LPN exams fundamentals practice questions, set 109
LPN exams · fundamentals
LPN exams fundamentals practice questionsset 109
You practice vitals, infection control, documentation, and the first nursing action when a patient is unstable. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five fundamentals questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Endocrine glands differ from exocrine glands in that .
A. endocrine glands are formed by epithelial tissue, but exocrine glands are primarily connective tissue
B. endocrine glands release hormones, whereas exocrine glands release waste
C. endocrine glands are ductless and exocrine glands release secretions at the body's surface or into ducts
D. endocrine glands are all interconnected, whereas exocrine glands act completely independently
Show answer and rationale
Correct answer: C — endocrine glands are ductless and exocrine glands release secretions at the body's surface or into ducts
Correct Answer: C
Rationale:
1. Endocrine glands are ductless: Endocrine glands release hormones directly into the bloodstream instead of using ducts.
2. Exocrine glands release secretions at the body's surface or into ducts: Exocrine glands release their secretions through ducts to the body's surface or specific locations.
3. Therefore, the key difference is the presence of ducts: Endocrine glands lack ducts, while exocrine glands have ducts for secretion. This distinction makes choice C the correct answer.
Summary:
A: Incorrect. Endocrine glands and exocrine glands can both be formed by epithelial tissue.
B: Incorrect. Exocrine glands release enzymes and other substances, not waste products.
D: Incorrect. There is no interconnection requirement for endocrine glands, and exocrine glands can also be interconnected.
Question 2
The ability of a specific tissue or organ to respond to the presence of a hormone is dependent on ________.
A. the location of the tissue or organ with respect to the circulatory path
B. the membrane potential of the cells of the target organ
C. the presence of the appropriate receptors on the cells of the target tissue or organ
D. nothingall hormones of the human body are able to stimulate any and all cell types because hormones are powerful and nonspecific
Show answer and rationale
Correct answer: C — the presence of the appropriate receptors on the cells of the target tissue or organ
The correct answer is C because the ability of a tissue or organ to respond to a hormone depends on the presence of specific receptors on the cells of the target tissue. These receptors are like locks that only fit the specific key (hormone). Without the appropriate receptors, the hormone cannot initiate a response.
A: The location of the tissue or organ with respect to the circulatory path may affect the speed of hormone delivery but does not determine the tissue's ability to respond.
B: The membrane potential of the cells of the target organ relates to cell signaling but does not determine the specificity of hormone response.
D: This choice is incorrect because hormones are specific and can only bind to cells with the appropriate receptors, making the statement that all hormones can stimulate any cell type nonsensical.
Question 3
The posterior pituitary gland stores and secretes
A. oxytocin and antidiuretic hormone
B. human growth hormone and thyroid stimulating hormone
C. prolactin and follicle stimulating hormone
D. glucocorticoids and androgens
Show answer and rationale
Correct answer: A — oxytocin and antidiuretic hormone
Step-by-step rationale:
1. The posterior pituitary gland stores oxytocin and antidiuretic hormone (ADH).
2. Oxytocin is responsible for uterine contractions and milk ejection.
3. ADH regulates water balance by controlling urine concentration.
4. These hormones are produced in the hypothalamus and released from the posterior pituitary.
5. Choice A is correct as it accurately identifies the hormones stored and secreted by the posterior pituitary.
Summary:
- Choice B is incorrect because human growth hormone and thyroid stimulating hormone are not stored or secreted by the posterior pituitary.
- Choice C is incorrect because prolactin and follicle stimulating hormone are produced by the anterior pituitary.
- Choice D is incorrect because glucocorticoids and androgens are not stored or secreted by the posterior pituitary.
Question 4
We want to prescribe scopolamine, as a transdermal drug delivery system (skin patch), for a patient who will be leaving for an expensive cruise and is very susceptible to motion sickness. For which of the following co-morbidities is scopolamine contraindicated?
