LPN LPN: Pharmacological Therapies 3 — Questions and Answers
Question 1: A patient prescribed digoxin has a heart rate of 52 bpm before the morning dose. What is the priority action?
- Administer the dose as scheduled
- Hold the dose and notify the provider (Correct answer)
- Administer half the prescribed dose
- Reassess the heart rate in one hour
Correct answer: Hold the dose and notify the provider
Digoxin should be held and the provider notified when the apical pulse is below 60 bpm in adults, as bradycardia is a sign of toxicity.
Question 2: Which assessment finding is most concerning in a patient receiving long-term corticosteroid therapy?
- Blood glucose of 145 mg/dL (Correct answer)
- Blood pressure of 118/78 mmHg
- Mild ankle edema
- White blood cell count of 9,000/mm³
Correct answer: Blood glucose of 145 mg/dL
Corticosteroids cause hyperglycemia by stimulating gluconeogenesis and impairing insulin sensitivity, requiring close glucose monitoring.
Question 3: An LPN is preparing to administer insulin. Which type of insulin is the ONLY type that can be given intravenously?
- NPH insulin
- Glargine (Lantus)
- Regular insulin (Correct answer)
- Lispro (Humalog)
Correct answer: Regular insulin
Regular insulin is the only insulin formulation approved for intravenous administration; all others are given subcutaneously.
Question 4: A patient is prescribed lisinopril for hypertension and develops a persistent dry cough. What is the nurse's best response?
- Teach the patient to use cough drops to manage the symptom
- Document the finding and report it to the provider (Correct answer)
- Reassure the patient that the cough will resolve after one week
- Administer a PRN antihistamine to suppress the cough
Correct answer: Document the finding and report it to the provider
A persistent dry cough is a common side effect of ACE inhibitors like lisinopril and should be reported so an alternative medication class can be considered.
Question 5: Which instruction should the nurse provide to a patient starting atorvastatin (Lipitor)?
- 'Take this medication in the morning with breakfast.'
- 'Report muscle pain or weakness to your provider promptly.' (Correct answer)
- 'Avoid green leafy vegetables while on this medication.'
- 'Limit fluid intake to prevent drug accumulation.'
Correct answer: 'Report muscle pain or weakness to your provider promptly.'
Muscle pain or weakness (myopathy) can be an early sign of rhabdomyolysis, a serious and potentially fatal side effect of statin therapy.
Question 6: A patient with a penicillin allergy is ordered cefazolin. What should the LPN do?
- Administer as ordered since the drugs are unrelated
- Administer with diphenhydramine to prevent reaction
- Hold the medication and notify the provider of the allergy (Correct answer)
- Dilute the medication more to reduce reaction risk
Correct answer: Hold the medication and notify the provider of the allergy
Cephalosporins and penicillins share a similar beta-lactam ring structure, and cross-reactivity can occur, requiring provider notification.
Question 7: Which electrolyte imbalance should the LPN monitor for in a patient receiving amphotericin B?
- Hypernatremia
- Hypercalcemia
- Hypokalemia (Correct answer)
- Hypermagnesemia
Correct answer: Hypokalemia
Amphotericin B is nephrotoxic and commonly causes hypokalemia and hypomagnesemia through renal potassium wasting.
LPN LPN: Pharmacological Therapies 3
A patient prescribed digoxin has a heart rate of 52 bpm before the morning dose.
What is the priority action?