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
Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy?
A. Using lemon glycerin swabs for oral hygiene.
B. Keeping the child NPO until all sores are healed.
C. Having the child swish and swallow viscous lidocaine.
D. Giving the child pudding for breakfast.
Show answer and rationale
Correct answer: D — Giving the child pudding for breakfast.
Mucositis, a painful chemotherapy side effect, involves inflamed, ulcerated mucous membranes, often in the mouth, complicating eating and hygiene. Offering pudding a soft, bland, cool food is the best intervention, as it minimizes irritation and pain, encouraging nutrition without exacerbating sores. Lemon glycerin swabs are harsh, with citric acid and chemicals worsening discomfort and delaying healing. Keeping the child NPO (nothing by mouth) for weeks until sores heal is impractical and risks malnutrition, as mucositis can persist throughout chemotherapy. Viscous lidocaine might numb pain but is a last resort if the child refuses all intake, not a first-line comfort measure. Pudding supports hydration and calorie intake safely, aligning with nursing's goal to maintain nutrition and comfort in pediatric oncology, reducing mucositis-related distress effectively.
Question 2
The patient has presented to the ambulatory surgery center to have a colonoscopy. The patient is scheduled to receive moderate sedation (conscious sedation) during the procedure. How will the nurse interpret this information?
A. The procedure results in loss of sensation in an area of the body.
B. The procedure requires a depressed level of consciousness.
C. The procedure will be performed on an outpatient basis.
D. The procedure necessitates the patient to be immobile.
Show answer and rationale
Correct answer: B — The procedure requires a depressed level of consciousness.
The correct answer is B: The procedure requires a depressed level of consciousness. Moderate sedation, also known as conscious sedation, involves administering medications to induce a state of decreased awareness and responsiveness while maintaining the patient's ability to independently maintain a patent airway and respond to verbal commands. This level of sedation allows the patient to be minimally responsive but still able to breathe independently.
Incorrect answers:
A: Loss of sensation in an area of the body is typically associated with local anesthesia, not moderate sedation.
C: The term "ambulatory surgery center" already indicates that the procedure will be performed on an outpatient basis, so this is redundant.
D: While the patient may be asked to lie still during the procedure, being immobile is not a defining characteristic of moderate sedation.
Question 3
Which of the following community nursing diagnoses will guide the Parish Health Team for concrete action after a health survey identified parasitism in children?
A. Parasitism as a foreseeable crisis
B. Malnutrition as a health deficit
C. Parasitism as a health deficit
D. Parasitism as a health threat
Show answer and rationale
Correct answer: C — Parasitism as a health deficit
In community health nursing, a nursing diagnosis must reflect the actual health status and guide actionable interventions. The survey identified parasitism through stool examinations, indicating an existing condition rather than a potential risk or crisis. This makes it a health deficit, as it represents a gap between the current health state and the desired state of well-being. A foreseeable crisis implies an anticipated event, not a confirmed issue, while a health threat suggests a risk without evidence of occurrence. Malnutrition, though related, was not the focus of the survey's findings. The diagnosis must align with the data collected parasitism is the evident problem requiring treatment and prevention strategies, such as deworming and hygiene education, making the most precise and actionable diagnosis the one that identifies it as a current health deficit.
Question 4
The nurse assesses a 5-year-old child who has been experiencing frequent headaches and vomiting. The nurse notices that the child is lethargic and has a positive Brudzinski sign. Which action should the nurse implement first?
A. Perform a complete neurological examination
B. Measure the child's head circumference
C. Check the child's blood glucose level
D. Notify the healthcare provider immediately
Show answer and rationale
Correct answer: D — Notify the healthcare provider immediately
The correct action for the nurse to implement first is to notify the healthcare provider immediately. The presence of lethargy and a positive Brudzinski sign in a child experiencing frequent headaches and vomiting may indicate a serious condition like meningitis. Prompt notification of the healthcare provider is crucial for timely evaluation and initiation of appropriate treatment.
Choice A is incorrect because while a neurological examination may be necessary, it is not the priority when a potentially serious condition like meningitis is suspected.
Choice B is incorrect as measuring the child's head circumference is not the most immediate action to take in this situation.
