ATI LPN
Pharmacology for LPN
1. The client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin. Which action should the nurse take next?
- A. Administer another dose of nitroglycerin.
- B. Notify the healthcare provider immediately.
- C. Have the client lie down and rest.
- D. Encourage the client to take deep breaths.
Correct answer: B
Rationale: When a client with a history of angina pectoris reports chest pain unrelieved by nitroglycerin, it may indicate a myocardial infarction, also known as a heart attack. In this situation, the nurse should immediately notify the healthcare provider to ensure prompt evaluation and appropriate intervention. Delay in seeking medical attention for chest pain unrelieved by nitroglycerin can be life-threatening, as it might be a sign of a more serious cardiac event. Administering another dose of nitroglycerin (Choice A) without further evaluation can be risky, as the client's condition may require a different intervention. Having the client lie down and rest (Choice C) or encouraging deep breaths (Choice D) are not appropriate actions in this scenario where a more serious cardiac event needs to be ruled out.
2. A client with hypertension is prescribed enalapril (Vasotec). The nurse should monitor the client for which adverse effect?
- A. Hypotension
- B. Hypertension
- C. Tachycardia
- D. Hyperglycemia
Correct answer: A
Rationale: Enalapril, an ACE inhibitor, can lead to hypotension, particularly following the initial dose or dosage escalation. This effect is due to the medication's mechanism of action in dilating blood vessels, which can result in lowered blood pressure. Monitoring for hypotension is crucial to prevent complications such as dizziness, lightheadedness, or fainting in clients taking enalapril. Choices B, C, and D are incorrect because enalapril does not typically cause hypertension, tachycardia, or hyperglycemia as adverse effects.
3. A client with hypertension is prescribed metoprolol (Lopressor). The nurse should monitor the client for which side effect?
- A. Tachycardia
- B. Bradycardia
- C. Hypertension
- D. Hyperglycemia
Correct answer: B
Rationale: Metoprolol is a beta-blocker that works by slowing the heart rate. Therefore, the nurse should monitor the client for bradycardia, which is a potential side effect of metoprolol. Bradycardia refers to a heart rate that is slower than normal, and it can be a concern when administering medications like metoprolol that affect heart rate. Choices A, C, and D are incorrect as tachycardia (fast heart rate), hypertension (high blood pressure), and hyperglycemia (high blood sugar) are not typically associated with metoprolol use. In fact, metoprolol is used to treat hypertension and certain heart conditions by lowering heart rate and blood pressure.
4. A client with heart failure is prescribed an angiotensin-converting enzyme (ACE) inhibitor. What instruction should the nurse reinforce to the client?
- A. Take the medication at bedtime.
- B. Report a persistent dry cough.
- C. Increase potassium-rich foods in the diet.
- D. Avoid taking the medication with meals.
Correct answer: B
Rationale: The correct answer is B. A persistent dry cough is a common side effect of ACE inhibitors and should be reported to the healthcare provider. This symptom can indicate a potential issue with the medication that may require adjustment or discontinuation. Choices A, C, and D are incorrect. Taking the medication at bedtime or with meals is not a specific instruction for ACE inhibitors. Increasing potassium-rich foods in the diet is not directly related to ACE inhibitor therapy and may not be suitable for all patients.
5. The nurse is preparing a client for discharge after a myocardial infarction (MI). Which instruction is most important for the nurse to reinforce with the client?
- A. Avoid engaging in sexual activity for at least 6 weeks.
- B. Engage in moderate physical activity daily.
- C. Take prescribed medications even if you feel well.
- D. Return to work only when medically cleared.
Correct answer: C
Rationale: The most critical instruction for a client after a myocardial infarction is to continue taking prescribed medications even if they feel well. This is essential in preventing another myocardial infarction or other complications. Discontinuing medications prematurely can be detrimental to the client's recovery and may increase the risk of further cardiovascular events. Choices A, B, and D are incorrect because engaging in sexual activity, physical activity, or returning to work are important aspects of the client's recovery, but not as crucial as ensuring medication compliance to prevent further cardiac issues.
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