Kaplan Qtrainer 1

The LPN/LVN cares for the client diagnosed with Clostridium difficile. The client has frequent, watery stools. Personnel are observed wearing gowns and gloves and washing hands. Which precaution does the LPN/LVN use when caring for this client? 1. Contact. 2. Airborne. 3. Standard. 4. Droplet.

1) CORRECT — Clostridium difficile requires contact precautions 2) used for measles, varicella zoster, tuberculosis 3) used for all clients at all times 4) used with conditions such as meningitis, pneumonia, diphtheria, pertussis, influenza

The LPN/LVN observes an increasing number of pressure ulcers in clients on the nursing unit. Additional observation identifies that the nursing assistive personnel (NAP) are turning clients every 3-4 hours instead of every 2 hours as is policy. The LPN/LVN recommends changes to the charge nurse for increasing the number of times the clients are turned each day. This is an example of which nursing role? 1. Client advocate. 2. Care planner. 3. Registered nurse role. 4. Provider of care.

1) CORRECT — a client advocate helps the organization improve itself and how it gives care for the betterment of the client 2) planning care is the responsibility of the RN with the help of all other health care providers 3) it is the responsibility of all health care providers to note where care is not appropriate and to brainstorm ways to improve care 4) when the nurse provides care, it is an implementation action; the activity in this question is the LPN/LVN advocating for better care

The LPN/LVN cares for the client diagnosed with terminal cancer of the esophagus. The client is comatose. The family says, "Please remove the tube feeding from my parent's stomach." Which document in the client's record determines if this is possible? 1. Living will. 2. Do not resuscitate order. 3. Informed consent. 4. Patient's Bill of Rights.

1) CORRECT — a living will identifies a client's wishes for end of life decisions; if the client can no longer speak for self, feeding tubes may be removed if that decision matches the client's wishes 2) a Do Not Resuscitate order is a directive given by the health care provider in accordance with a client's status, wishes, and family consent; provides death with dignity 3) informed consent is a document signed by the client or person with prescribed authority giving permission to do a procedure or give specific care 4) a Patient's Bill of Rights is a document by the American Hospital Association detailing what the client can expect from an institution regarding care

The LPN/LVN assists the client diagnosed with terminal cancer. The client tells the family, "Everything is fine and there will be no problems as soon as I get home." The LPN/LVN understands the client is using which coping response? 1. Denial. 2. Projection. 3. Suppression. 4. Displacement.

1) CORRECT — client is denying that death is coming 2) identifying problems as caused by something/someone else 3) conscious decision to exclude any painful thoughts 4) emotions about one thing expressed to/about something else

The LPN/LVN cares for the depressed client. The LPN/LPN notifies the RN when which observations are made? Select all that apply. 1. Client talks about ways to commit suicide. 2. Client gives away special possessions. 3. Client begins to make plans for the future. 4. Client talks about feeling helpless and hopeless. 5. Client wants to eat dinner with friends. 6. Client begins to abuse alcohol.

1) CORRECT — discussing suicide needs to be taken seriously 2) CORRECT — a classic sign of impending suicide attempt 3) positive signs of improved depression 4) CORRECT — discussing hopelessness and helplessness are signals of impending suicide attempt 5) increasing socialization is a positive sign of improvement 6) CORRECT — alcohol abuse may indicate deepening depression and possible suicide attempt

The LPN/LVN cares for the client diagnosed with type 2 diabetes mellitus. Which signs/symptoms listed in the history indicate the diagnosis of type 2 diabetes is correct? 1. Polyuria. 2. Polygastria. 3. Polydipsia. 4. Polyphagia. 5. Polycystia. 6. Polyneuropathy.

