LPN Practice 2

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1

A patient with allergies has been prescribed an antihistamine. Which response by the patient demonstrates understanding of the action of antihistamine drugs?

a.

“Antihistamines act by increasing the production of acetylcholine”

b.

“Antihistamines act by blocking histamine receptors in tissues”

c.

“Antihistamines act by increasing dilation of blood vessels”

d.

“Antihistamines act by blocking the release of histamine”

B

2

What is a common side effect of inhaled anti-inflammatory drugs for asthma?

a.

Anemia

b.

Bronchoconstriction

c.

Cutaneous itching

d.

Dry mouth

...

3

An adolescent with a history of asthma needs a drug to prevent exercise-induced asthma while playing high school sports. Which drug would be appropriate for this use?

a.

Cromolyn sodium

b.

Theochron

c.

Sus-Phrine

d.

Proventil

A

4

Which statement made by the patient demonstrates understanding of the use of oral mucolytics?

a.

“I will not use a humidifier while taking this drug.”

b.

“This drug will stop me from coughing.”

c.

“I will drink at least 2 quarts of water while taking this drug.”

d.

“This drug will cause my urine to change color.”

...

5

Why are xanthine agents seldom used to treat asthma now?

a.

They increase bronchial secretions at the same time that they induce bronchial dilation.

b.

They have no role in preventing bronchoconstriction or inflammation.

c.

They are all given intravenously.

d.

They have severe systemic side effects.

...

6

A patient who has been taking lisinopril for 2 years calls the clinic to report that her tongue and lips are swelling, making it hard for her to talk and swallow. What is your priority action?

a.

Take a complete history of all her allergies over the phone.

b.

Suggest that she take 25 mg of diphenhydramine as soon as possible.

c.

Tell her to go to the nearest emergency department or call 911 right now.

d.

Tell her that you will notify her healthcare provider for more instructions.

...

7

Which statement made by a patient who is prescribed to take clonidine twice daily indicates the need for more teaching?

a.

“When I get out of bed, I will take my time changing positions.”

b.

“If I forget my drug doses one day, I will take double doses the next day.”

c.

“If I get a cold, I will check with my healthcare provider before taking a cold drug.”

d.

“To determine how well my drugs are working, I will take my blood pressure every day.”

...

8

A patient newly prescribed to take propranolol for hypertension has all of the following health problems. For which one will you check with the healthcare provider before giving?

a.

Asthma

b.

Cataracts

c.

Atrial fibrillation

d.

Benign prostatic hyperplasia

...

9

You are assessing the knowledge of a patient who has been using nitroglycerine for about a year as needed for angina. Which statement indicates the need for more teaching?

a.

“I always get my prescription refilled every 3 months even when there are tablets left in the bottle.”

b.

“I know that my nitroglycerine is working when it tingles under my tongue and my chest pain goes away.”

c.

“I always carry at least three tablets with me in a baggie my purse in case I have chest pains while I am out.”

d.

“I only drink one cup of coffee (decaffeinated) each day because caffeine can interfere with the effectiveness of the nitroglycerine.”

...

10

Which category of diuretic drugs exerts its mechanism of action in the collecting duct?

a.

Loop diuretics

b.

Thiazide diuretics

c.

Potassium-sparing diuretics

d.

Thiazide-like sulfonamide diuretics

...

11

Which precaution is most important for the LPN/VN to teach a patient newly prescribed to take 10 mg of amiloride (Midamor) orally daily?

a.

“Avoid the use of salt substitutes.”

b.

“Avoid aspirin and aspirin-containing products.”

c.

“Eat plenty of bananas and oranges to prevent complications.”

d.

“Report a decrease in hearing to your healthcare provider immediately.

...

12

Which health problem is a potential side effect or adverse reaction of any class of diuretic drug?

a.

Dehydration

b.

Heart failure

c.

Blurred vision

d.

Urinary tract infection

...

13

You are teaching a patient about drug therapy for hyperlipidemia. Which statement made by the patient indicates that more teaching is needed?

a.

“I am so thankful that my high cholesterol has been cured by this drug.”

b.

“I always try to drink just about the same amount of fluid that I urinate each day.”

c.

“I have been taking this drug just before I go to bed so that it has the greatest effect.”

d.

“I will keep regular appointments with my healthcare provider to assess for any organ complications.”

...

14

Why are “statins” avoided during pregnancy and breast-feeding?

a.

These drugs cause hypotension in the fetus and infant.

b.

These drugs are associated with development of autism.

c.

They lower cholesterol levels in the fetus and infant.

d.

They can lead to miscarriage and early pregnancy loss.

...

15

A patient who has been taking atorvastatin for 6 months reports that he has stopped exercising because his muscles and joints are always so sore. What is the nurse’s best action?

a.

Document the report as the only action.

b.

Assess the patient’s range of joint motion.

c.

Hold the drug and notify the healthcare provider immediately.

d.

