LPN LPN: Pharmacological Therapies 2 — Questions and Answers
Question 1: A patient is prescribed metformin 500 mg twice daily. Which condition is an absolute contraindication for this medication?
- Type 2 diabetes mellitus
- Renal impairment with eGFR < 30 mL/min (Correct answer)
- Hypertension
- Hyperlipidemia
Correct answer: Renal impairment with eGFR < 30 mL/min
Metformin is contraindicated in severe renal impairment (eGFR < 30 mL/min) due to the risk of lactic acidosis.
Question 2: An LPN is administering heparin subcutaneously. Which action is correct technique?
- Massage the injection site after administration
- Aspirate before injecting to check for blood return
- Inject into the abdomen 2 inches from the umbilicus (Correct answer)
- Use a 1-inch needle for subcutaneous injection
Correct answer: Inject into the abdomen 2 inches from the umbilicus
Heparin should be injected into the abdomen at least 2 inches from the umbilicus to reduce bruising and ensure proper absorption.
Question 3: A patient taking warfarin reports eating large amounts of leafy green vegetables daily. What is the primary concern?
- Increased bleeding risk due to drug-food interaction
- Decreased anticoagulant effect due to high vitamin K intake (Correct answer)
- Gastrointestinal irritation from fiber content
- Elevated potassium levels affecting drug metabolism
Correct answer: Decreased anticoagulant effect due to high vitamin K intake
Vitamin K found in leafy greens antagonizes warfarin's anticoagulant effect, potentially reducing its therapeutic efficacy.
Question 4: Which medication requires the nurse to monitor serum potassium levels most closely?
- Amoxicillin
- Furosemide (Correct answer)
- Metoprolol
- Omeprazole
Correct answer: Furosemide
Furosemide is a loop diuretic that causes potassium wasting, placing patients at risk for hypokalemia.
Question 5: A patient is prescribed morphine 4 mg IV every 4 hours PRN for pain. The patient's respiratory rate is 10 breaths/min. What should the LPN do first?
- Administer the morphine as ordered
- Notify the charge nurse or physician immediately (Correct answer)
- Document the finding and reassess in 30 minutes
- Encourage the patient to breathe deeply and reassess
Correct answer: Notify the charge nurse or physician immediately
A respiratory rate of 10 breaths/min indicates respiratory depression, a serious opioid side effect requiring immediate notification.
Question 6: Which statement by a patient indicates understanding of taking oral iron supplements correctly?
- 'I should take my iron pill with a glass of milk.'
- 'I should take my iron pill with orange juice on an empty stomach.' (Correct answer)
- 'I should take my iron pill with my antacid to prevent upset stomach.'
- 'I should take my iron pill at the same time as my calcium supplement.'
Correct answer: 'I should take my iron pill with orange juice on an empty stomach.'
Vitamin C in orange juice enhances iron absorption, and taking iron on an empty stomach maximizes uptake.
Question 7: A patient receiving IV vancomycin develops flushing, erythema, and hypotension during infusion. What is the most likely cause?
- Anaphylactic reaction
- Red Man Syndrome from rapid infusion (Correct answer)
- Vancomycin-resistant infection
- Phlebitis at the IV site
Correct answer: Red Man Syndrome from rapid infusion
Red Man Syndrome is a non-immune infusion reaction caused by too-rapid vancomycin administration, causing histamine release.
LPN LPN: Pharmacological Therapies 2
A patient is prescribed metformin 500 mg twice daily.
Which condition is an absolute contraindication for this medication?