LPN exams medical-surgical practice questions, set 25
LPN exams · medical-surgical
LPN exams medical-surgical practice questionsset 25
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 is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. Which of the following is an important objective to decrease this risk?
A. Minimize seizures.
B. Prevent dehydration.
C. Promote cardiac output.
D. Reduce energy expenditure.
Show answer and rationale
Correct answer: B — Prevent dehydration.
The correct answer is B: Prevent dehydration. Dehydration can exacerbate hypoxia and increase the risk of cerebrovascular accidents in children with cardiac defects. Here's a step-by-step rationale:
1. Dehydration leads to decreased blood volume and thickening of blood, which can impair oxygen delivery to the brain.
2. Maintaining adequate hydration helps in optimizing blood flow and oxygen delivery to the brain, reducing the risk of strokes.
3. Minimizing seizures (choice A) is important, but not directly related to decreasing the risk of strokes.
4. Promoting cardiac output (choice C) is crucial for overall perfusion but does not specifically target the risk of strokes.
5. Reducing energy expenditure (choice D) may be important for conserving energy, but it does not directly address the risk of strokes associated with dehydration.
Question 2
A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38°C (100.4°F), and now her muscles and joints ache. Based on this information you advise the mother to:
A. Immediately bring the child to clinic for evaluation.
B. Come to the clinic next week on a scheduled appointment.
C. Treat the symptoms with acetaminophen and fluids, since it is most likely a viral illness.
D. Recognize that the child is trying to manipulate the parent by complaining of vague symptoms.
Show answer and rationale
Correct answer: A — Immediately bring the child to clinic for evaluation.
The correct answer is A: Immediately bring the child to clinic for evaluation. Given the child's medical history of a repaired ventricular septal defect (VSD) and presenting symptoms of decreased appetite, fever, and muscle/joint aches, there is concern for a possible infection or cardiac-related issue. It is crucial to promptly assess the child's condition due to the potential risks associated with cardiac conditions and infections in this population. Delaying evaluation could lead to serious complications.
Choices B and C are incorrect because waiting until next week or simply treating symptoms with acetaminophen may result in a missed opportunity to address a potentially serious issue. Choice D is incorrect as it dismisses the child's symptoms as manipulation, which is not a responsible or evidence-based approach to healthcare.
Question 3
A patient has a new order for magnetic resonance imaging (MRI) to evaluate possible left femur osteomyelitis after hip arthroplasty surgery. Which information indicates the nurse should consult with the health care provider before scheduling the MRI?
A. The patient has a pacemaker.
B. The patient is claustrophobic.
C. The patient wears a hearing aid.
D. The patient is allergic to shellfish.
Show answer and rationale
Correct answer: A — The patient has a pacemaker.
The correct answer is A because having a pacemaker can pose a significant risk during an MRI due to potential interference with the device's function. Pacemakers can malfunction or heat up during the MRI procedure, leading to serious complications. Consulting with the healthcare provider is crucial to determine if special precautions or alternative imaging methods are needed.
Choices B, C, and D are incorrect because:
B: Claustrophobia can be managed with medication or relaxation techniques, and open MRI machines are available for claustrophobic patients.
C: Hearing aids are generally safe during an MRI, and can be removed before the procedure if necessary.
D: Allergies to shellfish do not pose a direct risk during an MRI unless contrast dye containing shellfish is used, in which case alternative contrast agents can be used.
Question 4
In immune response mechanism clonal selection is a process in which:
A. a special type of clone cell line is identified in a cell culture
B. the proliferation and differentiation of lymphocytes occur in response to a specific antigen
C. cloning of a specific gene is done by inserting the same into a bacteria by recombinant DNA technology
D. selection of an appropriate cell type is done for the purpose of cloning
Show answer and rationale
Correct answer: B — the proliferation and differentiation of lymphocytes occur in response to a specific antigen
The correct answer is B because in immune response mechanism, clonal selection refers to the process where lymphocytes (T and B cells) proliferate and differentiate in response to a specific antigen. This process ensures that the immune system can effectively target and eliminate pathogens.
