LPN exams medical-surgical practice questions, set 6
LPN exams · medical-surgical
LPN exams medical-surgical practice questionsset 6
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
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. Redness and warmth around the wound
C. Foul-smelling greenish discharge from the wound
D. Granulation tissue forming in the wound bed
Show answer and rationale
Correct answer: C — Foul-smelling greenish discharge from the wound
Foul-smelling greenish discharge is the correct answer, indicating a potential complication such as infection in the pressure ulcer. This type of discharge, often linked to bacteria like Pseudomonas, combined with a foul odor, suggests microbial overgrowth that can hinder healing and lead to serious outcomes like sepsis if untreated. Prompt reporting and a wound culture are critical to identify the pathogen and tailor treatment. Serous drainage is typically clear and watery, a normal part of healing unless it becomes excessive or purulent. Redness and warmth around the wound are expected signs of inflammation and increased blood flow during early healing stages, not necessarily problematic unless accompanied by worsening symptoms. Granulation tissue is a healthy sign, showing new tissue growth and vascularization, not a complication. The distinct foul-smelling, greenish discharge stands out as an abnormal finding requiring immediate attention, distinguishing it from the other options.
Question 2
The client comes to the clinic complaining of sudden onset of high fever, chills, and a headache. The nurse assesses a patchy macular rash on the trunk and a circular type of rash that looks like an insect bite. Which question would be most appropriate for the nurse to ask during the interview?
A. Do you own dogs that stay in the yard?'
B. Have you been working in your garden lately?'
C. Have you been deer hunting in the last week?'
D. Do you use sunscreen when you are outside?'
Show answer and rationale
Correct answer: C — Have you been deer hunting in the last week?'
The correct answer is C: "Have you been deer hunting in the last week?" This question is the most appropriate because the client's symptoms of fever, chills, headache, patchy macular rash, and circular rash resembling an insect bite could indicate Lyme disease, which is commonly transmitted through deer ticks. By asking about deer hunting, the nurse can gather crucial information about potential exposure to ticks in the environment.
Summary of why the other choices are incorrect:
A: "Do you own dogs that stay in the yard?" - Owning dogs may be relevant for exposure to ticks but does not specifically address the client's recent activities that could have led to tick exposure.
B: "Have you been working in your garden lately?" - While gardening can also lead to tick exposure, it is not as directly related to the specific symptoms presented by the client in this case.
D: "Do you use sunscreen when you are outside?" - Sunscreen use is not relevant to the symptoms described and does
Question 3
An overweight, young adult male who was recently diagnosed with type 2 diabetes mellitus is admitted for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the nurse implement? (Select all that apply)
A. Check his fingerstick glucose
B. Assess his skin temperature and moisture
C. Measure his pulse and BP
D. All of the Above
Show answer and rationale
Correct answer: D — All of the Above
In this scenario, the patient is a young adult male with type 2 diabetes mellitus admitted for a hernia repair who is experiencing weakness and jitteriness. Checking his fingerstick glucose is crucial to assess his blood sugar levels, which can directly impact his symptoms. Assessing his skin temperature and moisture is important to evaluate his peripheral circulation and hydration status. Measuring his pulse and blood pressure helps in gauging his cardiovascular status. Therefore, all the actions mentioned in choices A, B, and C are appropriate for the nurse to implement in this situation to identify the underlying cause of the patient's symptoms. Choice D, 'All of the Above,' is the correct answer because all these actions are necessary for a comprehensive assessment of the patient's condition. Choices A, B, and C are incorrect individually as they each address different aspects of the patient's condition, and a holistic approach is needed to provide optimal care in this situation.
Question 4
The sister of a patient diagnosed with BRCA gene¢â‚¬"related breast cancer asks the nurse, 'Do you think I should be tested for the gene?' Which response by the nurse is most appropriate?
A. In most cases, breast cancer is not caused by the BRCA gene.
B. It depends on how you will feel if the test is positive for the BRCA gene.
C. There are many things to consider before deciding to have genetic testing.
D. You should decide first whether you are willing to have a bilateral mastectomy.
Show answer and rationale
Correct answer: C — There are many things to consider before deciding to have genetic testing.
The correct answer is C because genetic testing for the BRCA gene involves complex considerations beyond just the test results. By stating that there are many things to consider before deciding to have genetic testing, the nurse acknowledges the importance of discussing the potential implications of the test result, such as emotional, social, and medical factors. This response promotes informed decision-making and empowers the patient to make a well-considered choice.