Choice C is also incorrect as checking the child's blood glucose level, although important in some cases, is not the priority when a child presents with symptoms suggestive of meningitis.
Question 5
What is the priority nursing intervention for a patient with bulimia nervosa who is engaging in purging behaviors?
A. Monitor electrolyte levels and cardiac function.
B. Encourage self-monitoring of food intake.
C. Provide emotional support and promote body image acceptance.
D. Focus on encouraging weight loss through diet control.
Show answer and rationale
Correct answer: A — Monitor electrolyte levels and cardiac function.
The correct answer is A. The priority nursing intervention for a patient with bulimia nervosa engaging in purging behaviors is to monitor electrolyte levels and cardiac function. This is crucial due to the potential electrolyte imbalances and cardiac complications resulting from purging behaviors. Monitoring these parameters helps prevent life-threatening conditions such as hypokalemia and arrhythmias.
Option B is incorrect as self-monitoring of food intake may not address the immediate health risks associated with purging behaviors. Option C is also incorrect as emotional support and body image acceptance are important but not the immediate priority in this case. Option D is incorrect as focusing on weight loss through diet control can exacerbate the patient's eating disorder behaviors and does not address the urgent medical concerns associated with purging.
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Question 6
A patient asks when she should make an appointment for her first Pap (Papanicolaou) test to screen for cervical cancer. What is the nurse’s most appropriate response?
A. There is no need for Pap tests until after you have become pregnant.
B. All women should have the first Pap test after reaching menarche.
C. All women should have the first Pap test after they are 19 years of age.
D. All women should have the first Pap test when they become sexually active or at age 21.
Correct answer:
The correct answer is D. The first Pap test should be done when a woman becomes sexually active or at age 21, whichever comes first. This is because cervical cancer is associated with the human papillomavirus (HPV), which is a sexually transmitted infection. Screening at this stage helps detect any abnormalities early on, increasing the chances of successful treatment.
A: Incorrect. Waiting until after pregnancy is not recommended as early detection is crucial in preventing cervical cancer.
B: Incorrect. The age of menarche is not a reliable indicator for when to start screening for cervical cancer.
C: Incorrect. Waiting until 19 may miss early signs of cervical abnormalities that could lead to cancer.
In summary, choice D is the most appropriate response as it aligns with current screening guidelines and focuses on early detection for optimal outcomes.
A nurse is presenting information to the community about preventive measures to reduce the risk of contracting the West Nile virus. Which of the following instructions should the nurse include?
A. Reduce time spent outside
B. Encourage the use of insect repellent
C. Stay in the house
Correct answer:
The correct answer is B: Encourage the use of insect repellent. This is because insect repellent helps to deter mosquitoes, which are vectors for the West Nile virus. Mosquito bites are a common mode of transmission for the virus. By using insect repellent, individuals can protect themselves from mosquito bites and reduce the risk of contracting the virus.
Choice A (Reduce time spent outside) is not as effective as using insect repellent because mosquitoes can still bite individuals even when they are outdoors for a short period. Choice C (Stay in the house) is also not practical as it may not be feasible for individuals to stay indoors all the time.
Encouraging the use of insect repellent is a practical and effective preventive measure that individuals can easily incorporate into their daily routine to reduce the risk of contracting the West Nile virus.
A 15 year old male presents following a motorcycle crash. Initial examination reveals normal vital signs. There is a large bruise over his epigastrium that extends to the left flank. He has no other apparent injuries. A CT-scan of the abdomen demonstrates a ruptured spleen surrounded by a large hematoma and fluid in the pelvis. The next step in the patient's management is:
A. "Splenic artery embolization"
B. "Pneumococcal vaccine"
C. "Urgent laparotomy"
D. "Surgical consult"
Correct answer:
The correct answer is D: "Surgical consult." In this scenario, the patient has a ruptured spleen with associated hematoma and fluid in the pelvis, indicating active bleeding. A surgical consult is necessary to evaluate the need for surgical intervention such as splenectomy or splenic artery embolization. A surgical approach is crucial to control bleeding and manage potential complications. Choice A, splenic artery embolization, may be a treatment option, but a surgical consult is needed first to assess the patient's overall condition and suitability for this procedure. Choice B, pneumococcal vaccine, is important for patients with splenectomy but is not the immediate priority in this acute setting. Choice C, urgent laparotomy, is too specific without knowing the patient's stability and overall condition, making a surgical consult a more appropriate initial step.
