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 who has a history of chronic obstructive pulmonary disease (COPD) was hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels of 89% to 90%). In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching?
A. Have the patient repeat the instructions immediately after teaching.
B. Accomplish the patient teaching just before the scheduled discharge.
C. Arrange for the patient's caregiver to be present during the teaching.
D. Start giving the patient discharge teaching during the admission process.
Show answer and rationale
Correct answer: C — Arrange for the patient's caregiver to be present during the teaching.
The correct answer is C: Arrange for the patient's caregiver to be present during the teaching.
Rationale:
1. Involving the patient's caregiver promotes better understanding and support for the patient's care at home.
2. Caregivers can assist in reinforcing teaching, ensuring the patient follows instructions.
3. Caregivers can help monitor the patient for any signs of worsening condition or noncompliance.
4. This approach is effective in addressing potential barriers to compliance and continuity of care.
Summary of other choices:
A: Having the patient repeat instructions may not guarantee understanding or retention of information.
B: Teaching just before discharge may not allow enough time for the patient and caregiver to fully grasp and prepare for home care.
D: Starting teaching during admission may overwhelm the patient and may not address the need for ongoing support at home.
Question 2
A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from the left ear. On examination, she has pain when the ear is manipulated, including manipulation of the tragus. The canal is narrowed and erythematous, with some white debris in the canal. The rest of the examination is normal. What diagnosis would you assign this patient?
A. Otitis media
B. External otitis
C. Perforation of the tympanum
D. Cholesteatoma
Show answer and rationale
Correct answer: B — External otitis
The correct diagnosis for this patient is external otitis (choice B). The key findings that support this diagnosis include pain on manipulation of the ear, especially the tragus, narrowed and erythematous ear canal, drainage, and white debris in the canal. These are classic signs of external otitis, also known as swimmer's ear, which is an infection of the ear canal. Otitis media (choice A) typically presents with middle ear inflammation and fluid accumulation, but this patient's symptoms are more consistent with an external ear infection. Perforation of the tympanum (choice C) would present with different symptoms, such as hearing loss, ear discharge, and possible pain, but the examination findings described do not suggest a perforation. Cholesteatoma (choice D) is a benign growth in the middle ear and does not typically present with the external ear canal findings described in the patient.
Question 3
A nurse is caring for a patient who has had a total knee replacement. The patient is complaining of severe pain. What is the priority intervention?
A. Administer analgesics.
B. Administer antibiotics.
C. Administer insulin therapy.
D. Administer an oral anticoagulant.
Show answer and rationale
Correct answer: D — Administer an oral anticoagulant.
The correct answer is D: Administer an oral anticoagulant. The priority intervention for a patient who has had a total knee replacement and is experiencing severe pain is to administer an oral anticoagulant. This is because after surgery, there is an increased risk of blood clots forming in the legs due to immobility, which can lead to serious complications like pulmonary embolism. Administering an oral anticoagulant helps prevent the formation of blood clots and reduces the risk of these complications.
Summary:
- Option A (Administer analgesics): While controlling pain is important, in this case, preventing blood clots is the priority.
- Option B (Administer antibiotics): Antibiotics are not indicated unless there is an infection present.
- Option C (Administer insulin therapy): Insulin therapy is not relevant in this scenario unless the patient has diabetes that requires management.
Question 4
You are conducting a pupillary examination on a 34-year-old man. You note that both pupils dilate slightly. Both are noted to constrict briskly when the light is placed on the right eye. What is the most likely problem?
A. Optic nerve damage on the right
B. Optic nerve damage on the left
C. Efferent nerve damage on the right
D. Efferent nerve damage on the left
Show answer and rationale
Correct answer: B — Optic nerve damage on the left
The correct answer is B: Optic nerve damage on the left. When both pupils dilate slightly but the right pupil constricts briskly when light is shone on it, it indicates an afferent defect in the left eye. The optic nerve carries afferent (sensory) signals from the eye to the brain. Since the left optic nerve is damaged, the afferent signal from the left eye is not transmitted properly, resulting in the dilated pupils. The brisk constriction of the right pupil in response to light indicates that the efferent (motor) pathway is intact on the right side. Therefore, the problem is likely on the afferent pathway of the left optic nerve.