1) CORRECT — excessive urination because of excessive thirst 2) excessive secretion of flow of gastric juices 3) CORRECT — excessive thirst because of the hyperglycemia of diabetes 4) CORRECT — eating large amounts of food due to excessive hunger because of lack of absorption of nutrients 5) condition of having multiple cysts in an area of the body 6) a disease that affects many peripheral nerves in the body

The LPN/LVN assists a laboring multipara client who is 8 cm dilated, 90% effaced, and at +1 station. The client says, "I need to push now." Which action by the LPN/LVN is most appropriate? 1. Help the client with appropriate breathing exercises. 2. Request the RN give ordered pain medications. 3. Place client in knee-chest position. 4. Assist the client to the pushing position

1) CORRECT — feeling like pushing because presenting part pressing on perineum; not ready to push until 10 cm dilated and 100% 2) client not asking for pain medications; use breathing exercises 3) not appropriate unless client requests this position; used for prolapsed cord 4) client not ready to push until fully dilated and effaced

TThe LPN/LVN cares for the hospitalized client who sustained partial and full thickness burns to 30% of the body. Which order does the LPN/LVN question during the emergent phase of the thermal injury? 1. Administer analgesics by intramuscular injection. 2. Insert indwelling urinary catheter. 3. Insert a nasogastric tube to suction. 4. Initiate IV fluid therapy.

1) CORRECT — give by IV route as absorption is uneven through the muscle 2) indwelling urinary catheter helps with determining output and needed input 3) nasogastric tube helps prevent aspiration; client may develop paralytic ileus 4) client needs fluids rapidly

The LPN/LVN assists with a community program focusing on prevention of osteoporosis. Which interventions are included in the program? Select all that apply. 1. Encourage weight-bearing exercise. 2. Decrease intake of vitamin D. 3. Increase dietary calcium intake through dairy products. 4. Advocate the use of rubber mats in the shower. 5. Decrease foods and beverages containing caffeine. 6. Encourage smoking cessation methods.

1) CORRECT — increases bone density 2) increasing vitamin D helps with calcium absorption 3) CORRECT — increases bone strength 4) helps prevent falls, but not osteoporosis 5) CORRECT — caffeine is associated with phosphorus, which causes bone loss 6) CORRECT — smoking decreases bone density

The LPN/LVN cares for the 2-week-old infant diagnosed with patent ductus arteriosus. Surgical ligation is performed. The LPN/LVN notifies the RN that a complication has occurred if which observation is made? 1. Breath sounds are absent on the left side of the chest. 2. Respiratory rate is 40 breaths per minute. 3. Feet and hands are pink and warm. 4. Infant takes 4 ounces of formula at a feeding.

1) CORRECT — indicates a pneumothorax, a potential complication of the surgery 2) normal respirations are 30-60 per minute in the newborn 3) normal finding and may indicate successful surgery 4) normal amount of formula at this age; may indicate surgery was successful

The LPN/LVN observes the older client instilling prescribed eye drops directly onto the eyeball. Which response by the LPN/LVN is most appropriate? 1. "Let's use this mirror to see where to place the medication." 2. "You need to place the medication in the conjunctival sac." 3. "Didn't they show you how to do this correctly?" 4. "Are your hands steady enough to instill the medication?"

1) CORRECT — instructive, not confrontational; gives client something tangible to see 2) uses language client may not understand; not therapeutic communication 3) shames client; not therapeutic communication 4) assesses, but may cause concern by the client as to ability to care for self

The LPN/LVN identifies which client as being at highest risk for constipation? 1. Client with limited mobility. 2. Client taking digoxin. 3. Client with a colostomy. 4. Client drinking 3000 mL fluid per day.

1) CORRECT — mobility limitations increase risk for constipation 2) constipation not an adverse reaction to digoxin 3) more likely to have diarrhea than constipation 4) good fluid intake; unlikely to contribute to constipation

The LPN/LVN receives the results of a client's Papanicolaou (Pap) test. The results indicate a mild dysplasia. No infection is detected. The LPN/LVN anticipates which health care provider order? 1. Call the client to make an appointment for a repeat test in 8-12 weeks. 2. Refer the client to the specialty health care provider. 3. Call the client and schedule a repeat test in 2 weeks. 4. No order as this is a normal test result.

1) CORRECT — needs follow-up as this is an inconclusive result and continued care is required 2) health care provider will schedule a follow-up Pap test in 8-12 weeks before anything else 3) standard is to repeat the test in 8-12 weeks; may need a follow-up colposcopy 4) normal test result is negative or Class I

The LPN/LVN monitors the client receiving ceftazidime 750 mg every 8 hours IV as a secondary (piggyback). Which observation of the IV insertion site indicates it is safe for the medication to be administered? 1. The insertion site is normal skin temperature with no pain. 2. There is pain and inflammation at the insertion site. 3. The insertion site is pale and edematous. 4. There is erythema and warmth at the insertion site.

