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 22 year old male presents in your clinic, c/o pain in his testicle and penis. The pain began last night and has steadily become worse. He hurts when he urinates. He has not attempted intercourse since the pain began. He has tried Tylenol and Ibuprofen without improvement. Denies fever or night sweats. He has had 4 previous sexual partners and has had a new partner for the last month. She is using oral contraceptives and they do not use a condom. On exam, you see a young man lying on his side, mildly ill. His temp is 100.2. There are no visible lesions on the penis, or discharge from the meatus. The scrotum appears normal. Palpation of the testes reveals severe tenderness at the superior pole of the normal-sized left testicle. He also has tenderness when you palpate the structures superior to the testicle through the scrotal wall. The right testicle is unremarkable. An examining finger is placed through each inguinal ring without bulges noted with bearing down. Urine analysis shows WBCs and bacteria. What diagnosis of the male genitalia is most likely?
A. Acute orchitis
B. Acute epididymitis
C. Torsion of the spermatic cord
D. Prostatitis
Show answer and rationale
Correct answer: B — Acute epididymitis
The correct answer is B: Acute epididymitis. The patient's symptoms of pain in the testicle and penis, worsened pain with urination, and presence of WBCs and bacteria in the urine analysis are indicative of an infection. The severe tenderness at the superior pole of the left testicle and tenderness on palpation of structures superior to the testicle through the scrotal wall suggest involvement of the epididymis. The risk factors of multiple sexual partners and recent unprotected intercourse also support the diagnosis of epididymitis, which is commonly caused by sexually transmitted infections. Acute orchitis (choice A) typically presents with swelling and tenderness of the entire testicle, not just the epididymis. Torsion of the spermatic cord (choice C) presents with sudden onset severe testicular pain and may have a high-riding testicle. Prostatitis (choice D) presents with symptoms related to the prostate gland, such as pelvic
Question 2
Your client has an allergy to both penicillin and latex. Which of these pathophysiological facts should you apply when you are providing to this client?
A. The sensitizing dose of penicillin can lead to anaphylaxis.
B. The second dose of penicillin can lead to distributive shock.
C. You should be aware of the fact that about 10% of the population has an allergy to both penicillin and latex.
D. You should be aware of the fact that about 20% of the population has an allergy to both penicillin and latex.
Show answer and rationale
Correct answer: A — The sensitizing dose of penicillin can lead to anaphylaxis.
The correct answer is A. When a client has an allergy to both penicillin and latex, it is important to consider the risk of anaphylaxis from the sensitizing dose of penicillin. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur upon exposure to an allergen. In this case, the client's history of allergies indicates a heightened risk for anaphylaxis with penicillin. This pathophysiological fact is crucial to consider when providing care to this client.
Choices B, C, and D are incorrect because they do not directly address the specific risk associated with the client's allergy to both penicillin and latex. Choice B refers to distributive shock, which is not the primary concern in this scenario. Choices C and D provide statistics about the prevalence of allergies to penicillin and latex in the population, but these do not directly impact the care of a client with allergies to both substances.
Question 3
The nurse is obtaining a health history on a 3-month-old infant. During the interview, the mother states, "I think she is getting her first tooth because she has started drooling a lot." The nurse's best response would be:
A. "You're right, drooling is usually a sign of the first tooth."
B. "It would be unusual for a 3 month old to be getting her first tooth."
C. "This could be the sign of a problem with the salivary glands."
D. "She is just starting to salivate and hasn't learned to swallow the saliva."
Show answer and rationale
Correct answer: D — "She is just starting to salivate and hasn't learned to swallow the saliva."
The correct response is D: "She is just starting to salivate and hasn't learned to swallow the saliva." At 3 months old, infants often start drooling due to increased salivation as their salivary glands develop. This response acknowledges normal infant development and provides an explanation for the observed behavior.
Choice A (You're right, drooling is usually a sign of the first tooth) is incorrect because while drooling can be associated with teething, it is not the primary reason for drooling in a 3-month-old.
Choice B (It would be unusual for a 3-month-old to be getting her first tooth) is incorrect because teething can start as early as 3 months, although it is more common around 6 months.
Choice C (This could be the sign of a problem with the salivary glands) is incorrect as it jumps to a less likely conclusion of a salivary gland issue without considering the normal developmental process of salivation in infants
Question 4
A gerontologic nurse is teaching a group of medical nurses about the high incidence and mortality of pneumonia in older adults. What is a contributing factor to this that the nurse should describe?
