ATI LPN
LPN Pharmacology Assessment A
1. 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.
2. A client has a new prescription for transdermal nitroglycerin patches. Which of the following instructions should be included for proper use?
- A. Apply the patch to the same site each day.
- B. Place the patch on an area of skin away from skin folds and joints.
- C. Keep the patch on 24 hours per day.
- D. Replace the patch every 72 hours.
Correct answer: B
Rationale: Placing the nitroglycerin patch on an area of skin away from skin folds and joints is crucial to ensure optimal absorption and effectiveness of the medication. Placing the patch on skin folds or joints can interfere with absorption, potentially reducing the patch's efficacy. Therefore, it is essential to follow this instruction to maximize the therapeutic benefits of the nitroglycerin patches. The other options are incorrect because applying the patch to the same site each day can lead to skin irritation, keeping the patch on 24 hours per day may not be necessary depending on the specific patch instructions, and replacing the patch every 72 hours is not the standard frequency for nitroglycerin patches.
3. When educating a client about the use of risedronate to treat osteoporosis, which instruction should be included?
- A. Drink a full glass of water with each dose.
- B. Take the medication on an empty stomach.
- C. Remain upright for 30 minutes after taking the medication.
- D. Avoid lying down for at least 1 hour after taking the medication.
Correct answer: C
Rationale: The correct instruction for a client taking risedronate to treat osteoporosis is to remain upright for 30 minutes after taking the medication. This is important to prevent esophageal irritation, as risedronate can cause irritation if it remains in contact with the esophagus. By staying upright, the medication is more likely to reach the stomach quickly and reduce the risk of irritation to the esophagus. Choices A, B, and D are incorrect. Drinking a full glass of water is recommended, not milk, to help with swallowing the medication. Risedronate should be taken on an empty stomach, not with meals, to ensure proper absorption. Additionally, avoiding lying down for at least 1 hour after taking the medication helps prevent esophageal irritation.
4. A client with a history of myocardial infarction (MI) is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse reinforce?
- A. Store the tablets in a cool, dry place away from light.
- B. Take a tablet every 5 minutes if chest pain occurs.
- C. Place the tablets under the tongue for sublingual absorption.
- D. Take the tablets without water for faster effect.
Correct answer: A
Rationale: The correct answer is A. Nitroglycerin tablets are light and moisture-sensitive, so they should be stored in a cool, dry place away from light to maintain their effectiveness. Option B advises taking a tablet every 5 minutes, which may lead to overdose as this frequency is too high. Option C emphasizes the correct administration route for sublingual tablets. Option D is incorrect as water is not needed for the tablets to take effect.
5. The healthcare provider is evaluating the effects of care for a client with deep vein thrombosis (DVT). Which limb observations should the provider note as indicating the least success in meeting the outcome criteria for this problem?
- A. Pedal edema that is 3+
- B. Slight residual calf tenderness
- C. Skin warm, equal temperature in both legs
- D. Calf girth 1/8 inch larger than the unaffected limb
Correct answer: A
Rationale: Significant pedal edema, indicated by 3+, suggests ongoing or worsening venous insufficiency. This can be a sign that the care provided has not been effective in managing the deep vein thrombosis (DVT) and the associated complications. Monitoring and addressing pedal edema is crucial in the evaluation of DVT treatment outcomes and overall patient care. Choices B, C, and D are not indicative of the least success in meeting the outcome criteria for DVT. Slight residual calf tenderness, skin warmth, and a slightly larger calf girth do not necessarily point towards treatment failure or lack of improvement in DVT management.
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