LPN exams medical-surgical practice questions, set 21
LPN exams · medical-surgical
LPN exams medical-surgical practice questionsset 21
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
The home health nurse observes several small, round bruises on the back side of an elderly client's arms. What action by the nurse is indicated first?
A. Question the client about the cause of the bruises.
B. Discuss the bruises with the client's spouse.
C. Document the bruises, with plans to review them for changes on the next visit.
D. Contact the home health supervisor to report the findings.
Show answer and rationale
Correct answer: A — Question the client about the cause of the bruises.
The correct answer is A: Question the client about the cause of the bruises. This is the first action indicated because it allows the nurse to gather more information directly from the client to understand the potential cause of the bruises. By communicating with the client, the nurse can assess if the bruises are due to accidental bumps, medication side effects, abuse, or other underlying health issues. This direct communication is crucial for determining the appropriate follow-up actions.
Summary of other choices:
B: Discussing with the client's spouse does not directly involve the client, who should be the primary source of information.
C: Documenting the bruises is important but does not address the immediate need to gather more information from the client.
D: Contacting the supervisor is premature without first gathering information from the client.
Question 2
Which medication is associated with an increased risk of cardiac events?
A. Celecoxib
B. Diclofenac
C. Ibuprofen
D. Naproxen
Show answer and rationale
Correct answer: A — Celecoxib
The correct answer is A: Celecoxib. Celecoxib is a selective COX-2 inhibitor, which has been associated with an increased risk of cardiac events, such as heart attacks and strokes. This is due to its mechanism of action, which can lead to elevated blood pressure and interfere with normal blood clotting.
Celecoxib is specifically known to increase the risk of cardiovascular events compared to other nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, ibuprofen, and naproxen.
Diclofenac, ibuprofen, and naproxen are traditional NSAIDs that can also have cardiovascular risks, but the risk is generally lower compared to celecoxib.
In summary, celecoxib is associated with an increased risk of cardiac events due to its selective COX-2 inhibition, while the other choices are less likely to have as significant of an impact on cardiovascular health.
Question 3
A client with arterial insufficiency has an arterial ulcer on the dorsum of the foot. Which assessment finding should alert the nurse to a potential complication?
A. Absent or diminished pedal pulses
B. Cold, pale, or cyanotic skin color
C. Loss of hair growth on the lower leg
D. Gangrene or necrosis of the toes
Show answer and rationale
Correct answer: D — Gangrene or necrosis of the toes
Gangrene or necrosis of the toes is the correct finding to alert the nurse to a potential complication in an arterial ulcer. Arterial insufficiency reduces blood supply, causing ischemia, and gangrene dead tissue from prolonged oxygen deprivation signals severe progression, risking amputation or infection if not addressed urgently. Absent or diminished pedal pulses are expected in arterial insufficiency, reflecting chronic poor perfusion, not an acute complication unless suddenly worsening. Cold, pale, or cyanotic skin is typical due to low oxygen delivery, a baseline sign rather than an immediate threat. Loss of hair growth results from chronic nutrient deficiency, not an emergent issue. Gangrene escalates the situation, indicating critical tissue loss beyond typical arterial ulcer symptoms, necessitating immediate provider notification for intervention.
Question 4
A client with arterial insufficiency has an arterial ulcer on the dorsum of the foot. Which assessment finding should alert the nurse to a potential complication?
A. Absent or diminished pedal pulses
B. Cold, pale, or cyanotic skin color
C. Loss of hair growth on the lower leg
D. Gangrene or necrosis of the toes
Show answer and rationale
Correct answer: D — Gangrene or necrosis of the toes
Gangrene or necrosis of the toes is the correct finding to alert the nurse to a potential complication in an arterial ulcer. Arterial insufficiency reduces blood supply, causing ischemia, and gangrene dead tissue from prolonged oxygen deprivation signals severe progression, risking amputation or infection if not addressed urgently. Absent or diminished pedal pulses are expected in arterial insufficiency, reflecting chronic poor perfusion, not an acute complication unless suddenly worsening. Cold, pale, or cyanotic skin is typical due to low oxygen delivery, a baseline sign rather than an immediate threat. Loss of hair growth results from chronic nutrient deficiency, not an emergent issue. Gangrene escalates the situation, indicating critical tissue loss beyond typical arterial ulcer symptoms, necessitating immediate provider notification for intervention.
