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LPN exams medical-surgical practice questions, set 7

LPN exams · medical-surgical

LPN exams medical-surgical practice questions set 7

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

Which of the following conditions is most likely to cause a patient to present with potentially reversible pulseless electrical activity on the monitor?

  1. A. Traumatic asphyxia
  2. B. Wolf Parkinson White syndrome
  3. C. The R-on-T phenomenon
  4. D. Tension pneumothorax
Show answer and rationale

Correct answer: D — Tension pneumothorax

The correct answer is D: Tension pneumothorax. This condition can lead to decreased venous return to the heart, causing decreased cardiac output and ultimately pulseless electrical activity. Tension pneumothorax is a life-threatening emergency that requires immediate intervention to relieve pressure on the heart and lungs. A: Traumatic asphyxia can cause compression of the chest and airway obstruction, leading to respiratory distress but not necessarily pulseless electrical activity. B: Wolf Parkinson White syndrome is a cardiac condition characterized by an accessory pathway for electrical conduction in the heart, which can cause arrhythmias but not typically pulseless electrical activity. C: The R-on-T phenomenon refers to a specific ECG finding where a premature ventricular contraction occurs on the T wave of the preceding beat, which can lead to ventricular fibrillation but is less likely to result in pulseless electrical activity compared to tension pneumothorax.

Question 2

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?

  1. A. The patient's attitude
  2. B. The patient's learning style
  3. C. The patient's nutritional status
  4. D. The patient's presurgical level of function
Show answer and rationale

Correct answer: A — The patient's attitude

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.

Question 3

A 72-year-old male patient has arrived at the outpatient unit to receive an infusion of alemtuzumab (Compath). The patient tells the nurse this is the second time his chronic lymphocytic leukemia has relapsed and the second time he will receive this drug because he failed alemtuzumab therapy after being treated with an alkylating agent. What is the nurse's priority action?

  1. A. Calling the physician and questioning the order
  2. B. Washing your hands
  3. C. Beginning an intravenous infusion
  4. D. Canceling the infusion
Show answer and rationale

Correct answer: A — Calling the physician and questioning the order

The correct answer is A: Calling the physician and questioning the order. This is the priority action because the patient's history of relapse and prior failure of alemtuzumab therapy after receiving an alkylating agent raises concerns about potential drug interactions, contraindications, or other issues that need to be clarified with the physician before proceeding with the infusion. It is crucial to ensure patient safety and the effectiveness of the treatment by confirming the appropriateness of the order. Summary of other choices: B: Washing your hands - While hand hygiene is important, it is not the priority in this situation. C: Beginning an intravenous infusion - Starting the infusion without clarifying the order and potential issues first could be harmful to the patient. D: Canceling the infusion - While canceling the infusion may be necessary depending on the physician's response, it is not the initial action to take without consulting the physician first.

Question 4

In a patient with a history of chronic iron deficiency anemia requiring a recent blood transfusion and an extensive GI work-up, which statement is true based on their medications?

  1. A. A dedicated small bowel series has a high likelihood of being positive
  2. B. 81 mg of aspirin per day decreases the benefit of using a COX II inhibitor
  3. C. The patient should have a provocative arteriogram with heparin infusion to identify the source of blood loss
  4. D. Hormonal therapy has been shown to be effective in decreasing blood loss due to arteriovenous malformations
Show answer and rationale

Correct answer: B — 81 mg of aspirin per day decreases the benefit of using a COX II inhibitor

The correct answer is B: 81 mg of aspirin per day decreases the benefit of using a COX II inhibitor. Aspirin, a non-selective COX inhibitor, can interfere with the action of selective COX II inhibitors by competing for the same binding site on the COX enzyme. This competition can limit the effectiveness of the COX II inhibitor in reducing inflammation and pain. This is particularly important in patients with a history of chronic iron deficiency anemia who may require NSAIDs for pain management. Option A is incorrect because a dedicated small bowel series may not necessarily be positive for identifying the source of blood loss in this patient. Option C is incorrect as a provocative arteriogram with heparin infusion is an invasive procedure and not typically indicated as a first-line investigation for blood loss in patients with iron deficiency anemia. Option D is incorrect as hormonal therapy is not typically used to decrease blood loss from arteriovenous malformations.

