Random LPN Questions

Nurses care for clients in a variety of age groups. In which age group is the occurrence of chronic illness the greatest?

Older adults Chronic illness increases in older adults because of the multiple stresses of aging

An obese client with a hiatal hernia asks the nurse how to prevent esophageal reflux. What is the nurse's best response?

"Eat less food at each meal." Eating less food not only relieves intraabdominal pressure, but it promotes weight loss, which helps to decrease the tendency of gastric contents to reflux into the esophagus

A client was recently diagnosed with a cancerous lesion of the mouth. What should the nurse ask when analyzing the client's need for health education in relation to this health problem?

"Have you noticed any change in your appetite?" Problems involving the oral cavity often result in nutritional problems. The question "Have you noticed any change in your appetite?" will elicit more information.

The spouse of a client with an intracranial hemorrhage asks the nurse, "Why aren't they administering an anticoagulant?" How should the nurse respond?

"It is contraindicated because bleeding will increase." An anticoagulant should not be administered to a client who is bleeding because it will interfere with clotting and will increase hemorrhage.

The health care provider prescribes "bathroom privileges only" for a client with pulmonary edema. The client becomes irritable and asks the nurse whether it is really necessary to stay in bed so much. The nurse's best reply is:

"Rest helps your body direct energy to healing." A client's knowledge about the treatment program enhances compliance and reduces stress.

A client who just returned from a cardiac catheterization reports to the nurse that the pressure bandage on the right groin is tight. What action should the nurse take?

Assess the pulses distal to the dressing. Assessing the circulatory status of the extremity will determine whether the dressing is too tight.

A client has a tentative diagnosis of Cushing syndrome. The nurse's physical assessment of this client is likely to reveal the presence of:

Hypertension and moon face Increased glucocorticoids cause sodium and water retention, hypertension, and fat deposition, resulting in a moon face.

During a client's routine physical examination, a chest x-ray film reveals a lesion in the right upper lobe. What information in the client's history supports the health care provider's diagnosis of pulmonary tuberculosis?

Fever Night sweats Blood-tinged sputum Tuberculosis is an infectious disease in which recurrent fevers are present, usually in the late afternoon. Profuse diaphoresis at night (night sweats) is a classical sign of tuberculosis. Blood-tinged sputum (hemoptysis) results from pathophysiological trauma to mucous membranes.

A client has a Mantoux test as part of a yearly physical examination. The area of induration is 10 mm within 48 hours after having the test. The nurse concludes that this response indicates that the client has:

Been exposed to the tubercle bacillus Induration measuring 10 mm or more in diameter is interpreted as significant; it does not indicate that active tuberculosis is present.

The nurse observes a client collapse while walking down the hallway. The nurse rushes to the client and determines that the client is in cardiopulmonary arrest. What will the nurse do first?

Check for a carotid pulse According to the 2010 American Heart Association guidelines, assessing for a carotid pulse is the first step in CPR.

Which nursing interventions require a nurse to wear gloves?

Cleaning a newborn immediately after delivery and emptying a portable wound drainage system Personal protective equipment ( PPE) should be used because the newborn is covered with amniotic fluid and maternal blood. PPE should be used because the nurse may be exposed to blood and fluid that are contained in the portable wound drainage system.

A nurse is caring for a client who had major abdominal surgery one day ago. What factor increases the risk of this client developing a wound dehiscence?

Client being overweight Being grossly overweight is a predisposing factor to wound dehiscence because of decreased vascularity and fragility of adipose tissue and the added tension on the suture line. P

The nurse provides discharge teaching to a client with a history of angina. The nurse instructs the client to call for emergency services immediately if the client's pain:

Continues after rest and nitroglycerin When neither rest nor nitroglycerin relieves the pain, the client may be experiencing an acute myocardial infarction.

A nurse provides teaching for a client who is scheduled for a cholecystectomy. In the initial postoperative period, the nurse explains that the most important part of the treatment plan is:

Coughing and deep breathing The client who has a cholecystectomy will have difficulty taking deep breaths and coughing because of the location of the surgical incision.

A nurse is assessing a client and suspects diabetic ketoacidosis (DKA). What clinical findings support this conclusion?

Deep respirations and fruity odor to the breath Deep respirations and a fruity odor to the breath are classic signs of DKA because of the respiratory system's attempt to compensate by blowing off excess carbon dioxide, a component of carbonic acid.

