ATI LPN
LPN Pharmacology Assessment A
1. 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.
2. A healthcare professional is assessing a client who has a new prescription for furosemide. Which of the following findings should the healthcare professional report to the provider?
- A. Weight gain
- B. Dry cough
- C. Hypokalemia
- D. Increased appetite
Correct answer: C
Rationale: The correct answer is C: Hypokalemia. Hypokalemia is a common electrolyte imbalance associated with furosemide use due to its diuretic effect, which can lead to potassium loss. It is crucial to report hypokalemia promptly to the provider as it can result in serious complications such as cardiac arrhythmias. Monitoring and managing potassium levels are essential in patients taking furosemide to prevent adverse effects related to electrolyte imbalances. Choices A, B, and D are incorrect findings to report in a client prescribed furosemide. Weight gain is not typically associated with furosemide use, a dry cough is more commonly linked to ACE inhibitors, and increased appetite is not a common adverse effect of furosemide.
3. In a prenatal clinic, a client in the first trimester of pregnancy has a health record that includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply)
- A. Client has delivered one newborn at term
- B. Client has experienced no preterm labor
- C. Client has had two prior pregnancies
- D. ALL OF THE ABOVE - has one living child
Correct answer: D
Rationale: The client's health record data is interpreted as follows: G3 (gravida 3 - total number of pregnancies), T1 (term births - number of full-term deliveries), P0 (preterm births - number of preterm deliveries), A1 (abortions/miscarriages - total number of miscarriages or abortions), L1 (living children - total number of living children). Therefore, the client has had three pregnancies, one full-term delivery, no preterm labor, one miscarriage/abortion, and one living child. The correct interpretation is that the client has delivered one newborn at term, experienced no preterm labor, had two prior pregnancies, and has one living child. Therefore, choice D is correct. Choices A, B, and C are incorrect as they do not provide a comprehensive interpretation of all aspects of the client's health record data.
4. Regurgitation or reflux of acidic stomach contents back into the esophagus is known as:
- A. hiatal hernia.
- B. diverticulitis.
- C. gastroenteritis.
- D. gastroesophageal reflux disease.
Correct answer: D
Rationale: The correct answer is D: gastroesophageal reflux disease (GERD). GERD occurs when stomach acid flows back into the esophagus, causing symptoms like heartburn and regurgitation. Choice A, hiatal hernia, is a condition where part of the stomach pushes up into the chest through an opening in the diaphragm. Choice B, diverticulitis, is inflammation or infection of small pouches that can form in the lining of the digestive system. Choice C, gastroenteritis, is inflammation of the stomach and intestines typically caused by a viral or bacterial infection. Therefore, only choice D accurately describes the regurgitation or reflux of acidic stomach contents back into the esophagus.
5. A 55-year-old man presents with jaundice, pruritus, and dark urine. Laboratory tests reveal elevated bilirubin and alkaline phosphatase. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?
- A. Primary biliary cirrhosis
- B. Primary sclerosing cholangitis
- C. Gallstones
- D. Pancreatic cancer
Correct answer: A
Rationale: The clinical presentation of jaundice, pruritus, dark urine, elevated bilirubin and alkaline phosphatase, along with imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are characteristic of primary biliary cirrhosis. Primary biliary cirrhosis is an autoimmune liver disease that leads to destruction of intrahepatic bile ducts, causing cholestasis and liver damage. This condition typically presents in middle-aged women but can also affect men, as seen in this case.
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