1) CORRECT — normal insertion site without problems 2) indicates possible infiltration or phlebitis 3) indicates possible infiltration or phlebitis 4) indicates possible infiltration or phlebitis

The LPN/LVN expect to give Rho(D) immune globulin in which situation? 1. Mother is Rh+ and baby is Rh+. 2. Mother is Rh- and baby is Rh+. 3. Mother is Rh+ and baby is Rh-. 4. Mother is Rh- and baby is Rh-.

1) Rh+ mothers not at risk for Rh problems 2) CORRECT — Rh- mothers at risk for Rh problems with next pregnancy if baby is Rh+ 3) Rh+ mothers not at risk for Rh problems 4) if both mother and baby are Rh-, no possible problems exist

The LPN/LVN assists with the IV for the client diagnosed with osteomyelitis. The IV is gentamicin every 8 hours. The client asks why this IV medication is necessary. The LPN/LVN's response is based on which understanding of the disease process? 1. Abscess formation may occur before complete healing. 2. Surgery may be required if inadequate healing occurs. 3. Chronic osteomyelitis is very hard to treat effectively. 4. Draining wounds are harder to heal than other wounds.

1) abscess formation is a complication of the disease; not expected 2) surgery may be required to remove bone fragments 3) CORRECT — prevention of chronic osteomyelitis is important because chronic osteomyelitis will cause recurrences throughout life 4) draining is expected from this wound and helps remove infected material

The LPN/LVN refers the client to several organizations because of a diagnosis of chronic obstructive pulmonary disease (COPD). The LPN/LVN knows the client understands the disease process when the client chooses which intervention first? 1. Vaccination clinic for influenza vaccine. 2. Support group for clients with COPD. 3. Dietitian to increase protein in the diet. 4. Smoking cessation classes.

1) an influenza vaccination should be given each year; not most important 2) a very helpful organization, but not most important 3) a high protein, high calorie diet is helpful, but not most important 4) CORRECT — smoking causes the most damage and the client needs to stop smoking as soon as possible

The LPN/LVN monitors the older client in the home after a transurethral resection of the prostate (TURP). Which observation causes the LPN/LVN to report possible abuse or neglect to the RN? 1. Client is seated in lounge chair and asks for food. 2. Client states it is difficult getting to the bathroom. 3. Client is wearing a soiled diaper and cries frequently. 4. Client only answers questions when asked.

1) appropriate if nearing meal time; neglect if no evidence of food given to client recently 2) appropriate; no evidence of neglect or abuse; frequently may need assistance following surgery 3) CORRECT — appears uncared-for; unexplained crying is sign of abuse/neglect 4) appropriate; no evidence of neglect or abuse; possibly not very talkative

The LPN/LVN cares for the client in the home. The client has a nasogastric tube for feedings. The family has been taught how to give the feedings. The LPN/LVN intervenes if which observation is made? 1. Caregiver aspirates gastric contents. 2. Caregiver discards gastric aspirate. 3. Caregiver checks expiration date on the formula. 4. Caregiver flushes tube with 45 mL tap water after feeding.

1) aspiration of gastric contents establishes tube placement and determines if feeding is being digested 2) CORRECT — gastric contents should be re-fed before feeding is begun; if residual is more than 150 mL, check orders for next step 3) important to check expiration date and time to assure safe feeding for client 4) tube should be flushed with 30-60 mL tap water after feeding to prevent clogging of tube

The LPN/LVN cares for the infant diagnosed with tetralogy of Fallot. The parents ask the LPN/LVN what parts of the heart this involves. Which response is most appropriate? 1. Atria, aorta, and superior vena cava. 2. Ventricles, ductus arteriosis, and aorta. 3. Pulmonary artery, ventricles, and aorta. 4. Atria, foramen ovale, and ventricles.

1) atria and superior vena cava are not involved 2) ductus arteriosis is not involved 3) CORRECT — there is pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and overriding aorta 4) atria and foramen ovale are not involved

The LPN/LVN cares for the client diagnosed with a cardiac dysrhythmia. The client is given verapamil. Which observation in the home is most important for the LPN/LVN to report to the RN? 1. Signs of bleeding and hemorrhage. 2. Apical pulse and blood pressure. 3. Coughing or wheezing. 4. Respirations and temperature.

