LPN LPN
LPN Pharmacology Practice Test
1. A healthcare professional is preparing to administer a unit of packed red blood cells to a client. Which of the following actions should the healthcare professional take?
- A. Prime the blood tubing with normal saline.
- B. Verify the client’s identity using two identifiers.
- C. Infuse the blood rapidly over 30 minutes.
- D. Obtain the client’s vital signs every 4 hours during the transfusion.
Correct answer: B
Rationale: Verifying the client’s identity using two identifiers is a critical patient safety measure to ensure the correct patient receives the blood transfusion. This process involves checking the patient's identity using at least two unique identifiers, such as name, date of birth, or medical record number, to prevent administration errors. Priming the blood tubing with normal saline is necessary to ensure there are no air bubbles in the tubing, but it is not the immediate action required before administering the blood. Infusing packed red blood cells over 30 minutes is generally too rapid and can lead to adverse reactions; a slower rate is recommended for safe administration. Obtaining vital signs every 4 hours during the transfusion is not frequent enough to monitor the client adequately for potential transfusion reactions or complications; vital signs should be monitored more frequently, especially during the initial phase of the transfusion.
2. A client is receiving heparin therapy. Which of the following laboratory tests should be monitored to evaluate the effectiveness of the therapy?
- A. Prothrombin time (PT)
- B. International normalized ratio (INR)
- C. Activated partial thromboplastin time (aPTT)
- D. Complete blood count (CBC)
Correct answer: C
Rationale: Activated partial thromboplastin time (aPTT) is the most appropriate laboratory test to monitor the effectiveness of heparin therapy. Heparin works on the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps assess its anticoagulant effect. Therapeutic levels of aPTT for clients on heparin therapy are typically 1.5 to 2.5 times the control value. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, which acts on the extrinsic pathway of the coagulation cascade. Complete blood count (CBC) is not specific for monitoring the effectiveness of heparin therapy.
3. A client has been taking levothyroxine for 6 months. Which of the following findings indicates that the medication is effective?
- A. Weight gain
- B. Increased heart rate
- C. Decreased TSH levels
- D. Elevated blood pressure
Correct answer: C
Rationale: In a client taking levothyroxine for thyroid hormone replacement, decreased TSH levels indicate that the medication is effective. TSH levels decrease as the thyroid hormone levels are adequately replaced by levothyroxine, signaling a positive response to treatment. Choices A, B, and D are incorrect because weight gain, increased heart rate, and elevated blood pressure are not expected findings indicating the effectiveness of levothyroxine therapy. Weight gain may suggest inadequate dosing, while increased heart rate and elevated blood pressure could indicate over-replacement or side effects of the medication.
4. A healthcare provider is providing discharge instructions to a client who has a new prescription for digoxin. Which of the following instructions should the healthcare provider include?
- A. Take the medication at bedtime.
- B. Avoid taking antacids with this medication.
- C. Monitor your pulse rate daily.
- D. Increase your intake of potassium-rich foods.
Correct answer: C
Rationale: The correct answer is C: 'Monitor your pulse rate daily.' Monitoring the pulse rate daily is crucial when taking digoxin as it helps in early detection of digoxin toxicity. Digoxin can cause toxicity, which may manifest as changes in the heart rate, making monitoring the pulse rate an essential part of managing the medication. It is important for the client to be aware of their normal pulse rate and report any significant changes to their healthcare provider promptly. Choices A, B, and D are incorrect. Taking digoxin at bedtime is not a specific instruction related to monitoring its effects. Avoiding antacids is relevant for some medications, but not a key concern with digoxin. Increasing potassium-rich foods may interact with digoxin due to its effect on potassium levels, but monitoring the pulse rate is a more direct and immediate need for safety.
5. A healthcare professional is reviewing laboratory results for a client who has been taking carbamazepine. Which of the following findings should the healthcare professional report to the provider?
- A. WBC count 3,000/mm3
- B. Platelet count 150,000/mm3
- C. Hemoglobin 14 g/dL
- D. Serum potassium 4.5 mEq/L
Correct answer: A
Rationale: A WBC count of 3,000/mm3 indicates leukopenia, a serious side effect of carbamazepine. Leukopenia can increase the risk of infections due to decreased white blood cell count, which is important to report to the provider for further evaluation and management. Platelet count within normal range (choice B), hemoglobin level within normal range (choice C), and serum potassium level within normal range (choice D) are not directly associated with carbamazepine use and do not require immediate reporting as they do not indicate a serious adverse effect.
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