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 patient referred to physical therapy with chronic low back pain has failed to make any progress toward meeting established goals in over three weeks of treatment. The physical therapist has employed a variety of treatment techniques but has yet to observe improvement. What is the most appropriate next step?
A. Transfer the patient to another therapist's schedule.
B. Re-examine the patient and establish new goals.
C. Continue to modify the patient's treatment plan.
D. Alert the referring physician to the patient's status.
Show answer and rationale
Correct answer: B — Re-examine the patient and establish new goals.
The correct answer is B: Re-examine the patient and establish new goals. This is the most appropriate next step because if the patient has not shown progress in over three weeks, it indicates a need to reassess the current treatment plan and goals. By re-examining the patient, the therapist can identify any factors hindering progress and adjust the treatment plan accordingly. This proactive approach ensures the patient receives the most effective care.
Choice A: Transferring the patient to another therapist does not address the root cause of the lack of progress and may disrupt continuity of care.
Choice C: Simply continuing to modify the treatment plan without re-evaluating the patient may not lead to improved outcomes.
Choice D: Alerting the referring physician should be done after reassessment and establishing new goals, as the physician may require updated information but is not the immediate next step.
Question 2
The nurse is assessing a patient's mental status and asks the patient to recall three words. What is the nurse testing?
A. Recent memory.
B. Long-term memory.
C. Abstract reasoning.
D. Orientation.
Show answer and rationale
Correct answer: A — Recent memory.
The correct answer is A: Recent memory. By asking the patient to recall three words, the nurse is assessing the patient's ability to remember information that was just presented to them, which falls under recent memory. This test helps evaluate the patient's immediate memory function and can provide insights into cognitive impairments or memory deficits.
Incorrect choices:
B: Long-term memory - This choice is incorrect because the nurse is assessing the patient's ability to recall information presented in the immediate past, not from a long time ago.
C: Abstract reasoning - This choice is incorrect as assessing abstract reasoning involves tasks that require logical thinking and problem-solving, not simply recalling words.
D: Orientation - This choice is incorrect because orientation refers to awareness of person, place, time, and situation, which is not being tested by asking the patient to recall three words.
Question 3
A pregnant woman is prescribed a medication, while teaching the patient, the nurse explains that which pregnancy category drug would be the safest?
A. B
B. D
C. X
D. A
Show answer and rationale
Correct answer: D — A
Pregnancy categories classify drugs based on their risk to the fetus, guiding safe prescribing during pregnancy. The safest category indicates no evidence of harm in human studies, reflecting extensive research showing the drug poses minimal risk to fetal development. This contrasts with categories where animal studies show no risk but human data is lacking, or where risks increase, including potential harm or confirmed teratogenic effects. For a pregnant patient, the nurse prioritizes a drug with the strongest safety profile, backed by human data, to protect both mother and baby. Categories with known risks or insufficient evidence are avoided unless benefits outweigh dangers, which isn't the case for ‘safest.' This approach aligns with clinical guidelines to minimize congenital anomalies, ensuring the medication supports maternal health without compromising fetal well-being, a key consideration in obstetric care.
Question 4
The nurse is assessing a patient in the hospital who has received numerous antibiotics and notices that his tongue appears to be black and hairy. In response to his concern, what would the nurse say?
A. "We will need to get a biopsy to determine the cause."
B. "This is an overgrowth of hair and will go away in a few days."
C. "Black, hairy tongue is a fungal infection caused by all the antibiotics you have received."
D. "This is probably caused by the same bacteria you had in your lungs."
Show answer and rationale
Correct answer: C — "Black, hairy tongue is a fungal infection caused by all the antibiotics you have received."
The correct answer is C: "Black, hairy tongue is a fungal infection caused by all the antibiotics you have received."
