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
How many types of muscles are present in the body?
A. 4
B. 2
C. 3
D. 5
Show answer and rationale
Correct answer: C — 3
The body has three muscle types: cardiac, smooth, and skeletal, each with distinct roles. Cardiac muscle, in the heart, pumps blood involuntarily. Smooth muscle, in organs like the intestines, manages involuntary tasks like digestion. Skeletal muscle, attached to bones, drives voluntary movements like walking. Suggesting four or five types might confuse these with subtypes (e.g., fast-twitch skeletal) or non-muscle tissues, but anatomy recognizes only three based on structure and control. Two undercounts by omitting one, missing the full scope. Three aligns with histological and functional classification, reflecting their specialized purposes cardiac for circulation, smooth for visceral action, skeletal for locomotion. This trio covers all muscular functions, providing a clear, consistent framework for understanding the body's movement and maintenance systems.
Question 2
Which approach prevents conflict escalation in a diverse nursing team?
A. Standardizing all processes
B. Encouraging open dialogue
C. Enforcing strict rules
D. Rotating leadership roles
Show answer and rationale
Correct answer: B — Encouraging open dialogue
The correct answer is B: Encouraging open dialogue. This approach is effective in preventing conflict escalation in a diverse nursing team because it promotes communication, understanding, and respect among team members. By encouraging open dialogue, team members are able to express their perspectives, address misunderstandings, and work towards finding mutually agreeable solutions. This fosters a positive team culture and helps prevent conflicts from escalating.
Other choices are incorrect:
A: Standardizing all processes may not address the underlying issues causing conflicts in a diverse team.
C: Enforcing strict rules can create a rigid environment that stifles communication and creativity, potentially leading to increased conflict.
D: Rotating leadership roles may not necessarily address communication barriers or promote open dialogue among team members.
Question 3
A 70-year-old man with a history of hypertension presents with shortness of breath and orthopnea. His physical examination reveals bilateral pedal edema, crackles at the lung bases, and jugular venous distention. What is the most likely diagnosis?
A. Chronic obstructive pulmonary disease
B. Congestive heart failure
C. Pulmonary embolism
D. Renal failure
Show answer and rationale
Correct answer: B — Congestive heart failure
The correct answer is B: Congestive heart failure. This diagnosis is likely due to the patient's history of hypertension, presenting symptoms of shortness of breath, orthopnea, bilateral pedal edema, crackles at lung bases, and jugular venous distention. These findings are classic signs of congestive heart failure, indicating impaired heart function leading to fluid accumulation in the lungs and peripheral tissues. Chronic obstructive pulmonary disease (choice A) typically presents with a history of smoking, productive cough, and wheezing, not consistent with this patient's presentation. Pulmonary embolism (choice C) would present with sudden onset dyspnea and chest pain, not gradual symptoms as seen here. Renal failure (choice D) can cause fluid retention, but the combination of symptoms and signs in this patient points more towards congestive heart failure.
Question 4
The nurse reviews the laboratory results for 4 assigned clients. Which result is most important for the nurse to report to the primary health care provider?
A. Client with atrial fibrillation receiving warfarin for 7 days with an International Normalized Ratio (INR) of 1.1
B. Client with chronic bronchitis who has a hematocrit of 56% [0.56] and hemoglobin of 19 g/dL (190 g/L)
C. Client with Clostridium difficile infection who has a white blood cell count of 15,000/mm3 (15 × 109/L)
D. Client with sepsis receiving gentamycin who has a creatinine of 0.6 mg/dL (53 μmol/L)
Show answer and rationale
Correct answer: A — Client with atrial fibrillation receiving warfarin for 7 days with an International Normalized Ratio (INR) of 1.1
For a client with atrial fibrillation on warfarin, the therapeutic INR range is 2.0-3.0 to prevent clotting. An INR of 1.1 after 7 days indicates subtherapeutic anticoagulation, posing a high risk of thromboembolism, requiring urgent provider notification for dose adjustment. Elevated hematocrit and hemoglobin in chronic bronchitis suggest polycythemia due to hypoxia, but this is less immediately critical. A white blood cell count of 15,000/mm3 in Clostridium difficile infection is expected due to inflammation and doesn't demand immediate action unless worsening. A creatinine of 0.6 mg/dL in sepsis is normal, indicating no renal impairment from gentamycin yet. The INR result is most urgent, as it directly impacts the client's risk of a life-threatening event, necessitating prompt intervention to ensure effective anticoagulation and prevent stroke or embolism.
