ATI LPN
Pharmacology for LPN
1. The client with a new prescription for warfarin (Coumadin) is receiving teaching from the LPN/LVN. Which statement by the client indicates an understanding of the medication?
- A. I will avoid eating foods high in vitamin K, like spinach and broccoli.
- B. I will take aspirin instead of acetaminophen for headaches while on this medication.
- C. I can stop taking the medication once my symptoms improve.
- D. I will double my dose if I miss a dose to catch up.
Correct answer: A
Rationale: Clients prescribed with warfarin (Coumadin) need to maintain a consistent intake of vitamin K and avoid sudden increases in foods rich in vitamin K as it can interfere with the effectiveness of the medication. Choice A, 'I will avoid eating foods high in vitamin K, like spinach and broccoli,' is the correct statement indicating an understanding of the medication. This choice demonstrates knowledge of the importance of consistent vitamin K intake to prevent fluctuations in warfarin's effectiveness. Choices B, C, and D are incorrect. Choice B suggests a substitution that is not advised without consulting a healthcare provider. Choice C is incorrect as stopping warfarin suddenly can lead to serious health risks. Choice D is unsafe and incorrect since doubling the dose is not the correct action if a dose is missed.
2. A nurse is caring for a client who has diabetes mellitus and is receiving insulin. Which of the following findings should the nurse report to the provider?
- A. A fasting blood glucose of 90 mg/dL
- B. A blood glucose level of 200 mg/dL
- C. A hemoglobin A1c of 6%
- D. A fasting blood glucose of 100 mg/dL
Correct answer: B
Rationale: The correct answer is B. A blood glucose level of 200 mg/dL indicates hyperglycemia, which may necessitate insulin adjustment to better control the client's blood sugar levels. A fasting blood glucose of 90 mg/dL (choice A) is within the normal range, a hemoglobin A1c of 6% (choice C) is indicative of good long-term blood sugar control, and a fasting blood glucose of 100 mg/dL (choice D) is also within the normal range. Therefore, these findings do not require immediate reporting to the provider.
3. A healthcare provider is assessing fetal heart tones for a pregnant client. The provider has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the provider apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?
- A. Left upper quadrant
- B. Right upper quadrant
- C. Left lower quadrant
- D. Right lower quadrant
Correct answer: C
Rationale: When the fetal position is left occipital anterior, the point of maximum intensity of the fetal heart is best heard in the left lower quadrant of the client's abdomen. Placing the ultrasound transducer in the left lower quadrant allows for optimal detection of fetal heart tones in this specific fetal position. Choice A (Left upper quadrant) is incorrect as it is not where the fetal heart tones are best heard in this scenario. Choice B (Right upper quadrant) is also incorrect as it is not the recommended area for assessing fetal heart tones in a left occipital anterior position. Choice D (Right lower quadrant) is incorrect as the focus should be on the left side due to the fetal position mentioned.
4. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?
- A. I will take ibuprofen for headaches.
- B. I will use an electric razor to shave.
- C. I will avoid eating large amounts of leafy green vegetables.
- D. I will have my blood levels checked regularly.
Correct answer: A
Rationale: The correct answer is A. Ibuprofen can increase the risk of bleeding when taken with warfarin, as both medications affect clotting. The client should use alternative pain relievers like acetaminophen. Choice B is correct as using an electric razor is a safe choice to prevent cuts that could lead to bleeding. Choice C is correct as warfarin interacts with vitamin K found in leafy green vegetables. Choice D is correct as regular blood level checks are necessary to monitor the effects and adjust the warfarin dosage if needed.
5. When assessing a 6-year-old boy with pain in the right lower quadrant of his abdomen, which action should be performed first?
- A. Avoiding palpation of the abdomen.
- B. Palpating the right lower quadrant first.
- C. Auscultating bowel sounds for 2 minutes.
- D. Palpating the left upper quadrant first.
Correct answer: D
Rationale: Palpating the left upper quadrant first is the correct approach when assessing abdominal pain in a child. This method helps to minimize causing additional discomfort to the child and allows for a more accurate assessment of their reaction to palpation. By starting on the left upper quadrant, you can gauge the child's pain response before moving to the area of complaint, which may be more sensitive. This approach is essential for a thorough and less distressing abdominal assessment in pediatric patients.
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