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
Nurse Kris is teaching a client with history of atherosclerosis. To decrease the risk of atherosclerosis, the nurse should encourage the client to:
A. Avoid focusing on his weight.
B. Increase his activity level.
C. Follow a regular diet.
D. Continue leading a high-stress lifestyle.
Show answer and rationale
Correct answer: B — Increase his activity level.
The correct answer is B: Increase his activity level. Regular physical activity helps improve circulation, lower blood pressure, and reduce cholesterol levels, all of which can help decrease the risk of atherosclerosis. Exercise also helps maintain a healthy weight and reduces stress, which are additional risk factors for atherosclerosis.
Explanation for other choices:
A: Avoid focusing on his weight - Weight management is important in reducing the risk of atherosclerosis, so focusing on weight is beneficial.
C: Follow a regular diet - Following a healthy diet is important, but alone may not be sufficient to reduce the risk of atherosclerosis without physical activity.
D: Continue leading a high-stress lifestyle - High stress levels can contribute to the development of atherosclerosis, so it is important to reduce stress through relaxation techniques and exercise.
Question 2
A patient arrives in the emergency department with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patients care?
A. Oral administration of diuretics
B. Intravenous fluids to reduce the viscosity of secretions
C. Postural chest drainage
D. Pulmonary function testing
Show answer and rationale
Correct answer: C — Postural chest drainage
In acute bronchiectasis with copious secretions, postural chest drainage is the priority intervention, leveraging gravity to mobilize thick mucus from dilated bronchi, reducing obstruction and infection risk. This technique positioning the patient to drain specific lung segments (e.g., head-down for lower lobes) alleviates dyspnea and prevents atelectasis, a cornerstone of bronchiectasis management. Diuretics treat fluid overload, irrelevant to airway secretions. IV fluids may hydrate but don't directly thin bronchial mucus oral hydration or mucolytics are more apt. Pulmonary function testing assesses obstruction but doesn't clear secretions, delaying symptom relief. The nurse's focus on postural drainage, often paired with percussion, addresses the acute crisis's root mucus retention enhancing ventilation and supporting recovery in this chronic condition's exacerbation.
Question 3
Which of the following is true of mechanical lifts?
A. Mechanical lifts help prevent injury to the body.
B. It is safer for an NA to lift a resident without the help of a mechanical lift.
C. There is only one kind of mechanical lift.
D. When using a mechanical lift
Show answer and rationale
Correct answer: A — Mechanical lifts help prevent injury to the body.
The correct answer is A: Mechanical lifts help prevent injury to the body. This is true because mechanical lifts are designed to assist in lifting and transferring residents safely, reducing the risk of injury to both the resident and the caregiver. Mechanical lifts provide proper support and reduce strain on the caregiver's body.
Explanation for other choices:
B: It is safer for an NA to lift a resident without the help of a mechanical lift - This is incorrect because manual lifting without a mechanical lift increases the risk of injury to both the caregiver and the resident.
C: There is only one kind of mechanical lift - This is incorrect as there are various types of mechanical lifts available, each designed for specific needs and situations.
D: When using a mechanical lift - This choice is incomplete and does not provide a clear statement, making it incorrect.
Question 4
The nurse is teaching a review class on the lymphatic system. A participant shows correct understanding of the material with which statement?
A. Lymph flow is propelled by the contraction of the heart.'
B. The flow of lymph is slow, compared with that of the blood.'
C. One of the functions of the lymph is to absorb lipids from the biliary tract.'
D. Lymph vessels have no valves; therefore, lymph fluid flows freely from the tissue spaces into the bloodstream.'
Show answer and rationale
Correct answer: B — The flow of lymph is slow, compared with that of the blood.'
The correct answer is B: "The flow of lymph is slow, compared with that of the blood."
Rationale:
1. Lymphatic vessels lack a central pump like the heart, which results in slower lymph flow compared to blood flow.
2. The slow movement allows for thorough filtration and immune surveillance within lymph nodes.
3. The statement reflects an accurate understanding of the physiological differences between the lymphatic and circulatory systems.
Summary:
A: Incorrect - Lymph flow is not propelled by the contraction of the heart; it is propelled by skeletal muscle contractions and respiratory movements.
C: Incorrect - Lymph's main function is to collect excess tissue fluid and return it to the bloodstream, not to absorb lipids from the biliary tract.
D: Incorrect - Lymph vessels do have one-way valves that prevent backflow, ensuring the proper direction of lymph flow.
Question 5
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
A. Passive diffusion
B. Active transport
C. Glomerular filtration
D. First-pass effect
Show answer and rationale
Correct answer: D — First-pass effect
The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
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Question 6
A patient who was pregnant had a spontaneous abortion at approximately 4 weeks' gestation. At the time of the miscarriage, it was thought that all products of conception were expelled. Two weeks later, the patient presents at the clinic office complaining of “crampy†abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100°F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/minute (bpm), and respirations, 20 breaths per minute. Based on this assessment data, what does the nurse anticipate as a clinical diagnosis?
