ATI LPN
LPN Pharmacology Assessment A
1. The client with heart failure is receiving digoxin (Lanoxin). The nurse should monitor the client for which sign of digoxin toxicity?
- A. Hypertension
- B. Bradycardia
- C. Hyperglycemia
- D. Insomnia
Correct answer: B
Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin can cause disturbances in the heart's electrical conduction system, leading to a slower heart rate. Therefore, the nurse should closely monitor the client's heart rate for signs of bradycardia, which could indicate digoxin toxicity. Hypertension (Choice A), hyperglycemia (Choice C), and insomnia (Choice D) are not typically associated with digoxin toxicity. Therefore, they are incorrect choices for this question.
2. The healthcare provider assesses a client who has been prescribed furosemide (Lasix) for cardiac disease. Which electrocardiographic change would be a concern for a client taking a diuretic?
- A. Tall, spiked T waves
- B. A prolonged QT interval
- C. A widening QRS complex
- D. Presence of a U wave
Correct answer: D
Rationale: The presence of a U wave is often associated with hypokalemia, a possible side effect of diuretic therapy like furosemide. Hypokalemia can lead to U wave formation on an electrocardiogram, making the presence of U waves a concerning finding in clients taking diuretics. Tall, spiked T waves are typically seen in hyperkalemia, not hypokalemia. A prolonged QT interval is more commonly associated with conditions like Long QT syndrome or certain medications, not specifically with diuretics. A widening QRS complex is usually seen in conditions affecting the conduction system of the heart, such as bundle branch blocks, rather than being directly related to diuretic use.
3. The healthcare provider notes this rhythm on the client's cardiac monitor. The healthcare provider next reports that the client is experiencing which heart rhythm?
- A. Normal sinus
- B. Atrial fibrillation
- C. Sinus bradycardia
- D. Ventricular fibrillation
Correct answer: B
Rationale: The correct answer is B, Atrial fibrillation. Atrial fibrillation is characterized by an irregular and often rapid heart rate, which can lead to poor blood flow due to ineffective contractions of the atria. Sinus bradycardia (Choice C) is a regular but slow heart rhythm originating from the sinus node. Normal sinus rhythm (Choice A) refers to a regular heartbeat originating from the sinus node. Ventricular fibrillation (Choice D) is a life-threatening arrhythmia characterized by rapid, uncoordinated contractions of the ventricles.
4. A client has a new prescription for isoniazid. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach.
- B. Avoid drinking alcohol.
- C. Take the medication with an antacid.
- D. Increase your intake of leafy green vegetables.
Correct answer: B
Rationale: The correct answer is to instruct the client to avoid drinking alcohol. Isoniazid can cause liver damage, and alcohol consumption can increase this risk. Therefore, it is crucial to avoid alcohol while taking isoniazid to prevent potential liver complications. Choice A is incorrect because isoniazid is typically taken with food to reduce gastrointestinal upset. Choice C is incorrect because antacids can decrease the absorption of isoniazid. Choice D is incorrect as there is no specific recommendation to increase leafy green vegetable intake when taking isoniazid.
5. The LPN/LVN is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia?
- A. Tall, peaked T waves
- B. ST-segment depression
- C. Prolonged P-R interval
- D. Widening of the QRS complex
Correct answer: B
Rationale: ST-segment depression can indicate hypokalemia, affecting the heart's electrical conduction. Hypokalemia leads to alterations in the repolarization phase of the cardiac action potential, resulting in ST-segment depression on the ECG. Tall, peaked T waves are indicative of hyperkalemia, not hypokalemia. A prolonged P-R interval is more commonly associated with first-degree heart block. Widening of the QRS complex is typically seen in conditions like bundle branch blocks or ventricular tachycardia, not specifically in hypokalemia.
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