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
Appropriate statements concerning intrathecal drug delivery systems include:
A. In a patient with progressive cancer-related pain, a low-grade pelvic infection is an absolute contraindication for implanting either an intrathecal catheter or a pump, even under antibiotic cover.
B. Intrathecally administered opioids circulate to the central neuraxis, including the brainstem, where they are likely to cause drowsiness and respiratory depression.
C. In difficult cases, ziconotide can be administered with either an opioid or clonidine, or both.
D. As a mixture of opioid and clonidine is expected to distribute throughout the cerebrospinal fluid, the level of the catheter in the intrathecal space is unlikely to be important.
Show answer and rationale
Correct answer: B — Intrathecally administered opioids circulate to the central neuraxis, including the brainstem, where they are likely to cause drowsiness and respiratory depression.
Intrathecal drug delivery systems (IDDS) manage severe pain with nuances. A low-grade pelvic infection isn't an absolute contraindication; implantation may proceed with antibiotics if benefits outweigh risks (e.g., cancer palliation). Intrathecal opioids do reach the brainstem via cerebrospinal fluid, causing drowsiness and respiratory depression, though less than systemic routes due to lower doses still a key risk requiring monitoring. Ziconotide combines with opioids or clonidine for synergy in refractory pain, per clinical practice. Catheter tip position matters; drug distribution isn't uniform higher placement enhances rostral spread, affecting efficacy and side effects. MRI compatibility exists with most modern pumps. The brainstem effect of opioids underscores IDDS's potency and danger, necessitating careful titration and patient selection.
Question 2
Which part of the female reproductive system is responsible for the production of estrogen?
A. Ovary
B. Uterus
C. Fallopian tubes
D. Cervix
Show answer and rationale
Correct answer: A — Ovary
The correct answer is A: Ovary. Estrogen is primarily produced by the ovaries, specifically by the ovarian follicles. The ovaries contain specialized cells that produce estrogen in response to hormonal signals. Estrogen plays a crucial role in regulating the menstrual cycle, promoting the development of secondary sexual characteristics, and maintaining reproductive health.
The other choices (B: Uterus, C: Fallopian tubes, D: Cervix) are incorrect because they do not play a direct role in the production of estrogen. The uterus is the organ where a fertilized egg implants and develops during pregnancy. The fallopian tubes are responsible for transporting eggs from the ovaries to the uterus. The cervix is the lower part of the uterus that connects to the vagina. While these structures are important for reproduction, they do not produce estrogen.
Question 3
During patient teaching, a young woman asks the nurse the following question: 'If I get pregnant on the 'pill,' should I continue to take it?' What is the nurse's best response?
A. The pill has no effect on pregnancy.'
B. The pill will cause miscarriage.'
C. This is a personal choice for each woman.'
D. The pill can be harmful to the fetus and should be discontinued.'
Show answer and rationale
Correct answer: D — The pill can be harmful to the fetus and should be discontinued.'
When pregnancy occurs while using hormonal contraceptives, continuing the medication poses risks to fetal development. Estrogens in these drugs are contraindicated during pregnancy due to evidence linking their use to congenital anomalies, notably vaginal cancer in female offspring exposed in utero. This reflects the drug's hormonal influence, which can disrupt normal embryonic growth. Discontinuing the pill prevents potential teratogenic effects, prioritizing fetal safety over personal choice in this context. It doesn't inherently cause miscarriage, nor is it benign in pregnancy; its impact is significant and harmful. The nurse's response emphasizes this evidence-based precaution, guiding the woman to stop the medication immediately upon confirming pregnancy, aligning with clinical standards to mitigate adverse outcomes for the developing fetus.
Question 4
The nurse plans discharge teaching for a patient with chronic heart failure who has prescriptions for digoxin (Lanoxin) and hydrochlorothiazide. Which instruction should the nurse include?
A. Limit dietary sources of potassium.
B. Take the hydrochlorothiazide at bedtime.
C. Notify the health care provider if nausea develops.
D. Take the digoxin if the pulse is below 60 beats/min.
Show answer and rationale
Correct answer: C — Notify the health care provider if nausea develops.