Option A is incorrect because clonal selection does not refer to identifying a specific type of clone cell line in cell culture.
Option C is incorrect because clonal selection does not involve cloning a specific gene by inserting it into bacteria using recombinant DNA technology.
Option D is incorrect because clonal selection is not about selecting an appropriate cell type for cloning purposes.
In summary, the correct answer, option B, best describes the process of clonal selection in the context of the immune response mechanism.
Question 5
Following class of restriction endonucleases is commercially available and used in recombinant DNA technology:
A. Class 1
B. Class 2
C. Class 3
D. Class 5
Show answer and rationale
Correct answer: B — Class 2
The correct answer is B: Class 2. Class 2 restriction endonucleases are commonly used in recombinant DNA technology due to their specificity for recognizing short DNA sequences and cleaving within or near these sequences. They are commercially available, easy to use, and have well-defined recognition sites, making them ideal for molecular cloning applications.
Choice A (Class 1) is incorrect because Class 1 enzymes require both ATP and S-adenosyl methionine for activity, making them less practical for routine laboratory use.
Choice C (Class 3) is incorrect because Class 3 enzymes cleave DNA at two sites, potentially leading to unwanted DNA fragmentation in recombinant DNA technology.
Choice D (Class 5) is incorrect because Class 5 restriction enzymes do not exist in the classification system of restriction endonucleases.
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Question 6
A client is scheduled for a sigmoidoscopy and expresses anxiety about the procedure. What should the nurse do first?
A. Offer information about the procedure steps
B. Administer an anxiolytic before the procedure
C. Encourage the client to discuss their fears
D. Reassure the client that the procedure is common and safe
Correct answer:
The correct first action for the nurse when a client expresses anxiety about a procedure is to encourage the client to discuss their fears. By allowing the client to express their concerns, the nurse can provide personalized support, address specific worries, and offer tailored information. This approach helps to establish trust, reduce anxiety, and promote a therapeutic nurse-client relationship. Offering information about the procedure steps (Choice A) may be helpful but should come after addressing the client's fears. Administering an anxiolytic (Choice B) should not be the first action as it focuses on symptom management rather than addressing the underlying cause of anxiety. Reassuring the client that the procedure is common and safe (Choice D) is important but should follow active listening and addressing the client's fears.
The nurse is caring for a patient who has a diagnosis of chronic hepatitis B infection and has been prescribed an immune stimulant. After teaching the patient about the treatment plan, how might the nurse evaluate the effectiveness of teaching?
A. The patient can state where to go to get the medication.
B. The patient can state who will administer the medication.
C. The patient can state what positive effects to watch for.
D. The patient can state specific measures to avoid adverse effects.
Correct answer:
The correct answer is D because the patient being able to state specific measures to avoid adverse effects demonstrates a comprehensive understanding of the treatment plan. This indicates that the patient not only understands the benefits of the medication but also the potential risks associated with it. This knowledge is crucial in ensuring the patient's safety and well-being throughout the treatment.
A, B, and C are incorrect because knowing where to get the medication, who will administer it, and what positive effects to watch for are important aspects of medication management but do not directly assess the patient's understanding of potential adverse effects and safety measures. The focus should be on ensuring that the patient is well-informed about how to prevent and manage any negative outcomes related to the treatment.
A postoperative client reports incisional pain. The client has two prescriptions for PRN analgesia that accompanied the client from the post-anesthesia unit. Before selecting which medication to administer, which action should the nurse implement?