A. Older adults have less compliant lung tissue than younger adults
B. Older adults are not normally candidates for pneumococcal vaccination
C. Older adults often lack the classic signs and symptoms of pneumonia
D. Older adults often cannot tolerate the most common antibiotics used to treat pneumonia
Show answer and rationale
Correct answer: C — Older adults often lack the classic signs and symptoms of pneumonia
Older adults' high pneumonia incidence and mortality partly stem from atypical presentations, lacking classic signs like cough, fever, or chest pain, which delays diagnosis. Aging alters immune responses and symptom expression e.g., confusion or lethargy may predominate over respiratory complaints complicating timely treatment, especially in frail or comorbid patients. Lung compliance decreases with age, but this structural change doesn't directly obscure symptoms. Older adults are prime candidates for pneumococcal vaccination (e.g., PPSV23), recommended at 65+, countering higher risk, not excluding them. Antibiotic tolerance varies individually, not universally limiting treatment. The nurse's focus on absent classic signs educates staff to suspect pneumonia in subtle presentations (e.g., falls, delirium), prompting earlier diagnostics (e.g., chest X-ray) and intervention, critical for reducing mortality in this vulnerable group.
Question 5
The lower shelf of a bedside stand is generally used for storage of these items:
A. Water pitcher and cup
B. Linen and towel
C. Bedpan and urinal
D. Emesis basin and toothbrush
Show answer and rationale
Correct answer: C — Bedpan and urinal
The correct answer is C, bedpan and urinal, because the lower shelf of a bedside stand in a healthcare setting is typically used for storing items that are essential for patient care and comfort. Bedpans and urinals are commonly needed for patients who have difficulty getting out of bed to use the bathroom. These items are easily accessible when stored on the lower shelf, allowing healthcare providers to quickly assist patients.
A: Water pitcher and cup are usually placed on the top surface of the bedside stand for easy access by the patient.
B: Linen and towel are typically stored in a separate linen closet or cart in the patient's room.
D: Emesis basin and toothbrush are usually kept on the bedside table or in a designated area for personal hygiene needs.
In summary, choice C is correct as it aligns with the practicality and convenience of storing essential items for patient care on the lower shelf of a bedside stand.
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Question 6
Which nursing statement explains how methylphenidate works when teaching parents about this medication?
A. "Methylphenidate's sedation side effect assists children by decreasing their energy level."
B. "How methylphenidate works is unknown. Although it is a stimulant, it does combat the symptoms of ADHD."
C. "Methylphenidate helps the child focus by decreasing the amount of dopamine in the basal ganglia and neuron synapses."
D. "Methylphenidate decreases hyperactivity by increasing serotonin levels."
Correct answer:
The correct answer is B. Methylphenidate is a stimulant that works by increasing the levels of certain neurotransmitters in the brain, specifically dopamine and norepinephrine. It helps improve focus, attention, and impulse control in individuals with ADHD. While the exact mechanism of how it works is not fully understood, research suggests that it enhances the activity of these neurotransmitters in the brain.
Choice A is incorrect because methylphenidate is not a sedative and does not decrease energy levels.
Choice C is incorrect because methylphenidate works by increasing, not decreasing, the levels of dopamine in the brain.
Choice D is incorrect because methylphenidate primarily affects dopamine and norepinephrine levels, not serotonin levels.
In summary, choice B is the correct answer as it accurately describes the general understanding of how methylphenidate works as a stimulant to alleviate symptoms of ADHD.
During artificial ventilation in a patient with chronic obstructive pulmonary disease, air trapping:
A. Leads to hypotension when venous return is reduced significantly.
B. Is likely to be present when the capnogram fails to reach a plateau in expiration.
C. May be reduced by using a low respiratory rate.
D. Is reduced by decreasing the ratio of inspiratory time to expiratory time.
Correct answer:
Air trapping in COPD during mechanical ventilation occurs due to incomplete exhalation from airway obstruction, leading to intrinsic positive end-expiratory pressure (auto-PEEP). This increases intrathoracic pressure, compressing the vena cava and reducing venous return, which can cause hypotension a critical complication. A capnogram failing to plateau suggests prolonged exhalation, consistent with air trapping, but it's a diagnostic sign, not a consequence. A low respiratory rate allows more exhalation time, reducing air trapping, while decreasing the inspiratory-to-expiratory time ratio (e.g., shortening inspiration) similarly helps by extending exhalation. Positive end-expiratory pressure (PEEP) can exacerbate air trapping if excessive, but its effect depends on levels used. Hypotension from reduced venous return is a direct physiological result of severe air trapping, making it the most definitive statement in this context.
Which of the following best describes the general survey component of the physical examination?