Choices A, B, and D are incorrect:
A: This statement is inaccurate as a significant proportion of breast cancers are indeed linked to the BRCA gene mutations.
B: This response oversimplifies the decision-making process by focusing solely on emotional aspects, neglecting other critical factors that should be considered before genetic testing.
D: This option is not appropriate as it suggests a specific treatment option (bilateral mastectomy) without addressing the broader aspects of genetic testing and decision-making.
Question 5
Which statement, made by a 4-year-old child’s father, is true about the care of the preschooler’s teeth?
A. Because the ‘baby teeth’ are not permanent, they are not important to the child.'
B. My son can be encouraged to brush his teeth after I have thoroughly cleaned his teeth.'
C. My son’s ‘permanent teeth’ will begin to come in at 4 to 5 years of age.'
D. Fluoride supplements can be discontinued when my son’s ‘permanent teeth’ erupt.'
Show answer and rationale
Correct answer: B — My son can be encouraged to brush his teeth after I have thoroughly cleaned his teeth.'
Step 1: Proper dental care for children involves both parents and children. In this scenario, the father acknowledges his role in helping the child develop good oral hygiene habits.
Step 2: The father's statement shows understanding that children at this age may not be able to brush their teeth effectively on their own, hence the need for parental assistance.
Step 3: By stating that he will encourage his son to brush his teeth after thorough cleaning, the father is promoting proper dental care habits in the child.
Step 4: This approach instills the importance of oral hygiene in the child from an early age, setting a foundation for lifelong dental health.
Summary:
A: Incorrect. Baby teeth are essential for proper speech development, nutrition, and guiding permanent teeth.
C: Incorrect. Permanent teeth typically begin to come in around 6 years of age, not 4 to 5.
D: Incorrect. Fluoride supplements are important for dental health and should be continued as recommended by the dentist.
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Question 6
A nurse is caring for a client who has a pressure ulcer on the sacrum. Which intervention should the nurse perform first?
A. Apply a hydrocolloid dressing to the wound
B. Assess the wound for signs of infection
C. Cleanse the wound with normal saline solution
D. Reposition the client to relieve pressure on the wound
Correct answer:
Repositioning the client to relieve pressure on the wound is the correct first intervention. Using the ABCDE framework (Airway, Breathing, Circulation, Disability, Exposure), relieving pressure addresses circulation by preventing further tissue ischemia, the root cause of pressure ulcers. Immediate repositioning halts ongoing damage, enhances blood flow, and sets the stage for subsequent care, making it the priority action. Applying a hydrocolloid dressing promotes healing but doesn't address the immediate threat of pressure, which must stop first. Assessing for infection is crucial but secondary, as it evaluates status rather than intervening to prevent worsening. Cleansing with saline removes debris but doesn't tackle the underlying pressure causing the ulcer. Repositioning is foundational, as unrelieved pressure will negate other interventions' effectiveness, aligning with evidence-based protocols to prioritize tissue perfusion and stop progression in pressure ulcer management.
A client with disseminated intravascular coagulation (DIC) has a nursing diagnosis of Impaired Gas Exchange. Which action is inappropriate when providing care based on this nursing diagnosis?
A. Place client in low-Fowler position to improve gas exchange.
B. Monitor the client’s oxygen saturation continuously.
C. Maintain bed rest.
D. Encourage deep breathing and coughing.
Correct answer:
Correct answer: A. Placing the client in a low-Fowler position is inappropriate because it can worsen gas exchange in a client with DIC.
Rationale:
1. In DIC, impaired gas exchange is often due to microthrombi formation in the lungs, leading to ventilation-perfusion mismatch.
2. Placing the client in a low-Fowler position can further compromise ventilation by decreasing lung expansion and worsening perfusion.
3. Monitoring oxygen saturation continuously (B) is essential in assessing gas exchange status.
4. Maintaining bed rest (C) helps reduce oxygen demand and prevent complications from movement.
5. Encouraging deep breathing and coughing (D) can help maintain lung expansion and prevent atelectasis.
In summary, placing the client in a low-Fowler position is inappropriate as it can worsen gas exchange, while monitoring oxygen saturation, maintaining bed rest, and promoting deep breathing and coughing are appropriate interventions for a client with DIC and impaired gas exchange.
A nurse is caring for a client who has a pressure ulcer on the sacrum. Which intervention should the nurse perform first?