When a client who had an above-the-knee amputation (AKA) complains of phantom limb sensations, the nursing staff should:

Describe the neurological mechanisms in language that the client understands Explanation of the underlying mechanism usually helps calm anxiety about a phantom pain experience.

A nurse is reviewing a client's plan of care. What is the determining factor in the revision of the plan?

Effectiveness of the interventions When the implementation of a plan of care does not produce the desired outcome effectively, the plan should be changed.

What effect of anxiety makes it particularly important for the nurse to reduce the anxiety of a client with heart failure?

Increases heart workload Irritability and restlessness associated with anxiety increase the metabolic rate, heart rate, and blood pressure; these complicate heart failure. Anxiety does not directly interfere with respirations; an increase in cardiac workload will increase respirations

A nurse is obtaining a history and performing a physical assessment of a client who has cancer of the tongue. Which clinical findings should the nurse expect to identify?

Leukoplakia Alterations in taste Enlarged cervical lymph nodes Leukoplakia are white, thickened patches that tend to fissure and become malignant; ulcerations in the mouth or on the tongue may indicate cancer. Taste buds in the tongue may be impaired, resulting in alterations in taste. Regional lymph nodes enlarge as cancer cells begin to metastasize.

The primary health care provider prescribes a transfusion of two units of packed red blood cells for a client. When caring for the patient receiving administering blood, the priority nursing intervention is to:

Make sure the blood is infused at a slow rate during the first 15 minutes A slow rate provides time to recognize a reaction that is developing before too much blood is administered.

A client comes to the emergency department reporting symptoms of the flu. When the health history reveals intravenous drug use and multiple sexual partners, acute retroviral syndrome is suspected, and a test for the human immunodeficiency virus (HIV) is performed. Which clinical responses are associated most commonly with this syndrome?

Malaise and Swollen lymph glands Development of HIV-specific antibodies (seroconversion) is accompanied by a flulike syndrome called acute retroviral syndrome. This syndrome includes malaise, swollen lymph glands, fever, sore throat, headache, nausea, diarrhea, muscle/joint pain, or a diffuse rash.

A client with a distal femoral shaft fracture is at risk for developing a fat embolus. The nurse considers that a distinguishing sign that is unique to a fat embolus is:

Petechiae In addition to obstructing vessels in the lung, brain, and kidneys with systemic embolization of small vessels from fat globules, petechiae are noted in the buccal membranes, conjunctival sacs, hard palate, chest, and anterior axillary folds; these adaptations only occur with a fat embolism.

A nurse assesses a client's serum electrolyte levels in the laboratory report. What electrolyte in intracellular fluid should the nurse consider most important?

Potassium The concentration of potassium is greater inside the cell and is important in establishing a membrane potential, a critical factor in the cell's ability to function

Before a cholecystectomy vitamin K is prescribed. Which element, formed in the presence of vitamin K, should the nurse determine is the purpose of administering this medication?

Prothrombin Vitamin K is necessary in the formation of prothrombin to prevent bleeding. It is a fat-soluble vitamin and is not absorbed from the gastrointestinal (GI) tract in the absence of bile.

A nurse must establish and maintain an airway in a client who has experienced a near-drowning in the ocean. For which potential danger should the nurse assess the client?

Pulmonary edema Additional fluid from surrounding tissues will be drawn into the lung because of the high osmotic pressure exerted by the salt content of the aspirated ocean water; this results in pulmonary edema.

Three days after a cast is applied to a client's fractured tibia, the client reports that there is a burning pain over the ankle. The cast over the ankle feels warm to the touch, and the pain is not relieved when the client changes position. The nurse's priority action is to:

Report the client's concern to the primary health care provider The client's concern indicates tissue hypoxia or breakdown and should be reported to the health care provider.

A client is admitted to the hospital after sustaining serious burns that involve a large surface of the skin. The nurse is caring for the client during the emergent phase after the injury. Which nursing objective is the priority during this phase?

Restore fluid volume In the first 48 hours after a severe burn, fluid moves into the tissues surrounding the injured area. Fluid also is lost in drainage and from evaporation; this fluid loss results in a decreased circulating blood volume, which can cause hypovolemic shock. Although pain relief is an important aspect in the care of clients with burns, the immediate priority is to replace fluid losses to prevent death

A client with dehydration suddenly becomes diaphoretic, clammy, and pale. The client's blood pressure falls to 50/30. The nurse should place the patient is what position?

Trendelenburg A Trendelenburg position allows blood supply to the head.