LPN LPN: Pharmacological Therapies 4 — Questions and Answers
Question 1: A patient taking phenytoin (Dilantin) for seizures should be taught to report which finding to the provider?
- Mild drowsiness during the first week
- Gingival hyperplasia (gum overgrowth) (Correct answer)
- Slight nausea with the first dose
- Increased appetite after starting the medication
Correct answer: Gingival hyperplasia (gum overgrowth)
Gingival hyperplasia is a well-known side effect of phenytoin that requires regular dental care and should be reported to the provider.
Question 2: A patient is prescribed albuterol (ProAir) and fluticasone (Flovent) inhalers. In what order should they be administered?
- Fluticasone first, then albuterol 5 minutes later
- Albuterol first, then fluticasone 5 minutes later (Correct answer)
- Both inhalers can be used simultaneously
- Administer based on whichever symptom is more severe
Correct answer: Albuterol first, then fluticasone 5 minutes later
Albuterol (bronchodilator) is given first to open the airways, allowing the inhaled corticosteroid (fluticasone) to reach deeper into the lungs.
Question 3: A patient is ordered morphine 2-4 mg IV PRN for pain rated 7/10. The last dose was 3 hours ago. Which action is appropriate?
- Withhold the dose since only 3 hours have passed
- Administer 4 mg IV since the pain is severe (Correct answer)
- Administer 2 mg and reassess pain in 30 minutes
- Contact the provider to request an increase in dose frequency
Correct answer: Administer 4 mg IV since the pain is severe
With a pain rating of 7/10 and a PRN order for 2-4 mg, administering the higher end of the range is appropriate for severe pain.
Question 4: Which laboratory value indicates that a patient's INR therapeutic goal is being met for atrial fibrillation management with warfarin?
- INR 1.0
- INR 2.5 (Correct answer)
- INR 4.5
- INR 0.5
Correct answer: INR 2.5
The therapeutic INR range for atrial fibrillation is 2.0–3.0, and an INR of 2.5 falls within this therapeutic window.
Question 5: A patient prescribed lithium for bipolar disorder should be taught to maintain adequate intake of which substance to prevent toxicity?
- Calcium
- Sodium (Correct answer)
- Potassium
- Magnesium
Correct answer: Sodium
Sodium depletion causes the kidneys to reabsorb lithium instead of sodium, leading to lithium toxicity; adequate sodium intake is essential.
Question 6: A patient receiving chemotherapy is prescribed ondansetron. What is the primary purpose of this medication?
- To prevent infection during immunosuppression
- To stimulate white blood cell production
- To prevent chemotherapy-induced nausea and vomiting (Correct answer)
- To treat chemotherapy-related mouth sores
Correct answer: To prevent chemotherapy-induced nausea and vomiting
Ondansetron is a 5-HT3 receptor antagonist used as an antiemetic to prevent nausea and vomiting associated with chemotherapy.
Question 7: Which sign or symptom is most indicative of acetaminophen overdose in the later stages?
- Hypertension and bradycardia
- Jaundice and right upper quadrant pain (Correct answer)
- Respiratory alkalosis and tachypnea
- Hypoglycemia and cold clammy skin
Correct answer: Jaundice and right upper quadrant pain
Acetaminophen overdose causes hepatotoxicity, manifesting as jaundice and right upper quadrant pain due to liver damage in later stages.
LPN LPN: Pharmacological Therapies 4
A patient taking phenytoin (Dilantin) for seizures should be taught to report which finding to the provider?