A. Apply a hydrocolloid dressing to the wound
B. Assess the wound for signs of infection
C. Cleanse the wound with normal saline solution
D. Reposition the client to relieve pressure on the wound
Correct answer:
Repositioning the client to relieve pressure on the wound is the correct first intervention. Using the ABCDE framework (Airway, Breathing, Circulation, Disability, Exposure), relieving pressure addresses circulation by preventing further tissue ischemia, the root cause of pressure ulcers. Immediate repositioning halts ongoing damage, enhances blood flow, and sets the stage for subsequent care, making it the priority action. Applying a hydrocolloid dressing promotes healing but doesn't address the immediate threat of pressure, which must stop first. Assessing for infection is crucial but secondary, as it evaluates status rather than intervening to prevent worsening. Cleansing with saline removes debris but doesn't tackle the underlying pressure causing the ulcer. Repositioning is foundational, as unrelieved pressure will negate other interventions' effectiveness, aligning with evidence-based protocols to prioritize tissue perfusion and stop progression in pressure ulcer management.
Which of the following is a safety mechanism of the complement system?
A. Binding C5a to plasma inhibitors
B. Activation of complement only in the absence of pathogens
C. Covalent binding of C3b and C4b to pathogen surfaces
D. Suppression of C1 activation by antibodies
Correct answer:
Rationale for Choice C: Covalent binding of C3b and C4b to pathogen surfaces is a safety mechanism of the complement system because it helps in targeting pathogens specifically, enhancing opsonization, and preventing damage to host cells by limiting complement activation to the pathogen surface. C3b and C4b form stable covalent bonds with the pathogens, marking them for destruction by phagocytes. This mechanism ensures that complement activation is directed towards the pathogen and not host cells, thus maintaining immune homeostasis.
Summary:
A: Binding C5a to plasma inhibitors is not a safety mechanism but a regulatory mechanism in the complement system.
B: Activation of complement only in the absence of pathogens is incorrect as the complement system can be activated in response to various stimuli, not just pathogens.
D: Suppression of C1 activation by antibodies is not a safety mechanism but a regulatory mechanism involving the classical pathway of complement activation.
The client comes to the clinic complaining of sudden onset of high fever, chills, and a headache. The nurse assesses a patchy macular rash on the trunk and a circular type of rash that looks like an insect bite. Which question would be most appropriate for the nurse to ask during the interview?
A. Do you own dogs that stay in the yard?'
B. Have you been working in your garden lately?'
C. Have you been deer hunting in the last week?'
D. Do you use sunscreen when you are outside?'
Correct answer:
The correct answer is C: "Have you been deer hunting in the last week?" This question is the most appropriate because the client's symptoms of fever, chills, headache, patchy macular rash, and circular rash resembling an insect bite could indicate Lyme disease, which is commonly transmitted through deer ticks. By asking about deer hunting, the nurse can gather crucial information about potential exposure to ticks in the environment.
Summary of why the other choices are incorrect:
A: "Do you own dogs that stay in the yard?" - Owning dogs may be relevant for exposure to ticks but does not specifically address the client's recent activities that could have led to tick exposure.
B: "Have you been working in your garden lately?" - While gardening can also lead to tick exposure, it is not as directly related to the specific symptoms presented by the client in this case.
D: "Do you use sunscreen when you are outside?" - Sunscreen use is not relevant to the symptoms described and does
The client has a nasogastric (NG) tube and is receiving enteral feedings. What intervention should the nurse implement to prevent complications associated with the NG tube?
A. Flush the NG tube with water before and after feedings.
B. Check gastric residual volume every 6 hours.
C. Keep the head of the bed elevated at 30 degrees.
D. Replace the NG tube every 24 hours.
Correct answer:
Correct Answer: C - Keep the head of the bed elevated at 30 degrees.
Rationale:
1. Elevating the head of the bed at 30 degrees helps prevent aspiration by promoting proper drainage of gastric contents.
2. This position reduces the risk of reflux and pulmonary complications in clients with NG tubes.
3. It also helps maintain the proper position of the tube in the stomach, decreasing the likelihood of displacement.
Summary of Other Choices:
A. Flushing the NG tube with water before and after feedings is important for tube patency but does not directly prevent complications associated with the NG tube.
B. Checking gastric residual volume every 6 hours is important to monitor feeding tolerance but does not directly prevent complications related to the NG tube.
D. Replacing the NG tube every 24 hours is not necessary unless there are specific indications such as tube blockage or dislodgment. Regular replacement can increase the risk of complications and is not a standard practice.
A rehabilitation nurse is working with a patient who has had a below-the-knee amputation. The nurse knows the importance of the patient's active participation in self-care. In order to determine the patient's ability to be an active participant in self-care, the nurse should prioritize assessment of what variable?