Incorrect choices:
A: Optic nerve damage on the right - Incorrect because the brisk constriction of the right pupil indicates the efferent pathway on the right is intact.
C: Efferent nerve damage on the right - Incorrect because the brisk constriction of the
Question 5
Which statement most accurately describes substance dependence?
A. It is a lack of control over use. Tolerance and withdrawal symptoms occur when intake is reduced or stopped.
B. It occurs when psychoactive drug use interferes with the work of competing neurotransmitters.
C. Symptoms occur when two or more drugs that affect the central nervous system (CNS) have additive effects.
D. It involves taking a combination of substances to weaken or inhibit the effect of another drug.
Show answer and rationale
Correct answer: A — It is a lack of control over use. Tolerance and withdrawal symptoms occur when intake is reduced or stopped.
Rationale for Answer A:
1. Substance dependence involves a lack of control over use, leading to compulsive drug-seeking behavior.
2. Tolerance and withdrawal symptoms are key indicators of substance dependence when intake is reduced or stopped.
3. These symptoms result from physiological changes in the body due to chronic drug use.
4. The cycle of tolerance and withdrawal reinforces the dependence on the substance.
Summary of why other choices are incorrect:
B. Interference with neurotransmitters is more related to the pharmacological effects of drugs, not a defining feature of substance dependence.
C. Additive effects of drugs do not necessarily indicate substance dependence but rather interactions between different substances.
D. Combining substances to weaken effects does not define substance dependence; it is more about the compulsive use and physical dependence on a substance.
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Question 6
Diazepam (Valium) is prescribed for a client with anxiety. The nurse instructs the client to expect which side effect?
A. incoordination
B. cough
C. tinnitus
D. hypertension
Correct answer:
Diazepam, a benzodiazepine, is prescribed for anxiety due to its calming effects on the central nervous system. It enhances GABA activity, leading to sedation, but a common side effect is motor incoordination, including ataxia or unsteady movements. This occurs because the drug depresses neural activity, affecting muscle control and balance, necessitating safety precautions like avoiding driving. Cough, tinnitus, and hypertension aren't typical side effects; instead, diazepam may cause drowsiness, confusion, or hypotension in some cases. Incoordination is significant for clients, as it increases fall risk, especially in the elderly or those new to the medication. The nurse's instruction prepares the client for this expected effect, promoting adherence and safety by ensuring they anticipate and manage it, aligning with the drug's pharmacological profile and clinical use in anxiety management.
The nurse is assessing a patient's gait and notes that the patient lifts their foot high and slaps it down while walking. What does this finding suggest?
A. Ataxia.
B. Steppage gait.
C. Spastic hemiparesis.
D. Cerebellar dysfunction.
Correct answer:
The correct answer is B: Steppage gait. This finding suggests a steppage gait pattern, which is characterized by foot drop and excessive hip and knee flexion to lift the foot higher to avoid dragging it on the ground. This gait pattern is often seen in patients with weakness or paralysis of the dorsiflexor muscles of the foot, typically due to conditions such as peripheral neuropathy or nerve compression. This results in a high-stepping gait with foot slap during the swing phase of walking. Ataxia (A) refers to incoordination and would manifest as unsteady and uncoordinated movements, not specifically as foot slap. Spastic hemiparesis (C) typically presents with increased muscle tone and stiffness on one side of the body, affecting arm and leg movements. Cerebellar dysfunction (D) would present with ataxic gait, intention tremors, and dysmetria, rather than the specific steppage gait pattern
One important thing for the nursing assistant to check when a resident is being discharged is
A. Whether the resident will have enough food and drink for the trip home
B. Whether the resident or his family knows the address of his physician
C. Whether the resident has had all of his tubes and dressings removed by the nurse
D. Whether the resident or his family has paid his bill in full
Correct answer:
The correct answer is C because it is crucial for the nursing assistant to ensure that all tubes and dressings have been removed by the nurse before the resident is discharged. This is important for the resident's safety and well-being to prevent any complications or infections post-discharge. Checking for this ensures that the resident is ready to leave the healthcare facility in a stable condition.
