LPN exams medical-surgical practice questions, set 18
LPN exams · medical-surgical
LPN exams medical-surgical practice questionsset 18
You practice adult health stems across systems, then name the action that changes the outcome. 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 medical-surgical questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which finding for a 77-yr-old patient seen in the outpatient clinic requires further nursing assessment and intervention?
A. Symmetric joint swelling of fingers
B. Decreased right knee range of motion
C. Report of left hip aching when jogging
D. History of recent loss of balance and fall
Show answer and rationale
Correct answer: D — History of recent loss of balance and fall
The correct answer is D because a history of recent loss of balance and fall in an elderly patient may indicate potential underlying issues such as vestibular dysfunction, neurological problems, medication side effects, or musculoskeletal issues. Further assessment and intervention are crucial to prevent future falls and ensure patient safety.
A: Symmetric joint swelling of fingers is common in older adults and may be related to arthritis or other degenerative conditions, but it does not necessarily require immediate intervention.
B: Decreased right knee range of motion could be due to age-related changes or arthritis, which may warrant assessment but does not pose an immediate safety risk.
C: Report of left hip aching when jogging may indicate musculoskeletal issues or overuse injury, but it does not pose an immediate safety concern that requires urgent intervention.
Question 2
A nurse is assessing a client who has a pressure ulcer on the sacrum. Which finding should the nurse report to the wound care specialist?
A. The wound has a foul odor
B. The wound has a yellowish-green drainage
C. The wound has a granulation tissue in the base
D. The wound has a partial-thickness skin loss
Show answer and rationale
Correct answer: B — The wound has a yellowish-green drainage
Yellowish-green drainage is the correct finding to report to the wound care specialist, as it strongly suggests infection or necrosis in the pressure ulcer. This purulent exudate, often tied to bacterial presence like Pseudomonas or Staphylococcus, requires urgent evaluation, possibly a culture, and treatment to prevent worsening or systemic spread. Foul odor may hint at infection or anaerobic bacteria but isn't definitive alone, as some wounds smell without being infected, making it less specific. Granulation tissue is a positive healing sign, not a concern, indicating new tissue formation. Partial-thickness skin loss aligns with pressure ulcer staging (e.g., Stage 2) and isn't an acute issue to report unless deteriorating. The yellowish-green drainage stands out as a critical, actionable finding, necessitating specialist input to address potential infection and optimize care.
Question 3
An 85-year-old male resident of an extended care facility reaches for the hand of an unlicensed assistive personnel (UAP) and tries to kiss her hand several times during his morning care. The UAP reports the incident to the charge nurse. What is the best assessment of the situation?
A. This behavior can be considered sexual harassment and should be reported to the administration immediately.
B. The UAP should be reassigned to another group of residents, preferably females only.
C. The client may be suffering from touch deprivation and needs to know appropriate ways to express his need.
D. The resident needs to understand the rules regarding unwanted touching of the staff and the consequences.
Show answer and rationale
Correct answer: C — The client may be suffering from touch deprivation and needs to know appropriate ways to express his need.
The correct answer is C because the behavior exhibited by the resident may stem from touch deprivation rather than being intentional sexual harassment. Here's a step-by-step rationale:
1. Understanding the resident's age and environment (extended care facility) helps in interpreting his behavior.
2. The resident's actions suggest a need for touch, which is common in older adults who may lack physical contact.
3. Educating the resident on appropriate ways to express his need for touch can address the underlying issue.
4. Reassigning the UAP or reporting the incident as sexual harassment (options A and B) may not address the root cause of the behavior and could potentially harm the resident's well-being.
In summary, choice C focuses on addressing the resident's potential touch deprivation in a compassionate and understanding manner, making it the best assessment of the situation.
Question 4
A nurse is assessing a client who has a pressure ulcer on the sacrum. Which finding should the nurse report to the wound care specialist?