1) bleeding and hemorrhage are not adverse effects of verapamil 2) CORRECT — a decreased pulse and blood pressure indicate the dosage may be too high 3) coughing and wheezing are not associated as adverse effects of verapamil 4) verapamil does not change the respirations or temperature

The LPN/LVN cares for the client with reduced vision due to untreated glaucoma. The LPN/LVN evaluates the home related to accident prevention. Which action is most important for the LPN/LVN to take? 1. Ask client to stop drinking alcohol. 2. Create a clear pathway to the bathroom. 3. Encourage daily leg exercises. 4. Paint all stairs the same color.

1) client unlikely to stop drinking if client used to drinking on occasion 2) CORRECT — clutter may lead to falls, especially if client hurries to the bathroom 3) all stairs should have sturdy banisters/hand railings to hold for safety 4) the top and bottom steps should be painted a different color from the rest of the steps for easy identification

The LPN/LVN assists the RN in preparing a presentation about normal changes in the respiratory system in the older adult. Which information does the LPN/LVN suggest? 1. Increase in alveolar surface for gas exchange. 2. Decreased tissue damage from smoking. 3. Reduced susceptibility to lung infections. 4. Weakening of the respiratory muscles.

1) decrease in alveolar surface 2) increased damage occurs with smoking 3) increased susceptibility to infections 4) CORRECT — respiratory muscles weaken

The LPN/LVN cares for the client who had abdominal surgery yesterday. The client is to sit in the chair for 30 minutes. Place steps for transfer in correct order beginning with the first step.

1) first, position chair next to bed 2) second, lower bed to lowest position 3) third, raise head of bed 4) fourth, help client swing legs off side of bed 5) fifth, assist client to stand 6) sixth, assist client to pivot and sit

The LPN/LVN reviews information about thyrotoxicosis with the client. Which interventions are recommended for the client diagnosed with thyrotoxicosis? Select all that apply. 1. Levothyroxine sodium. 2. IV fluids. 3. Antipyretics. 4. Warming blanket. 5. Corticosteroids.

1) give antithyroid medication because too much thyroid hormone is being released 2) CORRECT — need to increase fluids rapidly due to potential cardiovascular collapse 3) CORRECT — temperature may rise to 106°F (41.4°C) 4) the client's temperature is elevated; a cooling blanket would be used 5) CORRECT — anti-inflammatory agents

The LPN/LVN explains the immunization schedule to the new parents. Which immunizations are recommended to be given in the first 11 months of life? Select all that apply. 1. Hepatitis A. 2. Varicella. 3. Hepatitis B.. 4. Measles, mumps, rubella. 5. Rotavirus.

1) greater than 12 months of age 2) 12 to 15 months 3) CORRECT — birth and 2 months 4) 12 to 15 months 5) CORRECT — 2 months and 4 months

The LPN/LVN cares for the client diagnosed with type 2 diabetes mellitus. Which meal choice indicates the client understands the goal of a diabetic diet? 1. Hot dog with bun, peas, French fries, ice cream. 2. Lettuce salad with carrots, green peppers, onions, celery, and no fat dressing. 3. Lunchmeat sandwich on white bread, potato chips, squash, and 2 cookies. 4. Lettuce salad with grilled chicken and low fat dressing, whole wheat crackers, and pears.

1) high carbohydrate foods and elevated fats 2) no protein or fat and few carbohydrates 3) some protein, high fat, high carbohydrates 4) CORRECT — high fiber, protein, some carbohydrates and fats; balanced with fruits and vegetables

he LPN/LVN at a school prepares to teach a program prepared by the RN. The topic is hazards of substance abuse. The class is third grade children. Which concept is most important for the LPN/LVN to stress with this group? 1. It is okay to try new things if your classmates are doing it. 2. Drinking alcohol is okay if your parents agree. 3. If someone offers alcohol or drugs to you, just say no. 4. If alcohol or drugs are offered to you, check with your parents first.