You are on-scene assisting another crew with a childbirth call that quickly turned into a neonatal resuscitation. The newborn does not have a palpable brachial pulse, but muffled heart tones and the monitor confirm a sluggish heart rate of 55 beats per minute. After reassessing him after a few minutes of high-quality chest compressions and effective ventilations with 100% oxygen concentration, the patient's heart rate fails to respond. Which of the following would be considered a class IIa intervention for this patient?
A. 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route
B. 0.01 mg/mL of a 1:1,000 concentration of epinephrine delivered via the intramuscular route
C. 0.25 mg/mL of a 1:1,000 concentration of epinephrine delivered via the endotracheal tube route
D. 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered intravenously
Correct answer:
The correct answer is A: 0.1 mg/mL of a 1:10,000 concentration of epinephrine delivered via the intraosseous route. In neonatal resuscitation, when a newborn fails to respond to initial resuscitative efforts, the next step is to administer epinephrine. In this scenario, the recommended dose for neonates is 0.1 mg/mL of a 1:10,000 concentration of epinephrine. Delivering it via the intraosseous route in this critical situation ensures rapid absorption and distribution, potentially improving the newborn's heart rate and perfusion.
Choice B is incorrect as the intramuscular route is not as effective and rapid in neonatal resuscitation compared to the intraosseous route. Choice C is also incorrect as delivering epinephrine via the endotracheal tube route is not recommended due to poor absorption and efficacy. Choice D is incorrect as intravenous access might not
In a patient with acromegaly, the nurse will expect to discover which assessment findings?
A. Heavy, flattened facial features
B. Growth retardation and a delayed onset of puberty
C. Overgrowth of bone in the face, head, hands, and feet
D. Increased height and weight and delayed sexual development
Correct answer:
Rationale: Acromegaly is a condition caused by excessive growth hormone production, leading to overgrowth of bones in the face, head, hands, and feet. This results in characteristic features such as enlarged facial bones, hands, and feet. The correct answer is C because it aligns with the typical assessment findings in acromegaly.
Summary of other choices:
A (Heavy, flattened facial features): This is not consistent with acromegaly, as the condition is characterized by overgrowth of bone rather than flattened features.
B (Growth retardation and a delayed onset of puberty): These findings are more indicative of growth hormone deficiency rather than excess, which is seen in acromegaly.
D (Increased height and weight and delayed sexual development): While increased height and weight may occur, delayed sexual development is not a common feature of acromegaly.
A patient with pleural effusion is scheduled for a thoracentesis. What is the nurse's role during the procedure?
A. Monitor oxygen saturation continuously.
B. Instruct the patient to hold their breath.
C. Position the patient on the affected side.
D. Provide emotional support and monitor vital signs.
Correct answer:
The correct answer is D because providing emotional support and monitoring vital signs are essential roles for the nurse during a thoracentesis procedure. Emotional support helps to reduce anxiety and promote patient comfort. Monitoring vital signs ensures patient safety and early detection of any complications.
Choice A (monitor oxygen saturation continuously) is not typically necessary during a thoracentesis unless the patient is at high risk for respiratory compromise.
Choice B (instruct the patient to hold their breath) is incorrect as the patient is usually instructed to breathe normally or take shallow breaths during the procedure to minimize movement.
Choice C (position the patient on the affected side) is also incorrect as the patient is typically positioned sitting upright or slightly leaning forward to facilitate access to the pleural space.
The nurse is providing discharge teaching for a patient who developed a pulmonary embolism after total knee surgery. The patient has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client?
A. Coumadin will continue to break up the clot over a period of weeks
B. Coumadin must be taken concurrent with ASA to achieve anticoagulation
C. Anticoagulant therapy usually lasts between 3 and 6 months
D. He should take a vitamin supplement containing vitamin K
Correct answer:
For a patient transitioning to warfarin after a pulmonary embolism (PE), the nurse must clarify that anticoagulant therapy prevents new clot formation rather than dissolving existing clots, which thrombolytics might address. The typical duration for PE treatment is 3 to 6 months, depending on risk factors like provoked events (e.g., surgery), balancing prevention of recurrence against bleeding risk. Warfarin does not require aspirin (ASA) for efficacy; combining them increases bleeding risk without enhancing anticoagulation for PE. Vitamin K antagonizes warfarin's effect by promoting clotting factor synthesis, so it's contraindicated unless reversing overdose. Teaching the 3-6 month duration empowers the patient to adhere to therapy, monitor for bleeding, and follow up for INR checks, ensuring safe management of this potentially recurrent condition post-surgery.