A: Whether the resident will have enough food and drink for the trip home - While important, this is not the nursing assistant's primary responsibility at discharge.
B: Whether the resident or his family knows the address of his physician - Important for follow-up care, but not the nursing assistant's immediate concern at discharge.
D: Whether the resident or his family has paid his bill in full - Financial matters are not typically within the nursing assistant's scope of responsibilities.
A 22-year-old unemployed roofer presents to your clinic, complaining of pain in his testicle and penis. He states the pain began last night and has steadily become worse. He states it hurts when he urinates and he has not attempted intercourse since the pain began. He has tried Tylenol and ibuprofen without improvement. He denies any fever or night sweats. His past medical history is unremarkable. He has had four previous sexual partners and has had a new partner for the last month. She is on oral contraceptives so he has not used condoms. His parents are both in good health. On examination you see a young man lying on his side. He appears mildly ill. His temperature is 100.2 and his blood pressure, respirations, and pulse are normal. On visualization of the penis he is circumcised, with no lesions or discharge from the meatus. Visualization of the scrotal skin appears unremarkable. Palpation of the testes shows 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 being noted with bearing down. His prostate examination is unremarkable. Urine analysis shows white blood cells and bacteria. What diagnosis of the male genitalia is most likely in this case?
A. Acute orchitis
B. Acute epididymitis
C. Torsion of the spermatic cord
D. Prostatitis
Correct answer:
The correct answer is B: Acute epididymitis. Epididymitis is characterized by pain, swelling, and inflammation of the epididymis, which is located next to the testicle. In this case, the patient's symptoms of testicular pain, pain with urination, and tenderness at the superior pole of the left testicle are classic signs of epididymitis. The presence of white blood cells and bacteria in the urine analysis further supports the diagnosis of an infectious process in the genitourinary tract. Acute orchitis (choice A) involves inflammation of the testicle itself, without the characteristic tenderness of the epididymis. Torsion of the spermatic cord (choice C) typically presents with sudden severe testicular pain and swelling, with absent cremasteric reflex. Prostatitis (choice D) would present with symptoms related to the prostate gland, such as perineal or pelvic pain, not the testicle and penis.
A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, "I wish I were dead! I'm just a burden on everybody."Â Based on this information, which nursing diagnosis is most appropriate?
A. Complicated grieving related to expectation of death
B. Chronic low self-esteem related to physical dependence
C. Ineffective coping related to unknown outcome of illness
D. Deficient knowledge related to lack of education about COPD
Correct answer:
The most appropriate nursing diagnosis is "Ineffective coping related to unknown outcome of illness" (Choice C). This is because the patient's expression of feeling like a burden and wishing to be dead indicates difficulty coping with the uncertainties and challenges of their COPD. The patient's emotional distress and sense of hopelessness suggest ineffective coping mechanisms in dealing with their illness.
Choice A (Complicated grieving) is incorrect because the patient's statement does not indicate grief over an actual loss, but rather a sense of burden and hopelessness. Choice B (Chronic low self-esteem) is incorrect as the patient's statement is more related to the impact of the illness on others rather than self-esteem issues. Choice D (Deficient knowledge) is not the most appropriate as the patient's statement reflects emotional distress rather than a lack of knowledge about COPD.
Which of the following adverse effects is most likely to occur during the therapy?
A. Macrocytic anemia
B. Hallucinations
C. Liver cirrhosis
D. Pancreatitis
Correct answer:
The correct answer is D: Pancreatitis. During therapy, certain medications can cause pancreatitis due to their toxic effects on the pancreas. This can lead to inflammation of the pancreas, resulting in symptoms such as severe abdominal pain, nausea, and vomiting. Pancreatitis is a serious condition that requires immediate medical attention.
Rationale:
- A (Macrocytic anemia): This adverse effect is more commonly associated with deficiencies in vitamin B12 or folic acid, not typically caused by medications during therapy.
- B (Hallucinations): Hallucinations are more likely to occur as a side effect of certain psychiatric medications or in cases of substance abuse, rather than during general therapy.
- C (Liver cirrhosis): Liver cirrhosis is a long-term consequence of chronic liver damage, often due to alcohol abuse or viral hepatitis, not typically a direct adverse effect of therapy.