A. Document the client's report of pain in the electronic medical record.
B. Determine which prescription will have the quickest onset of action.
C. Compare the client's pain scale rating with the prescribed dosing.
D. Ask the client to choose which medication is needed for the pain.
Correct answer:
The correct action the nurse should implement before selecting which medication to administer to a postoperative client who reports incisional pain is to compare the client's pain scale rating with the prescribed dosing. This ensures that the client receives the appropriate medication based on their pain level. Documenting the client's report of pain in the electronic medical record (Choice A) is important but should come after ensuring the right medication is given. Determining which prescription will have the quickest onset of action (Choice B) may not be the most relevant factor to consider when choosing the appropriate medication. Asking the client to choose the medication needed for the pain (Choice D) may not be appropriate as the nurse should rely on the pain scale rating and prescribed dosing to make a clinical decision.
The healthcare provider in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing?
A. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
B. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
C. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
D. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
Correct answer:
The correct answer is C. The patient with a sibling having newly diagnosed polycystic kidney disease may need a referral for genetic testing. Polycystic kidney disease has a genetic component, so there is a higher likelihood of the patient also having the condition. Referral for genetic testing can help in early diagnosis, management, and counseling for the patient and their family members.
Choice A is incorrect because strokes in maternal grandparents at advanced ages are not typically indicative of a need for genetic testing. Choice B is incorrect as cerebral palsy is not typically a genetic condition related to the patient's pregnancy test result. Choice D is incorrect as dyspnea in a smoking patient is more likely related to respiratory issues such as chronic obstructive pulmonary disease rather than a genetic condition.
During routine prenatal testing, a patient is diagnosed with human immunodeficiency virus infection. To help prevent perinatal transmission of human immunodeficiency virus to the fetus, what is the nurse's best action?
A. Provide the patient with contact information for an acquired immunodeficiency syndrome support group.
B. Educate the patient about the risks of human immunodeficiency virus disease to the fetus.
C. Notify the Centers for Disease Control and Prevention of the patient's diagnosis.
D. Provide written and oral education about the use of antiretroviral therapy during pregnancy.
Correct answer:
The correct answer is D because providing education about antiretroviral therapy during pregnancy is crucial in preventing perinatal transmission of HIV. Antiretroviral therapy significantly reduces the risk of transmission from mother to fetus. By educating the patient about the benefits and importance of adhering to antiretroviral therapy, the nurse empowers the patient to make informed decisions for the health of the fetus.
Choice A is incorrect because while support groups are important for emotional support, they do not directly address preventing perinatal transmission. Choice B is incorrect as educating about risks alone without providing specific preventive measures is not sufficient. Choice C is incorrect as notifying the CDC is not within the nurse's scope and does not directly impact prevention for this patient.
The nurse is caring for a patient diagnosed with rheumatoid arthritis (RA) who recently underwent a liver transplant. What immunosuppressant could this patient be prescribed that would treat both diagnoses?
A. Anakinra (Kineret)
B. Adalimumab (Humira)
C. Sirolimus (Rapamune)
D. Cyclosporine (Sandimmune)
Correct answer:
Step-by-step rationale for the correct answer A: Anakinra (Kineret):
1. Anakinra is an interleukin-1 receptor antagonist used to treat RA by reducing inflammation.
2. It does not suppress the immune system globally, making it safer for a patient with a recent liver transplant.
3. Anakinra can effectively treat RA without compromising the patient's immune system post-transplant.
Summary of why other choices are incorrect:
B: Adalimumab (Humira) is a tumor necrosis factor (TNF) inhibitor commonly used for RA but poses a risk of immunosuppression post-liver transplant.
C: Sirolimus (Rapamune) is an mTOR inhibitor used as an immunosuppressant post-transplant but is not typically prescribed for RA.
D: Cyclosporine (Sandimmune) is a calcineurin inhibitor used as an immunosuppressant post-transplant, but it is not indicated
The client with newly diagnosed osteoporosis is being taught by the nurse about dietary modifications. Which instruction should the nurse include?