A. Ectopic pregnancy
B. Uterine infection
C. Gestational trophoblastic disease
D. Endometriosis
Correct answer:
The correct answer is B: Uterine infection. The patient's presentation with crampy abdominal pain, scant serosanguineous vaginal drainage, negative pregnancy test, and vital signs indicating fever, hypotension, and tachycardia are indicative of a uterine infection, most likely post-miscarriage. The timing of symptoms 2 weeks after miscarriage aligns with the typical onset of infection. The absence of products of conception being expelled completely could have led to retained tissue causing infection. Ectopic pregnancy (A) would typically present with severe abdominal pain, vaginal bleeding, and positive pregnancy test. Gestational trophoblastic disease (C) would present with irregular vaginal bleeding and elevated hCG levels. Endometriosis (D) is a chronic condition characterized by pelvic pain and abnormal menstrual bleeding, not an acute post-miscarriage complication.
A nurse is providing care to four clients. Which of the following situations requires the nurse to complete an incident report?
A. A nurse tied a client's restraints straps to the moveable part of the bed frame.
B. An assistive personnel placed a surgical mask on a client who has TB before transporting her to radiology.
C. A nurse administered a medication to a client 30 minutes before the dose is due.
D. A client who has an IV infusion pump receives an additional 250 mL of IV fluid.
Correct answer:
The correct answer is C. An incident report should be completed when a nurse administers medication to a client significantly earlier than the scheduled time. This deviation from the prescribed schedule could potentially impact the client's treatment plan and requires documentation for proper evaluation and follow-up. Choices A, B, and D do not necessarily require an incident report. Choice A involves improper restraint application, which is a safety issue but does not directly involve medication administration. Choice B involves a protective measure for a client with TB, which is within the scope of practice for assistive personnel. Choice D describes an increase in IV fluid administration, which may need monitoring but does not necessarily indicate a need for an incident report unless there are specific complications or adverse effects related to the additional fluid.
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
A. Splitting
B. Projective identification
C. Isolation of affect
D. Dissociation
Correct answer:
The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things as all good or all bad, leading to extreme shifts in perception. In this case, the client initially viewed the psychiatrist as the best doctor but now hates him completely due to feeling abandoned. This sudden shift from idealization to devaluation is characteristic of splitting.
Choice B: Projective identification involves attributing one's own unacceptable feelings or traits onto another. This is not evident in the client's description.
Choice C: Isolation of affect refers to separating emotions from their source. The client is expressing strong emotions towards the psychiatrist, not isolating them.
Choice D: Dissociation involves a disruption in consciousness, memory, identity, or perception. The client is not displaying symptoms of dissociation in this scenario.
The nurse is assessing a client with chronic bronchitis. Which finding is most concerning?
A. Productive cough with thick sputum.
B. Clubbing of fingers.
C. Peripheral cyanosis.
D. Oxygen saturation of 88%.
Correct answer:
The correct answer is D: Oxygen saturation of 88%. This finding is most concerning because it indicates hypoxemia, which can lead to serious complications in a client with chronic bronchitis. Hypoxemia can result in tissue damage and impaired organ function. A low oxygen saturation level requires immediate intervention to prevent further deterioration.
Choice A (Productive cough with thick sputum) is a common symptom of chronic bronchitis and may indicate an exacerbation, but it is not as immediately concerning as hypoxemia.
Choice B (Clubbing of fingers) is a late sign of chronic hypoxemia and may be present in clients with chronic bronchitis, but it is not as urgent as a low oxygen saturation level.
Choice C (Peripheral cyanosis) is also a sign of hypoxemia, but oxygen saturation level provides a more accurate assessment of the client's oxygenation status.
Before administering an antibiotic that can cause nephrotoxicity, which lab value is most important for the PN to review?
A. Hemoglobin and Hematocrit
B. Serum Calcium
C. Serum Creatinine
D. WBC
Correct answer:
Serum creatinine is the most important lab value to review before administering an antibiotic that can cause nephrotoxicity. This is because serum creatinine is a key indicator of kidney function. An elevated serum creatinine level may indicate impaired renal function, and administering nephrotoxic drugs in such situations can further damage the kidneys. Monitoring serum creatinine levels helps healthcare providers assess renal function and make informed decisions regarding drug administration. Choices A, B, and D are not as directly related to kidney function and nephrotoxicity, making them less crucial in this scenario. Hemoglobin and hematocrit levels assess for anemia, serum calcium levels are more related to bone health and nerve function, and WBC count is associated with immune response, none of which directly reflect kidney function or the risk of nephrotoxicity.
A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process?