A. The wound has a foul odor
B. The wound has a yellowish-green drainage
C. The wound has a granulation tissue in the base
D. The wound has a partial-thickness skin loss
Show answer and rationale
Correct answer: B — The wound has a yellowish-green drainage
Yellowish-green drainage is the correct finding to report to the wound care specialist, as it strongly suggests infection or necrosis in the pressure ulcer. This purulent exudate, often tied to bacterial presence like Pseudomonas or Staphylococcus, requires urgent evaluation, possibly a culture, and treatment to prevent worsening or systemic spread. Foul odor may hint at infection or anaerobic bacteria but isn't definitive alone, as some wounds smell without being infected, making it less specific. Granulation tissue is a positive healing sign, not a concern, indicating new tissue formation. Partial-thickness skin loss aligns with pressure ulcer staging (e.g., Stage 2) and isn't an acute issue to report unless deteriorating. The yellowish-green drainage stands out as a critical, actionable finding, necessitating specialist input to address potential infection and optimize care.
Question 5
During an adaptive immune response to a pathogen an important outcome of the clonal selection process is:
A. An increase in the number of lymphocytes specific for the pathogen that activated the response
B. Elimination of lymphocytes that are not specific for the pathogen that activated the response
C. An increase in the number of antigen receptor specificities expressed by each lymphocyte
D. All of the above
Show answer and rationale
Correct answer: A — An increase in the number of lymphocytes specific for the pathogen that activated the response
The correct answer is A because during clonal selection, lymphocytes specific to the pathogen are activated, leading to their proliferation and differentiation into effector cells. This results in an increase in the number of lymphocytes specific for the pathogen, enhancing the immune response.
Choice B is incorrect because clonal selection does not involve the elimination of non-specific lymphocytes but rather the expansion of specific lymphocytes.
Choice C is also incorrect because clonal selection does not change the antigen receptor specificities expressed by lymphocytes but instead focuses on expanding the population of lymphocytes with receptors specific to the pathogen.
Therefore, the correct outcome of clonal selection is the increase in the number of lymphocytes specific for the pathogen that activated the response, making choice A the most accurate option.
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Question 6
A client is in the hospital and has received two doses of an angiotensin-converting enzyme for hypertension. When the nurse answers the client's call light, the client presents an appearance as shown below: What action by the nurse takes is most appropriate?
A. Administer epinephrine 1:1000, 0.3 mg IV push immediately.
B. Apply oxygen by facemask at 100% and a pulse oximeter.
C. Ensure a patent airway while calling the Rapid Response Team.
D. Reassure the client that these symptoms will go away.
Correct answer:
The correct answer is C: Ensure a patent airway while calling the Rapid Response Team. This is the most appropriate action because the client is showing signs of angioedema, a potentially life-threatening adverse reaction to angiotensin-converting enzyme (ACE) inhibitors. Angioedema can lead to airway obstruction and respiratory distress, so ensuring a patent airway is crucial. Calling the Rapid Response Team will provide immediate access to additional resources and expertise to manage the situation effectively.
Choice A (Administer epinephrine) is incorrect because epinephrine is not the first-line treatment for angioedema caused by ACE inhibitors. Choice B (Apply oxygen) may be helpful but does not address the urgent need to secure the airway. Choice D (Reassure the client) is inappropriate as the situation requires immediate intervention to prevent respiratory compromise.
A patient with a diagnosis of peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?
A. With meals
B. At bedtime
C. Before meals
D. After meals
Correct answer:
The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works by reducing stomach acid production. Taking it before meals allows the medication to be most effective in inhibiting the proton pumps before they are stimulated by food intake. This timing optimizes the drug's ability to reduce acid secretion during the digestion process.
Choice A (With meals) is incorrect because taking omeprazole with meals may reduce its effectiveness as it will not have enough time to inhibit acid production before food intake. Choice B (At bedtime) is also incorrect as omeprazole works best when taken before meals to prevent acid production. Choice D (After meals) is incorrect because waiting until after meals to take omeprazole means that acid production has already been stimulated by the food consumed, reducing the drug's effectiveness in inhibiting acid secretion.