1) lots of peer pressure; not acceptable to do things just because others are doing it 2) alcohol is not acceptable at this age, even in the home 3) CORRECT — best response at this age; not able to make judgments very well yet; still learning to think logically 4) hopefully, the parents would help the child understand, but children should be taught to say no on their own

The LPN/LVN instructs the client reporting frequency, urgency, and pain on urination. A midstream urine specimen is ordered. Which instruction is most important to give the client? 1. Start voiding, cleanse meatus after first 30 mL, collect specimen. 2. Empty bladder in toilet, then a catheter will collect the remaining urine. 3. Straight catheterize for sterile sample and collect all urine in bladder. 4. Cleanse meatus, start voiding, collect specimen after first 30 mL.

1) meatus is cleansed before urine stream started 2) test for residual urine; may not be any urine left 3) not appropriate for midstream sample 4) CORRECT — correct procedure

The LPN/LVN cares for the elderly client diagnosed with a urinary tract infection and dehydration. The health care provider writes numerous orders. Which order does the LPN/LVN delegate to the nursing assistive personnel (NAP)? 1. Administer trimethoprim/sulfamethoxazole 160 mg every 12 hours for 10 days. 2. Maintain diet high in potassium and magnesium. 3. Obtain intake and output every 4 hours for 8 days. 4. Assess for ambulation ability and need for physical therapy.

1) medication administration not a task for the NAP 2) requires knowledge of foods high in those minerals 3) CORRECT — routine task NAP is trained to complete 4) NAP can help with exercises after the assessment completed by physical therapy

The LPN/LVN identifies that the client requires assistance with bathing. Which observation helps the LPN/LVN know the client only needs partial help? 1. Client requires assistance of two persons to roll from side to side. 2. Client requires assistance to eat meals and has limited arm movement. 3. Client has right arm and left leg in traction and is unable to turn side to side. 4. Client has right leg in a cast and answers the phone.

1) much limitation in movement; unable to assist 2) unable to use arms to eat and so unable to bathe 3) may be able to help with washing face, but not much else 4) CORRECT — client able to do at least part of bath

The LPN/LVN assists the new postpartum client with breastfeeding. The LPN/LVN knows breastfeeding is successful if which observation is made? 1. Mother positions baby with head turned to breast. 2. Tip of nipple is fully in infant's mouth. 3. Mother forces infant's mouth open and places nipple inside. 4. Infant swallows after every 2-3 sucks.

1) need to position with whole body turned to breast 2) infant needs to have nipple and areola in mouth 3) should brush infant's cheek with nipple to start the rooting reflex 4) CORRECT — indicates milk is coming into the mouth

The LPN/LVN makes an assignment to the nursing assistive personnel (NAP) from these four clients. Which client assignment is appropriate for the NAP? 1. Client with a myocardial infarction who is constipated and needs an enema. 2. Client with a gastroduodenostomy who is to receive the first feeding. 3. Client with a total hip replacement who requires help with bathing. 4. Client with pneumonia who requires vital signs and lung assessment.

1) needs assessment during enema and defecation for pain or dysrhythmias 2) needs close monitoring for aspiration 3) CORRECT — NAP provides assistance with normal ADLs; no assessment required 4) NAP may do vital signs but not lung assessment

The LPN/LVN cares for the client whose order is for cefditoren 200 mg twice daily PO for tonsillitis. The LPN/LVN questions the order if which information is found in the client's history? 1. Allergy to aspirin. 2. Allergy to milk products. 3. Drinks alcohol 5 times every week. 4. Takes calcium supplements daily.

1) no interaction or cross allergy with aspirin 2) CORRECT — contains sodium caseinate and will cause a reaction; contraindicated for this client 3) alcohol not prohibited with this medication 4) calcium supplements not prohibited with this medication

The LPN/LVN assists the family caring for the client in the home. The client is diagnosed with Alzheimer's disease. Which family comment indicates a good understanding of the client's future? 1. "We can expect our parent to improve in the next several weeks." 2. "We need to place our parent in a long-term care facility immediately." 3. "If we add more foods with antioxidants to our parent's diet, we will see improvement." 4. "If we safety-proof the house, we can leave our parent for short periods of time."

1) no method of improvement is currently available; family should expect a steady decline in functionality 2) it depends on the family and their ability to care for the client in the home; an alternative is to employ persons to help with care in the home 3) foods high in antioxidants may help prevent Alzheimer's disease but will not reverse the disease process 4) CORRECT — the house needs to be safety-proofed before the client is left alone, even for short times; safety includes removing stove knobs and double-locking doors and windows

The LPN/LVN cares for the 4-year-old client receiving IV methotrexate. In which situation does the LPN/LVN request intervention by the RN? 1. Child becomes restless and wants food. 2. Child reports pain and a burning sensation at insertion site. 3. Child has diarrheal stool and vomits. 4. Child says head hurts and becomes dizzy.

