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
There has been a mass casualty shooting at a nearby school. A nurse is working in the emergency department and is asked to triage clients as they arrive at the hospital. One of the clients arriving at the emergency department is in a wheelchair speaking to a nurse frantically while clutching his leg around a bloodied bandage and his foot is oddly angled. Based on this information, which of the following tag colors would the triage nurse assign this client?
A. red
B. yellow
C. black
D. green
Show answer and rationale
Correct answer: B — yellow
The correct answer is B: yellow. This client is displaying signs of delayed care needed, as he is speaking and alert but has a serious injury requiring immediate medical attention. The client's frantic state and the bloodied bandage indicate a potentially severe injury. The oddly angled foot suggests a possible fracture or dislocation, requiring urgent care but not immediate life-saving interventions. Assigning a yellow tag ensures the client receives prompt treatment without overwhelming the resources needed for critically injured individuals.
Incorrect options:
A: Red tag is for clients with life-threatening injuries who require immediate attention.
C: Black tag is for clients who are deceased or have injuries incompatible with survival.
D: Green tag is for clients with minor injuries or who require minimal medical care.
Question 2
A client who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia developed tardive dyskinesia as evidenced by tongue thrusting and chewing motions. The physician discontinued the chlorpromazine and prescribed Seroquel (quetiapine). As a result of this change, the nurse should carefully monitor for:
A. Development of pseudoparkinsonism
B. Development of dystonic reactions
C. Improvement in tardive dyskinesia
D. Worsening of anticholinergic symptoms
Show answer and rationale
Correct answer: C — Improvement in tardive dyskinesia
The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, such as chlorpromazine. Quetiapine (Seroquel) is a second-generation antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, the client is less likely to experience worsening of tardive dyskinesia symptoms. Monitoring for improvement in tardive dyskinesia is essential in this situation.
Choices A, B, and D are incorrect:
A: Development of pseudoparkinsonism is less likely with quetiapine compared to first-generation antipsychotics like chlorpromazine.
B: Dystonic reactions are acute side effects and are not typically associated with switching to quetiapine.
D: Anticholinergic symptoms are not directly related to tardive dyskinesia
Question 3
A nurse and a tech dispute task delegation. Which approach fosters teamwork?
A. Assign tasks unilaterally
B. Facilitate a role clarification discussion
C. Let them work it out alone
D. Reprimand both for arguing
Show answer and rationale
Correct answer: B — Facilitate a role clarification discussion
The correct answer is B: Facilitate a role clarification discussion. This approach fosters teamwork by encouraging open communication, clarifying each team member's roles and responsibilities, and resolving any misunderstandings or conflicts. By facilitating a discussion, it promotes mutual understanding and collaboration, leading to a more harmonious work environment.
Choices A, C, and D are incorrect:
A: Assign tasks unilaterally does not encourage teamwork as it lacks collaboration and may lead to resentment or lack of accountability.
C: Let them work it out alone can exacerbate the conflict and potentially harm teamwork by avoiding the issue instead of addressing it directly.
D: Reprimanding both for arguing is counterproductive as it does not address the root cause of the conflict and may create a negative work atmosphere.
Question 4
A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication?
A. "Touch carries a different meaning for different individuals."
B. "Touch is often used when deescalating volatile client situations."
C. "Touch is used to convey interest and warmth."
D. "Touch is best combined with empathy when dealing with anxious clients."
Show answer and rationale
Correct answer: A — "Touch carries a different meaning for different individuals."
The correct answer is A because touch carries a different meaning for different individuals. This statement acknowledges the importance of individual preferences and boundaries in therapeutic touch. It emphasizes the necessity of understanding and respecting each client's unique perspective on touch.
Explanation of why other choices are incorrect:
B: This statement oversimplifies the use of touch in de-escalating volatile situations and does not address the complexity of touch in therapeutic communication.
C: While touch can convey interest and warmth, this statement does not encompass the full range of meanings and implications that touch can have in therapeutic interactions.
