LPN exams medical-surgical practice questions, set 23
LPN exams · medical-surgical
LPN exams medical-surgical practice questionsset 23
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 most common type of leukaemia in adults over 55 is:
A. Acute lymphatic leukaemia
B. Acute myeloid leukaemia
C. Chronic myeloid leukaemia
D. Chronic lymphocytic leukaemia
Show answer and rationale
Correct answer: D — Chronic lymphocytic leukaemia
The correct answer is D: Chronic lymphocytic leukaemia (CLL). CLL is the most common type of leukaemia in adults over 55, characterized by the slow accumulation of abnormal lymphocytes in the blood and bone marrow. This type of leukaemia typically progresses slowly and may not require immediate treatment.
Rationale:
1. Age group: CLL predominantly affects older adults, making it the most common type of leukaemia in individuals over 55.
2. Chronic nature: CLL is a chronic leukaemia, characterized by a slow progression of the disease.
3. Lymphocytic origin: CLL involves abnormal lymphocytes, which are a type of white blood cell.
Summary:
A: Acute lymphatic leukaemia (ALL) is more common in children and young adults.
B: Acute myeloid leukaemia (AML) is more common in older adults but not the most common in individuals over 55.
C: Chronic myeloid
Question 2
A 70-year-old woman presents with fatigue, anorexia, and weight loss. She has noticed darkening of her skin, particularly in sun-exposed areas. Laboratory tests reveal hyponatremia, hyperkalemia, and low cortisol levels. What is the most likely diagnosis?
A. Cushing's syndrome
B. Addison's disease
C. Hypothyroidism
D. Pheochromocytoma
Show answer and rationale
Correct answer: B — Addison's disease
The most likely diagnosis for the 70-year-old woman is Addison's disease. The symptoms of fatigue, anorexia, weight loss, darkened skin, along with hyponatremia, hyperkalemia, and low cortisol levels indicate adrenal insufficiency. Addison's disease is characterized by inadequate production of cortisol and aldosterone by the adrenal glands. The darkening of the skin, known as hyperpigmentation, is a classic sign of Addison's due to increased ACTH levels stimulating melanin production. In contrast, Cushing's syndrome presents with weight gain, hypertension, and high cortisol levels. Hypothyroidism typically presents with weight gain, cold intolerance, and constipation. Pheochromocytoma presents with hypertension, palpitations, and headaches due to excess catecholamine production. Therefore, the correct diagnosis in this case is Addison's disease.
Question 3
A client who participates in a health maintenance organization (HMO) needs a bone marrow transplant for the treatment of breast cancer. The client tells the nurse that she is concerned that her HMO may deny her claim. What action by the nurse best addresses the client's need at this time?
A. Have the client's healthcare provider write a letter to the HMO explaining the need for the transplant.
B. Help the client place a call to the HMO to seek information about limitations of coverage.
C. Encourage the client to contact a lawyer to file a lawsuit against the HMO if necessary.
D. Have the social worker contact the state board of insurance to register a complaint against the HMO.
Show answer and rationale
Correct answer: B — Help the client place a call to the HMO to seek information about limitations of coverage.
The correct answer is B: Help the client place a call to the HMO to seek information about limitations of coverage. This is the best action because it directly addresses the client's concern by clarifying the coverage for the bone marrow transplant. By contacting the HMO, the client can get accurate information on whether the transplant is covered and what steps need to be taken for approval. This empowers the client to make informed decisions regarding their healthcare.
Choice A is incorrect because having the healthcare provider write a letter may not directly address the client's concerns about coverage. Choice C is incorrect as contacting a lawyer should be a last resort after exploring other options. Choice D is incorrect as involving the state board of insurance is not necessary at this stage and may escalate the situation unnecessarily.
Question 4
The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?
A. It would be very helpful if you could integrate more physical activity into your routine.
B. You're considered to be overweight, so you should be diligent about maintaining a healthy diet.
C. You might want to consider some of the surgical options that have been developed for treating obesity.
D. With your permission, I'd like you to refer to a support group for individuals who live with severe obesity.
Show answer and rationale
Correct answer: A — It would be very helpful if you could integrate more physical activity into your routine.