A. Angle-closure (narrow-angle) glaucoma
B. Bradycardia
C. History of shellfish allergies
D. Resting blood pressure of 112/70
Show answer and rationale
Correct answer: A — Angle-closure (narrow-angle) glaucoma
The correct answer is A: Angle-closure (narrow-angle) glaucoma. Scopolamine, an anticholinergic medication, can worsen angle-closure glaucoma by causing pupil dilation leading to increased intraocular pressure. This can result in a sudden and severe increase in eye pressure, leading to potential vision loss. Therefore, it is contraindicated in patients with narrow-angle glaucoma.
B: Bradycardia is not a contraindication for scopolamine use as it may actually help in treating motion sickness.
C: History of shellfish allergies is not a contraindication for scopolamine as the medication is not derived from shellfish and is safe for patients with this allergy.
D: Resting blood pressure of 112/70 is not a contraindication for scopolamine use as it falls within the normal range and should not pose any significant risk.
Question 5
Nervousness, increased body temperature, and increased blood-pressure are indications of _______.
A. diabetes mellitus
B. hypoglycemia
C. hypothyroidism
D. hyperthyroidism
Show answer and rationale
Correct answer: D — hyperthyroidism
The correct answer is D: hyperthyroidism. Nervousness, increased body temperature, and increased blood pressure are classic symptoms of hyperthyroidism. This condition is characterized by an overactive thyroid gland, leading to an excess production of thyroid hormones. These hormones can cause an increase in metabolism, leading to symptoms such as nervousness, heat intolerance, and elevated heart rate. Diabetes mellitus (A) is not associated with increased body temperature or blood pressure. Hypoglycemia (B) is characterized by low blood sugar levels, leading to symptoms such as dizziness and confusion, not increased body temperature. Hypothyroidism (C) is characterized by an underactive thyroid gland, leading to symptoms such as fatigue, weight gain, and cold intolerance, not increased body temperature or blood pressure.
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Question 6
You are a resident in a hospital in a very poor part of the world. Their drug selection is limited. A patient presents with acute cardiac failure, for which your preferred drug is dobutamine, given intravenously. However, there is none available. Which of the following other drugs, or combination of drugs, would be a suitable alternative?
A. Dopamine (at a very high dose)
B. Ephedrine
C. Ephedrine plus propranolol
D. Norepinephrine plus phentolamine
Correct answer:
The correct answer is D: Norepinephrine plus phentolamine. Norepinephrine is a potent vasopressor that can increase blood pressure and cardiac output in acute cardiac failure. Phentolamine is an alpha-blocker that can help counteract the vasoconstrictive effects of norepinephrine.
Rationale:
1. Norepinephrine: Increases blood pressure and cardiac output, improving perfusion to vital organs in acute cardiac failure.
2. Phentolamine: Counteracts the vasoconstrictive effects of norepinephrine, preventing excessive vasoconstriction.
Summary:
A: Dopamine at a very high dose may not be as effective as norepinephrine in acute cardiac failure.
B: Ephedrine is a less potent vasopressor compared to norepinephrine.
C: Ephedrine plus propranolol combination may lead to conflicting effects on blood pressure and heart rate
Intravenous administration of epinephrine to a patient results in a severe decrease in diastolic pressure and an increase in cardiac output. Which of the following drugs might the patient have previously taken that could account for this unexpected effect?
A. Propranolol
B. Atropine
C. Phenylephrine
D. Prazosin
Correct answer:
The correct answer is D: Prazosin. Prazosin is an alpha-1 adrenergic receptor antagonist, which blocks the vasoconstrictor effect of catecholamines like epinephrine, leading to vasodilation and a decrease in diastolic pressure. The unexpected effect of a decrease in diastolic pressure and an increase in cardiac output after epinephrine administration suggests that the patient might have taken a drug that blocks alpha-1 receptors. Propranolol (A) is a beta-blocker, which would not cause this effect. Atropine (B) is a muscarinic receptor antagonist and would not explain the observed effects. Phenylephrine (C) is an alpha-1 agonist, so it would not result in the described response. Therefore, Prazosin (D) is the most likely drug the patient previously took to account for the unexpected effects of epinephrine administration.