D: While empathy is important in conjunction with touch, this statement does not capture the diversity of meanings that touch can hold for clients.
Question 5
The nurse is caring for a 4-year-old child following surgical removal of a stage I neuroblastoma. Which of the following interventions will be most appropriate for this child?
A. Applying aloe vera lotion to irradiated areas of skin
B. Administering antiemetics as prescribed for nausea
C. Giving medications as ordered via least invasive route
D. Maintaining isolation as prescribed to avoid infection
Show answer and rationale
Correct answer: C — Giving medications as ordered via least invasive route
Post-surgical care for a stage I neuroblastoma (localized, surgically resected) focuses on recovery with minimal invasiveness, making giving medications via the least invasive route preferably oral most appropriate for a 4-year-old. This reduces trauma, anticipates needs like pain relief, antiemetics, or steroids (e.g., dexamethasone for swelling), and suits a stable post-op child without chemotherapy or radiation yet, as stage I often requires surgery alone. Aloe vera implies radiation, not indicated here post-surgery. Antiemetics are useful but too narrow broader medication needs apply. Isolation isn't standard for stage I post-op unless immunosuppression emerges later. This intervention balances efficacy and comfort, aligning with pediatric nursing's goal to minimize distress while ensuring effective postoperative management.
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Question 6
Mrs. Smith is positioned in chair. Which one of the following is false?
A. Her back and buttocks are against the back of the chair
B. Her feet are flat on the floor or wheelchair footrests
C. Her paralyzed arms rest on her lap
D. The back of her knees and calves are away from the chair
Correct answer:
Proper positioning in a chair enhances comfort and prevents complications like pressure ulcers or poor circulation. Mrs. Smith's back and buttocks against the chair back and feet flat on the floor or footrests are correct for stability and support. The back of her knees and calves being away from the chair edge prevents pressure on those areas, which is also correct. However, stating that her paralyzed arms rest on her lap as universally true is misleading. With paralysis, arms may not naturally rest on the lap without support, such as pillows or armrests, due to lack of muscle control. In practice, paralyzed limbs require intentional positioning to avoid strain or injury, and without clarification of support, this statement does not hold as a standard positioning rule, making it the false option based on typical care protocols.
When a nurse assigned to a manipulative client for 5 days becomes aware of feelings of reluctance to interact with the client, the next action by the nurse should be to
A. Discuss the feeling of reluctance with an objective peer or supervisor
B. Limit contacts with the client to avoid reinforcement of manipulative behavior
C. Confront the client about the negative effects of behaviors on other clients and staff
D. Develop a behavior modification plan that will promote more functional behavior
Correct answer:
When a nurse experiences reluctance to interact with a manipulative client, it is essential to address these feelings constructively. Discussing the feeling of reluctance with an objective peer or supervisor allows the nurse to gain perspective, reflect on the situation, and develop appropriate strategies for patient care. This action promotes self-awareness, professional growth, and ensures that patient care is not compromised. Option B is incorrect because avoiding the client may not address the underlying issues and can impact the therapeutic relationship. Option C is inappropriate as confronting the client may escalate the situation and hinder effective communication. Option D is not the immediate action needed in this scenario, as it focuses on behavior modification rather than addressing the nurse's feelings of reluctance.
Which patient in the ear, nose, and throat (ENT) clinic should the nurse assess first?
A. A patient who is complaining of a sore throat and has a muffled voice.
B. A patient who has a 'scratchy throat' and a positive rapid strep antigen test.
C. A patient who is receiving radiation for throat cancer and has severe fatigue.
D. A patient with a history of a total laryngectomy whose stoma is red and inflamed.
Correct answer:
The correct answer is A because a patient with a sore throat and a muffled voice may indicate a potential airway obstruction, such as peritonsillar abscess or epiglottitis, requiring immediate assessment to prevent respiratory compromise.
Choice B is incorrect because a 'scratchy throat' and a positive rapid strep test may indicate a bacterial infection but do not pose an immediate threat to the airway.
Choice C is incorrect as the patient receiving radiation for throat cancer and experiencing severe fatigue requires assessment but not as urgently as a potential airway obstruction.
Choice D is incorrect because a red and inflamed stoma in a patient with a history of laryngectomy may indicate infection or irritation, but it does not pose an immediate threat to the airway as the patient already has a stoma for breathing.
An adult trauma patient suffered a fall from greater than 15 feet. When predicting the injuries associated with this type of injury, the paramedic should evaluate the distance fallen, the position of the body on impact, and which of the following?
A. The type of landing surface involved
B. The ambient temperature at the time of the fall
C. The patient's neurological status
D. The body parts that were struck with the most force
Correct answer:
The correct answer is A: The type of landing surface involved. When predicting injuries from a fall, the landing surface is crucial as it determines the amount of force transmitted to the body upon impact. A harder surface can result in more severe injuries. Evaluating the type of landing surface helps in assessing the mechanism of injury and potential injuries sustained.
Explanation:
- A: The type of landing surface directly affects the force of impact and the resulting injuries.
- B: Ambient temperature is not relevant to predicting injuries from a fall.
- C: Although important, the patient's neurological status is not directly related to the mechanism of injury in this scenario.
- D: While the body parts struck with the most force can indicate potential injuries, it is not as crucial as evaluating the landing surface.
How should a healthcare professional respond to a patient with diabetic ketoacidosis (DKA)?
A. Administer insulin
B. Administer IV fluids
C. Monitor blood glucose
D. All of the above
Correct answer:
When managing a patient with diabetic ketoacidosis (DKA), it is crucial to administer insulin to lower blood sugar levels, administer IV fluids to correct dehydration and electrolyte imbalances, and monitor blood glucose levels regularly to ensure they are within the target range. Therefore, all of the above options are essential components of the comprehensive treatment plan for DKA. Administering insulin alone may lower blood sugar levels but will not address the fluid and electrolyte imbalances seen in DKA. Similarly, administering IV fluids alone may help with dehydration but will not address the high blood sugar levels or the need for insulin. Monitoring blood glucose alone is not sufficient to treat DKA; it must be accompanied by appropriate interventions to address the underlying causes and complications of the condition.
You are the nurse working with an elderly, competent client who refuses a vitamin B injection ordered by the physician. The family insists that this injection be given, and you give it while the client is objecting. Even though the client improves, the client contacts a lawyer. From your knowledge of nursing and the law, you realize that you:
A. did the right thing because the client improved.
B. should have had the family put their request in writing.
C. have commited an assault against the client.
D. have committed an act of battery against the client.
Correct answer:
Administering a vitamin B injection to a competent client who refuses it, despite family insistence and subsequent improvement, constitutes battery. Battery is the unlawful physical contact with a person without consent, and in healthcare, consent is a fundamental right for competent adults. The client's objection overrides family wishes, and giving the injection violates autonomy, a core ethical principle. The outcome of improvement doesn't justify the action legally or ethically. Assault involves threatening harm, whereas battery is the act itself, making this the correct classification. Getting family requests in writing or focusing on the outcome doesn't negate the lack of consent. This scenario underscores the importance of respecting patient rights and the legal consequences of disregarding them, even with good intentions.
You are called to assist a 55-year-old male who complains of sudden onset chest pain, dyspnea, and palpitations. On arrival, he is found semi-conscious with a pulse rate too fast to palpate and a blood pressure of 80 systolic. Once on the monitor, he is exhibiting an irregularly wide complex tachycardia, with a polymorphic QRS appearance, at nearly 200 per minute. Which of the following would be the most effective intervention for this patient?
A. Administer procainamide at 20 mg/min IV infusion, per protocol
B. Administer 6 mg of adenosine IVP, followed by 12 mg, twice for a total of 30 mg, per protocol
C. Administer defibrillation per protocol
D. Administer synchronized electrical cardioversion at 50-100 joules, per protocol
Correct answer:
The correct answer is C: Administer defibrillation per protocol. In this scenario, the patient is presenting with signs of unstable ventricular tachycardia or ventricular fibrillation. Defibrillation is the most effective intervention as it delivers a shock to the heart to reset the abnormal rhythm. It is crucial in cases of pulseless ventricular tachycardia or ventricular fibrillation to restore a normal heart rhythm and improve cardiac output. Administering medications like procainamide (choice A) or adenosine (choice B) would not be effective as the patient is in a pulseless state. Synchronized electrical cardioversion (choice D) is typically used for stable tachyarrhythmias, not for pulseless rhythms. Defibrillation is the immediate and appropriate intervention to save the patient's life by restoring normal cardiac function.
A patient with bipolar disorder is hyperactive and has not slept for 3 days. Mood and behavior are labile. The patient threatens to hit another patient. Which response by the nurse is appropriate?
A. Stop that now. No one did anything to provoke an attack by you.
B. If you try that again, you will be placed in seclusion immediately.
C. Do not hit anyone. If you are unable to control yourself, we will help you.
D. You know we will not let you hit anyone. Why do you continue this behavior?
Correct answer:
The correct answer is C because it acknowledges the patient's struggle to control their behavior and offers support. It emphasizes the importance of not hitting anyone while also reassuring the patient that help is available if needed. This response promotes a therapeutic environment by setting clear boundaries and offering assistance rather than using threats or aggression.
Choice A is incorrect as it may escalate the situation by using a confrontational tone, potentially provoking further aggression. Choice B is also incorrect as it threatens the patient with seclusion, which can be seen as punitive and may not address the underlying issues causing the behavior. Choice D is incorrect as it does not provide a clear directive to prevent violence and instead questions the patient's behavior without offering immediate support.
A nurse begins to prepare a client for surgery. The surgeon has not yet obtained informed consent with the client; however, the operating room team has asked that the client be ready to transport to the surgical suite within the hour. Which of the following actions would be the least appropriate?
A. Ask the client to remove her hearing aid.
B. Remove contact lenses and offer the client her glasses.
C. Ensure that the client is wearing a wristband with her name, patient number, and date of birth.
D. Ask that a family member collect and keep any jewelry that the client is wearing.
Correct answer:
The correct answer is A: Ask the client to remove her hearing aid. This is the least appropriate action because removing a hearing aid does not affect the client's safety during surgery. The rationale is that hearing aids do not pose a risk in the operating room and are not typically removed for surgery.
Removing contact lenses and offering glasses (B) is important to prevent eye injury during surgery. Ensuring the client wears a wristband with identification details (C) is crucial for patient safety and proper identification. Asking a family member to collect and keep jewelry (D) is important to prevent loss or damage during surgery.
In summary, the removal of a hearing aid is not necessary for surgery preparation, unlike the other choices which are crucial for patient safety and proper care during the surgical process.
Which of the following is a guideline for a nursing assistant who is caring for a resident with an IV line?
A. The NA should disconnect the IV line when the bag is empty.
B. The NA should not measure blood pressure on an arm with an IV.
C. The NA should only get the IV site wet during the resident's bath.
D. The NA should lower the IV bag below the site for short intervals.
Correct answer:
The correct answer is B: The NA should not measure blood pressure on an arm with an IV. This is because measuring blood pressure on an arm with an IV can disrupt the IV line, leading to potential complications such as infiltration or dislodgment. It is important to avoid applying pressure or constricting the area around the IV site to ensure proper flow of fluids and medication.
Explanation of other choices:
A: The NA should not disconnect the IV line when the bag is empty as this can lead to air entering the line, causing air embolism.
C: The NA should avoid getting the IV site wet during the resident's bath to prevent infection or dislodgment of the IV catheter.
D: Lowering the IV bag below the site for short intervals is not recommended as it can cause an uneven flow rate and compromise the effectiveness of IV therapy.
LPN exams fundamentals practice questions, set 88 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
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