Step-by-step rationale for the correct answer (A):
1. BMI of 33.5 indicates the client is in the overweight category.
2. Physical activity can help in weight management and improving overall health.
3. Integrating physical activity can help in reducing weight and lowering BMI.
4. Health promotion advice should focus on lifestyle changes rather than surgical interventions or support groups.
Summary of why other choices are incorrect:
B: While maintaining a healthy diet is important, focusing solely on diet may not be as effective as incorporating physical activity for weight management.
C: Surgical options are typically considered for severe obesity cases, which may not be necessary at a BMI of 33.5.
D: Referring to a support group for severe obesity may not be appropriate at this stage as lifestyle modifications should be the initial approach.
Question 5
A client has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this client's health?
A. The development of bacterial cellulitis on compromised skin surfaces
B. Fluid and electrolyte imbalances resulting from the loss skin integrity
C. A cascading autoimmune response that may result in shock
D. The presence of diffuse lesions and skin sloughing on the client's mucous membranes
Show answer and rationale
Correct answer: D — The presence of diffuse lesions and skin sloughing on the client's mucous membranes
The correct answer is D. The presence of diffuse lesions and skin sloughing on the client's mucous membranes is the greatest immediate threat in toxic epidermal necrolysis (TEN). This condition results in severe skin detachment, leading to increased risk of infection, fluid loss, and electrolyte imbalances. Skin sloughing can also affect mucous membranes, increasing the risk of respiratory compromise, sepsis, and systemic infection. The other choices are not the greatest immediate threat in TEN. Bacterial cellulitis (choice A) is a potential complication but not the most immediate threat. Fluid and electrolyte imbalances (choice B) are significant but secondary to the skin sloughing. A cascading autoimmune response (choice C) can occur in TEN but is not the immediate threat compared to the risk of mucous membrane involvement and skin sloughing.
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Question 6
The preceptor is orienting a new graduate nurse to the critical care unit. The preceptor asks the new graduate to state symptoms that most likely indicate the beginning of a shock state in a critically ill client. What findings should the new graduate nurse identify?
A. Warm skin, hypertension, and constricted pupils.
B. Bradycardia, hypotension, and respiratory acidosis.
C. Mottled skin, tachypnea, and hyperactive bowel sounds.
D. Tachycardia, mental status change, and low urine output.
Correct answer:
The correct answer is D: Tachycardia, mental status change, and low urine output. In the early stages of shock, the body compensates by increasing heart rate (tachycardia) to maintain perfusion. Mental status change can indicate decreased cerebral perfusion. Low urine output is a sign of decreased renal perfusion.
A: Warm skin, hypertension, and constricted pupils are not indicative of shock. In shock, skin becomes cool and clammy, blood pressure drops, and pupils dilate.
B: Bradycardia, hypotension, and respiratory acidosis are not early signs of shock. Bradycardia and hypotension occur in the late stages of shock. Respiratory acidosis is a complication of shock, not an early symptom.
C: Mottled skin, tachypnea, and hyperactive bowel sounds are signs of shock but not early indicators. Mottled skin appears in the late stages of shock, tach
A patient with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse monitor to assess the effectiveness of the medication?
A. Complete blood count (CBC)
B. Prothrombin time (PT)/INR
C. Partial thromboplastin time (PTT)
D. Serum potassium level
Correct answer:
The correct answer is B: Prothrombin time (PT)/INR. This is because warfarin is a medication that affects the clotting ability of the blood by inhibiting vitamin K-dependent clotting factors. PT/INR is the specific laboratory test used to monitor the effectiveness of warfarin therapy. PT measures how long it takes for blood to clot, while INR standardizes the PT results. Monitoring PT/INR helps to ensure that the patient is within the target therapeutic range for anticoagulation.
Incorrect choices:
A: Complete blood count (CBC) - CBC does not directly assess the effectiveness of warfarin therapy.
C: Partial thromboplastin time (PTT) - PTT is used to monitor the effectiveness of heparin therapy, not warfarin.
D: Serum potassium level - Monitoring serum potassium level is not directly related to assessing the effectiveness of warfarin therapy.
