LPN exams fundamentals practice questions set 38

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Lung cancer risk in smokers is heavily influenced by the age of smoking initiation, with earlier exposure amplifying cumulative damage to lung tissue. Starting young extends the duration of carcinogen exposure (e.g., polycyclic aromatic hydrocarbons), increasing DNA mutations and oncogenic potential, as evidenced by higher incidence in lifelong smokers who began in adolescence. Risk does decrease after cessation dropping significantly within 10-15 years contradicting the notion of permanent risk or mandatory annual X-rays, which aren't standard for all ex-smokers. Cigarette type (e.g., tar, nicotine levels) matters, but pack-years and initiation age outweigh this factor. Other risk factors (e.g., radon, genetics) contribute but are secondary to smoking's dose-dependent effect. The nurse's accurate response educates students on the preventable, time-sensitive nature of this risk, reinforcing cessation's protective impact.

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Stopping the infusion is the nurse's first intervention when observing a red, swollen venipuncture site, as this may indicate phlebitis, infiltration, or infection. Halting the IV prevents further tissue damage or fluid extravasation, prioritizing patient safety. Redness and swelling suggest inflammation or leakage into surrounding tissue, requiring immediate cessation to assess severity and plan next steps, like site relocation or physician consultation. Calling the physician follows assessment, not precedes stopping the infusion, as the nurse acts within scope to mitigate harm first. Slowing the infusion might worsen damage if fluid is already escaping the vein. A cold towel could reduce swelling later but doesn't address the active infusion causing the issue. Stopping the infusion is the critical initial step, enabling evaluation and preventing complications, aligning with nursing's focus on prompt, protective action.

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Step 1: The correct answer is D because advanced maternal age (AMA), generally defined as 35 years or older, is a well-known risk factor for chromosomal abnormalities, such as Down syndrome. Step 2: Down syndrome is more common in babies born to mothers over the age of 35 due to the increased likelihood of errors in cell division during egg development. Step 3: Given the patient's age of 44, she falls into the category of AMA and is at an increased risk for chromosomal abnormalities in her baby. Step 4: Option A is incorrect as the risk is not solely based on gene mutation but rather on the increased chance of chromosomal abnormalities due to age. Step 5: Option B is incorrect as it focuses on intrauterine growth retardation, which is not directly related to the patient's query about birth defects. Step 6: Option C is incorrect as a referral to high-risk obstetrics may not be necessary solely based on the patient's

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The client has a do-not-resuscitate order is correct. The nurse should include the client's current prescriptions, including code status, in a change-of-shift report. The client has a continuous IV of lactated Ringer's is correct. The type of IV solution being administered is an element of the 'Background' portion of the SBAR tool. The nurse should provide a summary of any medications or treatments the client has received to date, which will prevent medication errors and promote client safety. The client was straight catheterized for 350 mL 2 hr ago is correct. The amount of urine output is an element of the 'Background' portion of the SBAR tool. Other pertinent elements of this category are vital signs, pain rating, and any change from previous assessments. The client has Medicare insurance is incorrect. This information is not relevant to the client's clinical care and is not an element of the SBAR communication tool.

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The correct answer is A. In spinal cord injury with autonomic nervous system involvement, there is disruption of sympathetic and parasympathetic control. This leads to bradycardia due to loss of sympathetic tone, hypotension due to disrupted baroreceptor reflexes, and loss of sweating or shivering ability due to impaired temperature regulation. Choice B is incorrect because hypertension and warm, dry skin are more indicative of sympathetic overactivity, not autonomic dysfunction. Numbness of fingertips is not a typical feature of autonomic involvement. Choice C is incorrect as tachycardia and hypertension are more suggestive of sympathetic overactivity, and one-sided paralysis and amnesia are not specific to autonomic dysfunction. Choice D is incorrect as tachycardia and diaphoresis suggest sympathetic overactivity, while cool and clammy skin is more indicative of hypovolemia rather than autonomic dysfunction.