Suggest that the patient continue to exercise but take aspirin an hour before starting.

...

16

What are the most common side effects of any drug used to manage hypertension?

a.

Headache and an increased risk for nose bleeds

b.

Low blood pressure and an increased risk for falls

c.

Water retention and an increased risk for low sodium levels

d.

Low potassium levels and in increased risk for hearing loss

...

17

Which category of drugs for hypertension has the potential to make heart failure worse?

a.

Angiotensin receptor blockers

b.

Beta blockers

c.

Calcium channel blockers

d.

High ceiling “loop” diuretics

...

18

When asking the family of a patient with Alzheimer’s disease who takes the drug donepezil (Aricept) what other prescribed or over-the-counter drugs the patient takes, they list all the following drugs. Which one will you tell them to stop giving the patient?

a.

Aspirin

b.

Buspirone

c.

Vitamin C

d.

Dextromethorphan

...

19

When admitting a new patient with Alzheimer’s to a memory unit of a long-term care facility, you note that she is prescribed both memantine and rivastigmine. What is your best action?

a.

Give both drugs as prescribed.

b.

Ask the patient when she usually takes these drugs.

c.

Notify the prescriber that both drugs are for Alzheimer’s disease.

d.

Give the memantine one odd-numbered days and rivastigmine on even-numbered days.

...

20

Which precaution is most important to tell parents of young children prescribed lamotrigine for epilepsy?

a.

“Give this drug to your child at night only to prevent dizziness.”

b.

“Ensure that your child takes a multiple vitamin daily while he or she is on this drug.”

c.

“Check your child daily for a rash and call your healthcare provider immediately if one develops.”

d.

“Weigh your child weekly and be sure to report a weight loss of 2 lb or more to your healthcare provider at your next visit.”

...

21

Which drug category is useful in promoting sleep among patients with insomnia?

a.

Sedatives

b.

ACE inhibitors

c.

Atypical antipsychotics

d.

Selective serotonin reuptake inhibitors

...

22

____ 22. Which drug would you anticipate will be given to a patient who experienced an overdose of a benzodiazepine?

a.

Rifampin

b.

Naloxone

c.

Flumazenil

d.

Epinepherine

...

23

You are preparing to teach a patient with anxiety disorder about the actions of the nonbenzodiazepine drug buspirone. What would you inform the patient about how this drug works?

a.

“Buspirone acts by affecting the serotonin and dopamine neurotransmitters.”

b.

“Buspirone acts by inhibiting GABA pathways to decrease anxiety.”

c.

“Buspirone acts by affecting the monoamine oxidase pathway.”

d.

“Buspirone acts by inhibiting the action of dopamine receptors.”

...

24

The family of a patient who has been taking the antipsychotic fluphenazine (Prolixin) for the last 2 years. The patient’s family reports the patient has suddenly begun smacking her lips, and involuntarily sticking out her tongue. What would be your best first action?

a.

Call the healthcare provider to report these symptoms.

b.

Tell the family to hold the next dose of fluphenazine.

c.

Inform the family that these symptoms are expected, and of no concern.

d.

Tell the family that these symptoms will disappear over time as the drug dose stabilizes.

...

25

You are teaching a patient about the adverse effects associated with selective serotonin reuptake inhibitors (SSRIs). Which adverse effect would you inform your patient about?

a.

Metallic taste.

b.

Sexual dysfunction.

c.

Cardiovascular disease.

d.

Extrapyramidal symptoms.

...

26

A young adult patient taking an SSRI for the past 2 weeks comes in for an evaluation and follow-up appointment. Which potential side effect should you check for in this patient?

a.

Suicidal thoughts.

b.

Psychotic episodes.

c.

Delusional thinking.

d.

Schizo-affective disorders.

...

27

You are caring for a patient who will begin treatment for anxiety and depression that has been unresponsive to other drugs with isocarboxazid. Which of the following statements made by the patient would indicate understanding of the teaching related to this drug?

a.

“I will take both my isocarboxazid and my SSRI drugs at the same time each day.”

b.

“I will avoid situations that cause me to lose fluids and become dehydrated.”

c.

“I will avoid eating foods containing tyramine that can increase blood pressure.”

d.

“I will take my isocarboxazid weekly, as this drug is long-acting”

...

28

You have just completed teaching with a patient who is beginning lithium. Which of the following statements made by the patient demonstrates understanding of this drug?

a.

“I will need to increase my salt intake while taking this drug.”

b.

“I will need regular blood testing while taking this drug.”

c.

“I may develop mild memory loss while taking this drug.”

d.

“Lithium cannot be taken with tyrosine-containing foods.”

...

29

You are taking the history of a patient who is suspected of having lithium toxicity. What symptoms would you expect the patient to report?

a.

Increased drowsiness, weakness and nausea.

b.

Heart palpitations, seizures, and muscle spasm.

c.

Decreased urine output, vision loss and irritability.

d.

Increased mania, excessive salivation and tachycardia.

...