1) no relation to IV therapy 2) CORRECT — IV likely infiltrated; requires intervention 3) adverse effects of medication and to be expected 4) adverse effects of medication and to be expected

The LPN/LVN observes the 1-hour-old newborn. Which vital sign causes the LPN/LVN to intervene? 1. Temperature 98.2°F (36.78°C) axillary. 2. Pulse 150 bpm. 3. Respirations 20 breaths per min. 4. BP 72/45 mm Hg.

1) normal temperature is 97.6 - 98.6°F (36.44 - 37°C) 2) normal pulse 120-160 bpm 3) CORRECT — normal respirations are 30-60 breaths per min; infant needs to be stimulated 4) normal BP 60-80/40-50 mm Hg

The LPN/LVN cares for the client who experiences vertigo. The client says, "I am afraid to go anywhere because of these attacks. I guess I will just live in the house." Which entry by the LPN/LVN in the client's record is most appropriate? 1. Client plans to stay in the house until vertigo is resolved. 2. Client is making plans to remain at home temporarily. 3. Client states, "I am afraid to go anywhere" due to vertigo. 4. Client is afraid of the vertigo and doesn't want to go out.

1) not accurate as client says nothing about resolution of the vertigo 2) not accurate because client says nothing about temporary aspect of plan 3) CORRECT — accurate restatement of what client said; appropriate documentation 4) while this is accurate, it is not the best documentation; include quotations of client whenever possible

The LPN/LVN cares for the client diagnosed with otitis media. Ampicillin is prescribed. The client says, "I don't want to take any antibiotics, just pain medications." Which action by the LPN/LVN is best? 1. Tell the client that antibiotics must be taken for healing. 2. Inform the health care provider of the client's wishes. 3. Request the family tell the client to take the antibiotics. 4. Let the client know care cannot be provided unless the antibiotics are taken.

1) not necessarily in this case; negates the client's right to refuse treatment 2) CORRECT — client has the right to refuse any treatment; LPN/LVN acts as client advocate 3) not appropriate action 4) not true or appropriate; coercion

The LPN/LVN observes the client on complete bed rest. The client becomes restless and irritable. The LPN/LVN takes which action? 1. Checks record for appropriate medication. 2. Assures client that ambulation will be possible soon. 3. Repositions client in bed. 4. Provides a snack for the client.

1) not necessary if repositioning is effective 2) may be false reassurance; does not help current restlessness 3) CORRECT — LPN/LVN recognizes need to reposition client 4) no indication the client is hungry; requires LPN/LVN to assess client needs

The LPN/LVN monitors the client diagnosed with a closed head injury. The LPN/LVN does a neurological check. Which items are included in the neurological check? Select all that apply. 1. Blood pressure and pulse. 2. Level of consciousness. 3. Motor function. 4. Ability to reason. 5. Pupillary response.

1) not part of the neurological check 2) CORRECT — change in level of consciousness is first indicator of neurological status 3) CORRECT — changes in ability to move is indicator of neurological status 4) very difficult to establish this ability; not part of the neurological check 5) CORRECT — reaction to light is an important part of the neurological check

The LPN/LVN cares for the client diagnosed with chronic bronchitis. Ipratropium by inhalation is prescribed. The LPN/LVN knows the client displays the desired effects of the medication when which observation is made? 1. Respirations increase from 10 to 18 breaths per minute. 2. Pulse rate decreases from 80 to 60 beats per minute. 3. Wheezing is no longer present. 4. Client reports decreased dizziness and headache.

1) respiratory rate should decrease from abnormal to normal range 2) pulse not usually affected by ipratropium 3) CORRECT — indicates lungs are clearing; expected effect 4) dizziness and headache are possible adverse effects, not desired effects

The LPN/LVN cares for the older client diagnosed with pneumonia. The client becomes restless and confused and tries to pull out the IV line and the catheter. The LPN/LVN anticipates which health care provider order? 1. Vest restraint. 2. Lorazepam 1 mg IM every 8 hours PRN. 3. Removal of IV and catheter. 4. Oxygen at 3 L/min by nasal cannula.

