LPN exams medical-surgical practice questions, set 24
LPN exams · medical-surgical
LPN exams medical-surgical practice questionsset 24
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 nurse notes a reddened area on the right heel that does not turn lighter in color when pressed with a finger. Which term will the nurse use to describe this area?
A. Reactive hyperemia
B. Secondary erythema
C. Blanchable hyperemia
D. Nonblanchable erythema
Show answer and rationale
Correct answer: D — Nonblanchable erythema
The nurse identifies 'nonblanchable erythema' for a reddened right heel that doesn't lighten under pressure, indicating early tissue damage, per Potter's *Essentials* (9th Ed.). This Stage 1 pressure injury sign e.g., persistent redness over 30 minutes shows capillary occlusion, unlike 'reactive hyperemia' , which blanches e.g., fades in seconds from temporary blood rush. 'Secondary erythema' isn't a term e.g., no such condition exists in wound care. 'Blanchable hyperemia' lightens e.g., normal response to pressure relief. A nurse pressing e.g., no color shift notes nonblanchable's risk (e.g., 50% progress to ulcers), per NPUAP, needing intervention (e.g., offloading). Unlike reactive's fleeting flush or blanchable's safety, nonblanchable signals deep ischemia, a key assessment in physiological integrity, making the precise, correct term.
Question 2
A client with venous insufficiency has a venous stasis ulcer on the lower leg. Which instruction should the nurse give to the client to promote wound healing?
A. Apply compression stockings or bandages to the affected leg
B. Avoid crossing the legs or wearing tight-fitting clothing
C. Keep the leg elevated when sitting or lying down
D. All of the above
Show answer and rationale
Correct answer: D — All of the above
All of the above,' is correct, as all listed instructions applying compression stockings or bandages , avoiding crossing legs or tight clothing , and keeping the leg elevated promote healing of a venous stasis ulcer. Venous insufficiency causes blood pooling, edema, and pressure, impairing wound recovery. Compression therapy enhances venous return, reducing swelling and supporting circulation. Avoiding leg crossing or tight garments prevents vessel constriction, maintaining blood flow. Elevation above heart level uses gravity to drain fluid, alleviating edema and pressure. Each action targets a facet of venous ulcer pathology, and together, they form a comprehensive strategy to improve oxygenation, reduce inflammation, and accelerate healing, making D the most inclusive and effective choice for patient education in this chronic condition.
Question 3
A client with venous insufficiency has a venous stasis ulcer on the lower leg. Which instruction should the nurse give to the client to promote wound healing?
A. Apply compression stockings or bandages to the affected leg
B. Avoid crossing the legs or wearing tight-fitting clothing
C. Keep the leg elevated when sitting or lying down
D. All of the above
Show answer and rationale
Correct answer: D — All of the above
All of the above,' is correct, as all listed instructions applying compression stockings or bandages , avoiding crossing legs or tight clothing , and keeping the leg elevated promote healing of a venous stasis ulcer. Venous insufficiency causes blood pooling, edema, and pressure, impairing wound recovery. Compression therapy enhances venous return, reducing swelling and supporting circulation. Avoiding leg crossing or tight garments prevents vessel constriction, maintaining blood flow. Elevation above heart level uses gravity to drain fluid, alleviating edema and pressure. Each action targets a facet of venous ulcer pathology, and together, they form a comprehensive strategy to improve oxygenation, reduce inflammation, and accelerate healing, making D the most inclusive and effective choice for patient education in this chronic condition.
Question 4
Vaccinations help prepare the body to fight invasions of a specific pathogen by
A. inhibiting antigen production
B. stimulating antibody production
C. inhibiting white blood cell production
D. stimulating red blood cell production
Show answer and rationale
Correct answer: B — stimulating antibody production
The correct answer is B: stimulating antibody production. Vaccinations introduce a weakened or inactive form of a pathogen to trigger the immune response. This leads to the production of specific antibodies that recognize and attack the pathogen upon future exposure. Antibodies play a crucial role in neutralizing and eliminating pathogens.
A: Inhibiting antigen production is incorrect because vaccines aim to stimulate the immune system's response to antigens, not inhibit their production.
C: Inhibiting white blood cell production is incorrect because white blood cells are vital components of the immune system and are not suppressed by vaccinations.
D: Stimulating red blood cell production is incorrect because vaccinations do not have a direct impact on red blood cell production, which is primarily regulated by the body's own mechanisms.