Question 5

A 35-year-old male patient presents with right upper quadrant pain, fever for the past 48 hours, preceded by new onset jaundice over the past few weeks. He states that he has had diarrhea on and off for several years but never had this investigated. A liver ultrasound is negative for gallstones or evidence of cholecystitis. His lab tests reveal total bilirubin 6.2, alkaline phosphatase 450, AST 150, ALT 120, albumin 2.6. The next diagnostic test of choice would be

  1. A. Liver biopsy
  2. B. Magnetic resonance cholangiopancreatography
  3. C. Hepatitis B surface antigen and hepatitis C RNA assay
  4. D. Colonoscopy with biopsies
Show answer and rationale

Correct answer: B — Magnetic resonance cholangiopancreatography

The correct answer is B: Magnetic resonance cholangiopancreatography (MRCP). Given the patient's clinical presentation of right upper quadrant pain, fever, jaundice, and abnormal liver function tests, MRCP is the next diagnostic test of choice to evaluate the biliary tree and pancreatic ducts for possible obstruction or structural abnormalities. This would help identify the cause of the patient's symptoms, such as biliary obstruction or choledocholithiasis. Choice A: Liver biopsy is not the next step in this scenario as the patient's symptoms are suggestive of a biliary or pancreatic etiology rather than a primary liver pathology. Choice C: Hepatitis B surface antigen and hepatitis C RNA assay may be relevant for evaluating viral hepatitis, but in this case, the patient's symptoms and lab results are more indicative of a biliary or pancreatic issue. Choice D: Colonoscopy with biopsies is not the next appropriate step as the patient's symptoms and lab results are not

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Question 6

A client has a wound on the lower leg that is covered with dry, yellow crusts. The nurse recognizes this as an indication of:

  1. A. Slough
  2. B. Eschar
  3. C. Granulation tissue
  4. D. Epithelial tissue
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Question 7

A client has a wound on the lower leg that is covered with dry, yellow crusts. The nurse recognizes this as an indication of:

  1. A. Slough
  2. B. Eschar
  3. C. Granulation tissue
  4. D. Epithelial tissue
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Question 8

Which information should the nurse discuss with the client diagnosed with seborrheic dermatitis of the scalp?

  1. A. Use a fine-toothed comb to comb out the hair after shampooing.'
  2. B. Apply hydrocortisone 1% to the scalp area twice a day.'
  3. C. Rotate two or three different types of shampoos daily.'
  4. D. Dry the hair using the high heat setting for at least 5 minutes.
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Question 9

What is the primary function of anaphylotoxins (e.g., C3a, C4a, C5a) in the immune system?

  1. A. Suppressing inflammation
  2. B. Facilitating antigen presentation
  3. C. Inducing inflammation and recruiting immune cells
  4. D. Neutralizing pathogens
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Question 10

What is the immunologic term to indicate the process that eliminates developing T cells whose T-cell receptors bind too strongly to self-peptide/MHC complexes?

  1. A. Negative selection
  2. B. Positive selection
  3. C. Peripheral tolerance
  4. D. Lineage commitment
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Question 11

The nurse is preparing a patient to receive immunosuppressant drugs on an outpatient basis. What is the priority for the nurse to arrange for this patient in the home environment?

  1. A. A caregiver who is skilled in cardiopulmonary resuscitation (CPR)
  2. B. A caregiver who will provide adequate nutrition
  3. C. Supportive care and comfort measures
  4. D. Arrange for a home care nurse to administer injections
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Question 12

The skin accounts for what percentage of the body weight?

  1. A. 2%
  2. B. 10%
  3. C. less than 2%
  4. D. 7%
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Question 13

Administer a mantoux skin test to a client- inform the client that the purpose of a mantoux skin test using purified protein derivative is to do which of the following?

  1. A. Decrease the hypersensitivity of the client's reaction to PPD- it's not a vaccine and therefore, cannot decrease hypersensitivity to purified protein derivative
  2. B. Provide immunity against tuberculosis
  3. C. Identify if a client has been infected with mycobacterium tuberculosis- identify individuals who have been infected
  4. D. Detect active tuberculosis infection immediately
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Question 14

A client with myelogenous leukemia is receiving an autologous bone marrow transplantation (BMT). What is the priority intervention that the nurse should implement when the bone marrow is repopulating?

  1. A. Administer sargramostim (Leukine, Prokine).
  2. B. Infuse PRBC and platelet transfusions.
  3. C. Give parenteral prophylactic antibiotics.
  4. D. Maintain a protective isolation environment.
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Question 15

Aspirin is prescribed for a 9-year-old child with rheumatic fever to control the inflammatory process, promote comfort, and reduce fever. What intervention is most important for the nurse to implement?

  1. A. Instruct the parents to hold the aspirin until the child has first had a tepid sponge bath.
  2. B. Administer the aspirin with at least two ounces of water or juice.
  3. C. Notify the healthcare provider if the child complains of ringing in the ears.
  4. D. Advise the parents to question the child about seeing yellow halos around objects.
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About these LPN exams medical-surgical questions

LPN exams medical-surgical practice questions, set 7 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.

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