Rationale:
1. Black, hairy tongue is a known side effect of prolonged antibiotic use, leading to fungal overgrowth.
2. Antibiotics can disrupt the natural balance of bacteria in the mouth, allowing fungi to overgrow.
3. Fungal infections can manifest as a black, hairy appearance on the tongue.
4. Biopsy is not typically needed for the diagnosis of black, hairy tongue.
5. Overgrowth of hair is not a plausible explanation for this condition.
6. The black, hairy tongue is not caused by the same bacteria the patient had in his lungs.
Summary:
Choice C is correct as it accurately links the patient's antibiotic use to the fungal infection causing black, hairy tongue. Choices A, B, and D are incorrect as they do not address the specific cause of this condition and provide inaccurate information.
Question 5
A patient in the ICU is status post embolectomy after a pulmonary embolus. What assessment parameter does the nurse monitor most closely on a patient who is postoperative following an embolectomy?
A. Pupillary response
B. Pressure in the vena cava
C. White blood cell differential
D. Pulmonary arterial pressure
Show answer and rationale
Correct answer: D — Pulmonary arterial pressure
Post-embolectomy for pulmonary embolus (PE), the nurse most closely monitors pulmonary arterial pressure (PAP) via a pulmonary artery catheter, as it directly reflects the procedure's success in relieving pulmonary vascular obstruction. Elevated PAP pre-surgery indicates blockage; post-surgery, a decrease signals clot removal efficacy, while persistent elevation suggests residual emboli or reperfusion issues, guiding further intervention (e.g., thrombolytics). Pupillary response assesses neurological status, irrelevant unless cerebral hypoxia occurred. Vena cava pressure isn't routinely monitored and lacks specificity for PE outcomes. White blood cell differential tracks infection or inflammation, not acute hemodynamic status. PAP monitoring, alongside urinary output for perfusion, equips the nurse to detect complications (e.g., re-embolization), ensuring optimal postoperative management in this critical ICU patient.
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Question 6
Mrs. Sales also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?
A. Inhibition of the parasympathetic reflex
B. Esophageal emptying hastens
C. Loss of tone of the smooth muscles of the colon
D. Decreased ability to absorb fluids in the lower intestines
Correct answer:
The correct answer is C: Loss of tone of the smooth muscles of the colon. As individuals age, the smooth muscles of the colon can lose their tone, resulting in slower peristalsis and decreased bowel movements, leading to constipation. This physical change is a common factor contributing to constipation in older adults.
A: Inhibition of the parasympathetic reflex is not directly related to constipation in aging individuals. Parasympathetic stimulation usually promotes bowel movements.
B: Esophageal emptying hastening is not relevant to constipation. Esophageal emptying refers to the movement of food from the esophagus into the stomach, not the colon.
D: Decreased ability to absorb fluids in the lower intestines is not a typical physical change associated with aging that predisposes individuals to constipation. Constipation is more commonly linked to issues with colonic motility rather than fluid absorption.
A patient has had a 'terrible itch' for several months that he has been continuously scratching. On examination, the nurse might expect to find:
A. A keloid.
B. A fissure.
C. Keratosis.
D. Lichenification.
Correct answer:
The correct answer is D: Lichenification. Lichenification is a skin condition characterized by thickening and hardening of the skin due to chronic irritation or scratching. In this case, the patient's continuous scratching of the itch has led to lichenification. This is evident by the rough and leathery texture of the skin upon examination.
A: A keloid is an overgrowth of scar tissue that can occur after a wound heals, not typically associated with chronic scratching.
B: A fissure is a small, painful crack in the skin that can occur due to dryness or trauma, not a result of continuous scratching.
C: Keratosis refers to various skin conditions characterized by thickening of the skin, but it is not specifically associated with chronic scratching like lichenification.
In summary, lichenification is the most likely finding in this scenario due to the chronic scratching leading to skin thickening and hardening.
Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethically relevant consideration is important to the nurse as an advocate for these patients?
A. balance between benefits and harms in patient care
B. norms of family life
C. considerations of power
D. cost-effectiveness and allocation
Correct answer:
The correct answer is C: considerations of power. In this scenario, the nurse needs to consider the power dynamics at play due to the social status of the children's families. The child of a famous sports figure may have more influence and resources, potentially leading to unfair advantages in accessing healthcare compared to the child from a low-income family. By being aware of these power dynamics, the nurse can advocate for equal treatment and fair allocation of resources.