Target cells for hypothalamic releasing hormones are in the
A. thyroid
B. hypothalamus
C. anterior pituitary
D. posterior pituitary
Correct answer:
The correct answer is C: anterior pituitary. Hypothalamic releasing hormones target cells in the anterior pituitary to stimulate the release of specific pituitary hormones. The hypothalamus produces releasing hormones that travel through the hypophyseal portal system and bind to receptors on cells in the anterior pituitary, triggering the release of hormones such as ACTH, TSH, LH, FSH, and GH. This interaction between the hypothalamus and anterior pituitary forms the hypothalamic-pituitary axis, regulating various physiological processes. Choices A (thyroid) and D (posterior pituitary) are incorrect as they are not the primary targets of hypothalamic releasing hormones. Choice B (hypothalamus) is also incorrect as releasing hormones do not target cells within the hypothalamus itself, but rather the anterior pituitary.
With respect to calcium metabolism / bone formation:
A. osteoclasts secrete alkaline phosphatase
B. osteoblasts are haemopoietic derivatives of monocyte lineage
C. 1,25(OH)2 ???D3 and PTH stimulate both osteoblasts and osteoclasts
D. oestrogens are thought to be protective of osteoporosis as their main effect is osteoblasts stimulation
Correct answer:
Rationale for Correct Answer (C):
1,25(OH)2 D3 and PTH stimulate both osteoblasts and osteoclasts. 1,25(OH)2 D3 enhances calcium absorption in the gut, promotes bone resorption, and stimulates osteoclast activity. PTH increases calcium levels in the blood by enhancing calcium reabsorption in the kidney and stimulating osteoclast activity. Both hormones indirectly stimulate osteoblasts by increasing calcium availability for bone formation.
Summary of Incorrect Choices:
A: Osteoclasts actually secrete acid, not alkaline phosphatase.
B: Osteoblasts are derived from mesenchymal stem cells, not monocytes.
D: Estrogens have a dual effect, inhibiting bone resorption by osteoclasts and stimulating bone formation by osteoblasts; their main effect is inhibiting osteoclast activity, not solely stimulating osteoblasts.
Step-by-step rationale:
1. Adrenaline causes vasoconstriction leading to increased blood pressure.
2. Prazosin is an alpha-1 adrenergic receptor antagonist.
3. By blocking alpha-1 receptors, prazosin reverses the vasoconstrictive effects of adrenaline.
4. Propranolol (A) is a non-selective beta-blocker and would not directly counteract adrenaline's vasoconstrictive effects.
5. Phenylephrine (B) is a vasoconstrictor itself and would further exacerbate the hypertensive effect of adrenaline.
6. Amphetamine (D) is a sympathomimetic drug that would also enhance the hypertensive effects of adrenaline.
Summary:
Prazosin (C) is the correct answer as it specifically targets the alpha-1 adrenergic receptors responsible for the hypertensive effects of adrenaline. Propranolol, phenylephrine, and amphetamine would
A 63-year-old man is in stable condition after an acute myocardial infarction when he became hypotensive for 3 hours before paramedical personnel arrived. Over the next week, the serum urea nitrogen level increases to 48 mg/dL, the serum creatinine level increases to 5 mg/dL, and the urine output decreases. He undergoes hemodialysis for the next 2 weeks and then develops marked polyuria, with urine output of 2 to 3 L/day. His renal function gradually returns to normal. Release of which of the following substances most likely participated in the elevation of BUN, creatinine, and reduced urinary output?
A. Aldosterone
B. Endothelin
C. Erythropoietin
D. Natriuretic peptide
Correct answer:
The most common cause of acute tubular necrosis is ischemic injury. The hypotension that develops after myocardial infarction causes decreased renal blood flow, with intrarenal vasoconstriction. Sublethal endothelial injury from reduced renal blood flow leads to the increased release of the vasoconstrictor endothelin and diminished amounts of the vasodilators nitric oxide and prostaglandin. The ischemic form of acute tubular injury is often accompanied by rupture of the basement membrane (tubulorrhexis). An initiating phase that lasts approximately 1 day is followed by a maintenance phase during which progressive oliguria and increasing blood urea nitrogen levels occur, with salt and water overload. This is followed by a recovery phase, during which there is a steady increase in urinary output and hypokalemia.
