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
A new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment. Which action by the nurse is best?
A. Ensure the client is placed in protective isolation.
B. Hand off a pregnant client to another nurse.
C. No special action is necessary to care for this client.
D. Read the policy on handling radioactive excreta.
Show answer and rationale
Correct answer: D — Read the policy on handling radioactive excreta.
Iodine-131 is a radioactive isotope used in treatments like thyroid cancer therapy, and it is excreted through body fluids such as urine and sweat. This poses a radiation hazard to healthcare workers and others if not managed properly. The best action for a new nurse is to read the facility's policy on handling radioactive excreta, as this ensures adherence to safety protocols specific to the institution, protecting both the nurse and the client. Protective isolation is not typically required for iodine-131 patients; instead, radiation precautions limit exposure to others. Handing off a pregnant client might be relevant in other contexts but isn't the priority here unless the nurse is pregnant herself, which isn't specified. Assuming no special action is needed is dangerous given the radioactive nature of the treatment. Reviewing the policy equips the nurse with the knowledge to manage waste, maintain a safe distance, and use protective equipment, aligning with radiation safety principles critical in oncology nursing.
Question 2
During the implementation phase of the nursing process for medication administration, which procedure is considered essential?
A. Monitor the patient's response to the drug therapy
B. Following the five rights of medication administration
C. Establishing measurable and realistic outcomes
D. Use NANDA nursing diagnoses to plan care delivery
Show answer and rationale
Correct answer: B — Following the five rights of medication administration
In the nursing process, the implementation phase focuses on carrying out the planned interventions, such as administering medications to the patient. A critical aspect of this phase is ensuring safety and accuracy during medication administration. The five rights ensuring the correct patient receives the correct drug, in the correct dose, via the correct route, at the correct time serve as a universal standard to minimize errors and promote patient safety. Monitoring the patient's response is important but typically occurs in the evaluation phase, not implementation. Establishing outcomes is part of the planning phase, while using NANDA diagnoses aids in identifying problems during assessment and planning, not directly during implementation. The emphasis on the five rights directly aligns with the hands-on action of giving medication, making it essential to this phase. This structured approach reduces the risk of adverse events, ensures therapeutic effectiveness, and upholds professional standards in nursing practice.
Question 3
Which of the following medication types are used to decrease the workload of the heart by blocking sympathetic stimulation of receptors that work on the SA node and myocardial cells, thus decreasing the force of myocardial contraction and directly reducing a patient's heart rate?
A. Alpha-adrenergic agents
B. Beta-blockers
C. Calcium-channel blockers
D. Sodium-channel blockers
Show answer and rationale
Correct answer: B — Beta-blockers
The correct answer is B: Beta-blockers. Beta-blockers decrease the workload of the heart by blocking the sympathetic stimulation of beta-adrenergic receptors in the heart. This action results in a decrease in heart rate and the force of myocardial contraction. By blocking these receptors, beta-blockers reduce the impact of adrenaline and other stress hormones on the heart, leading to a decrease in the heart's workload.
A: Alpha-adrenergic agents primarily work on alpha-adrenergic receptors and do not have the same effect on decreasing the workload of the heart.
C: Calcium-channel blockers work by blocking calcium channels in the heart and blood vessels, leading to vasodilation and decreased contractility of the heart. While they can reduce the heart's workload, they do not primarily target sympathetic stimulation of receptors working on the SA node and myocardial cells.
D: Sodium-channel blockers primarily affect the conduction of electrical impulses in the heart and are used for different purposes, such as
Question 4
Several clients are members of a therapy group for clients with eating disorders. Of what particular use is this type of group therapy for treatment of eating disorders?
A. Spending time in a group setting helps the client focus on things other than food.
B. Interacting with clients who have similar problems helps prevent secondary gains related to being different.
C. Focusing on problems experienced by other group members helps the client avoid having to deal with personal concerns.
D. None of the above.
Show answer and rationale
Correct answer: B — Interacting with clients who have similar problems helps prevent secondary gains related to being different.
The correct answer is B because interacting with clients who have similar problems in a therapy group for eating disorders helps prevent secondary gains related to feeling different or unique in their struggles. This interaction can offer a sense of validation, support, and understanding, which can be crucial for individuals with eating disorders. It fosters a sense of belonging and reduces the feelings of isolation that often accompany these disorders.
Choice A is incorrect because the primary focus of group therapy for eating disorders is to address and work through issues related to food and body image, rather than distracting clients from these concerns.