Question 5
The discovery of immunoglobulin gene rearrangement helped to explain:
A. How the number of different immunoglobulins produced by an individual can be far greater than the number of genes in the human genome
B. How the number of genes in the human genome can be far greater than the number of different immunoglobulins produced by an individual
C. How thousands of immunoglobulin chains of different sequence may be produced by a single B cell
D. Both A and C are correct
Show answer and rationale
Correct answer: A — How the number of different immunoglobulins produced by an individual can be far greater than the number of genes in the human genome
The correct answer is A: How the number of different immunoglobulins produced by an individual can be far greater than the number of genes in the human genome. Immunoglobulin gene rearrangement occurs during B cell development, leading to the generation of a diverse repertoire of antibodies from a limited number of genes. This process allows for the production of a vast array of immunoglobulins through mechanisms like V(D)J recombination. Choice B is incorrect because the gene rearrangement process actually enables a single gene to encode for multiple immunoglobulins. Choice C is partially correct but does not fully capture the significance of gene rearrangement in expanding the diversity of immunoglobulins beyond what the genome would suggest. Choice D is incorrect as it combines a correct statement (A) with an incomplete statement (C).
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Question 6
A patient recovering from 25% total body surface area burns has a low-grade fever. What should the nurse do to reduce this patient's risk of developing an infection?
A. Follow contact precautions
B. Implement protective isolation
C. Use sterile technique for all dressing changes
D. Administer prophylactic antibiotics as prescribed
Correct answer:
The correct answer is C: Use sterile technique for all dressing changes. Sterile technique reduces the risk of introducing harmful microorganisms into the burn wound, thus decreasing the likelihood of infection. By maintaining a sterile environment during dressing changes, the nurse can help protect the patient's vulnerable skin and promote healing.
A: Following contact precautions is important for preventing the spread of infection, but it does not directly address the risk of infection in the burn wound.
B: Implementing protective isolation is unnecessary in this case as the patient's low-grade fever does not indicate the need for isolation.
D: Administering prophylactic antibiotics is not recommended in this scenario as it can contribute to antibiotic resistance and is not necessary unless there is a confirmed infection present.
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.
What is the primary advantage of the memory function in adaptive immunity?
A. Rapid and stronger responses to previously encountered antigens
B. Direct killing of pathogens without prior activation
C. Enhanced cytokine secretion
D. Resistance to all infections without exposure
Correct answer:
The correct answer is A because memory function in adaptive immunity allows for rapid and stronger responses to previously encountered antigens. This is achieved through the presence of memory cells, such as memory B and T cells, which can quickly recognize and respond to specific pathogens upon re-exposure. This leads to a faster and more efficient immune response, providing better protection against future infections.
Choice B is incorrect because direct killing of pathogens without prior activation is a function of innate immunity, not adaptive immunity. Choice C is incorrect as enhanced cytokine secretion is not the primary advantage of memory function. Choice D is incorrect because while memory function provides protection against previously encountered antigens, it does not confer resistance to all infections without exposure.
A 40-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Diabetes insipidus
D. Hyperthyroidism
Correct answer:
The most likely diagnosis for a 40-year-old woman presenting with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is Type 1 diabetes mellitus.
1. Age: Type 1 diabetes commonly presents at a younger age.
2. Symptoms: Polyuria, polydipsia, fatigue are classic symptoms of uncontrolled diabetes.
3. Laboratory tests: Hyperglycemia and ketonuria indicate insulin deficiency.
4. Clinical presentation: Presence of ketonuria suggests metabolic derangement due to lack of insulin.
In summary, Type 1 diabetes is the correct choice due to the age of the patient, symptoms, laboratory findings, and clinical presentation. Diabetes insipidus (choice C) presents with polyuria and polydipsia but lacks hyperglycemia and ketonuria. Type 2 diabetes (choice B) typically presents at an older age and rarely with ketonuria. Hyperthyroidism (choice D)
A school-age client, recently diagnosed with asthma, also has a peanut allergy. The nurse instructs the family to not only avoid peanuts but also to carefully check food label ingredients for peanut products and to make sure dishes and utensils are adequately washed prior to food preparation. The mother asks why this is specific for her child. Based on the client’s history, the nurse knows that this client is at an increased risk for which complication?
A. Urticaria
B. Diarrhea
C. Anaphylaxis
D. Headache
Correct answer:
The correct answer is C: Anaphylaxis. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur rapidly in individuals with peanut allergies. The client's history of asthma and peanut allergy puts them at a higher risk for experiencing anaphylaxis when exposed to peanuts. Anaphylaxis can cause symptoms such as difficulty breathing, swelling, a drop in blood pressure, and can be fatal if not treated promptly with epinephrine.
A: Urticaria is a skin rash that can occur in response to an allergic reaction, but it is not as severe or life-threatening as anaphylaxis.
B: Diarrhea is not typically a common symptom of an allergic reaction to peanuts and does not pose the same level of risk as anaphylaxis.
D: Headache is not a common symptom of an allergic reaction to peanuts and is not as severe as anaphylaxis.
A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?