T-cell antigen receptors are distinguished from antibodies by which of the following
A. T-Cell receptors are glycosylated
B. T-cell receptors must interact with antigen uniquely presented by other cells but not with free antigen
C. T-Cell receptors bind various cytokines
D. T-Cell receptors bind complement to lyse cells
Correct answer:
The correct answer is B. T-cell receptors must interact with antigens uniquely presented by other cells but not with free antigen. This is because T-cell receptors recognize antigens that are processed and presented on the surface of other cells via major histocompatibility complex (MHC) molecules. T-cell receptors specifically bind to the antigen-MHC complex, allowing T-cells to respond to specific foreign antigens.
A: T-cell receptors are not distinguished from antibodies by glycosylation. Both T-cell receptors and antibodies can be glycosylated, so this does not differentiate them.
C: T-cell receptors do not bind various cytokines. Cytokine receptors are separate entities that mediate cellular responses to cytokines.
D: T-cell receptors do not bind complement to lyse cells. Complement activation is a separate immune response mechanism not involving T-cell receptors.
A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?
A. Administer a Fleet enema as prescribed and remain with the client
B. Contact the primary care provider promptly and report these signs of perforation
C. Position the client supine and insert an NG tube
D. Page the primary provider and report that the client may be obstructed
Correct answer:
The correct answer is B: Contact the primary care provider promptly and report these signs of perforation.
Rationale:
1. Sudden increase in temperature, sudden onset of exquisite abdominal tenderness, and uncharacteristically rigid abdomen are signs of perforation in diverticulitis.
2. Promptly contacting the primary care provider allows for immediate evaluation and intervention.
3. Perforation is a serious complication that requires urgent medical attention to prevent further complications like sepsis.
Summary of other choices:
A: Administering a Fleet enema is not appropriate and can worsen the condition of a perforated diverticulum.
C: Inserting an NG tube is not indicated for a perforated diverticulum and may exacerbate the situation.
D: Reporting the client may be obstructed is not accurate based on the signs presented and does not address the urgency of perforation.
The nurse needs to change a dressing on the client's abdomen. Which of the following techniques should be implemented?
A. Contact precautions
B. Standard precautions
C. Droplet precautions
D. Airborne precautions
Correct answer:
The correct answer is B: Standard precautions. Standard precautions should be implemented when changing a dressing on a client's abdomen as it includes hand hygiene, gloves, and appropriate personal protective equipment based on the risk of exposure to blood or body fluids. This technique helps prevent the spread of infection and ensures the safety of both the nurse and the client.
A: Contact precautions are used for clients with specific infections that can be transmitted by direct contact.
C: Droplet precautions are for infections transmitted through respiratory droplets.
D: Airborne precautions are for infections transmitted via small particles that remain in the air for a long time.
In summary, Standard precautions are the most appropriate technique for changing a dressing on a client's abdomen as they provide a comprehensive approach to infection prevention.
Teaching with a female client who has a new diagnosis of systemic lupus erythematosus (SLE) about factors that can trigger an exacerbation of SLE- determine that the client requires further teaching when she identifies which of the following as a factor that can exacerbate SLE?
A. Pregnancy- due to hormonal changes, pregnancy can exacerbate SLE, advise the client of the risk, monitor closely for renal and cardiovascular effects
B. Exercise- can follow an exercise program to increase the aerobic capacity of cells and improve immune function, and the client should develop such a program with her provider's assistance
C. Sunlight exposure
D. Emotional stress
Correct answer:
Step 1: Exercise is the correct answer. Regular exercise is beneficial for individuals with SLE as it can help improve aerobic capacity and immune function, which can help manage the condition. Therefore, it is important for the client to work with her provider to develop an appropriate exercise program.
Step 2: Pregnancy (choice A) can exacerbate SLE due to hormonal changes, leading to increased risk of renal and cardiovascular effects. Sunlight exposure (choice C) can trigger flare-ups in some individuals with SLE. Emotional stress (choice D) can also worsen SLE symptoms by affecting the immune system.
Summary:
Choice A is incorrect because pregnancy can exacerbate SLE due to hormonal changes. Choice C is incorrect because sunlight exposure can trigger flare-ups in some individuals with SLE. Choice D is incorrect because emotional stress can also worsen SLE symptoms.