Question 5
The nurse is performing a general survey. Which action is a component of the general survey?
A. Observing the patient's body stature and nutritional status
B. Interpreting the subjective information the patient has reported
C. Measuring the patient's temperature, pulse, respirations, and blood pressure
D. Observing specific body systems while performing the physical assessment
Show answer and rationale
Correct answer: A — Observing the patient's body stature and nutritional status
The correct answer is A because observing the patient's body stature and nutritional status is a key component of the general survey, which involves assessing the overall appearance and health status of the patient. This step provides valuable information about the patient's overall well-being and can help identify any potential health issues.
Choice B is incorrect because interpreting subjective information reported by the patient is part of the health history, not the general survey.
Choice C is incorrect because measuring vital signs (temperature, pulse, respirations, and blood pressure) is part of the physical assessment, not the general survey.
Choice D is incorrect because observing specific body systems while performing the physical assessment is also not part of the general survey, but rather a focused assessment on particular body systems.
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Question 6
What action should the LPN/LVN take to prevent postoperative complications in a client who has undergone abdominal surgery?
A. Encourage the client to use an incentive spirometer regularly.
B. Assist the client in ambulating as soon as possible.
C. Position the client in high Fowler's position.
D. Encourage the client to cough and deep breathe regularly.
Correct answer:
Encouraging the client to use an incentive spirometer regularly is crucial in preventing postoperative complications after abdominal surgery. This action helps prevent atelectasis by promoting lung expansion and improving air exchange in the lungs, reducing the risk of respiratory complications. Assisting the client in ambulating early is important for preventing issues like deep vein thrombosis but may not directly address respiratory concerns postoperatively. Positioning the client in high Fowler's position can help with respiratory distress but is not as specific to preventing postoperative respiratory complications as using an incentive spirometer. While encouraging the client to cough and deep breathe is generally beneficial for lung expansion, using an incentive spirometer is more effective and targeted in preventing atelectasis after abdominal surgery.
A nurse does not assist with ambulation for a postoperative patient on the first day after surgery. The patient falls and fractures a hip. What charge might be brought against the nurse?
A. assault
B. battery
C. fraud
D. negligence
Correct answer:
The correct answer is D: negligence. Negligence refers to the failure to exercise the standard of care that a reasonably prudent person would have in a similar situation. In this case, the nurse failed to assist with ambulation, which resulted in harm to the patient. The charge of negligence would be appropriate as the nurse did not fulfill their duty of care to prevent harm to the patient.
The other choices are incorrect:
A: Assault involves intentional acts that cause a person to fear that they will be physically harmed. The nurse did not intend for the patient to fall.
B: Battery involves intentional harmful or offensive contact with another person without their consent. The nurse did not intentionally cause harm to the patient.
C: Fraud involves intentional deception for personal gain. There is no evidence of intentional deception in this scenario.
A client has a terminal diagnosis and their health is declining. The client requests information about advance directives. Which of the following responses should the nurse make?
A. Offering to discuss advance directives and provide brochures respects the client's request and provides information.
B. Informing the client that advance directives are not necessary at this time is incorrect as they play a crucial role in end-of-life care.
C. Scheduling a meeting with the family to discuss advance directives is not the most appropriate response as the client directly requested information.
D. Directing the client to ask their provider about advance directives does not directly address the client's request for information.