What type of immunity is provided by T lymphocytes?
A. Humoral immunity
B. Cell-mediated immunity
C. Passive immunity
D. Innate immunity
Correct answer:
The correct answer is B: Cell-mediated immunity. T lymphocytes are a type of white blood cell that plays a critical role in cell-mediated immunity by directly attacking infected cells and coordinating the immune response. This type of immunity is essential for fighting intracellular pathogens such as viruses and certain bacteria.
A: Humoral immunity is mediated by B cells and involves the production of antibodies to neutralize pathogens. T lymphocytes do not directly participate in humoral immunity.
C: Passive immunity is acquired through the transfer of antibodies from one individual to another, providing immediate protection. T lymphocytes are not involved in passive immunity.
D: Innate immunity is the body's first line of defense against pathogens and does not involve T lymphocytes, which are part of the adaptive immune response.
When examining an 87-year-old home health patient, the nurse notes a musky, sour body odor. Based on this assessment, the most appropriate nursing action is to
A. schedule a nursing assistant to help the patient bathe several times weekly.
B. teach the patient to apply a moisturizing body lotion daily.
C. consult with the health care provider to obtain a prescription for a topical antifungal.
D. ask about use of prescription and over-the-counter (OTC) skin medications.
Correct answer:
The correct answer is A because the musky, sour body odor observed in the 87-year-old patient likely indicates poor personal hygiene. Therefore, scheduling a nursing assistant to help the patient bathe several times weekly is the most appropriate action to address this issue and promote cleanliness and comfort. This approach ensures proper hygiene practices are maintained, which can help improve the patient's overall well-being and prevent skin infections.
Choices B, C, and D are incorrect because teaching the patient to apply moisturizing lotion, obtaining a prescription for a topical antifungal, or asking about skin medications do not directly address the root cause of the musky odor, which is likely due to poor hygiene. These options focus on skincare and treatment for skin conditions, which may not be the primary concern in this case.
You suspect your unconscious adult trauma patient may have increased intracranial pressure from a closed head injury. Due to the compression forces of increased intracranial pressure, at what level of brain injury would be expected if the patient is exhibiting Cheyne-Stokes respirations and is presenting with increasing blood pressure readings and a decreasing, reactive pulse rate?
A. Cortex and upper brainstem
B. Midbrain region
C. Medulla oblongata
D. Lower portion of the brainstem
Correct answer:
The correct answer is A: Cortex and upper brainstem. When a patient with increased intracranial pressure exhibits Cheyne-Stokes respirations, increasing blood pressure, and decreasing, reactive pulse rate, it indicates dysfunction at the level of the cortex and upper brainstem. Cheyne-Stokes respirations are associated with damage at the level of the cortex. Increasing blood pressure and decreasing, reactive pulse rate are signs of raised intracranial pressure affecting the upper brainstem. Dysfunction at the midbrain region or lower portion of the brainstem would present with different symptoms, such as pinpoint pupils or abnormal posturing. The medulla oblongata is responsible for controlling vital functions like breathing and heart rate, so dysfunction in this region would present with more severe respiratory and cardiovascular symptoms.
When observing a newly admitted elderly client with dementia resisting care, what approach should the nurse take to facilitate cooperation?
A. Use short, simple sentences and maintain a calm demeanor
B. Involve family members to provide reassurance
C. Offer choices to empower the client
D. All of the above
Correct answer:
When dealing with a newly admitted elderly client with dementia who is resistant to care, it is crucial to employ multiple strategies to facilitate cooperation. Using short, simple sentences and maintaining a calm demeanor can help the client better understand instructions and reduce agitation. Involving family members can provide comfort and reassurance to the client, potentially decreasing resistance. Offering choices allows the client to feel a sense of control and autonomy in their care, which can increase cooperation and reduce challenging behaviors. Therefore, a combination of clear communication, family involvement, and providing choices is essential to effectively engage and care for a client with dementia. Choices A, B, and C all play crucial roles in addressing the needs of the client, making 'All of the above' the correct answer.