A. Intermittent episodes of acute bronchospasm
B. Alveolar distention and impaired diffusion
C. Dilation of bronchi and bronchioles
D. Excessive gas exchange in the bronchioles
Correct answer:
Bronchiectasis involves chronic, irreversible dilation of bronchi and bronchioles from repeated inflammation or infection, destroying muscle and elastic tissue. This widening traps mucus, fostering recurrent infections and obstruction, leading to respiratory difficulties like chronic cough and dyspnea. Acute bronchospasm, tightening of airways, is asthma's hallmark, not bronchiectasis's structural damage. Alveolar distention and impaired diffusion occur in emphysema, affecting gas exchange at the alveolar level, not bronchial dilation. Excessive gas exchange isn't a feature bronchiectasis reduces effective ventilation. The student nurse's recognition of this pathophysiology confirmed by imaging (e.g., CT showing bronchial widening) prepares them to anticipate copious sputum and infection risk, guiding care like chest physiotherapy to manage this distinct airway disease.
A change nurse is planning to introduce a new type of infusion pump to the unit nursing staff. Which one of the following statements by the charge nurse displays that she has more skill as a change agent?
A. I want to let everyone know today we start using a new infusion pump.'
B. It is never too late to learn how to use a new infusion pump.'
C. I want to remind everyone about the dates/times for the new infusion pump in-services planned for next week.'
D. This week we expect to have an in-service on the new infusion pump.'
Correct answer:
The correct answer is C because it demonstrates effective planning and communication skills as a change agent. By reminding everyone about the dates/times for the upcoming in-services, the charge nurse is ensuring that staff are aware and prepared for the training sessions on the new infusion pump. This proactive approach helps to facilitate a smooth transition and ensures that staff have the necessary knowledge and skills to use the new equipment.
Choices A, B, and D do not display the same level of planning and communication as choice C. Choice A simply announces the start of using the new pump without providing any further details or guidance. Choice B, while positive, does not offer any concrete information or support for staff learning about the new pump. Choice D mentions an upcoming in-service but lacks the specific details and reminders that choice C provides.
A nurse provides care to clients of a community clinic that serves a large immigrant population. Which intervention reflects primary prevention for this group?
A. Screening for tuberculosis
B. Providing vaccinations
C. Referring clients with hypertension to a specialist
D. Teaching clients with diabetes foot care
Correct answer:
Primary prevention stops illness before it starts, vital for immigrants facing unique risks. Providing vaccinations like measles or flu shots builds immunity, preventing outbreaks in a group often under-vaccinated due to access or prior country norms, a top nursing action in clinics. Screening for tuberculosis is secondary, catching disease early, common in immigrant health but not preventive. Referring hypertension cases or teaching diabetic foot care is tertiary, managing existing conditions, not averting onset. Vaccinations align with primary prevention's proactive stance data shows they cut infectious disease rates in such populations addressing environmental and social vulnerabilities. Nursing leverages this to protect community health, ensuring immigrants, often in crowded settings, dodge preventable illnesses, a practical, impactful step for this clinic's focus.
The pathophysiology of Asthma differs from COPD as:
A. It is characterised by airflow limitation.
B. There is abnormal inflammatory response to exposure to noxious particles or gases.
C. The airflow limitation is reversible.
D. It is considered an obstructive lung disease.
Correct answer:
Asthma and COPD both feature airflow obstruction, but their pathophysiology diverges critically. Both have limitation, but asthma's is intermittent and reversible with bronchodilators due to bronchial hyperresponsiveness and inflammation (e.g., eosinophilic), per Farrell (2017). COPD's abnormal inflammatory response to noxious stimuli (e.g., smoking) causes progressive, irreversible damage (e.g., neutrophilic, emphysema), not asthma's profile. Reversibility defines asthma spirometry normalizes post-treatment unlike COPD's fixed obstruction (FEVâ‚/FVC <0.7 persists). Both are obstructive diseases, but this isn't the distinguishing feature. Asthma's reversible limitation stems from smooth muscle spasm and mucosal edema, responsive to therapy, contrasting COPD's structural loss (alveolar destruction), making this the key differential in clinical management and prognosis.
The nurse is teaching an overweight patient to administer subcutaneous heparin. Which statement by the patient indicates understanding of the teaching?
A. I should insert the needle and inject the medication without aspirating for blood.
B. I should put firm pressure on the injection site to decrease the risk for bleeding.
C. I will insert the needle at a 10-degree angle when injecting.
D. The subcutaneous route is used because absorption is faster this way.
Correct answer:
Subcutaneous heparin injections require specific techniques to ensure safety and efficacy. Option A is correct because aspirating (checking for blood return) isn't necessary for subcutaneous injections and may cause tissue trauma; the needle is inserted and medication injected directly. Option B is incorrect as firm pressure isn't recommended gentle pressure prevents bruising, especially with anticoagulants like heparin. Option C is wrong because a 10-degree angle is too shallow; 45-90 degrees is standard, depending on body fat. Option D is false as subcutaneous absorption is slower than intramuscular or IV routes, chosen for heparin's sustained effect. The patient's statement in A reflects proper technique, reducing complications like hematoma formation, and demonstrates understanding of the nurse's teaching for safe self-administration of this critical anticoagulant.
LPN exams fundamentals practice questions, set 63 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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