Choice C is incorrect because the purpose of group therapy is to provide a safe space for clients to explore and address their personal concerns within a supportive group setting, not to avoid dealing with them.
Choice D is also incorrect as interacting with similar others in a therapy group has specific benefits for individuals with eating disorders.
Question 5
The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines, antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient would most likely include which drug or drug classes?
A. Vasodilators alone
B. ACE inhibitors alone
C. Calcium channel blockers with thiazide diuretics
D. Beta blockers with thiazide diuretics
Show answer and rationale
Correct answer: C — Calcium channel blockers with thiazide diuretics
The correct answer is C: Calcium channel blockers with thiazide diuretics. According to JNC-8 guidelines, for African-American patients with hypertension, initial drug therapy should include calcium channel blockers or thiazide diuretics due to their proven efficacy in this population. Calcium channel blockers help relax blood vessels and improve blood flow, while thiazide diuretics help reduce fluid volume and blood pressure. This combination has shown better outcomes and reduced risk of adverse effects in African-American patients.
Incorrect choices:
A: Vasodilators alone - Not recommended as initial therapy for newly diagnosed hypertensive African-American patients.
B: ACE inhibitors alone - While ACE inhibitors are effective in treating hypertension, they are not the first-line choice for African-American patients based on JNC-8 guidelines.
D: Beta blockers with thiazide diuretics - Beta blockers are not the preferred initial therapy for hypertensive African-American patients according to JNC-8 guidelines.
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Question 6
What type of immunity is present at birth?
A. Active
B. Passive
C. Nonspecific
D. Specific
Correct answer:
The correct answer is C: Nonspecific. At birth, infants possess nonspecific immunity, also known as innate immunity. This type of immunity provides immediate defense against a wide range of pathogens without prior exposure. It includes physical barriers like skin, chemical barriers like stomach acid, and cellular defenses like macrophages. This innate immunity is essential for protecting newborns from infections until their adaptive immune system develops.
Explanation of other choices:
A: Active immunity is acquired through exposure to antigens and the subsequent production of antibodies by the individual's own immune system. It is not present at birth.
B: Passive immunity is acquired through the transfer of pre-formed antibodies from another individual, such as through breast milk or placental transfer. It is not present at birth.
D: Specific immunity, also known as adaptive immunity, is developed over time through exposure to specific antigens and the production of memory cells. It is not present at birth.
A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume of a television or radio. The most likely cause of his hearing loss is:
A. Otosclerosis.
B. Presbycusis.
C. Trauma to the bones.
D. Frequent ear infections.
Correct answer:
The correct answer is A: Otosclerosis. Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, specifically the stapes bone. This abnormal bone growth can lead to conductive hearing loss, which may result in the patient experiencing progressive hearing loss. In this case, the patient's symptoms of hearing improvement with louder sounds or increased volume suggest a conductive hearing loss, which is common in otosclerosis.
Choice B: Presbycusis, is age-related hearing loss and typically presents as a gradual decline in hearing over time, not necessarily with a sudden progressive loss as described in the scenario.
Choice C: Trauma to the bones would likely result in a more sudden onset of hearing loss, not a progressive loss as described in the scenario.
Choice D: Frequent ear infections may lead to temporary hearing loss due to fluid buildup or damage to the ear structures, but the symptoms described in the scenario are more indicative of a chronic condition like otosclerosis.
The nursing staff is continually upset about inability to provide clients with supplies needed because third-party payers will not reimburse for those items. This is an example of which conflict antecedent
A. Task interdependencies
B. Distancing
C. Role
D. Incompatible goals
Correct answer:
The correct answer is D: Incompatible goals. In this scenario, the conflict arises from the incompatible goals of the nursing staff wanting to provide necessary supplies to clients and the third-party payers not reimbursing for those items. This conflict stems from the misalignment of goals between the two parties, leading to frustration and upset among the nursing staff.
A: Task interdependencies refer to conflicts arising from the interdependence of tasks, which is not the main issue in this scenario.
B: Distancing involves avoiding or minimizing contact with the source of conflict, which is not the primary factor in this situation.
C: Role conflict arises when individuals experience conflicting expectations from different roles, which is not the central issue in the scenario.
In summary, the correct answer is D because the conflict stems from the incompatible goals between the nursing staff and third-party payers, while the other choices do not accurately capture the main conflict antecedent in this scenario.