Leader A gets input from his or her staff but makes the decision herself. What kind of leader is she?
A. An autocratic leader
B. A free-rein leader
C. A democratic-participative leader
D. A consultative-democratic leader
Correct answer:
Leader A is a consultative-democratic leader because she seeks input from her staff before making a decision, but ultimately makes the decision herself. The consultative aspect involves gathering input from others, while the democratic aspect involves the leader making the final decision. This style allows for collaboration and input while still maintaining the leader's authority.
Choice A (autocratic leader) is incorrect because in an autocratic leadership style, the leader makes decisions without seeking input from others.
Choice B (free-rein leader) is incorrect because in a free-rein leadership style, the leader delegates decision-making to the team members without much involvement.
Choice C (democratic-participative leader) is incorrect because in this style, the leader involves the team in decision-making and the final decision is made collectively rather than by the leader alone.
You are transporting a 20-year-old pregnant female from a local hospital to a medical facility that specializes in high-risk pregnancies when you note the patient is experiencing unexplained hypotension and bradycardia. The patient has a patent IV and is being administered magnesium that was initiated by hospital staff. On the cardiac monitor, the patient presents with a lengthening PR interval and signs of an impending high-degree nodal block. Which of the following interventions would be most appropriate in this case?
A. Increase the magnesium sulfate infusion rate, and administer a 1,000 mL normal saline bolus to support the patient's blood pressure
B. Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity
C. Continue the infusion, but administer potassium chloride to counteract the adverse effects of the magnesium chloride administration
D. Reduce the infusion by half, and administer dextrose 50% to counteract the adverse cardiac effects caused by the magnesium chloride infusion
Correct answer:
The correct answer is B: Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity.
Rationale:
1. **Stop magnesium infusion**: Magnesium toxicity can cause hypotension, bradycardia, and high-degree nodal block, hence stopping the infusion is crucial.
2. **Administer calcium chloride**: Calcium is the antidote for magnesium toxicity as it competes with magnesium for binding sites, reversing its effects.
3. **Corrects adverse effects**: Calcium chloride helps in counteracting the negative effects of magnesium on the cardiovascular system.
Summary:
- **Option A**: Increasing magnesium and giving saline won't address magnesium toxicity.
- **Option C**: Potassium won't counteract magnesium toxicity.
- **Option D**: Reducing infusion and giving dextrose won't correct magnesium toxicity.
Vital signs are fundamental indicators used by healthcare professionals to assess the basic physiological functions of the body, such as temperature, pulse, respiration, and blood pressure. An indication of basic body functioning, accurately captures this concept because vital signs reflect how well the body is maintaining homeostasis and performing essential tasks like circulation and oxygenation. Signs and symptoms of a disease, is incorrect because vital signs are not exclusively tied to illness; they are monitored in healthy individuals too. A part of human composition, is vague and does not specify function, while Physiology and anatomy, refers to broader scientific fields rather than the specific measurements vital signs represent. Thus, B is the most precise and appropriate definition, aligning with clinical practice where vital signs serve as a baseline for evaluating health status.
A couple is scheduled to have a Huhner test for infertility. In preparation for the test, the nurse will instruct the couple about
A. being sedated during the procedure
B. determining the estimated time of ovulation.
C. experiencing shoulder pain after the procedure.
D. refraining from intercourse before the appointment.
Correct answer:
The correct answer is B because the Huhner test is used to assess the quality of cervical mucus and its ability to support sperm survival and movement. Therefore, determining the estimated time of ovulation is crucial as it ensures that the test is performed during the most fertile period of the woman's cycle. This increases the chances of obtaining accurate and relevant results.
A: Being sedated during the procedure is unnecessary as the Huhner test is a simple and non-invasive procedure that does not require sedation.
C: Experiencing shoulder pain after the procedure is not a common side effect of the Huhner test and is not a significant aspect to focus on during preparation.
D: Refraining from intercourse before the appointment is not specifically required for the Huhner test, as the purpose of the test is to evaluate the quality of cervical mucus rather than the presence of sperm.
LPN exams fundamentals practice questions, set 51 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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