The correct answer is C: Notify the health care provider if nausea develops. This is important because nausea can be a sign of digoxin toxicity, a potential side effect of digoxin. By promptly notifying the healthcare provider, appropriate action can be taken to prevent any serious complications.
A: Limit dietary sources of potassium - This is not directly related to the medications prescribed and is not necessary for the patient's current condition.
B: Take the hydrochlorothiazide at bedtime - Timing of hydrochlorothiazide administration is not as critical as monitoring for side effects or interactions with other medications.
D: Take the digoxin if the pulse is below 60 beats/min - This instruction could lead to potential overdosing if the patient takes digoxin unnecessarily based solely on heart rate without considering other factors.
Question 5
The LPN/LVN is assisting with the care of a client who has had a stroke. Which intervention is most important to include in the client's plan of care to prevent joint contractures?
A. Encourage the client to perform active range-of-motion exercises.
B. Use pillows to keep the client's extremities in a functional position.
C. Place the client in a prone position for 30 minutes each day.
D. Perform passive range-of-motion exercises on the affected side.
Show answer and rationale
Correct answer: B — Use pillows to keep the client's extremities in a functional position.
Using pillows to keep the client's extremities in a functional position is crucial in preventing joint contractures. This intervention helps maintain proper alignment of the joints and reduces the risk of contractures by preventing prolonged positioning that can lead to muscle shortening. Encouraging the client to perform active range-of-motion exercises (Choice A) is beneficial for maintaining mobility but may not be the most important intervention to prevent joint contractures. Placing the client in a prone position for 30 minutes each day (Choice C) can be helpful for preventing pressure ulcers but is not directly related to preventing joint contractures. Performing passive range-of-motion exercises on the affected side (Choice D) can aid in maintaining joint flexibility but may not be as crucial as using pillows to prevent joint contractures.
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Question 6
You are on-scene with an apneic adult who collapsed one to two minutes prior to your arrival, according to bystanders. Which of the following endotracheal tube size ranges would be most appropriate for an average adult respiratory arrest patient who shows no signs of airway trauma or obstruction?
A. 6.5-8.5 ET tube
B. 9.0-10.0 ET tube
C. 7.5-8.5 ET tube
D. 4.5-6.5 ET tube
Correct answer:
The correct answer is C: 7.5-8.5 ET tube. This size range is most appropriate for an average adult respiratory arrest patient with no signs of airway trauma or obstruction.
Rationale:
1. Size range 7.5-8.5 is standard for adult males and females with average airway anatomy.
2. Choosing too small a tube (option D) can lead to inadequate ventilation.
3. Choosing too large a tube (options A and B) can cause trauma to the airway and increase the risk of complications.
4. Considering the patient has no signs of airway trauma or obstruction, a mid-range size tube (option C) provides a balance between effective ventilation and minimizing potential harm.
In summary, option C is the most appropriate choice as it balances the need for effective ventilation while minimizing the risk of complications in an average adult respiratory arrest patient.
B. Take medications that cause a decrease in urinary output
C. Have a force fluids medical order
D. Need to do range of motion exercises to improve muscle tone
Correct answer:
The correct answer is D because range of motion exercises can help improve muscle tone in individuals with congestive heart failure, aiding in overall physical functioning and quality of life. It is important for patients with heart failure to maintain muscle strength to support the heart and enhance exercise tolerance.
A: Being on a high-sodium diet is not recommended for individuals with congestive heart failure as it can lead to fluid retention and worsen symptoms.
B: Medications that cause a decrease in urinary output can exacerbate fluid retention, which is detrimental for individuals with congestive heart failure.
C: Having a force fluids medical order is not typically necessary for individuals with congestive heart failure unless there are specific indications, as excessive fluid intake can worsen symptoms and lead to fluid overload.
An adult patient tells the case manager, 'I dont have bipolar disorder anymore, so I dont need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now Im bored and dont have any friends.' Where should the nurse refer the patient? Select one tha does not apply.
