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. The client with a history of left-sided heart failure is exhibiting increasing shortness of breath and frothy sputum. What is the priority nursing action?
- A. Administer oxygen
- B. Encourage coughing and deep breathing
- C. Place the client in a supine position
- D. Notify the healthcare provider immediately
Correct answer: A
Rationale: Shortness of breath and frothy sputum are indicative of pulmonary edema, a serious condition that requires immediate intervention to improve oxygenation. Administering oxygen is the priority action to support the client's respiratory function and prevent further deterioration. Oxygen therapy helps increase the oxygen levels in the blood, alleviate respiratory distress, and support vital organ function. Prompt intervention with oxygen can help stabilize the client while further assessments and treatments are initiated. Encouraging coughing and deep breathing may worsen the client's condition by increasing respiratory effort. Placing the client in a supine position can further compromise breathing in a client with pulmonary edema. Notifying the healthcare provider is important but not the priority when the client's respiratory status is deteriorating.
3. A client with hypertension is prescribed a thiazide diuretic. What instruction should the nurse reinforce to the client?
- A. Take the medication in the morning.
- B. Increase potassium intake in the diet.
- C. Weigh yourself daily.
- D. Limit fluid intake to 2 liters per day.
Correct answer: C
Rationale: The correct answer is to weigh oneself daily. This instruction is important as daily weights help monitor fluid loss and are crucial for detecting early signs of fluid imbalance when taking a diuretic. Weighing daily allows for timely adjustments in treatment and helps prevent complications associated with fluid imbalance. Choice A is not directly related to the client's need for monitoring fluid balance. Choice B, although important for some diuretics, is not specific to thiazide diuretics. Choice D is not appropriate as limiting fluid intake without proper monitoring can lead to dehydration, especially when taking diuretics.
4. A client with a history of coronary artery disease (CAD) is being discharged after angioplasty. Which instruction should the LPN/LVN reinforce to the client?
- A. You should report any chest pain or discomfort to your health care provider.
- B. Avoid all physical activity for the next 2 weeks.
- C. Return to work immediately after discharge.
- D. Take aspirin only if you experience chest pain.
Correct answer: A
Rationale: The correct instruction to reinforce is to 'Report any chest pain or discomfort to your health care provider.' This is crucial because chest pain post-angioplasty can indicate complications that need immediate attention. Choice A is incorrect because returning to work immediately may not be advisable after angioplasty, as the client needs time to recover. Choice B is incorrect because avoiding all physical activity for 2 weeks may not be necessary; instead, gradual resumption of activities is usually recommended. Choice D is incorrect because aspirin should be taken as prescribed by the healthcare provider, not just when chest pain occurs.
5. A client has a new prescription for atenolol. Which of the following instructions should be included in the discharge teaching?
- A. Take the medication at bedtime.
- B. Monitor your heart rate daily.
- C. Increase your intake of potassium-rich foods.
- D. Avoid consuming dairy products.
Correct answer: B
Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking atenolol. Atenolol can lead to bradycardia, a slow heart rate. By monitoring heart rate daily, the client can promptly identify any significant changes and seek medical attention if necessary. This proactive approach enables early detection of potential adverse effects of atenolol, contributing to the client's safety and well-being. Choices A, C, and D are incorrect because taking atenolol at bedtime, increasing potassium-rich foods intake, or avoiding dairy products are not specific instructions related to the potential side effects of atenolol.
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