A 36-year-old security officer comes to your clinic, complaining of a painless mass in his scrotum. He found it 3 days ago during a testicular self-examination. He has had no burning with urination and no pain during sexual intercourse. He denies any weight loss, weight gain, fever, or night sweats. His past medical history is notable for high blood pressure. He is married and has three healthy children. He denies using illegal drugs, smokes two to three cigars a week, and drinks six to eight alcoholic beverages per week. His mother is in good health and his father had high blood pressure and coronary artery disease. On physical examination he appears anxious but in no pain. His vital signs are unremarkable. On visualization of his penis, he is circumcised and has no lesions. His inguinal region has no lymphadenopathy. Palpation of his scrotum shows a soft cystic-like lesion measuring 2 cm over his right testicle. There is no difficulty getting a gloved finger through either inguinal ring. With weight bearing there are no bulges. His prostate examination is unremarkable. What disorder of the scrotum does he most likely have?
A. Hydrocele
B. Scrotal hernia
C. Testicular tumor
D. Varicocele
Correct answer:
The correct answer is A: Hydrocele. A hydrocele is a fluid-filled sac surrounding the testicle that typically presents as a painless mass in the scrotum. In this case, the patient's presentation of a painless, soft, cystic-like lesion over the right testicle is consistent with a hydrocele. The absence of other concerning symptoms like weight loss, fever, or night sweats also points towards a benign condition like hydrocele. The lack of difficulty with inguinal ring passage and absence of bulges with weight bearing rule out a scrotal hernia. Testicular tumor typically presents with different characteristics such as testicular pain or hard, irregular masses. Varicocele is characterized by enlarged veins in the scrotum, not a fluid-filled sac. Therefore, based on the patient's presentation and physical examination findings, the most likely diagnosis is a hydrocele.
Which of the following security concerns is also a sentinel event that must be reported?
A. A possible vulnerability of the facility’s information technology to hacking
B. The assisted suicide of a client in your facility by the spouse of the client
C. Vulnerability to computer hacking
D. Potential information theft
Correct answer:
The correct answer is B because the assisted suicide of a client in a healthcare facility is a sentinel event, a serious adverse event that requires immediate investigation and reporting to ensure patient safety and quality improvement. This event poses significant risks to patient well-being and requires immediate attention to prevent future occurrences.
Explanation for why the other choices are incorrect:
A: A possible vulnerability of the facility’s information technology to hacking is a security concern but not necessarily a sentinel event that requires mandatory reporting.
C: Vulnerability to computer hacking is a security concern related to IT systems but does not qualify as a sentinel event.
D: Potential information theft is a security concern but does not meet the criteria of a sentinel event that requires immediate reporting for patient safety.
A nurse is caring for a patient with a history of hypertension who is complaining of dizziness and headache. What is the priority action?
A. Administer antihypertensive medication.
B. Administer a beta-blocker.
C. Administer oxygen therapy.
D. Administer oral antihypertensives.
Correct answer:
The correct answer is D: Administer oral antihypertensives. The priority action for a patient with hypertension experiencing dizziness and headache is to address the underlying cause of the symptoms, which is likely elevated blood pressure. Administering oral antihypertensives will help lower the patient's blood pressure and alleviate the symptoms.
Explanation:
1. Assess the patient's vital signs to confirm hypertension.
2. Administering oral antihypertensives is a quick and effective way to lower blood pressure.
3. Monitoring the patient's response to the medication is crucial.
4. Administering oxygen therapy (Choice C) is not the priority as the symptoms are likely due to hypertension, not hypoxia.
5. Administering antihypertensive medication (Choice A) or a beta-blocker (Choice B) via other routes may not be as quick or effective as oral medications.
LPN exams fundamentals practice questions, set 67 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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