A. The patient's attitude
B. The patient's learning style
C. The patient's nutritional status
D. The patient's presurgical level of function
Correct answer:
The correct answer is A: The patient's attitude. This is because attitude plays a crucial role in determining a patient's willingness and motivation to actively participate in their self-care post-amputation. A positive attitude can lead to better adherence to rehabilitation plans and faster recovery. Assessing the patient's attitude allows the nurse to gauge their mindset, motivation, and emotional readiness, which are essential for successful rehabilitation.
Summary:
- B: The patient's learning style: While important for education and training, it is not as critical as attitude for active participation in self-care.
- C: The patient's nutritional status: While important for overall health, it is not directly related to the patient's ability to actively participate in self-care.
- D: The patient's presurgical level of function: While useful information, it does not determine the patient's current mindset and willingness to engage in self-care activities post-amputation.
The nurse has contributed to a staff education program on immunity. Which participant response indicates a correct understanding of the type of immunity that protects newborns for the first 3 months of life as a result of maternal transmission of IgG?
A. Active natural immunity occurs.
B. Passive natural immunity occurs.
C. Active artificial immunity occurs.
D. Passive artificial immunity occurs.
Correct answer:
The correct answer is B: Passive natural immunity occurs. This type of immunity is achieved through the transfer of antibodies (IgG) from the mother to the fetus during pregnancy. The antibodies provide protection to the newborn for the first few months of life. It is considered passive because the newborn is not actively producing the antibodies themselves.
A: Active natural immunity occurs when the body produces its antibodies in response to exposure to an antigen. This is not the case for newborns receiving maternal IgG.
C: Active artificial immunity occurs when the body is intentionally exposed to an antigen, such as through vaccination, to stimulate an immune response. This is not relevant to the scenario described.
D: Passive artificial immunity occurs when pre-formed antibodies are transferred to an individual through a medical intervention, such as receiving immune globulin. This is not applicable to the situation of maternal transmission of IgG to newborns.
The day after a 60-yr-old patient has open reduction and internal fixation (ORIF) for an open, displaced tibial fracture, the nurse identifies the priority nursing diagnosis as
A. activity intolerance related to deconditioning.
B. risk for constipation related to prolonged bed rest.
C. risk for impaired skin integrity related to immobility.
D. risk for infection related to disruption of skin integrity.
Correct answer:
Rationale for Correct Answer (D): The priority nursing diagnosis is "risk for infection related to disruption of skin integrity" because the patient underwent ORIF for an open tibial fracture, which increases the risk of infection due to the disruption of skin integrity. Post-surgery, there is a higher susceptibility to infection, which can lead to serious complications and delayed healing. Monitoring for signs of infection and implementing appropriate interventions is crucial to prevent further complications.
Summary of Incorrect Choices:
A: Activity intolerance is not the priority as the patient is not likely to be ambulating immediately after ORIF for a tibial fracture.
B: Risk for constipation is not the priority as it is not directly related to the surgical procedure and can be managed with appropriate interventions.
C: Risk for impaired skin integrity is not the priority as the main concern post-ORIF is infection due to the open fracture, which takes precedence.
Which information should the nurse discuss with the client diagnosed with seborrheic dermatitis of the scalp?
A. Use a fine-toothed comb to comb out the hair after shampooing.'
B. Apply hydrocortisone 1% to the scalp area twice a day.'
C. Rotate two or three different types of shampoos daily.'
D. Dry the hair using the high heat setting for at least 5 minutes.
Correct answer:
Correct Answer: C
Rationale: The nurse should discuss rotating two or three different types of shampoos daily with the client diagnosed with seborrheic dermatitis of the scalp. This is because using different shampoos can help prevent the scalp from becoming resistant to one specific shampoo and can also help target different aspects of the condition. Using the same shampoo repeatedly may lead to decreased effectiveness over time. Additionally, rotating shampoos can help prevent the buildup of product residue on the scalp, which can exacerbate seborrheic dermatitis symptoms. This approach promotes scalp health and reduces the risk of irritation and flare-ups.
Incorrect Choices:
A: Using a fine-toothed comb after shampooing may exacerbate irritation and inflammation in seborrheic dermatitis.
B: Applying hydrocortisone 1% twice a day may provide temporary relief but is not a long-term solution for managing seborrheic dermatitis and can have side effects with prolonged
LPN exams medical-surgical practice questions, set 6 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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