Correct answer:
When a client with a terminal illness asks about advance directives, it is essential to provide the information they seek. Choice A is the correct response as it acknowledges the client's request and offers to discuss advance directives while providing additional resources in the form of brochures. This approach empowers the client to make informed decisions about their end-of-life care. Choices B, C, and D are incorrect because they do not directly address the client's request or provide the information the client is seeking. Choice B dismisses the importance of advance directives, which are crucial in end-of-life care planning. Choice C involves the family unnecessarily when the client directly requested information. Choice D deflects the responsibility back to the client to seek information from their provider instead of addressing their immediate request.
Which client should the medical unit nurse assess first after receiving shift report?
A. The 84-year-old client diagnosed with pneumonia who is afebrile but getting restless
B. The 25-year-old client diagnosed with influenza and has a headache
C. The 56-year-old client diagnosed with left side hemothorax with tidaling in the water seal of the chest drainage system
D. The 38-year-old client diagnosed with a sinus infection who has green drainage from the nose
Correct answer:
The correct answer is A because the elderly client with pneumonia getting restless may indicate a change in condition or potential complications, requiring immediate assessment. Restlessness can be a sign of decreased oxygenation or sepsis in pneumonia patients.
Choice B is incorrect as a headache in a young adult with influenza is not typically an immediate priority compared to potential respiratory distress in the elderly client.
Choice C is incorrect as tidaling in the chest drainage system is expected and does not necessarily require immediate assessment unless other signs of distress are present.
Choice D is incorrect as green drainage from the nose in a client with a sinus infection may indicate a bacterial infection but is not typically an urgent concern compared to potential acute respiratory compromise in the elderly client with pneumonia.
The nurse is assessing a patient's abdomen and notes that the patient has a firm, non-tender mass. What is the next step in the assessment?
A. Percuss the area to assess for fluid.
B. Palpate the mass to assess for tenderness.
C. Auscultate for bowel sounds.
D. Refer the patient for imaging.
Correct answer:
The correct answer is D: Refer the patient for imaging. When a nurse encounters a firm, non-tender mass in the abdomen, it is important to proceed with imaging to determine the nature of the mass. Imaging studies such as ultrasound, CT scan, or MRI can provide valuable information about the size, location, and characteristics of the mass. This step is crucial in identifying the potential underlying causes of the mass, such as tumors, cysts, or other abnormalities.
Option A is incorrect because percussion is not typically used to assess for fluid in a mass. Option B is incorrect as palpation may not be safe if the mass is suspected to be malignant. Option C is incorrect as auscultation for bowel sounds may not provide relevant information about the mass. The best course of action is to refer the patient for imaging to further evaluate the mass accurately.
What is the primary purpose of standards of nursing practice?
A. to provide a method by which nurses perform skills safely
B. to ensure knowledgeable, safe, comprehensive nursing care
C. to establish nursing as a profession and a discipline
D. to enable nurses to have a voice in healthcare policy
Correct answer:
The primary purpose of standards of nursing practice (Correct Answer: B) is to ensure knowledgeable, safe, comprehensive nursing care. This answer is correct because standards guide nurses in delivering high-quality care based on evidence-based practices, ensuring patient safety and well-being. Standards encompass not just skills but also knowledge, critical thinking, ethics, and communication.
Incorrect choices:
A: While standards do help nurses perform skills safely, their primary purpose is broader and includes knowledge and comprehensive care.
C: Establishing nursing as a profession and a discipline is important but not the primary purpose of standards, which focus on guiding clinical practice.
D: While nurses may advocate for healthcare policy, the primary purpose of standards is to ensure quality care, not specifically to enable policy advocacy.
How should a healthcare professional manage a patient with congestive heart failure?
