ATI LPN
LPN Pharmacology Assessment A
1. The healthcare professional is assisting in the care of a client diagnosed with deep vein thrombosis (DVT). Which instruction should be reinforced to prevent complications?
- A. Elevate the affected leg using pillows.
- B. Perform leg exercises while sitting.
- C. Wear snug compression stockings.
- D. Avoid applying ice packs to injuries.
Correct answer: A
Rationale: Elevating the affected leg using pillows is crucial in managing deep vein thrombosis (DVT) as it helps reduce swelling and promote venous return, thereby decreasing the risk of complications such as pulmonary embolism. This position aids in improving blood circulation and preventing blood clots from forming or worsening in the affected leg. Performing leg exercises while sitting might increase the risk of dislodging a blood clot. While snug compression stockings are beneficial, the primary focus should be on elevation. Avoiding ice packs on injuries is unrelated to DVT management.
2. What action should the healthcare provider take to reduce the risk of vesicant extravasation in a client receiving intravenous chemotherapy?
- A. Administer an antiemetic before starting the chemotherapy.
- B. Instruct the client to drink plenty of fluids during the treatment.
- C. Keep the head of the bed elevated until the treatment is completed.
- D. Monitor the client's intravenous site hourly during the treatment.
Correct answer: D
Rationale: Monitoring the intravenous site hourly is essential to identify early signs of extravasation, such as swelling or pain, which can help prevent tissue damage. Prompt detection allows for immediate intervention, minimizing the risk of serious complications associated with vesicant extravasation.
3. A 65-year-old white female with a history of arthritis, congestive heart failure, and osteoporosis complains of odynophagia for two weeks. A barium swallow shows a moderate-sized crater just above the gastroesophageal junction. What is the least likely contributor to this condition?
- A. NSAIDs
- B. Alendronate
- C. Iron sulfate
- D. Calcium channel blocker
Correct answer: D
Rationale: In this case, the least likely contributor to the condition described is the calcium channel blocker. NSAIDs, alendronate, and iron sulfate have been associated with pill-induced esophagitis, which can present with symptoms like odynophagia and erosions or ulcers on imaging studies. Pill-induced esophagitis is often due to factors like inadequate water intake with the medication, being in a supine position, or underlying motility disorders. Discontinuation of the offending medication typically leads to rapid resolution of esophageal injury. Acid-suppressive therapy may be used to prevent reflux-related damage.
4. What is the pattern of fever in enteric fever?
- A. Intermittent fever
- B. Relapsing fever
- C. Pel-Ebstein fever
- D. Continuous fever
Correct answer: D
Rationale: Enteric fever, caused by Salmonella typhi or paratyphi, is characterized by a continuous fever pattern. The fever typically persists without significant fluctuations, distinguishing it from diseases with intermittent or relapsing fever patterns. Pel-Ebstein fever, a cyclic pattern of fever seen in Hodgkin's lymphoma, is not associated with enteric fever. Relapsing fever is a characteristic of diseases like Borrelia recurrentis infection. Intermittent fever is seen in conditions like malaria.
5. A client with rheumatoid arthritis is taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?
- A. Weight loss
- B. Hypoglycemia
- C. Hypertension
- D. Hyperkalemia
Correct answer: C
Rationale: The correct answer is C: Hypertension. Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium and water retention, leading to increased blood pressure. Options A, B, and D are incorrect. Weight loss is not typically associated with prednisone use; instead, weight gain is more common. Hypoglycemia is not a common adverse effect of prednisone; in fact, it can elevate blood sugar levels. Hyperkalemia is also not a typical adverse effect of prednisone; instead, it can cause hypokalemia, or low potassium levels.
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