A. Psychoeducational classes
B. Vocational rehabilitation
C. Social skills training
D. A homeless shelter
Correct answer:
The patient does not understand the illness and need for adherence to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with serious mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking the skill down into smaller verbal and nonverbal components. Work gives meaning and purpose to life, so vocational rehabilitation can assist with this aspect of care. The nurse case manager will function in the role of crisis stabilizer, so no related referral is needed. The patient presently has a home and does not require a homeless shelter.
What is the purpose of endometrial biopsy in fertility evaluations?
A. To determine ovarian reserve and egg quality.
B. To assess the receptivity of the uterine lining for implantation.
C. To measure hormone levels in the bloodstream.
D. To monitor embryo development after IVF.
Correct answer:
The correct answer is B: To assess the receptivity of the uterine lining for implantation. Endometrial biopsy is performed to evaluate the quality of the uterine lining and its ability to support embryo implantation. By examining the endometrial tissue, doctors can assess factors such as thickness, pattern, and receptivity, crucial for successful implantation and pregnancy.
Incorrect choices:
A: To determine ovarian reserve and egg quality - Endometrial biopsy does not provide information on ovarian reserve or egg quality.
C: To measure hormone levels in the bloodstream - Endometrial biopsy does not measure hormone levels in the bloodstream; instead, it focuses on the uterine lining.
D: To monitor embryo development after IVF - Endometrial biopsy is not used to monitor embryo development; it is primarily for assessing uterine receptivity.
A patient is seen in the clinic for complaints of "fainting episodes that started last week." How should the nurse proceed with the examination?
A. Blood pressure readings are taken in both the arms and the thighs.
B. The patient is assisted to a lying position, and his blood pressure is taken.
C. His blood pressure is recorded in the lying, sitting, and standing positions.
D. His blood pressure is recorded in the lying and sitting positions; these numbers are then averaged to obtain a mean blood pressure.
Correct answer:
Rationale:
1. Recording blood pressure in lying, sitting, and standing positions helps assess for orthostatic hypotension.
2. Orthostatic hypotension can cause fainting episodes when changing positions.
3. Lying, sitting, and standing readings provide a comprehensive evaluation of blood pressure changes.
4. It helps in identifying if there is a significant drop in blood pressure from lying to standing.
5. This approach aligns with best practices in diagnosing syncope and fainting episodes.
Summary of Other Choices:
A. Taking blood pressure in arms and thighs is not relevant to assessing orthostatic changes.
B. Only taking blood pressure in a lying position does not provide a complete evaluation of potential orthostatic issues.
D. Averaging lying and sitting positions may miss important changes when transitioning to a standing position.
What is one of the nursing assistant's responsibilities for tube feedings?
A. Inserting tubes
B. Giving tube feedings
C. Positioning the resident
D. Cleaning or suctioning the tubes
Correct answer:
The correct answer is B: Giving tube feedings. Nursing assistants are responsible for administering tube feedings to residents as directed by the healthcare team. This involves setting up the feeding, checking the placement of the tube, monitoring the resident during feeding, and documenting intake accurately.
A: Inserting tubes - Nursing assistants do not insert tubes; this is typically done by nurses or other trained healthcare professionals.
C: Positioning the resident - While important for comfort and safety, positioning the resident is not specifically related to tube feedings.
D: Cleaning or suctioning the tubes - While maintaining cleanliness of the tubes is important, this task is usually performed by nurses or trained staff. Nursing assistants may assist with cleaning, but it is not their primary responsibility for tube feedings.
You are called to assist an adult diabetic who was found unconscious in bed. On arrival, your patient is unresponsive with snoring respirations and cool, clammy skin. Your glucometer will not power up, so blood glucose analysis is impossible at the present time. Which of the following would be most appropriate after controlling the patient's airway and delivering high-flow oxygen therapy?