A. It assesses the patient's chief complaint.
B. It includes observations about the patient's appearance, behavior, and mobility.
C. It documents findings from a review of systems.
D. It evaluates the patient's vital signs.
Correct answer:
The correct answer is B because the general survey component of the physical examination focuses on observations related to the patient's appearance, behavior, and mobility. This step is crucial in gathering initial information about the patient's overall health status and can provide important clues for further evaluation. Assessing the patient's appearance can reveal signs of distress, nutritional status, or hygiene. Observing behavior can indicate mental status or emotional state. Mobility assessment can identify physical limitations or abnormalities.
A, C, and D are incorrect:
A: Assessing the patient's chief complaint is part of the focused history taking, not the general survey component.
C: Documenting findings from a review of systems is part of the comprehensive history taking, not the general survey.
D: Evaluating vital signs is a separate component of the physical examination and not part of the general survey.
A patient has talked constantly throughout the group therapy session, often repeating the same comments. Other members were initially attentive then became bored, inattentive, and finally sullen. Which comment by the nurse leader would be most effective?
A. Say to everyone, Most of you have become quiet. I wonder if it might be related to concerns you may have about how the group is progressing today.
B. Say to everyone, One person has done most of the talking. I think it would be helpful for everyone to say how that has affected your experience of the group.
C. Say to everyone, I noticed that as our group progressed, most members became quiet, then disinterested, and now seem almost angry. What is going on?
D. Say to the talkative patient, You have been doing most of the talking, and others have not had a chance to speak as a result. Could you please yield to others now?
Correct answer:
The most effective action the nurse leader can take will be the one that encourages the group to solve its own problem. Pointing out changes in the group and asking members to respond to them lays the foundation for a discussion of group dynamics. Asking members to respond to the talkative patient puts that patient in an awkward position, likely increasing her anxiety. As anxiety increases, monopolizing behavior tends to increase as well, so this response would be self-defeating. Asking members what is going on is a broader opening and might lead to responses unrelated to the issue that bears addressing; narrowing the focus to the group process more directly addresses what is occurring in the group. Focusing on the talkative patient would be less effective and involves the leader addressing the issue instead of members first attempting to do so themselves (giving them a chance to practice skills such as assertive communication).
A patient has talked constantly throughout the group therapy session, often repeating the same comments. Other members were initially attentive then became bored, inattentive, and finally sullen. Which comment by the nurse leader would be most effective?
A. Say to everyone, "Most of you have become quiet. I wonder if it might be related to concerns you may have about how the group is progressing today."
B. Say to everyone, "One person has done most of the talking. I think it would be helpful for everyone to say how that has affected your experience of the group."
C. Say to everyone, "I noticed that as our group progressed, most members became quiet, then disinterested, and now seem almost angry. What is going on?"
D. Say to the talkative patient, "You have been doing most of the talking, and others have not had a chance to speak as a result. Could you please yield to others now?"
Correct answer:
The most effective action the nurse leader can take will be the one that encourages the group to solve its own problem. Pointing out changes in the group and asking members to respond to them lays the foundation for a discussion of group dynamics. Asking members to respond to the talkative patient puts that patient in an awkward position, likely increasing her anxiety. As anxiety increases, monopolizing behavior tends to increase as well, so this response would be self-defeating. Asking members what is going on is a broader opening and might lead to responses unrelated to the issue that bears addressing; narrowing the focus to the group process more directly addresses what is occurring in the group. Focusing on the talkative patient would be less effective and involves the leader addressing the issue instead of members first attempting to do so themselves (giving them a chance to practice skills such as assertive communication).
A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, "Describe what you think about your present weight and how you look."Â Which response would be most consistent with anorexia nervosa?
A. "I'm fat and ugly."Â
B. "What I think about myself is my business."Â
C. "I'm grossly underweight, but I cover it well."Â
D. "I'm a few pounds overweight, but I can live with it."Â
Correct answer:
The correct answer is A because the response indicates a distorted body image, a common characteristic of anorexia nervosa. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted perception of body image, leading individuals to see themselves as overweight despite being underweight. In this case, the patient's response of "I'm fat and ugly" demonstrates a negative perception of their weight and appearance, which aligns with the distorted body image seen in anorexia nervosa.
Choices B, C, and D are incorrect:
B: "What I think about myself is my business" - This response does not indicate a distorted body image or negative perception of weight and appearance, which are key features of anorexia nervosa.
C: "I'm grossly underweight, but I cover it well" - While this response acknowledges being underweight, it does not reflect the distorted body image commonly seen in anorexia nervosa.
