to prevent gastrointestinal upset
- B. Discontinue the aspirin if experiencing ringing in the ears
- C. Take the aspirin at bedtime to minimize side effects
- D. Avoid taking aspirin if also taking other NSAIDs
Correct answer: A
Rationale: Taking aspirin with food is recommended to prevent gastrointestinal irritation and upset, which are common side effects of aspirin. It helps protect the stomach lining and reduce the risk of developing ulcers. This instruction is crucial in promoting medication adherence and minimizing discomfort for the patient. Choices B, C, and D are incorrect because discontinuing aspirin without consulting a healthcare provider, taking it at bedtime, or avoiding it if taking other NSAIDs can have negative consequences on the patient's health and treatment plan.
3. A client has a new prescription for rifampin. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Expect red-orange discoloration of body fluids.
- C. Monitor for signs of hyperglycemia.
- D. Avoid consuming dairy products.
Correct answer: B
Rationale: The correct answer is to inform the client to expect red-orange discoloration of body fluids when taking rifampin. Rifampin is known to cause this side effect, which is harmless but can be surprising to patients. It is important for the nurse to educate the client about this expected change to prevent unnecessary concern or alarm. Monitoring for hyperglycemia is not directly related to rifampin, and taking the medication with food or avoiding dairy products are not specific instructions for this medication.
4. The LPN/LVN is assisting in the care of a client with a diagnosis of heart failure who is receiving digoxin (Lanoxin). Which laboratory result should the nurse monitor closely?
- A. Serum sodium
- B. Serum potassium
- C. Serum calcium
- D. Serum glucose
Correct answer: B
Rationale: The correct answer is serum potassium. Monitoring serum potassium levels is crucial when a client is receiving digoxin (Lanoxin) because low potassium levels can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac complications, such as arrhythmias. Therefore, close monitoring of serum potassium is essential to prevent adverse effects and ensure the safe administration of digoxin in clients with heart failure. Serum sodium, serum calcium, and serum glucose levels are also important laboratory values to monitor in clients with heart failure, but they are not directly associated with the risk of digoxin toxicity. Monitoring these values helps in assessing overall health status, fluid balance, and metabolic functions in the client.
5. 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.
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