A classification of wound that usually heals quickly, generally within days to weeks, with well-approximated edges and lessened infection risk is:
A. Abrasion wound
B. Acute wound
C. Chronic wound
D. Unintentional wound
Correct answer:
Acute wound,' as it describes a wound that heals quickly (days to weeks) with well-approximated edges and reduced infection risk. Acute wounds, like cuts or surgical incisions, follow a predictable healing trajectory due to minimal tissue loss and prompt repair, often via primary intention. 'Abrasion wound' is a type of injury (scraping), not a healing classification, and may heal slower if extensive. 'Chronic wound' persists beyond weeks, often due to underlying conditions like diabetes, contradicting quick healing. 'Unintentional wound' defines cause (accidental), not healing speed or edge alignment. In nursing, identifying acute wounds guides timely interventions e.g., suturing versus chronic wounds needing prolonged care. B aligns with the description's focus on healing dynamics, distinguishing it as the accurate classification over specific wound types or causation.
A classification of wound that usually heals quickly, generally within days to weeks, with well-approximated edges and lessened infection risk is:
A. Abrasion wound
B. Acute wound
C. Chronic wound
D. Unintentional wound
Correct answer:
Acute wound,' as it describes a wound that heals quickly (days to weeks) with well-approximated edges and reduced infection risk. Acute wounds, like cuts or surgical incisions, follow a predictable healing trajectory due to minimal tissue loss and prompt repair, often via primary intention. 'Abrasion wound' is a type of injury (scraping), not a healing classification, and may heal slower if extensive. 'Chronic wound' persists beyond weeks, often due to underlying conditions like diabetes, contradicting quick healing. 'Unintentional wound' defines cause (accidental), not healing speed or edge alignment. In nursing, identifying acute wounds guides timely interventions e.g., suturing versus chronic wounds needing prolonged care. B aligns with the description's focus on healing dynamics, distinguishing it as the accurate classification over specific wound types or causation.
A client is admitted to the hospital with a burn injury covering $30% of the body surface area. The nurse anticipates that the client will require which type of dressing for wound care?
A. Hydrocolloid dressing
B. Hydrogel dressing
C. Alginate dressing
D. Silver dressing
Correct answer:
Silver dressing is the correct answer because it's ideal for burn injuries covering 30% of the body surface area due to its antimicrobial properties, reducing infection risk a major concern in burns where skin barriers are compromised. Silver ions kill bacteria, manage pain, inflammation, and odor, supporting healing in high-risk wounds. Hydrocolloid dressing is occlusive, suited for minimal-drainage wounds, but can trap bacteria in infected or heavily exudative burns, risking maceration. Hydrogel dressing hydrates dry wounds but lacks sufficient absorption for burn exudate and isn't antimicrobial, making it less suitable. Alginate dressing absorbs heavy exudate but isn't ideal for dry or minimally draining burns and lacks inherent infection control. Given the burn's extent and infection vulnerability, silver dressing offers the best protective and therapeutic benefits.
The following are stages in the regeneration of skin following an injury: blood clot/scab formation, calcium injection, epidermis covers granulation tissue, epidermis covers scar tissue. The correct order for these events is:
A. 4, 3, 2, 1
B. 2, 4, 1, 3
C. 1, 2, 3, 4
D. 4, 3, 1, 2
Correct answer:
The correct order for the stages in skin regeneration following an injury is: 1) Blood clot/scab formation, 2) Epidermis covers granulation tissue, 3) Epidermis covers scar tissue, and 4) Calcium injection.
Rationale:
1) Blood clot/scab formation occurs first to stop bleeding and prevent infection.
2) Epidermis covering granulation tissue signifies the growth of new tissue.
3) Epidermis covering scar tissue indicates the completion of tissue repair.
4) Calcium injection is not a typical stage in skin regeneration; it does not play a direct role in the natural healing process.
Summary:
Choice A is incorrect as it starts with covering scar tissue, which is a later stage. Choice B is incorrect as it introduces calcium injection, which is not a standard stage. Choice D is incorrect as it places calcium injection before blood clot formation, which is inaccurate.
LPN exams medical-surgical practice questions, set 18 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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