D: "I'm a
A client with anorexia nervosa has refused meal trays and supplemental feedings for 3 days following admission to the general hospital. The nurse can anticipate that intervention will include:
A. IV infusions beginning immediately and continuing for 48 hours after client begins eating.
B. Tube feedings until the client eats 90% of all meals for 1 day.
C. Placing the client on suicide precautions and one-to-one observation.
D. Limiting peer group visitors for 2 weeks.
Correct answer:
The correct answer is B. Tube feedings until the client eats 90% of all meals for 1 day. This intervention is appropriate for a client with anorexia nervosa who is refusing to eat. Tube feedings ensure adequate nutrition while also encouraging the client to resume eating orally. It is a gradual approach that aims to transition the client back to regular eating habits.
Explanation for why other choices are incorrect:
A: IV infusions are not the first-line intervention for a client with anorexia nervosa refusing to eat. This choice does not address the underlying issue of the client's refusal to eat.
C: Placing the client on suicide precautions and one-to-one observation is not indicated solely based on refusal to eat. This choice does not address the nutritional needs of the client.
D: Limiting peer group visitors for 2 weeks does not address the client's refusal to eat and is not a relevant intervention in this situation.
Under which of the following conditions should a nursing assistant not take an oral temperature on a person?
A. The person has influenza.
B. The person almost certainly has a fever.
C. The person is over six years old.
D. The person is confused or disoriented.
Correct answer:
The correct answer is D because when a person is confused or disoriented, they may not be able to cooperate in holding the thermometer properly or keeping their mouth closed during the reading, leading to inaccurate results. Therefore, it is crucial not to take an oral temperature in such cases to ensure the accuracy of the measurement.
Choice A (The person has influenza) is not a valid reason to avoid taking an oral temperature. Influenza itself does not prevent the accurate measurement of oral temperature.
Choice B (The person almost certainly has a fever) does not necessarily indicate that an oral temperature should not be taken. It is still important to assess the person's temperature accurately to confirm the presence of a fever.
Choice C (The person is over six years old) is irrelevant to the decision of not taking an oral temperature. Age alone does not impact the ability to take an oral temperature accurately.
An 18 y/o man presents with paralysis in both legs and arms after a motorcycle crash. His BP is 60/40 and pulse 140 bpm. He should:
A. "Undergo exploratory celiotomy"
B. Be treated for neurogenic shock
C. Be treated for hypovolemic shock
D. Undergo immediate nasotracheal intubation
Correct answer:
The correct answer is C: Be treated for hypovolemic shock.
Rationale:
1. The patient's low blood pressure (60/40) and high pulse rate (140 bpm) indicate hypovolemic shock due to significant blood loss from the crash.
2. Treatment for hypovolemic shock involves restoring intravascular volume with intravenous fluids to improve perfusion and stabilize the patient's condition.
3. Initiating treatment for hypovolemic shock is crucial to prevent further complications and improve the patient's chances of survival.
Summary:
- Choice A (Undergo exploratory celiotomy) is incorrect as it involves abdominal surgery and is not indicated based on the presented symptoms.
- Choice B (Be treated for neurogenic shock) is incorrect as the symptoms are more indicative of hypovolemic shock.
- Choice D (Undergo immediate nasotracheal intubation) is incorrect as airway management is not the primary concern in this scenario, addressing hypov
After the blood transfusion, you assessed the client for blood transfusion reactions. The following assessments were noted: HR: 120 bpm, Pulse: +4 in quality, presence of fine, short, high pitched crackling at base. Which of the following is your FIRST action?
A. Maintain bed rest with legs elevated.
B. Place the client in high-Fowler's position.
C. Increase the rate of infusion of intravenous fluids.
D. Consult with the primary health care provider (PHCP) regarding initiation of oxygen therapy.
Correct answer:
The correct first action is D: Consult with the primary health care provider (PHCP) regarding initiation of oxygen therapy. This is because the client is showing signs of a potential transfusion reaction, likely a pulmonary embolism. The client's rapid heart rate, bounding pulse, and crackling sound at the base suggest a possible pulmonary issue. Oxygen therapy is crucial to improve oxygenation and stabilize the client's condition. Consulting with the PHCP ensures timely intervention and appropriate management.
A: Maintaining bed rest with legs elevated would not address the potential respiratory distress the client is experiencing.
B: Placing the client in high-Fowler's position may help improve oxygenation, but consulting the PHCP for oxygen therapy is the priority.
C: Increasing the rate of IV fluids is not the priority when the client is showing signs of a potential serious complication like a pulmonary embolism.
LPN exams fundamentals practice questions, set 34 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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