Question 5
A nurse is assessing a client with a pressure ulcer on the sacrum. Which finding should the nurse report to the provider immediately?
A. The wound has a foul odor and purulent drainage
B. The wound has a black, necrotic tissue in the center
C. The wound has a red, granulating tissue at the edges
D. The wound has a yellow, sloughing tissue on the surface
Show answer and rationale
Correct answer: A — The wound has a foul odor and purulent drainage
Foul odor and purulent drainage is the correct finding to report immediately, as it signals an acute infection in the pressure ulcer. This combination suggests bacterial proliferation, potentially leading to sepsis or deeper tissue damage, requiring urgent provider intervention, wound culture, and possibly antibiotics. Black, necrotic tissue indicates eschar, which needs debridement but isn't immediately life-threatening unless unstable or infected, manageable by the wound team. Red, granulating tissue is a healthy sign of healing, not a concern. Yellow, sloughing tissue represents slough, which delays healing but isn't an emergency unless paired with infection signs. The foul odor and purulent drainage escalate the situation to critical, demanding prompt reporting to prevent systemic complications, distinguishing it as the priority among these findings.
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Question 6
Which type of intention is characterized by intentional wounds with minimal tissue loss, in which the edges are closely approximated?
A. Primary intention
B. Delayed primary intention
C. Secondary intention
D. Tertiary intention
Correct answer:
Primary intention,' as it describes intentional wounds (e.g., surgical incisions) with minimal tissue loss and closely approximated edges, typically closed with sutures or staples. This method promotes rapid healing, minimal scarring, and low infection risk due to immediate edge alignment. 'Delayed primary intention' involves intentional wounds left open briefly before closure, not immediate approximation. 'Secondary intention' applies to wounds with significant tissue loss, healing open from the base up, with unapproximated edges. 'Tertiary intention' combines initial open healing with later closure, also not immediate. In nursing, primary intention is standard for clean surgical wounds, ensuring efficient recovery. The question's emphasis on minimal loss and close edges rules out alternatives, making A the precise fit per wound healing classifications.
What is the role of pattern recognition in innate immunity, as proposed by Janeway?
A. Specific recognition of antigens
B. Binding toxins to create immunity
C. Identifying common pathogen-associated molecular patterns
D. Suppressing lymphocyte activation
Correct answer:
Pattern recognition in innate immunity, as proposed by Janeway, involves identifying common pathogen-associated molecular patterns (PAMPs). This is crucial for initiating the immune response against pathogens. PAMPs are specific molecular patterns found on pathogens but not on host cells. By recognizing these patterns, the innate immune system can quickly and effectively identify potential threats and trigger the appropriate immune response.
Explanation of why other choices are incorrect:
A: Specific recognition of antigens is a function of adaptive immunity, not innate immunity.
B: Binding toxins to create immunity is not the primary role of pattern recognition in innate immunity.
D: Suppressing lymphocyte activation is not the role of pattern recognition in innate immunity; rather, it is involved in activating immune responses against pathogens.
A nurse is assessing a client with a pressure ulcer on the sacrum. Which finding should the nurse report to the provider immediately?
A. The wound has a foul odor and purulent drainage
B. The wound has a black, necrotic tissue in the center
C. The wound has a red, granulating tissue at the edges
D. The wound has a yellow, sloughing tissue on the surface
Correct answer:
Foul odor and purulent drainage is the correct finding to report immediately, as it signals an acute infection in the pressure ulcer. This combination suggests bacterial proliferation, potentially leading to sepsis or deeper tissue damage, requiring urgent provider intervention, wound culture, and possibly antibiotics. Black, necrotic tissue indicates eschar, which needs debridement but isn't immediately life-threatening unless unstable or infected, manageable by the wound team. Red, granulating tissue is a healthy sign of healing, not a concern. Yellow, sloughing tissue represents slough, which delays healing but isn't an emergency unless paired with infection signs. The foul odor and purulent drainage escalate the situation to critical, demanding prompt reporting to prevent systemic complications, distinguishing it as the priority among these findings.
