LPN LPN
LPN Pharmacology Assessment A
1. A client with a diagnosis of acute myocardial infarction (MI) is receiving thrombolytic therapy. The nurse monitors the client for which potential complication associated with this therapy?
- A. Hypertension
- B. Bleeding
- C. Hyperkalemia
- D. Hypoglycemia
Correct answer: B
Rationale: Thrombolytic therapy is associated with an increased risk of bleeding due to its mechanism of action in dissolving blood clots. Therefore, the nurse should closely monitor the client for any signs of hemorrhage, such as unexplained bruising, bleeding gums, or blood in the urine or stools. Hypertension is not a common complication of thrombolytic therapy. Hyperkalemia and hypoglycemia are also not typically associated with this therapy.
2. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?
- A. Take one tablet daily with breakfast
- B. Take one tablet every 5 minutes as needed, up to three times
- C. Take one tablet every hour until pain subsides
- D. Take one tablet only if pain does not subside after 30 minutes
Correct answer: B
Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.
3. 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.
4. A client with a history of deep vein thrombosis (DVT) is prescribed warfarin (Coumadin). The nurse should include which instruction in the discharge teaching?
- A. Take the medication at the same time each day
- B. Avoid green leafy vegetables in your diet
- C. Increase your intake of vitamin K-rich foods
- D. Stop the medication if you notice any bruising
Correct answer: A
Rationale: Taking warfarin at the same time each day is crucial to maintain consistent blood levels and ensure the effectiveness of the medication in preventing clot formation. Consistent timing helps in monitoring and adjusting the dosage as needed to keep the international normalized ratio (INR) within the therapeutic range to prevent clotting events or excessive bleeding. Choices B, C, and D are incorrect. Avoiding green leafy vegetables is a misconception; while they are high in vitamin K which antagonizes warfarin, they should not be avoided but consumed in moderation. Increasing vitamin K-rich foods can interfere with warfarin's effectiveness. Stopping the medication due to bruising can be dangerous as it may indicate a clotting problem that the medication is intended to prevent.
5. The nurse is teaching a client about lifestyle changes to manage hypertension. Which dietary change should the nurse recommend?
- A. Increase intake of red meat
- B. Use salt substitutes liberally
- C. Limit sodium intake to 2 grams per day
- D. Increase intake of processed foods
Correct answer: C
Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' This recommendation is crucial in managing hypertension because excessive sodium intake can lead to elevated blood pressure. Reducing sodium intake helps the body regulate fluid balance and lower blood pressure. Choices A, B, and D are incorrect. Increasing red meat intake can worsen hypertension due to its high saturated fat content. Using salt substitutes liberally can also be harmful as they often contain high amounts of potassium, which can be problematic for individuals with certain health conditions. Increasing processed foods consumption is generally discouraged in hypertension management due to their high sodium content and low nutritional value.
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