A. Increase your intake of high-calcium foods.
B. Limit your intake of vitamin D-rich foods.
C. Avoid foods high in phosphorus.
D. Increase your intake of high-sodium foods.
Correct answer:
The correct answer is A: Increase your intake of high-calcium foods. Osteoporosis is a condition characterized by low bone density, and calcium is essential for bone health. Increasing calcium intake can help strengthen bones and prevent further bone loss. Foods high in calcium, such as dairy products, leafy green vegetables, and fortified foods, are beneficial for individuals with osteoporosis.
Summary of other choices:
B: Limiting intake of vitamin D-rich foods is not advised, as vitamin D plays a crucial role in calcium absorption and bone health.
C: Avoiding foods high in phosphorus is not necessary, as phosphorus is also important for bone health and overall body function.
D: Increasing intake of high-sodium foods is not recommended, as high sodium intake can lead to calcium loss from the bones, worsening osteoporosis.
The nurse is assessing a group of older adults. Which client is at greatest risk for skin breakdown? A person who has:
A. Altered balance.
B. Reduced sensation of pressure.
C. Impaired hearing ability.
D. Impaired visual acuity.
Correct answer:
Correct Answer: B - Reduced sensation of pressure
Rationale:
1. Reduced sensation of pressure leads to decreased ability to feel discomfort and adjust position, increasing risk of prolonged pressure on the skin.
2. Prolonged pressure can cause tissue damage and skin breakdown, especially in older adults with fragile skin.
3. Proper sensation of pressure is crucial for individuals to respond to discomfort and prevent pressure ulcers.
Summary of Other Choices:
A. Altered balance: While altered balance can increase the risk of falls, it is not directly related to skin breakdown.
C. Impaired hearing ability: Impaired hearing may affect communication but does not directly impact skin breakdown.
D. Impaired visual acuity: Impaired vision can affect safety and mobility but is not a primary risk factor for skin breakdown.
The two components of the integumentary system are the
A. epidermis and superficial fascia.
B. cutaneous membrane and accessory structures.
C. cutaneous membrane and hypodermis.
D. integument and hypodermis.
Correct answer:
The correct answer is B: cutaneous membrane and accessory structures. The integumentary system consists of the cutaneous membrane (skin) and accessory structures like hair, nails, and glands. The skin is the main component responsible for protection, sensation, and temperature regulation. The accessory structures support these functions.
A: epidermis and superficial fascia - The epidermis is a layer of the skin, not a component of the integumentary system. Superficial fascia is a layer of connective tissue beneath the skin.
C: cutaneous membrane and hypodermis - The hypodermis is a subcutaneous layer beneath the skin, not a component of the integumentary system.
D: integument and hypodermis - The integument is another term for the skin, not a separate component. Hypodermis is not a component of the integumentary system.
A group of students is attending an in-service about do-not-resuscitate orders. Which of the following statements by one of the students indicate the need for further teaching?
A. Do-not-resuscitate orders are a form of euthanasia and I can just participate in a slow code if not completed.'
B. My nursing license will not be in jeopardy if I follow do-not resuscitate orders.'
C. Do-not-resuscitate orders may be rescinded if the client wishes.'
D. All of the above
Correct answer:
The correct answer is A: "Do-not-resuscitate orders are a form of euthanasia and I can just participate in a slow code if not completed." This statement is incorrect because do-not-resuscitate orders are not a form of euthanasia. Euthanasia involves intentionally ending a patient's life, while DNR orders allow for a natural death without resuscitative measures. Additionally, participating in a "slow code" is unethical and not an appropriate response to a DNR order. Choices B and C are correct statements. B: "My nursing license will not be in jeopardy if I follow do-not-resuscitate orders" is true as long as the nurse follows legal and ethical guidelines. C: "Do-not-resuscitate orders may be rescinded if the client wishes" is also accurate as patients have the right to change their preferences regarding resuscitative measures.
LPN exams medical-surgical practice questions, set 25 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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