Which type of intention is characterized by intentional wounds with minimal tissue loss, in which the edges are closely approximated?
A. Primary intention
B. Delayed primary intention
C. Secondary intention
D. Tertiary intention
Correct answer:
Primary intention,' as it describes intentional wounds (e.g., surgical incisions) with minimal tissue loss and closely approximated edges, typically closed with sutures or staples. This method promotes rapid healing, minimal scarring, and low infection risk due to immediate edge alignment. 'Delayed primary intention' involves intentional wounds left open briefly before closure, not immediate approximation. 'Secondary intention' applies to wounds with significant tissue loss, healing open from the base up, with unapproximated edges. 'Tertiary intention' combines initial open healing with later closure, also not immediate. In nursing, primary intention is standard for clean surgical wounds, ensuring efficient recovery. The question's emphasis on minimal loss and close edges rules out alternatives, making A the precise fit per wound healing classifications.
Which of the following terms describes a bed that is completely made with the bedspread and blankets in place?
A. Closed bed
B. Open bed
C. Occupied bed
D. Unoccupied bed
Correct answer:
The correct answer is A: Closed bed. A closed bed refers to a bed that is neatly made with bedspread and blankets in place. This term is used in healthcare settings to indicate a bed that is ready for a new patient or for a patient who is not currently in bed.
Rationale:
1. Closed bed signifies cleanliness and readiness for use.
2. The term "closed" implies that the bed is fully made and not in use.
3. It helps maintain a hygienic environment and prevents the accumulation of dust or germs on the bed linens.
Summary of other choices:
B: Open bed - Incorrect because an open bed does not have the bedspread and blankets in place.
C: Occupied bed - Incorrect as it refers to a bed that is currently being used by a patient.
D: Unoccupied bed - Incorrect because it refers to a bed that is empty but may not necessarily be fully made with bed linens.
The nurse assesses a patient who has just arrived in the postanesthesia recovery area (PACU) after a blepharoplasty. Which assessment data should be reported to the surgeon immediately?
A. The patient complains of incisional pain.
B. The patient's heart rate is 110 beats/minute.
C. The patient is unable to detect when the eyelids are touched.
D. The skin around the incision is pale and cold when palpated.
Correct answer:
The correct answer is D because pale and cold skin around the incision indicates poor circulation and potential compromised blood flow, which could lead to tissue damage or necrosis. This is a critical finding that requires immediate attention to prevent further complications.
A: Incisional pain is expected postoperatively and can be managed with pain medication, it does not indicate an immediate need for intervention.
B: Heart rate elevation can be a normal response to surgery and anesthesia, and 110 beats/minute may not be concerning depending on the patient's baseline and clinical context.
C: Temporary loss of sensation or numbness around the incision site is common after blepharoplasty due to local anesthesia effects, and it usually resolves as the anesthesia wears off. It does not require immediate intervention unless it persists or worsens.
In a mixed-lymphocyte culture, lymphocytes from person X, who is homozygous for the HLA-Dw7 allele, are irradiated and then cultured with lymphocytes from person Z... DNA synthesis is NOT stimulated. The proper conclusion to be drawn is that
A. person Z is homozygous for HLA-Dw7
B. person Z is homozygous or heterozygous for HLA-Dw7
C. person Z is heterozygous for HLA-Dw7
D. person Z does not carry the HLA-Dw7 allele
Correct answer:
The correct answer is B because if DNA synthesis is not stimulated in the mixed-lymphocyte culture, it indicates that person Z has at least one allele that is different from person X's HLA-Dw7 allele. This rules out person Z being homozygous for HLA-Dw7 (choice A) as there would be no difference in HLA alleles between the two individuals. Similarly, person Z being heterozygous for HLA-Dw7 (choice C) is too specific as it assumes only one specific allele is different. Choice D is incorrect as it states that person Z does not carry the HLA-Dw7 allele, which cannot be concluded definitively from the information provided. Therefore, the most reasonable conclusion is that person Z is either homozygous or heterozygous for HLA-Dw7 (choice B) since there is a lack of DNA synthesis stimulation, indicating a difference in HLA alleles between the two individuals.
