ATI LPN
LPN Pharmacology Assessment A
1. 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.
2. A 34-year-old woman presents with intermittent abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?
- A. Irritable bowel syndrome
- B. Celiac disease
- C. Lactose intolerance
- D. Crohn's disease
Correct answer: B
Rationale: The patient's symptoms of intermittent abdominal pain, bloating, and diarrhea that improve with fasting, along with a history of iron deficiency anemia, are highly suggestive of celiac disease. In celiac disease, gluten ingestion leads to mucosal damage in the small intestine, causing malabsorption of nutrients like iron, leading to anemia. The improvement of symptoms with fasting can be explained by the temporary avoidance of gluten-containing foods. Irritable bowel syndrome typically does not improve with fasting. Lactose intolerance usually presents with symptoms after dairy consumption, not with fasting. Crohn's disease typically presents with more chronic symptoms and is not commonly associated with improvement on fasting.
3. A client has a new prescription for captopril. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Monitor for signs of hypokalemia.
- C. Take the medication at bedtime.
- D. Monitor for a dry cough.
Correct answer: D
Rationale: The correct answer is to monitor for a dry cough. Captopril is known to cause a persistent dry cough as a common side effect. If a dry cough develops, it should be reported to the healthcare provider promptly, as it may necessitate discontinuation of the medication. Choice A is incorrect because captopril is usually taken on an empty stomach. Choice B is incorrect as hypokalemia is not a common side effect of captopril. Choice C is incorrect as captopril is typically taken during the day and not specifically at bedtime.
4. What are the signs and symptoms of a pulmonary embolism?
- A. Sudden shortness of breath
- B. Chest pain
- C. Cough with blood
- D. All of the above
Correct answer: D
Rationale: A pulmonary embolism can manifest with sudden shortness of breath, chest pain, and coughing up blood. These symptoms are classic presentations of a pulmonary embolism due to the blockage of blood flow to the lungs. Therefore, the correct answer is 'All of the above.' Each symptom alone can be seen in various other conditions, but when occurring together, they strongly suggest a pulmonary embolism. Sudden shortness of breath is due to decreased oxygenation, chest pain can result from the strain on the heart, and coughing with blood may indicate damage to the lung tissue. Choosing any single symptom would not encompass the full range of presentations seen in a pulmonary embolism.
5. A client with gout is prescribed allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects?
- A. Nausea
- B. Metallic taste
- C. Fever
- D. Drowsiness
Correct answer: C
Rationale: The correct answer is C: Fever. Fever can indicate a serious hypersensitivity reaction to allopurinol, known as allopurinol hypersensitivity syndrome, which can be severe and even life-threatening. Nausea and drowsiness are common side effects of allopurinol but not necessarily indications to discontinue the medication. Metallic taste is not typically associated with allopurinol use. Therefore, the nurse should emphasize to the client the importance of reporting any signs of fever promptly for further evaluation and management.
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