A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory value should the nurse monitor to assess the effectiveness of the medication?

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LPN Pharmacology Practice Questions Questions

Question 1 of 9

A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory value should the nurse monitor to assess the effectiveness of the medication?

Correct Answer: B

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are the laboratory values used to monitor the effectiveness of warfarin therapy. These values help ensure that the client is within the therapeutic range for anticoagulation. PT measures the time it takes for blood to clot, while INR standardizes PT results to minimize variations between laboratories. Monitoring these values is crucial to prevent complications such as bleeding or clot formation. Activated partial thromboplastin time (aPTT) (Choice A) is more commonly used to monitor heparin therapy. Platelet count (Choice C) assesses the number of platelets in the blood and is not specific to warfarin therapy. Erythrocyte sedimentation rate (ESR) (Choice D) is a non-specific marker of inflammation and is not used to monitor the effectiveness of warfarin therapy.

Question 2 of 9

An 86-year-old patient is seen in clinic for a scheduled follow-up after starting a new oral medication 1 month prior. The patient reports no change in symptoms, and a laboratory test reveals a subtherapeutic serum drug level. The NP caring for this patient should:

Correct Answer: D

Rationale: The correct answer is D because elderly patients often have adherence issues due to cost or confusion, so checking pill count assesses compliance before adjusting dose. Choice A is incorrect as frequency isn’t the first step. Choice B is wrong since dose increase without compliance check is premature. Choice C is inaccurate as bowel changes aren’t the primary concern.

Question 3 of 9

An adolescent girl has decided to become a vegetarian. The primary care NP should counsel her about iron intake and considering a vitamin containing:

Correct Answer: A

Rationale: The correct answer is A because vegetarians often lack zinc, critical alongside iron. Choice B is incorrect (vitamin A not primary). Choice C is wrong (vitamin C aids iron, not primary). Choice D is inaccurate (potassium unrelated).

Question 4 of 9

A healthcare professional is preparing to administer ceftriaxone 1 g IM to a client who has a pelvic infection. Which of the following actions should the healthcare professional plan to take?

Correct Answer: D

Rationale: Administering ceftriaxone in a large muscle is crucial for proper absorption and to reduce the risk of pain or tissue irritation. Intramuscular administration of ceftriaxone helps achieve optimal therapeutic levels in the bloodstream for the treatment of the pelvic infection. Choices A, B, and C are incorrect. Choice A is not recommended as ceftriaxone should not be administered as a bolus over 5 minutes. Choice B is irrelevant because the question is about the administration route, not the reconstitution process. Choice C is also irrelevant as it does not pertain to the administration but to the quality of the reconstituted medication.

Question 5 of 9

A client with a history of angina pectoris reports chest pain while ambulating in the corridor. What should the nurse do first?

Correct Answer: B

Rationale: When a client with a history of angina pectoris experiences chest pain while ambulating, the priority action for the nurse is to assist the client to sit or lie down. This helps reduce the demand on the heart by decreasing physical exertion. Checking vital signs, administering medication, or applying oxygen can follow once the client is in a more comfortable position. Checking vital signs (Choice A) may be important but addressing the immediate discomfort by positioning the client comfortably takes precedence. Administering sublingual nitroglycerin (Choice C) is appropriate but should come after ensuring the client's comfort. Applying nasal oxygen (Choice D) can be beneficial, but it should not be the first action; assisting the client to sit or lie down is the initial priority.

Question 6 of 9

Therapeutic drug monitoring would be appropriate for which drug?

Correct Answer: B

Rationale: Choice B is correct because phenytoin has a narrow therapeutic index, requiring monitoring of peak and trough levels to ensure efficacy and avoid toxicity, unlike broader-range drugs. Choice A is incorrect as acetaminophen's wide safety margin and short-term use don't typically need monitoring. Choice C is wrong because albuterol's inhaled route and rapid action don't require blood level checks. Choice D is incorrect since only phenytoin fits the monitoring profile.

Question 7 of 9

Drugs that should be avoided in transgender men receiving testosterone therapy include:

Correct Answer: A

Rationale: Choice A is correct because estrogen counteracts testosterone's masculinizing effects in transgender men, conflicting with therapy aims, so it's avoided. Choice B is incorrect as alpha blockers don't interfere with testosterone goals. Choice C is wrong because beta blockers are unrelated to therapy effects. Choice D is incorrect since only estrogen applies.

Question 8 of 9

A client with a history of heart failure is being discharged with a prescription for digoxin (Lanoxin). The nurse should include which instruction in the discharge teaching?

Correct Answer: A

Rationale: The correct instruction for discharge teaching regarding digoxin (Lanoxin) is to advise the client to take their pulse before each dose and to hold the medication if their pulse is below 60 beats per minute. Digoxin can cause bradycardia, so monitoring the pulse is crucial to prevent potential complications. Choice B is incorrect because excessive fluid intake can lead to fluid overload, worsening heart failure. Choice C is not directly related to digoxin therapy. Choice D is inaccurate as digoxin is usually taken on an empty stomach to facilitate absorption.

Question 9 of 9

While assessing a client taking propranolol, which finding should the nurse report to the provider?

Correct Answer: A

Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.

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