What is the purpose of progesterone supplementation after embryo transfer in IVF?
A. To induce ovulation for the next cycle.
B. To support the uterine lining and enhance implantation success.
C. To suppress natural hormone levels for better control.
D. To eliminate the risk of multiple pregnancies.
Correct answer:
The correct answer is B: To support the uterine lining and enhance implantation success. Progesterone supplementation is crucial after embryo transfer in IVF because it helps prepare the uterine lining for implantation and provides hormonal support to maintain a pregnancy. Progesterone is essential for the embryo to implant and for the early stages of pregnancy to progress. Therefore, the purpose of progesterone supplementation is to enhance the chances of successful implantation and support early pregnancy development.
Choices A, C, and D are incorrect:
A: To induce ovulation for the next cycle - Progesterone supplementation is not used to induce ovulation after embryo transfer in IVF. Ovulation should have already occurred before the embryo transfer.
C: To suppress natural hormone levels for better control - Progesterone supplementation is not used to suppress hormone levels but rather to support hormonal balance during the implantation phase.
D: To eliminate the risk of multiple pregnancies - Progesterone
A 70 year old suffers blunt chest trauma after being struck by a car. On presentation, his GCS is 15, BP is 145/90, HR is 72. RR is 24 and O2-sat on 5L is 91%. Chest x-ray demonstrates multiple right sided rib fractures. ECG demonstrates normal sinus rhythm with no conduction abnormalities. Management should include:
A. "Placement of a 22Fr right sided chest tube"
B. "Serial troponins and cardiac monitoring"
C. "Monitored i.v analgesia"
D. "Thoracic splinting
Correct answer:
The correct answer is C: "Monitored i.v analgesia." In this scenario, the patient has blunt chest trauma with rib fractures causing pain. The management should focus on controlling pain to improve respiratory effort and prevent complications like pneumonia. IV analgesia is recommended to provide effective pain relief and improve patient outcomes.
Choice A: "Placement of a 22Fr right sided chest tube" is incorrect because there is no indication for chest tube insertion based on the information provided. The patient's vital signs are stable and there are no signs of tension pneumothorax.
Choice B: "Serial troponins and cardiac monitoring" is incorrect because there are no indications of cardiac injury based on the normal ECG and the absence of cardiac symptoms. Troponins and cardiac monitoring are not necessary at this point.
Choice D: "Thoracic splinting" is incorrect because splinting is not typically recommended for rib fractures in elderly patients. It may restrict respiratory effort and cause more harm
The nurse manager is conducting an educational session for the nurses on non-selective beta-adrenergic blockers ( $\beta$ blockers). How should the nurse manager accurately describe the mechanism of action of these medications? List the options in order from first to last.
A. Heart rate and blood pressure are decreased
B. Epinephrine and norepinephrine actions are blocked
C. Betaâ‚ and betaâ‚‚ receptor sites are blocked
D. Cardiac workload and oxygen demand decreases
Correct answer:
Non-selective beta-adrenergic blockers (e.g., propranolol) inhibit the sympathetic nervous system's effects on betaâ‚ (heart) and betaâ‚‚ (lungs, vessels) receptors. The mechanism sequence is: (1) Betaâ‚ and betaâ‚‚ receptor sites are blocked (C), (2) Epinephrine and norepinephrine actions are blocked (B), (3) Heart rate and blood pressure are decreased (A), (4) Cardiac workload and oxygen demand decreases (D). Blocking beta receptors (C) is the initial step, preventing catecholamines (B) from binding, which reduces heart rate and vasoconstriction (A), ultimately lowering myocardial oxygen demand (D). Incorrect sequencing, like starting with heart rate reduction, skips the pharmacological basis. The CSV requires one answer, so C is chosen as the foundational step. Rationale: Beta blockade directly inhibits receptor activation, a primary action taught in pharmacology education, leading to downstream effects critical for conditions like hypertension or angina, ensuring nurses understand the drug's systemic impact.
Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend?
A. Continue fundal massage, and pack the vagina with sterile ABD or trauma pads
B. Administer lactated Ringer's solution run wide open using macro-drip tubing under pressure
C. Administer a fluid bolus of 1,000 mL of normal saline, and transport the patient in the Trendelenburg position
D. Administer oxytocin infusion (1 unit per 100 mL of lactated Ringer's solution) at 20 to 30 gtts/min (micro-drip tubing) depending on bleeding severity
Correct answer:
The correct answer is D because administering oxytocin infusion is the most appropriate intervention for postpartum hemorrhage due to uterine atony, which is a common cause of excessive bleeding after delivery. Oxytocin helps to stimulate uterine contractions, which will help control the bleeding by reducing the size of the blood vessels at the placental site. This intervention is evidence-based and recommended in postpartum hemorrhage management protocols. Other choices are incorrect because:
A: Packing the vagina is not indicated unless there is active vaginal bleeding that cannot be controlled by other methods.