A. Administer diuretics and monitor fluid balance
B. Provide a high-sodium diet and restrict fluids
C. Administer oxygen and provide pain relief
D. Provide bronchodilators and encourage mobility
Correct answer:
Correct answer: The most appropriate management for a patient with congestive heart failure is to administer diuretics to help remove excess fluid and monitor fluid balance. Diuretics help reduce the workload on the heart and alleviate symptoms of fluid overload. Choice B is incorrect because patients with congestive heart failure are usually advised to limit sodium intake and carefully monitor fluid intake. Choice C is incorrect because although oxygen therapy may be necessary in certain cases, it is not the primary management for congestive heart failure. Pain relief is not a primary intervention for this condition. Choice D is incorrect because bronchodilators are not the first-line treatment for congestive heart failure. Encouraging mobility is important, but administering diuretics and monitoring fluid balance take precedence in managing this condition.
A nurse is caring for a patient who has a history of hypertension and is experiencing chest pain. What is the priority action?
A. Administer nitroglycerin.
B. Administer aspirin.
C. Monitor vital signs.
D. Administer IV fluids.
Correct answer:
The correct answer is A: Administer nitroglycerin. The priority action in this scenario is to address the chest pain, which could be indicative of a myocardial infarction or heart attack. Nitroglycerin helps to dilate blood vessels, improve blood flow to the heart, and relieve chest pain. Administering nitroglycerin promptly can help alleviate the patient's symptoms and potentially prevent further cardiac damage.
Choice B (Administer aspirin) is also a common intervention for chest pain, but nitroglycerin is the priority as it directly addresses the underlying cause of chest pain in this case.
Choice C (Monitor vital signs) and choice D (Administer IV fluids) are important interventions but are not the priority when a patient with a history of hypertension presents with chest pain, as addressing the potential cardiac issue should be the primary focus.
A young woman is being seen in the gynecology clinic of the local health department. She has decided to begin hormonal contraceptives. What action is specific to hormonal contraceptives and should be taught to this woman?
A. The cervical mucus is made resistant to penetration by spermatozoa.
B. The follicle-stimulating hormone release is increased to block fertility.
C. The maturation of the endometrial lining is activated by contraceptive.
D. The pituitary gland increases the synthesis and release of luteinizing hormone.
Correct answer:
Hormonal contraceptives work by altering the reproductive environment to prevent pregnancy. One key mechanism is thickening the cervical mucus, which creates a barrier that hinders sperm from reaching the upper reproductive tract, thus reducing the chance of fertilization. This effect stems from the progestin component, which suppresses hypothalamic gonadotropin-releasing hormone, subsequently decreasing follicle-stimulating hormone and luteinizing hormone levels to prevent ovulation. The endometrial lining, rather than maturing fully, becomes less receptive to implantation due to these hormonal changes. Teaching this focuses on how the medication physically impedes sperm movement, a critical aspect for the woman to understand its contraceptive action, ensuring informed use and adherence while aligning with its pharmacological impact on fertility regulation.
A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient's neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ______ and should ______.
A. agranulocytosis"¦check the patient's complete blood count for changes
B. tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale
C. Tourette's syndrome"¦consult the patient's physician about a neuro evaluation
D. anticholinergic effects"¦consult the physician about possible medication changes
Correct answer:
Step 1: The patient is showing signs of abnormal movements like lip smacking, grimacing, and snakelike motions, which are indicative of tardive dyskinesia (TD).
Step 2: TD is a side effect of long-term antipsychotic use, such as fluphenazine decanoate.
Step 3: The Abnormal Involuntary Movement Scale is a validated tool to assess the severity of TD.
Step 4: Administering the Abnormal Involuntary Movement Scale will help confirm the diagnosis of TD.
Step 5: Prompt recognition of TD is crucial as it may be irreversible and can worsen over time if not addressed.
Summary:
- A: Agranulocytosis is a condition characterized by low white blood cell count, not related to the patient's symptoms.
- C: Tourette's syndrome presents with different symptoms and requires specialized evaluation.
- D: Anticholinergic effects do not typically manifest as the described
LPN exams fundamentals practice questions, set 69 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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