A: Balance between benefits and harms in patient care is important but not as relevant in this context as considering power dynamics.
B: Norms of family life may be important in some situations but do not directly address the ethical consideration of power in this scenario.
D: Cost-effectiveness and allocation are important factors but do not directly address the ethical consideration of power dynamics between the two children's families.
What shortens the sarcomere during muscle contraction?
A. The binding of acetylcholine at the neuromuscular junction
B. The myosin heads binding to actin filaments and pulling them toward the center of the A-band
C. The release of calcium ions from the sarcoplasmic reticulum
D. The breakdown of ATP by the sarcoplasmic reticulum
Correct answer:
Sarcomere shortening, the basis of muscle contraction, occurs via the sliding filament mechanism. Myosin heads, protruding from thick filaments, bind to actin on thin filaments, forming cross-bridges. Using ATP-derived energy, these heads execute a power stroke, pulling actin toward the sarcomere's center specifically the A band's midpoint reducing the distance between Z lines and shortening the sarcomere. Acetylcholine initiates this by triggering an action potential, but it's not the direct shortening mechanism. Calcium release from the sarcoplasmic reticulum enables myosin-actin binding by shifting tropomyosin, a crucial step but not the act of shortening. ATP breakdown powers the process, yet the sarcoplasmic reticulum stores calcium, not hydrolyzes ATP for shortening. The myosin-actin interaction is the mechanical driver, making it the precise answer, central to muscle movement and the sliding filament theory.
A parent of a child with Wilms tumor asks the nurse about surgery. Which statement concerning the type of surgery for Wilms tumor is most accurate?
A. Surgery is only done if chemotherapy and radiation fail.
B. Surgery is usually performed within 24 to 48 hours of admission.
C. Surgery is the least favorable therapy for the treatment of Wilms tumor.
D. Surgery will be delayed until the child's overall health status improves.
Correct answer:
Wilms tumor, a kidney cancer in children, is primarily treated with surgical resection (nephrectomy) as the cornerstone of therapy, typically performed within 24 to 48 hours of diagnosis to remove the tumor before it spreads. This urgency stems from its responsiveness to surgery and the need to stage the cancer accurately, guiding subsequent chemotherapy or radiation. Delaying surgery until chemotherapy or radiation fails is incorrect surgery is the initial step, not a last resort. It's not the least favorable option; rather, it's the preferred first-line treatment due to high cure rates when combined with adjuvant therapies. Waiting for health improvement isn't standard unless the child is critically unstable, which isn't typical at diagnosis. The nurse's accurate explanation reassures parents and underscores surgery's role, aligning with pediatric oncology protocols to optimize outcomes in Wilms tumor management.
A nurse is teaching about perspective transformation. In which order will the nurse list the first four stages?
A. Stability, dissonance, confusion, and dealing with uncertainty
B. Dissonance, confusion, dealing with uncertainty, and stability
C. Confusion, stability, dealing with uncertainty, and dissonance
D. Dealing with uncertainty, stability, dissonance, and confusion
Correct answer:
The correct order is A: Stability, dissonance, confusion, and dealing with uncertainty. This sequence follows the stages of perspective transformation as outlined by Mezirow's theory of transformative learning. Firstly, individuals start with stability in their existing beliefs. Then, they experience dissonance when encountering new information conflicting with their beliefs. This leads to confusion as they struggle to reconcile the inconsistencies. Finally, they reach the stage of dealing with uncertainty by reevaluating their perspectives and integrating new knowledge.
Summary of other choices:
B: Incorrect - Dissonance does not come before stability in the process of perspective transformation.
C: Incorrect - Confusion does not come before dissonance in the process of perspective transformation.
D: Incorrect - Dealing with uncertainty does not come before stability in the process of perspective transformation.
It is considered negligent when the nurse delegates which of the following tasks to a CNA?
