LPN exams fundamentals practice questions set 74

Correct answer:

The correct answer is C: Sims position. During an enema, the Sims position is preferred because it helps to facilitate the flow of the enema solution and allows for easier insertion of the enema tip. In the Sims position, the resident lies on their left side with the right knee flexed towards the chest. This position helps to promote the movement of the solution towards the rectum and reduces the risk of discomfort or injury. Incorrect choices: A: Lateral position is a general term and does not specify the optimal positioning for an enema. B: Supine position (lying flat on the back) is not ideal for administering an enema as it can make it harder for the solution to flow properly. D: Fowler's position (sitting up at a 45-90 degree angle) is not suitable for enema administration as it may not allow for proper flow and insertion of the enema tip.

Correct answer:

In bronchiectasis care, the nurse prioritizes the patient successfully mobilizing pulmonary secretions, addressing the disease's core issue chronic bronchial dilation trapping thick, purulent mucus. Effective clearance via chest physiotherapy or postural drainage reduces infection risk, obstruction, and dyspnea, improving ventilation and quality of life in this irreversible condition. Maintaining 98% oxygen saturation is unrealistic 90-94% often suffices in chronic lung disease and not the primary focus. Reducing pulmonary blood pressure isn't a bronchiectasis hallmark; it's more relevant in cor pulmonale or pulmonary hypertension. Resuming prediagnosis function in 72 hours is unfeasible given bronchiectasis's permanence. The nurse's goal of secretion mobilization tracked by sputum volume drives symptom relief, aligning with evidence-based management.

Correct answer:

The correct answer is C because collaborating with a client while developing a nursing care plan empowers the client to actively participate in their own care decisions, respecting their autonomy. This approach ensures that the client's values, preferences, and needs are considered, fostering a sense of control over their healthcare journey. Incorrect choices: A: This option focuses on setting goals for the client without necessarily involving them in the decision-making process, limiting their autonomy. B: While important for client safety, assessing for postprocedural complications does not directly promote client autonomy as it is more focused on the nurse's responsibilities. D: Encouraging independent ambulation is beneficial, but it does not necessarily involve the client in the decision-making process, unlike collaborating on a care plan.

Correct answer:

The correct answer is D: Encourage skin-to-skin contact between the mother and neonate. This action is crucial following a cesarean delivery to promote bonding, regulate the baby's temperature, and facilitate breastfeeding. Skin-to-skin contact also helps stabilize the baby's heart rate, breathing, and blood sugar levels. A: Allowing the birth partner to hand the neonate to the mother may be a good practice but is not as essential as skin-to-skin contact for immediate benefits. B: Assisting the mother and partner to cut the umbilical cord is not typically the nurse's responsibility immediately after a cesarean delivery and does not provide the same benefits as skin-to-skin contact. C: Moving the neonate into the visual field of the mother is important for bonding but does not offer the same physiological benefits as direct skin-to-skin contact.

Correct answer:

The correct answer is D: Discuss the need for an injectable antibiotic with the health care provider. If a patient continues to have positive sputum smears for AFB after 2 months of standard TB treatment, it suggests drug resistance. The next step would be to consider adding an injectable antibiotic like amikacin or streptomycin to the treatment regimen. This decision should be made in consultation with the healthcare provider based on culture and sensitivity testing results. A: Teaching about drug-resistant TB is important, but the immediate action should be to adjust the treatment regimen. B: Scheduling directly observed therapy may help with medication adherence but does not address the need for a change in treatment. C: Asking about medication adherence is important, but if the patient has been compliant, a change in treatment is necessary.

Correct answer:

The correct answer is D: Varicocele. Varicocele is the most likely abnormality in this case due to the presence of a "bag of worms" feeling upon palpation through the right inguinal ring, especially when the patient bears down. Varicocele is a dilation of the veins within the spermatic cord, leading to a mass resembling a bag of worms. The patient's symptoms of aching in the testicle that worsens throughout the day and improves in the morning are characteristic of varicocele, as increased intra-abdominal pressure exacerbates the symptoms. The absence of discrete masses on palpation and no bulges on bearing down help rule out other conditions like scrotal hernia. Hydrocele presents as a painless fluid-filled sac around the testicle, not a "bag of worms." Scrotal edema would present with swelling and pitting edema, which are not described in this case.

Correct answer:

The correct answer is D: Be accountable for his or her own actions. This is the most important nursing responsibility when ethical situations arise because accountability ensures that the nurse takes ownership of their decisions and actions, reflecting on the ethical implications. By being accountable, the nurse acknowledges their role in the ethical situation and works towards resolving it. Choice A is incorrect because relying solely on external advice may not align with the nurse's personal ethical beliefs and professional standards. Choice B is incorrect as neutrality may not always be appropriate in ethical dilemmas where advocating for the patient's best interest is crucial. Choice C is incorrect as ethical questions are not solely the responsibility of the health team, but also of the individual nurse who directly interacts with the patient.

Correct answer:

The correct answer is B: Percuss the thorax bilaterally, noting any differences in percussion tones. This action should be taken next because it can provide valuable information about the underlying cause of the patient's respiratory distress. Percussion can help identify abnormal air or fluid accumulation in the lungs or pleural space, which could be contributing to the breathing difficulties. It is an important assessment technique to determine if there are changes in lung density or presence of abnormal sounds. Counting respirations (A) is important but may not provide immediate information on the cause of distress. Waiting for a chest x-ray (C) can delay necessary interventions. Inspecting the thorax for masses or bleeding (D) is not as crucial as assessing for changes in percussion tones in a patient experiencing sudden respiratory distress.

Correct answer:

During an asthma attack, the preferred intervention is an inhaled beta-adrenergic agonist (e.g., albuterol), which rapidly relaxes bronchial smooth muscle, reversing airflow obstruction from bronchospasm, mucus, and inflammation. This short-acting bronchodilator acts within minutes, opening airways and relieving acute dyspnea, aligning with asthma guidelines (e.g., GINA) for exacerbations. Corticosteroids reduce inflammation but take hours, unsuitable for immediate relief. Anticholinergics (e.g., ipratropium) complement beta-agonists in severe cases but aren't first-line alone. Peak flow monitoring assesses obstruction severity, not treating it. The nurse's swift administration via inhaler ensuring proper technique (e.g., spacer use) restores ventilation, critical for this child's acute respiratory crisis, preventing escalation to status asthmaticus.

Correct answer:

Lung cancer tops the list of cancer deaths in North America for both men and women, as noted in the feedback, with over 570,000 deaths projected in 2011 alone. Smoking is the primary risk factor for lung cancer, making cessation the most direct intervention to tackle this killer. Self-breast and testicular exams target breast and testicular cancers, respectively, which rank lower in mortality (breast is second for women, prostate second for men). Colonoscopies address colorectal cancer, third in frequency, but lung cancer's dominance ties directly to smoking's prevalence. By pushing cessation, nurses hit the root cause head-on, reducing exposure to carcinogens like tar and nicotine that drive malignant transformation in lung tissue. This aligns with primary prevention, cutting incidence before it starts, unlike screening which catches disease later.