the lpnlvn is collecting data on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain during the admission the client r
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Nursing Elites

ATI LPN

LPN Pharmacology

1. The LPN/LVN is collecting data on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain. During the admission, the client reports chest pain. The nurse should immediately ask the client which question?

Correct answer: B

Rationale: In a client with angina pectoris, determining the location of chest pain is crucial for assessing the potential severity and cause. This information helps the nurse to further evaluate the nature of the pain and its probable origin, aiding in timely and appropriate interventions. Choices A, C, and D are not as immediately relevant as determining the location of the chest pain when assessing a client with angina pectoris.

2. What is the initial action the nurse should take for a client who had a myocardial infarction (MI) and is experiencing restlessness, agitation, and an increased respiratory rate?

Correct answer: A

Rationale: Administering oxygen is the priority action for a client experiencing restlessness, agitation, and an increased respiratory rate after a myocardial infarction (MI). This intervention helps ensure adequate oxygenation, improve cardiac function, and reduce the workload on the heart. Oxygen therapy takes precedence over administering medications like morphine sulfate or notifying the healthcare provider as it addresses the immediate need for oxygenation. Checking the blood pressure is also important but not as urgent as ensuring proper oxygen supply.

3. A client is taking furosemide. Which of the following findings should the nurse report to the provider?

Correct answer: C

Rationale: Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. Hypokalemia is a serious electrolyte imbalance that can cause various cardiac and muscular issues. Therefore, the nurse should promptly report hypokalemia to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because weight gain, dry cough, and increased appetite are not typically associated with furosemide use and are not immediate concerns that require urgent reporting.

4. Which laboratory test should be monitored to evaluate the effectiveness of anticoagulant therapy in a client with deep vein thrombosis (DVT)?

Correct answer: B

Rationale: Activated partial thromboplastin time (aPTT) is the laboratory test monitored to evaluate the effectiveness of anticoagulant therapy, particularly with heparin. It measures the time it takes for blood to clot, and monitoring aPTT helps ensure the therapeutic range is maintained to prevent clot formation and excessive bleeding. Choices A, C, and D are incorrect because a complete blood count (CBC) assesses overall health, serum electrolytes evaluate the body's electrolyte balance, and liver function tests assess liver health, none of which directly evaluate the effectiveness of anticoagulant therapy for DVT.

5. A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action?

Correct answer: A

Rationale: In a client with myocardial infarction experiencing chest pain during activity, the priority action is to stop the activity immediately to reduce the heart's workload and oxygen demand. Assisting the client back to bed helps in reducing stress on the heart and can prevent worsening of the condition. Reporting the chest pain episode to the healthcare provider is important but should not delay taking immediate action to alleviate symptoms. Taking the client's blood pressure and administering nitroglycerin are secondary actions after ensuring the client's safety and comfort. Therefore, the correct action is to assist the client back into bed.

Similar Questions

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