A. Administer glucagon to the patient intramuscularly in a large muscle group like the gluteal muscles
B. Start an intravenous line, draw blood samples, and administer one amp of dextrose 50 percent (D50)
C. Start an intravenous line, and draw blood samples before administering a glucose-containing IV fluid bolus
D. Quickly establish an intravenous line, and transport the patient to the nearest hospital for blood glucose analysis prior to medication administration
Correct answer:
The correct answer is B because administering one amp of dextrose 50% (D50) intravenously is the most appropriate action for an unconscious diabetic patient with hypoglycemia. Here's the rationale:
1. Glucagon (Choice A) requires an intact liver glycogen store to be effective, which may not be the case in some diabetic patients.
2. Administering a glucose-containing IV fluid bolus (Choice C) may delay the delivery of glucose to the brain, which is critical in this emergency situation.
3. Transporting the patient to the hospital for blood glucose analysis (Choice D) would waste valuable time, as immediate glucose administration is crucial.
Administering D50 intravenously provides a rapid source of glucose directly into the bloodstream, ensuring a quick increase in blood sugar levels to reverse hypoglycemia and improve the patient's condition.
You are taking care of a patient who has had a colporrhaphy. Which option would indicate a priority assessment during the postoperative period?
A. Documentation of a pessary in the operative procedure notes by the physician
B. Removal of vaginal packing as ordered by the physician
C. Use of a cell saver for transfusion therapy in the postoperative period
D. Order for removal of staples 2 to 3 days post-procedure
Correct answer:
The correct answer is B: Removal of vaginal packing as ordered by the physician. This is a priority assessment because leaving the vaginal packing in place for too long can lead to complications such as infection or tissue damage. It is important to follow the physician's orders for timely removal to prevent these risks.
A: Documentation of a pessary in the operative notes is important for accuracy but not a priority assessment in the postoperative period.
C: The use of a cell saver for transfusion therapy is not directly related to the immediate postoperative care of a colporrhaphy patient and is not a priority assessment in this context.
D: The removal of staples 2 to 3 days post-procedure is important but not as time-sensitive as the removal of vaginal packing. It can be done at a later stage without immediate risk to the patient.
The following are nursing interventions to address the problems on parasitism EXCEPT:
A. Treatment of patients with broad spectrum antihelmintics
B. Stress that vegetables should be thoroughly washed especially if eaten raw
C. Teach proper disposal of stools and stress that it shouldn't be used as fertilizer
D. Encouraging hand washing before and after eating
Correct answer:
Effective interventions for parasitism target its transmission and treatment. Administering antihelmintics directly addresses the infection by eliminating parasites, while washing vegetables prevents ingestion of parasite eggs, and proper stool disposal reduces environmental contamination a key transmission route. Hand washing, although a general hygiene practice, is less specific to parasitism prevention compared to the other options, which directly interrupt the parasite lifecycle (e.g., fecal-oral route or soil contamination). Parasites like helminths are primarily spread through contaminated food, water, or soil, not solely through hand contact before or after eating. Thus, while hand washing is beneficial, it does not uniquely target parasitism's root causes as effectively as the other interventions, making it the exception in this context.
The nurse is assessing a patient's extraocular movements. Which cranial nerves are being evaluated?
A. Cranial nerves II, III, and IV.
B. Cranial nerves III, IV, and VI.
C. Cranial nerves V, VI, and VII.
D. Cranial nerves II, V, and VII.
Correct answer:
The correct answer is B: Cranial nerves III, IV, and VI. These cranial nerves are responsible for controlling the extraocular muscles. Cranial nerve III (oculomotor) controls most of the eye movements, cranial nerve IV (trochlear) controls the superior oblique muscle, and cranial nerve VI (abducens) controls the lateral rectus muscle. Evaluating these cranial nerves allows the nurse to assess the full range of eye movements.
Choice A (Cranial nerves II, III, and IV) includes the optic nerve (II) which is responsible for vision, not extraocular movements. Choice C (Cranial nerves V, VI, and VII) involves the trigeminal nerve (V) responsible for facial sensation, not eye movements. Choice D (Cranial nerves II, V, and VII) includes the optic nerve (II) and facial nerve (VII), which are not primarily involved in controlling extraocular movements
LPN exams fundamentals practice questions, set 77 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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