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Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents, typically arising in flat bones like the pelvis, chest wall (e.g., ribs), or vertebrae, and the diaphysis of long bones. A hallmark is a palpable, non-tender mass, making non-tender swelling on the ribs a strong indicator, as it aligns with the tumor's common chest wall location and lack of initial pain sensitivity. Dull bone pain above the knee suggests a long bone issue, possibly osteosarcoma, which favors the metaphysis, not Ewing's typical diaphysis site. An abdominal mass crossing the midline is more characteristic of Wilms tumor or neuroblastoma, not Ewing sarcoma. An asymptomatic upper back mass could suggest various tumors, but lacks specificity for Ewing's flat bone preference. Nurses must recognize this presentation to facilitate prompt imaging and biopsy, critical for early diagnosis and treatment planning in pediatric oncology.

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The correct answer is A: Exercise. George used exercise as a stress management technique. Swimming during his lunch hour helped him reduce his anxiety and jitteriness. Exercise is known to release endorphins, which are chemicals in the brain that act as natural painkillers and mood elevators. It also helps in reducing stress hormones like cortisol. By engaging in physical activity, George was able to alleviate his feelings of anxiety. Summary: - Choice B: Deep breathing focuses on controlling breathing patterns to reduce stress, but it was not mentioned in the scenario that George used this technique. - Choice C: Guided imagery involves visualizing calming and peaceful images to reduce stress, which was not mentioned in George's case. - Choice D: Progressive muscle relaxation involves tensing and relaxing different muscle groups to reduce stress, but George did not use this technique as mentioned in the scenario.

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The correct answer is B: To maintain the uterine lining for implantation and pregnancy. Progesterone is crucial in early pregnancy as it helps in thickening and maintaining the uterine lining to support implantation of the fertilized egg and sustain the pregnancy. It also plays a role in suppressing the immune response to prevent rejection of the embryo. A: To stimulate fetal development - Incorrect. Progesterone primarily focuses on preparing the uterus for pregnancy rather than directly stimulating fetal development. C: To trigger ovulation and release of the egg - Incorrect. Progesterone is involved in the second half of the menstrual cycle after ovulation has occurred and is not responsible for triggering ovulation. D: To increase the production of amniotic fluid - Incorrect. Progesterone does not directly impact the production of amniotic fluid, which is mainly regulated by the fetal kidneys and placenta.

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The correct answer is A: "Air splints." Air splints are not typically used in the immobilization of a patient with suspected spinal cord injury. The rationale behind this is that air splints do not provide adequate support and stabilization for potential spinal injuries. On the other hand, choices B, C, and D are commonly used in spinal immobilization. "Bolstering devices" help maintain proper alignment of the spine. "A long spine board" is used to safely transfer the patient while keeping the spine in a neutral position. "A scoop-style stretcher" allows for easy and gentle transfer of the patient onto a backboard without compromising spinal alignment. In summary, the use of air splints is not recommended for spinal immobilization due to inadequate support, while bolstering devices, a long spine board, and a scoop-style stretcher are appropriate tools for immobilizing a patient with suspected spinal cord injury.

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The correct medication to anticipate for this patient is a benzodiazepine, such as lorazepam (Ativan). Rationale: 1. Benzodiazepines are commonly used to treat acute agitation and anxiety in patients, which is present in this case. 2. Lorazepam has a rapid onset of action and can help calm the patient quickly. 3. It can help manage the patient's perception of the window blinds as snakes and reduce agitation. 4. Benzodiazepines are safer for patients with alcohol intoxication compared to other sedatives or antipsychotics. Summary of Incorrect Choices: A: Monoamine oxidase inhibitors are not typically used for acute agitation and anxiety. They have a slower onset of action and are not first-line for this situation. B: Phenothiazines may worsen the patient's condition due to their potential side effects like sedation and hypotension. D: Narcotic analgesics are not appropriate for managing anxiety or agitation