ATI LPN
LPN Pharmacology
1. The nurse is informed during shift report that a client is experiencing occasional ventricular dysrhythmias. The nurse reviews the client's laboratory results, recalling that which electrolyte imbalance could be responsible for this development?
- A. Hypokalemia
- B. Hypernatremia
- C. Hypochloremia
- D. Hypercalcemia
Correct answer: A
Rationale: Hypokalemia, which is low potassium levels, can disrupt the normal electrical activity of the heart and lead to ventricular dysrhythmias. Potassium plays a crucial role in maintaining the heart's rhythm, and a deficiency can result in dangerous heart rhythm abnormalities. Hypernatremia (Choice B), which is high sodium levels, does not directly impact heart rhythm. Hypochloremia (Choice C), which is low chloride levels, is not typically associated with ventricular dysrhythmias. Hypercalcemia (Choice D), which is high calcium levels, is not a common cause of ventricular dysrhythmias.
2. A 55-year-old man presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?
- A. Primary biliary cirrhosis
- B. Primary sclerosing cholangitis
- C. Gallstones
- D. Pancreatic cancer
Correct answer: A
Rationale: The constellation of symptoms including fatigue, pruritus, and jaundice, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are classical features of primary biliary cirrhosis.
3. A nurse is providing discharge teaching to a client who has a prescription for digoxin. Which of the following instructions should the nurse include?
- A. Take your pulse before taking the medication.
- B. Take the medication with an antacid.
- C. Double the dose if you miss one.
- D. Take the medication with a high-fiber meal.
Correct answer: A
Rationale: The correct answer is A: 'Take your pulse before taking the medication.' When administering digoxin, it is crucial to monitor the pulse rate because digoxin can cause bradycardia (slow heart rate). Checking the pulse helps in assessing the heart rate before taking the medication, as bradycardia is a common side effect of digoxin. Choice B is incorrect because digoxin should not be taken with antacids, as they can reduce its absorption. Choice C is incorrect; the dose should never be doubled if a dose is missed. Choice D is incorrect because taking digoxin with a high-fiber meal can also affect its absorption. Therefore, the essential instruction for the client is to monitor the pulse before taking digoxin.
4. A client has been prescribed albuterol. Which of the following is a priority adverse effect the nurse should monitor?
- A. Tachycardia
- B. Bradycardia
- C. Dizziness
- D. Hypertension
Correct answer: A
Rationale: Corrected Rationale: Albuterol, a beta-2 adrenergic agonist, can lead to tachycardia due to its stimulant effect on beta-2 receptors in the heart. Monitoring for tachycardia is crucial as it can be a sign of excessive sympathetic stimulation and may lead to severe complications. Bradycardia, dizziness, and hypertension are less likely adverse effects of albuterol, making them lower priority for monitoring in this context.
5. The client with a history of angina pectoris is being discharged after coronary artery bypass graft (CABG) surgery. Which statement by the client indicates a need for further teaching?
- A. I will avoid lifting heavy objects for at least 6 weeks.
- B. I will call the doctor if I develop a fever or drainage from my incisions.
- C. I will take my pain medication before doing any activities that might cause discomfort.
- D. I can resume my normal activities, including driving, as soon as I feel like it.
Correct answer: D
Rationale: The correct answer is D because after CABG surgery, patients need to follow specific guidelines for resuming activities, and driving is typically restricted for a certain period to ensure safety and proper recovery. Resuming normal activities too soon, including driving, can pose risks to the client's health and safety. It is essential to emphasize to the client the importance of following the healthcare provider's recommendations regarding activity restrictions post-surgery to prevent complications and promote optimal recovery. Choices A, B, and C are correct statements that align with post-CABG discharge instructions, emphasizing the importance of avoiding heavy lifting, monitoring for signs of infection, and managing pain effectively.
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