An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority for this infant?
A. Risk for Aspiration Related to Regurgitation
B. Acute Pain Related to Esophageal Defect
C. Ineffective Infant Feeding Pattern Related to Uncoordinated Suck and Swallow
D. Ineffective Tissue Perfusion: Gastrointestinal, Related to Decreased Circulation
Correct answer:
The correct answer is A: Risk for Aspiration Related to Regurgitation. This is the priority because the infant with esophageal atresia and tracheoesophageal fistula is at high risk for aspiration due to the abnormal connection between the esophagus and trachea. Aspiration can lead to serious complications such as pneumonia and respiratory distress. Addressing this risk is crucial for the infant's safety and well-being.
Choice B (Acute Pain) is not the priority as aspiration poses a more immediate threat to the infant's health. Choice C (Ineffective Infant Feeding Pattern) is important but addressing the risk of aspiration takes precedence. Choice D (Ineffective Tissue Perfusion) is not directly related to the immediate danger of aspiration in this case. Prioritizing the prevention of aspiration is essential for the infant's safety and effective care.
The physician has decided to prescribe T- and B-cell suppressors for a patient diagnosed with psoriasis. What drug will be ordered for this patient?
A. Alefacept (Amevive)
B. Azathioprine (Imuran)
C. Cyclosporine (Neoral)
D. Glatiramer acetate (Copaxone)
Correct answer:
The correct answer is A: Alefacept (Amevive). Alefacept is a biologic drug that specifically targets T-cells, which play a crucial role in the pathogenesis of psoriasis. By suppressing T-cell activity, Alefacept helps to reduce the inflammation and proliferation of skin cells seen in psoriasis. Additionally, Alefacept does not impact B-cell function, making it a suitable choice for this patient.
Choice B (Azathioprine) is incorrect because it primarily acts on B-cells and is not as effective in targeting T-cells involved in psoriasis.
Choice C (Cyclosporine) is incorrect as it is a calcineurin inhibitor that suppresses T-cell activity but also affects B-cells.
Choice D (Glatiramer acetate) is incorrect as it is used to treat multiple sclerosis by modulating the immune response but does not specifically target T-cells involved in psoriasis.
The client admitted with a diagnosis of a fractured hip who is in Buck's traction is complaining of severe pain. Which intervention should the nurse implement?
A. Adjust the patient-controlled analgesia (PCA) machine for a lower dose.
B. Ensure the weights of the Buck's traction are off the floor and hang freely.
C. Raise the head of the bed to 45 degrees and the foot to 15 degrees.
D. Turn the client on the affected leg using pillows to support the other leg.
Correct answer:
The correct answer is B: Ensure the weights of the Buck's traction are off the floor and hang freely. This intervention is essential to maintain proper traction and alignment of the fractured hip, which can help alleviate pain. When the weights are not hanging freely, the traction may not be effective, causing increased pain and potential complications.
Explanation of why the other choices are incorrect:
A: Adjusting the PCA machine for a lower dose may temporarily relieve pain, but it does not address the underlying issue of ineffective traction.
C: Raising the head and foot of the bed may provide comfort but does not directly address the issue of inadequate traction.
D: Turning the client on the affected leg can worsen the fracture and cause more pain, contrary to the goal of relieving pain in a client with a fractured hip in Buck's traction.
LPN exams medical-surgical practice questions, set 21 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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