LPN Pharmacological Therapies 3 — Questions and Answers
Question 1: A patient is receiving IV vancomycin too rapidly and develops flushing and redness of the face, neck, and chest. The nurse recognizes this as:
- Anaphylaxis
- Red Man Syndrome (Correct answer)
- Stevens-Johnson Syndrome
- Serum sickness
Correct answer: Red Man Syndrome
Red Man Syndrome is an infusion-related reaction to rapid vancomycin administration, causing flushing and erythema over the upper body.
Question 2: Which instruction is most important when teaching a patient who is prescribed oral tetracycline?
- Take with a full glass of milk to prevent GI upset
- Take on an empty stomach and avoid dairy products (Correct answer)
- Take with antacids to improve absorption
- Take at bedtime to reduce side effects
Correct answer: Take on an empty stomach and avoid dairy products
Dairy products, antacids, and calcium chelate tetracycline, significantly reducing absorption; it should be taken on an empty stomach.
Question 3: A patient is prescribed metformin for type 2 diabetes. When should this medication be held?
- Before any outpatient appointment
- Before and after procedures requiring iodinated contrast dye (Correct answer)
- When blood glucose falls below 120 mg/dL
- During high-carbohydrate meals
Correct answer: Before and after procedures requiring iodinated contrast dye
Metformin must be held before contrast procedures and for 48 hours after to prevent lactic acidosis if contrast causes acute kidney injury.
Question 4: Which side effect is most commonly associated with ACE inhibitors such as lisinopril?
- Hyperkalemia and persistent dry cough (Correct answer)
- Hypokalemia and constipation
- Bradycardia and weight gain
- Peripheral edema and tachycardia
Correct answer: Hyperkalemia and persistent dry cough
ACE inhibitors commonly cause a dry, persistent cough due to bradykinin accumulation and can cause hyperkalemia by reducing aldosterone.
Question 5: The nurse is administering insulin glargine (Lantus). Which statement is correct about this medication?
- It should be mixed with regular insulin for better control
- It is a long-acting insulin with no pronounced peak (Correct answer)
- It must be given 30 minutes before meals
- It can be administered intravenously in emergencies
Correct answer: It is a long-acting insulin with no pronounced peak
Insulin glargine is a long-acting basal insulin with a flat action profile and no pronounced peak, providing 24-hour coverage.
Question 6: A patient receiving heparin therapy has an aPTT result of 120 seconds (therapeutic range 60-100 seconds). What is the appropriate nursing action?
- Increase the heparin infusion rate
- Administer the antidote protamine sulfate
- Notify the provider of supratherapeutic levels (Correct answer)
- Continue current infusion and recheck in 6 hours
Correct answer: Notify the provider of supratherapeutic levels
An aPTT above the therapeutic range indicates supratherapeutic anticoagulation; the nurse should notify the provider for dose adjustment.
Question 7: A nurse is preparing to administer a high-alert medication. Which safety practice is most critical?
- Checking the medication color before administration
- Performing an independent double-check with another nurse (Correct answer)
- Preparing the medication at the bedside
- Administering the medication before charting
Correct answer: Performing an independent double-check with another nurse
High-alert medications require an independent double-check by a second nurse to reduce the risk of serious patient harm.
LPN Pharmacological Therapies 3
A patient is receiving IV vancomycin too rapidly and develops flushing and redness of the face, neck, and chest.
The nurse recognizes this as: