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
During a cardiac assessment, the nurse notes a grade 3/6 systolic murmur at the left sternal border. What is the appropriate documentation for this finding?
A. Systolic murmur, grade 3/6, heard best at the left sternal border.
B. Diastolic murmur, grade 3/6, heard best at the left sternal border.
C. Systolic click, grade 3/6, heard best at the left sternal border.
D. Diastolic click, grade 3/6, heard best at the left sternal border.
Show answer and rationale
Correct answer: A — Systolic murmur, grade 3/6, heard best at the left sternal border.
Rationale for Correct Answer (A):
1. The term "systolic" indicates that the murmur occurs during systole.
2. The grade 3/6 signifies the loudness or intensity of the murmur.
3. "Heard best at the left sternal border" specifies the location where the murmur is most audible.
4. Therefore, documenting "Systolic murmur, grade 3/6, heard best at the left sternal border" accurately describes the finding.
Incorrect Choices:
B: Diastolic murmurs occur during diastole, not systole.
C: A systolic click is a distinct sound different from a murmur.
D: Diastolic clicks are also distinct sounds and do not indicate a murmur.
Summary:
Choice A is correct because it accurately describes the type, intensity, and location of the murmur. Choices B, C, and D are incorrect due to inaccuracies in the timing or nature of the sound
Question 2
During an examination of a woman, the nurse notices that her left breast is slightly larger than her right breast. Which of these statements is true about this finding?
A. Breasts should always be symmetric.
B. Asymmetry of breast size and shape is probably due to breastfeeding and is nothing to worry about.
C. Asymmetry is not unusual, but the nurse should verify that this change is not new.
D. Asymmetry of breast size and shape is very unusual and means she may have an inflammation or growth.
Show answer and rationale
Correct answer: C — Asymmetry is not unusual, but the nurse should verify that this change is not new.
Step-by-step rationale for why choice C is correct:
1. Asymmetry of breast size is not uncommon, as breasts are typically not perfectly symmetrical.
2. The nurse should verify that the change is not new to rule out any concerning underlying issues.
3. This step is important to ensure the asymmetry is not a new development, which could indicate a potential problem.
4. By verifying that the change is not new, the nurse can provide appropriate care or further evaluation if needed.
Summary of why the other choices are incorrect:
A: Breasts do not need to always be symmetric; natural variation exists.
B: Breastfeeding can cause temporary asymmetry, but the nurse should still verify the change is not new.
D: Asymmetry is not necessarily indicative of inflammation or growth; verifying the change's timeline is crucial.
Question 3
A nurse is educating a patient about the two-week wait period after an IVF embryo transfer. What should the nurse emphasize?
A. Avoid any physical activity during this time.
B. Take a pregnancy test immediately after the transfer.
C. Focus on stress management and follow any prescribed medications.
D. Increase protein intake to improve embryo implantation chances.
Show answer and rationale
Correct answer: C — Focus on stress management and follow any prescribed medications.
The correct answer is C: Focus on stress management and follow any prescribed medications. During the two-week wait period after an IVF embryo transfer, it is crucial for the patient to manage stress levels as high stress can negatively impact implantation. Following prescribed medications is important for maintaining optimal conditions for the embryo to implant successfully.
Avoiding physical activity (choice A) is not necessary as moderate physical activity is usually permitted unless advised otherwise by the healthcare provider. Taking a pregnancy test immediately (choice B) is not recommended as it may not accurately reflect the outcome at such an early stage. Increasing protein intake (choice D) may be beneficial for overall health but does not directly impact embryo implantation during the two-week wait period.
Question 4
Cody is a teenager with a history of leukemia and an enlarged spleen. Today he presents with fairly significant left upper quadrant pain. On examination of this area a rough grating noise is heard. What is this sound?
A. It is a splenic rub.
B. It is a variant of bowel noise.
C. It represents borborygmi.
D. It is a vascular noise.
Show answer and rationale
Correct answer: A — It is a splenic rub.
The correct answer is A: It is a splenic rub. The rough grating noise heard on examination is characteristic of a splenic rub, which occurs when the peritoneum overlying the spleen rubs against the spleen itself. This is often associated with conditions like splenic infarction or abscess. In Cody's case, with his history of leukemia and an enlarged spleen, this finding is concerning and warrants further investigation.
Summary of other choices:
B: It is not a variant of bowel noise as bowel noises are typically more high-pitched and gurgling in nature.
C: It is not borborygmi, which refers to the normal sounds produced by the movement of gas and fluid in the intestines.
D: It is not a vascular noise as those are usually associated with blood flow abnormalities and are not typically heard in the left upper quadrant.
Question 5
A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse?
A. Eliciting the health history of a client presenting with an illness
B. Evaluating the number of clients presenting with similar diseases
C. Performing a physical examination of an ill client
D. C M
Show answer and rationale
Correct answer: B — Evaluating the number of clients presenting with similar diseases
The correct answer is B: Evaluating the number of clients presenting with similar diseases. As a nurse epidemiologist, the nurse's main role is to analyze and interpret data related to disease patterns in populations. By evaluating the number of clients with similar diseases, the nurse can identify trends, risk factors, and potential outbreaks. This activity helps in disease surveillance and prevention efforts.
Explanation for other choices:
A: Eliciting health history - This task is more aligned with a clinical nurse's role in assessing individual patients, not with an epidemiologist's population-level focus.
C: Performing a physical examination - Similar to eliciting health history, physical examinations are more related to individual patient care rather than population-based analysis.
D: C M - Incorrect choice.
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Question 6
A nurse is assessing a patient whose respiratory disease in characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient?
A. Signs of oxygen toxicity
B. Chronic chest pain
C. A barrel chest
D. Long, thin fingers
Correct answer:
Chronic hyperinflation, typical in COPD with emphysema, results from air trapping due to alveolar destruction and loss of elastic recoil, reshaping the thorax into a barrel chest expanded anteroposterior diameter from flattened diaphragm and elevated ribs. The nurse assesses this physical sign via inspection, noting a rounded chest contour, reflecting advanced disease. Oxygen toxicity occurs with prolonged high O2 therapy, not hyperinflation itself. Chronic chest pain isn't a COPD feature unless from comorbidities (e.g., pleurisy), as emphysema involves dyspnea over pain. Long, thin fingers (arachnodactyly) relate to Marfan syndrome, not lung disease. Barrel chest's presence informs the nurse of disease severity, guiding interventions like breathing techniques or oxygen titration to manage chronic respiratory compromise.
Which information would the nurse include when teaching parents about task performance improvement for a child diagnosed with ADHD?
A. The parents should isolate the child when completing homework to improve focus.
B. The parents should withhold privileges if homework is not completed within a 2-hour period.
C. The parents should divide the homework task into smaller steps and provide an activity break.
D. The parents should administer an extra dose of methylphenidate prior to homework.
Correct answer:
The correct answer is C. Dividing the homework task into smaller steps and providing an activity break helps children with ADHD manage their attention and focus better. This approach breaks down the task into manageable parts, reducing overwhelm and improving completion rates. It also incorporates movement and breaks, which are beneficial for children with ADHD.
A is incorrect because isolating the child can lead to feelings of loneliness and may not address the underlying attention issues. B is incorrect as withholding privileges can create negative associations with homework and may not address the root cause of the attention difficulties. D is incorrect because adjusting medication should always be done under the guidance of a healthcare professional and not as a standard strategy for task performance improvement.
When should a nurse leader escalate a conflict to administration?
A. When it involves a minor disagreement
B. When it persists despite mediation
C. When it's between two staff nurses
D. When it's a one-time issue
Correct answer:
Step-by-step rationale:
1. Escalating a conflict to administration is necessary when it persists despite mediation to prevent it from escalating further.
2. In cases of persistent conflicts, mediation has failed to resolve the issue, indicating a need for higher intervention.
3. Administration can provide additional resources and authority to address the underlying causes of the conflict effectively.
4. Escalating minor disagreements, one-time issues, or conflicts between staff nurses may not require administration involvement unless they escalate or persist.
Summary:
Choice B is correct because escalating conflicts to administration is crucial when mediation fails to resolve persistent conflicts. Choices A, C, and D are incorrect as they do not emphasize the need for escalation when conflicts persist despite mediation.
The correct answer is C: Carcinoma breast. Tamoxifen citrate is primarily indicated for the treatment of breast cancer. It is a selective estrogen receptor modulator that helps block the effects of estrogen on breast tissue. This is effective in hormone-receptor-positive breast cancer, helping to reduce the risk of recurrence and improve survival rates.
A: Female infertility - Tamoxifen is not indicated for female infertility and can actually cause birth defects.
B: Endometrial carcinoma - Tamoxifen use is associated with an increased risk of developing endometrial carcinoma.
D: Endometriosis - Tamoxifen is not indicated for the treatment of endometriosis and may worsen the condition.
Therefore, the correct answer is C as it aligns with the established use of tamoxifen citrate in the treatment of breast cancer.
A client with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the client:
A. To a day hospital program
B. For psychosocial rehabilitation
C. For cognitive therapy
D. To assertiveness training
Correct answer:
The correct answer is B: For psychosocial rehabilitation. This option is the best choice as it focuses on improving the client's social skills and job-related abilities through structured programs. Psychosocial rehabilitation helps individuals with mental health conditions develop the necessary skills for successful integration into the community, including job skills training and social skill development. Referring the client to a day hospital program (A) may not address the specific needs related to job skills and social skills. Cognitive therapy (C) primarily focuses on addressing cognitive distortions and may not directly target the client's social and job-related deficits. Assertiveness training (D) may be helpful, but it may not address the broader range of skills needed for successful job placement and retention.
What would be the best response by a nursing assistant if a surveyor asks her a question?
A. The NA should answer honestly and to the best of her ability.
B. The NA should offer suggestions for making improvements in the facility.
C. The NA should refuse to answer any questions until her supervisor is present.
D. The NA should make up an answer if she does not know the answer to the question.
Correct answer:
The correct answer is A because honesty and providing information to the best of one's ability is essential in maintaining integrity and transparency during surveying processes. This aligns with ethical standards and ensures accurate data collection.
Explanation:
1. Honesty is crucial in professional conduct.
2. Providing answers to the best of one's ability shows dedication and competence.
3. Fosters trust between the surveyor and the nursing assistant.
4. Upholds ethical and professional standards.
Incorrect Choices:
B: Offering suggestions goes beyond the scope of the question and can potentially lead to misinterpretation.
C: Refusing to answer without a supervisor may create a negative impression and hinder the survey process.
D: Making up an answer compromises integrity and can lead to misinformation.
A nurse is caring for a patient who is experiencing chest pain and has a history of myocardial infarction (MI). What is the priority action?
A. Administer nitroglycerin.
B. Administer beta-blockers.
C. Administer oxygen and monitor.
D. Administer analgesics.
Correct answer:
The correct answer is A: Administer nitroglycerin. Nitroglycerin is the first-line medication for chest pain related to myocardial infarction as it helps dilate blood vessels, improving blood flow to the heart. Administering nitroglycerin promptly can help relieve chest pain and prevent further damage to the heart.
Summary of other choices:
B: Administer beta-blockers - Beta-blockers may be used later to stabilize the heart rate and blood pressure but are not the priority in the acute phase of MI.
C: Administer oxygen and monitor - Administering oxygen is important, but nitroglycerin takes precedence in relieving chest pain and improving blood flow.
D: Administer analgesics - While analgesics may help with pain relief, nitroglycerin is specifically indicated for chest pain related to MI and should be given first.
A patient asks about the purpose of egg retrieval in IVF. What should the nurse explain?
A. Egg retrieval removes immature eggs for storage.
B. It collects mature eggs from the ovaries for fertilization in the lab.
C. Egg retrieval monitors ovarian reserve.
D. It is performed after implantation to confirm pregnancy.
Correct answer:
The correct answer is B: It collects mature eggs from the ovaries for fertilization in the lab.
Rationale:
1. Egg retrieval in IVF involves retrieving mature eggs from the woman's ovaries to be fertilized with sperm in a laboratory setting.
2. These fertilized eggs (embryos) are then transferred back into the uterus for potential implantation.
3. This process is crucial for successful IVF as it allows for controlled fertilization outside the body.
Summary of other choices:
A: Incorrect. Egg retrieval is not for storing immature eggs but for obtaining mature eggs for immediate fertilization.
C: Incorrect. Egg retrieval is not for monitoring ovarian reserve; this is typically done through other tests.
D: Incorrect. Egg retrieval occurs before implantation to collect eggs for fertilization, not after implantation.
A client is 48 hours postoperative following a small bowel resection. The client reports gas pains in the periumbilical area. The nurse should plan care based on which of the following factors contributing to this postoperative complication?
A. Impaired peristalsis of the intestines
B. Infection at the surgical site
C. Fluid overload
D. Inadequate pain management
Correct answer:
Gas pains in the periumbilical area postoperatively are often caused by impaired peristalsis and bowel function. Following abdominal surgery, it is common for peristalsis to be reduced due to surgical manipulation and anesthesia effects. This reduction in peristalsis can lead to the accumulation of gas in the intestines, resulting in gas pains. Infection at the surgical site (Choice B) would present with localized signs of infection such as redness, swelling, warmth, and drainage, rather than diffuse gas pains. Fluid overload (Choice C) would manifest with symptoms such as edema, increased blood pressure, and respiratory distress, not gas pains. Inadequate pain management (Choice D) may lead to increased discomfort, but it is not the primary cause of gas pains in the periumbilical area following a small bowel resection.
A patient newly diagnosed as HIV-positive seeks the nurse's advice on how to reduce the risk of infections. The patient says, 'I went to church years ago and I was in my best health then. Maybe I should start going to church again.' Which response will the nurse offer?
A. Religion does not usually affect health, but you were younger and stronger then.'
B. Contact with supportive people at a church might help, but religion itself is not especially helpful.'
C. Studies show that spiritual practices can enhance immune system function and coping abilities.'
D. Going to church would expose you to many potential infections. Let's think about some other options.'
Correct answer:
The correct answer is C because research indicates that spiritual practices can positively impact immune system function and coping abilities, which can help reduce the risk of infections in HIV-positive individuals. This response acknowledges the potential benefits of spiritual practices on health outcomes.
Choice A is incorrect as it dismisses the potential influence of spiritual practices on health and instead attributes the patient's previous good health to youth and strength.
Choice B is incorrect because it acknowledges the benefit of social support but does not directly address the potential health benefits of spiritual practices.
Choice D is incorrect as it focuses solely on the risk of infections from attending church without considering the potential positive effects of spiritual practices on health.
LPN exams fundamentals practice questions, set 95 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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