A. Take folic acid supplements as prescribed.
B. Avoid alcohol completely.
C. Expect to see immediate results.
D. Limit fluid intake to 1 liter per day.
Correct answer:
The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, causing side effects. Supplementing with folic acid can help manage these side effects. It is crucial for the nurse to emphasize the importance of taking folic acid as prescribed to prevent adverse effects.
Summary of Incorrect Choices:
B: Avoid alcohol completely - While alcohol should be limited or avoided due to potential liver toxicity with methotrexate, complete avoidance may not be necessary for all patients.
C: Expect to see immediate results - Methotrexate takes time to work, and patients should not expect immediate results. Patience is necessary.
D: Limit fluid intake to 1 liter per day - There is no specific guideline to limit fluid intake with methotrexate. Adequate hydration is important for overall health.
A nurse is assessing a client with a pressure ulcer on the sacrum. Which finding indicates a potential complication of the wound?
A. Serous drainage from the wound
B. Erythema around the wound edges
C. Foul odor from the wound
D. Granulation tissue in the wound bed
Correct answer:
Foul odor from the wound is the correct answer, as it suggests a potential complication like infection or necrotic tissue, which can impede healing and lead to serious issues like sepsis. Serous drainage is normal, consisting of clear, watery fluid from capillaries, and doesn't inherently signal trouble unless excessive or cloudy. Erythema around the wound edges is expected during healing, reflecting increased blood flow and inflammation, not necessarily a complication unless it worsens or spreads. Granulation tissue in the wound bed is a positive sign of healing, indicating new tissue growth, not a problem. Foul odor, however, often accompanies bacterial overgrowth or dead tissue breakdown, requiring immediate assessment, possibly a culture, and intervention to prevent escalation, distinguishing it as a red flag among these findings.
A nurse is assessing a client with a pressure ulcer on the sacrum. Which finding indicates a potential complication of the wound?
A. Serous drainage from the wound
B. Erythema around the wound edges
C. Foul odor from the wound
D. Granulation tissue in the wound bed
Correct answer:
Foul odor from the wound is the correct answer, as it suggests a potential complication like infection or necrotic tissue, which can impede healing and lead to serious issues like sepsis. Serous drainage is normal, consisting of clear, watery fluid from capillaries, and doesn't inherently signal trouble unless excessive or cloudy. Erythema around the wound edges is expected during healing, reflecting increased blood flow and inflammation, not necessarily a complication unless it worsens or spreads. Granulation tissue in the wound bed is a positive sign of healing, indicating new tissue growth, not a problem. Foul odor, however, often accompanies bacterial overgrowth or dead tissue breakdown, requiring immediate assessment, possibly a culture, and intervention to prevent escalation, distinguishing it as a red flag among these findings.
A client is scheduled for patch testing to determine allergies to several substances. Which nursing activities associated with this test are best delegated to a medical assistant working in the allergy clinic?
A. Explain the purpose of the testing to the client.
B. Examine the patch area for evidence of a reaction.
C. Schedule the client to return to the clinic in 2 days for follow-up.
D. Monitor for anaphylactic reactions after administration of the test.
Correct answer:
The correct answer is C because scheduling a client for a follow-up appointment is an administrative task that can be delegated to a medical assistant. This task does not require specialized nursing knowledge or assessment skills.
Explanation of why the other choices are incorrect:
A: Explaining the purpose of the testing to the client requires nursing knowledge and understanding of the procedure, so it should be performed by a nurse.
B: Examining the patch area for evidence of a reaction involves assessment skills that only a nurse should perform to accurately identify and interpret potential reactions.
D: Monitoring for anaphylactic reactions after administration of the test is a critical nursing responsibility that requires immediate intervention if a reaction occurs. This task should not be delegated to a medical assistant.
A patient recovering from 25% total body surface area burns has a low-grade fever. What should the nurse do to reduce this patient's risk of developing an infection?
A. Follow contact precautions
B. Implement protective isolation
C. Use sterile technique for all dressing changes
D. Administer prophylactic antibiotics as prescribed
Correct answer:
The correct answer is C: Use sterile technique for all dressing changes. Sterile technique reduces the risk of introducing harmful microorganisms into the burn wound, thus decreasing the likelihood of infection. By maintaining a sterile environment during dressing changes, the nurse can help protect the patient's vulnerable skin and promote healing.
A: Following contact precautions is important for preventing the spread of infection, but it does not directly address the risk of infection in the burn wound.
B: Implementing protective isolation is unnecessary in this case as the patient's low-grade fever does not indicate the need for isolation.
D: Administering prophylactic antibiotics is not recommended in this scenario as it can contribute to antibiotic resistance and is not necessary unless there is a confirmed infection present.
LPN exams medical-surgical practice questions, set 24 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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