Priority Decision: A patient is admitted to the emergency department with acute abdominal pain. What nursing intervention should the nurse implement first?
A. Measurement of vital signs
B. Administration of prescribed analgesics
C. Assessment of the onset, location, intensity, duration, and character of the pain
D. Physical assessment of the abdomen for distention, bowel sounds, and pigmentation changes
Correct answer:
The correct answer is C. Assessing the onset, location, intensity, duration, and character of the pain is the priority because it helps determine the potential cause of the abdominal pain. This information guides further interventions and informs the healthcare team about the urgency of the situation.
Choice A (Measurement of vital signs) can be important but assessing the pain characteristics takes precedence as it directly informs the urgency of the situation.
Choice B (Administration of prescribed analgesics) should be delayed until the cause of the pain is identified to prevent masking symptoms that could aid in diagnosis.
Choice D (Physical assessment of the abdomen) is important but assessing the pain characteristics comes first to guide the physical assessment and subsequent interventions.
A client with ulcerative colitis, who experiences severe diarrhea, is prescribed a cleansing enema to relieve the symptoms. Which of the following interventions should the nurse consider at this stage?
A. Question the physician about the use of the cleansing enema
B. Educate the client about the procedure of cleansing enema
C. Position the client comfortably to receive the cleansing enema
D. Instruct the client to visit the toilet before receiving the enema
Correct answer:
The correct answer is A: Question the physician about the use of the cleansing enema. In this scenario, the nurse should question the physician because administering a cleansing enema to a client with ulcerative colitis and severe diarrhea can potentially exacerbate the condition. The nurse needs to verify if the enema is the appropriate intervention and if there are alternative treatments that may be safer and more effective.
Summary:
- Choice B: Educating the client about the procedure does not address the potential risks of administering the enema.
- Choice C: Positioning the client comfortably is important but does not address the appropriateness of the enema.
- Choice D: Instructing the client to visit the toilet before the enema does not address the potential risks associated with the procedure.
A patient diagnosed with severe hypermagnesemia is exhibiting diminished reflexes and respiratory depression. Which of the following interventions should be prioritized?
A. Administer calcium gluconate IV.
B. Initiate dialysis immediately.
C. Start an infusion of potassium chloride.
D. Provide oral phosphate supplements.
Correct answer:
The correct answer is A: Administer calcium gluconate IV. In severe hypermagnesemia, excess magnesium suppresses neuromuscular function, leading to diminished reflexes and respiratory depression. Calcium gluconate antagonizes the effects of hypermagnesemia and can quickly restore neuromuscular function, including respiratory drive. Prioritizing this intervention is crucial to prevent further respiratory compromise.
Choice B (Initiate dialysis immediately) may be necessary for severe cases, but it is not the initial priority in managing acute symptoms. Choice C (Start an infusion of potassium chloride) is incorrect as it can worsen hypermagnesemia by further disrupting electrolyte balance. Choice D (Provide oral phosphate supplements) is not appropriate for immediate management of severe hypermagnesemia.
Which is INCORRECT regarding nerve supply to the gut?
A. the blood vessels are known to have enteric, parasympathetic and sympathetic innervation
B. the myenteric plexus lies between the longitudinal and circular muscle layers
C. parasympathetic supply is via vagal and sacral nerve
D. sympathetic supply is often inhibitory on cholinergic postganglionic fibres
Correct answer:
The correct answer is A because blood vessels in the gut are primarily innervated by sympathetic and parasympathetic fibers, not by enteric nerves. Enteric nerves are confined to the gastrointestinal tract itself and are responsible for regulating gut motility, secretion, and blood flow. Sympathetic innervation typically causes vasoconstriction, while parasympathetic innervation promotes vasodilation. The myenteric plexus (Auerbach's plexus) lies between the longitudinal and circular muscle layers, regulating gut motility. Parasympathetic supply to the gut is mainly through the vagus nerve (cranial nerve X) and sacral nerves (pelvic splanchnic nerves). Sympathetic supply can either be inhibitory or excitatory, but generally, sympathetic fibers are inhibitory on cholinergic postganglionic fibers in the gut.
LPN exams fundamentals practice questions, set 109 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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