B: Administering lactated Ringer's solution at a rapid rate is not the first-line treatment for postpartum hemorrhage.
C: Trendelenburg position and a fluid bolus of normal saline are not recommended as they can increase the risk of fluid overload and do not address the underlying cause of the bleeding.
In summary, administering oxytocin infusion is the most appropriate intervention to manage post
Which statement demonstrates an understanding of the value of using rating scales when assessing and documenting client responses?
A. Documentation is standardized for all depressed clients when you use the depression rating scale.'
B. The depression rating scale makes tracing a client's response to antidepressant medication much more reliable.'
C. Clients seem to be able to assign a number to their feelings of depression better than describing them verbally.'
D. Depressed clients seldom have the energy to adequately respond to an assessment if a depression rating scale isn't used.'
Correct answer:
The correct answer is B because using a rating scale, like the depression rating scale, provides a quantifiable measure of a client's depressive symptoms, allowing for a more objective assessment and tracking of changes over time. It enhances reliability by standardizing the evaluation process and making it easier to monitor the effectiveness of interventions, such as antidepressant medication. This choice highlights the value of rating scales in clinical practice.
Incorrect answers:
A: This choice focuses on standardization of documentation but doesn't directly address the value of using rating scales for assessing client responses.
C: While clients may find it easier to assign a number to their feelings, this does not specifically relate to the benefits of using rating scales in assessment and documentation.
D: This choice makes assumptions about the energy levels of depressed clients and does not address the key point of the question about the value of using rating scales for assessment and documentation.
The infection control nurse has asked the staff to work on reducing the number of iatrogenic infections on the unit. Which of the following actions on the nurses’ part would contribute to reducing health care–acquired infections? (Select all that apply.)
A. Teaching correct handwashing to assigned patients
B. Using correct procedures in starting and caring for an intravenous infusion
C. Providing perineal care to a patient with an indwelling urinary catheter
D. Isolating a patient on antibiotics who has been having loose stool for 24 hours
Correct answer:
Correct Answer: C
Rationale:
1. Providing perineal care to a patient with an indwelling urinary catheter is essential in preventing infections as it helps maintain proper hygiene and reduces the risk of urinary tract infections.
2. Proper perineal care also helps in preventing catheter-associated urinary tract infections (CAUTIs), which are common iatrogenic infections in healthcare settings.
3. This action aligns with evidence-based practice guidelines for reducing healthcare-acquired infections.
Summary:
- Choice A (Teaching correct handwashing): While important for overall infection control, this choice does not directly address reducing iatrogenic infections.
- Choice B (Using correct procedures for IV care): While important for preventing bloodstream infections, it does not specifically target iatrogenic infections.
- Choice D (Isolating a patient on antibiotics with loose stool): Isolation helps with preventing the spread of infectious diseases but does not directly address iatrogenic infections.
A nurse is moving to another state and will be working at an acute care facility. Prior to beginning practice, what actions should the nurse take to be compliant with state guidelines for nursing practice?
A. Research the laws and regulations that govern nursing practice in the new state
B. Visit the state board of nursing offices
C. Locate the state nursing practice acts
D. Let the present state board of nursing know that the nurse is leaving the state
Correct answer:
Relocating to practice nursing in a new state requires diligence to ensure compliance with local regulations, as each state's nurse practice act varies, even within compact states. Researching the laws and regulations governing nursing practice in the new state is a critical first step, providing insight into licensure requirements, scope of practice, and any unique provisions. Locating the state nursing practice act, often available online, offers the primary source of these rules, allowing the nurse to study and reference them regularly for updates. Accessing educational resources, like those from the National Council of State Boards of Nursing (NCSBN), further clarifies expectations. Visiting the state board isn't necessary unless required for licensure, and notifying the current state isn't typically mandatory unless exiting a compact agreement. These actions ensure the nurse practices legally and safely, adapting to the new state's standards while protecting their professional integrity and patient safety.
LPN exams fundamentals practice questions, set 12 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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