When examining an 87-year-old home health patient, the nurse notes a musky, sour body odor. Based on this assessment, the most appropriate nursing action is to
A. schedule a nursing assistant to help the patient bathe several times weekly.
B. teach the patient to apply a moisturizing body lotion daily.
C. consult with the health care provider to obtain a prescription for a topical antifungal.
D. ask about use of prescription and over-the-counter (OTC) skin medications.
Correct answer:
The correct answer is A because the musky, sour body odor observed in the 87-year-old patient likely indicates poor personal hygiene. Therefore, scheduling a nursing assistant to help the patient bathe several times weekly is the most appropriate action to address this issue and promote cleanliness and comfort. This approach ensures proper hygiene practices are maintained, which can help improve the patient's overall well-being and prevent skin infections.
Choices B, C, and D are incorrect because teaching the patient to apply moisturizing lotion, obtaining a prescription for a topical antifungal, or asking about skin medications do not directly address the root cause of the musky odor, which is likely due to poor hygiene. These options focus on skincare and treatment for skin conditions, which may not be the primary concern in this case.
The nurse is caring for a patient with a chemical burn injury. The priority nursing intervention is to:
A. remove the patient's clothes and flush the area with water.
B. apply saline compresses.
C. contact a poison control center for directions on neutralizing agents.
D. remove all jewelry.
Correct answer:
The correct answer is A: remove the patient's clothes and flush the area with water. This is the priority intervention because it helps to stop the burning process by removing the source of the chemical and diluting it with water. Flushing the area with water helps to prevent further damage to the skin and underlying tissues. Removing the patient's clothes is important to prevent further exposure to the chemical.
Choice B (apply saline compresses) is not the priority because simply applying compresses does not address the need to remove the source of the chemical and dilute it. Choice C (contact a poison control center) is not the priority as immediate action is needed to stop the burning process. Choice D (remove all jewelry) is important but not the priority compared to removing the patient's clothes and flushing the area with water.
The evening nurse reviews the nursing documentation in the male client's chart and notes that the day nurse has documented that the client has a stage II pressure ulcer in the sacral area. Which of the following would the nurse expect to note on assessment of the client's sacral area?
A. Partial-thickness skin loss of the dermis
B. Full-thickness skin loss
C. Blistering without skin loss
D. Intact skin with redness
Correct answer:
The correct answer is A: Partial-thickness skin loss of the dermis. This aligns with the definition of a stage II pressure ulcer, which involves partial-thickness skin loss involving the epidermis and/or dermis. This stage typically presents as a shallow open ulcer with a red-pink wound bed.
Choice B (Full-thickness skin loss) is incorrect as it corresponds to a stage III pressure ulcer where there is full-thickness tissue loss.
Choice C (Blistering without skin loss) is incorrect as it describes a stage II pressure injury, not a pressure ulcer.
Choice D (Intact skin with redness) is incorrect as it signifies a stage I pressure ulcer, where there is non-blanchable erythema of intact skin.
Therefore, the nurse would expect to see partial-thickness skin loss of the dermis in the sacral area of the client with a stage II pressure ulcer.
What interleukin receptor antagonist would the nurse anticipate is most likely to be ordered for a patient, 25 years old, who has not responded to traditional antirheumatic drugs?
A. Natalizumab (Tysabri)
B. Anakinra (Kineret)
C. Eculizumab (Soliris)
D. Adalimumab (Humira)
Correct answer:
The correct answer is B: Anakinra (Kineret). Anakinra is an interleukin-1 receptor antagonist, which is used to treat patients with rheumatoid arthritis who have not responded to traditional antirheumatic drugs. Interleukin-1 is a key cytokine involved in the inflammatory response seen in rheumatoid arthritis. By blocking the action of interleukin-1, Anakinra helps reduce inflammation and joint damage in these patients.
A: Natalizumab (Tysabri) is a monoclonal antibody used to treat multiple sclerosis by preventing immune cells from crossing the blood-brain barrier.
C: Eculizumab (Soliris) is a monoclonal antibody used to treat rare blood disorders by blocking a specific part of the immune system.
D: Adalimumab (Humira) is a tumor necrosis factor (TNF) inhibitor used to treat various autoimmune diseases like rheumatoid arthritis, ps
LPN exams medical-surgical practice questions, set 23 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