A. Nasotracheal suctioning an alert and oriented patient
B. Obtaining a blood glucose value using a lancet and password protected glucometer
C. Obtaining a urine sample from the Foley catheter
D. Ambulating a patient to the restroom
Correct answer:
Delegation must align with the scope of practice for a Certified Nursing Assistant (CNA). Nasotracheal suctioning is an invasive procedure requiring sterile technique and assessment of airway patency, which exceeds a CNA's training and is reserved for licensed nurses. Improper suctioning can cause trauma, hypoxia, or infection, making this delegation negligent. Obtaining a blood glucose value is within a CNA's scope if trained, as it involves a simple, non-invasive procedure with clear protocols. Collecting a urine sample from a Foley catheter is also permissible, as it's a routine task not requiring clinical judgment. Ambulating a patient is a basic mobility assistance task CNAs are trained to perform safely. Delegating nasotracheal suctioning to a CNA violates standards of care, as it requires skills and judgment beyond their role, potentially compromising patient safety and exposing the nurse to legal liability.
Which of the following can be an effective way to prevent unintended weight loss?
A. Promoting independence by insisting residents feed themselves without help
B. Serving favorite foods
C. Telling the resident when a meal looks unappetizing
D. Insisting that residents eat everything on their trays no matter what
Correct answer:
The correct answer is B: Serving favorite foods. This is an effective way to prevent unintended weight loss because it increases the likelihood that the resident will enjoy and consume their meals. By serving favorite foods, the resident is more likely to have an appetite and eat enough to maintain their weight. This approach respects the resident's preferences and promotes a positive dining experience.
A: Promoting independence by insisting residents feed themselves without help may not be effective if the resident has difficulty feeding themselves, leading to inadequate food intake.
C: Telling the resident when a meal looks unappetizing may discourage the resident from eating, resulting in unintended weight loss.
D: Insisting that residents eat everything on their trays no matter what can be counterproductive as it may lead to stress or resistance during mealtimes, potentially causing decreased food intake.
You are serving as the supervisory nurse for a home healthcare agency in the community. You are doing an admission assessment for a 76 year old male client who resides with his elderly wife. Which of the following assessments would indicate that the couple needs some education relating to home safety?
A. The client has refrigerated foods labelled with an expiration date.
B. You assess that the home is free of scatter rugs that many use to protect the feet against hard floors.
C. The client uses the FIFO method for insuring food safety.
D. The client assures you that the smoke alarm batteries are replaced annually to insure that they work.
Correct answer:
Step 1: The correct answer is D because ensuring that smoke alarm batteries are replaced annually is crucial for home safety, especially for elderly individuals who may have decreased mobility or sensory perception.
Step 2: Smoke alarms are essential for early detection of fires, which is crucial for elderly individuals who may have difficulty escaping quickly.
Step 3: By replacing the batteries annually, the client demonstrates proactive measures to protect themselves and their spouse from potential fire hazards.
Step 4: Choices A, B, and C are not indicators of needing education on home safety as they all reflect positive practices related to food storage, fall prevention, and food safety.
Summary: Option D is the correct answer as it directly relates to fire safety, a critical aspect of home safety for elderly individuals. Options A, B, and C are not relevant to home safety education in this context.
Using Maslow's hierarchy of basic human needs, which of the following nursing diagnoses has the highest priority?
A. Ineffective breathing pattern related to pain, as evidenced by shortness of breath.
B. Anxiety related to impending surgery, as evidenced by insomnia.
C. Risk of injury related to autoimmune dysfunction.
D. Impaired verbal communication related to tracheostomy, as evidenced by the inability to speak.
Correct answer:
Maslow's hierarchy prioritizes physiological needs (e.g., breathing) over safety, love, esteem, and self-actualization. Ineffective breathing pattern, evidenced by shortness of breath, threatens oxygenation a fundamental survival need making it the highest priority. Pain-induced respiratory distress could escalate to hypoxia, requiring immediate action like repositioning or oxygen support. Anxiety, while distressing, is a psychological need, lower on Maslow's scale unless it impairs breathing (not indicated here). Risk of injury is a safety concern, important but not immediate unless actualized. Impaired communication affects social interaction, even lower priority, manageable with alternative methods. Breathing's critical role in sustaining life places this diagnosis at the top, demanding swift nursing response to stabilize the patient before addressing less urgent needs, aligning with Maslow's foundational logic.
LPN exams fundamentals practice questions, set 40 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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