1) restraints are used as a last resort; if increased oxygen levels are not helpful, may need a restraint for the wrists only; vest restraint will not keep hands from tubes 2) sedation is a chemical restraint and likely to make the respiratory problems worse 3) client needs IV for fluids and medications; catheter necessary for I & O, especially if client confused 4) CORRECT — restlessness and confusion likely caused by low oxygen levels

The LPN/LVN cares for the client receiving cimetidine 300 mg every 6 hours PO. The LPN/LVN notifies the RN if which observation is made related to the cimetidine? 1. Client blood pressure changes from 128/70 mm Hg to 118/70 mm Hg. 2. Client reports blurred vision and a cough. 3. Client reports a dry mouth and difficulty urinating. 4. Client becomes confused and hallucinates.

1) small change not related to cimetidine 2) not related to cimetidine, but may require investigation as to the source 3) not related to cimetidine, but may require further investigation 4) CORRECT — adverse effects requiring further investigation

The LPN/LVN is ready to administer a pneumonia vaccine to the older client. The client says, "I never needed this before. Why do I need it now?" Which is the best response by the LPN/LVN? 1. "You will be exposed to more pneumonia germs as you get older." 2. "The medication helps you with the allergic response you have developed to the infection." 3. "You are taking a lot of medications now that may reduce your immune system response." 4. "Your immune system produces fewer cells that fight infection as you get older."

1) the exposure to pneumonia remains stable throughout life 2) pneumonia vaccine is not immunotherapy and there is no evidence of an allergic response to the infection 3) no indication the client is taking a lot of medications, although some medications may reduce the immune system response 4) CORRECT — the immune system declines as the person ages and fewer T and B cells are produced and those cells that are produced have less activity

The LPN/LVN assists the client with self-monitoring of blood glucose before breakfast. The glucose reading is 150 mg/dL. Which action does the LPN/LVN take next? 1. Gives breakfast to the client immediately. 2. Gives insulin according to the orders. 3. Reports the reading to the RN. 4. No action as this is a normal glucose level.

1) this is high for a fasting glucose reading 2) CORRECT — this is a high reading for a fasting glucose and needs to be covered by insulin before breakfast is given 3) reports to RN after giving insulin per sliding scale 4) normal fasting glucose is 60 to 100 mg/dL

The LPN/LVN assists the older client diagnosed with tuberculosis. The client is placed in isolation. Caregivers entering and exiting the room wear surgical masks and gloves. Which action does the LPN/LVN take? 1. None as this is the appropriate attire to use with this isolation. 2. Calls the house supervisor to obtain the required masks. 3. Informs the charge nurse that required masks are not being worn. 4. Notifies the health care provider to remove the client from isolation.

1) tuberculosis isolation requires all to wear N-95 respirator masks 2) the house supervisor is not the next person in the chain of command 3) CORRECT — follow chain of command to report behaviors not meeting standards 4) client needs to remain in isolation

The LPN/LVN cares for the client beginning to take fluphenazine. The teaching about the medication is effective if the client makes which statements? Select all that apply. 1. "I will use sunscreen and long sleeves if I need to be in the sun." 2. "If my mouth becomes dry, I will chew sugarless gum." 3. "When I get up from my chair or the bed, I can stand up right away." 4. "I can continue to enjoy my beer while I watch sporting events." 5. "I will add some salt to my foods when I prepare meals." 6. "I will stop taking this medication gradually when the health care provider says I can."

1."I will use sunscreen and long sleeves if I need to be in the sun." 2."If my mouth becomes dry, I will chew sugarless gum." 5."I will add some salt to my foods when I prepare meals." 6."I will stop taking this medication gradually when the health care provider says I can.

The LPN/LVN cares for the client diagnosed with diabetes insipidus and dehydration. An IV of 1000 mL normal saline is started. The order is for the IV to run in over 5 hours. If the drop factor is 15, how many drops per minute does the LPN/LVN calculate the IV must run? Do not round.

Ratio/Proportion: 1000 mL / 5 hours = x mL / 1 hour 1000 = 5 x x = 200 mL / hour 200 mL / 60 min X 15 gtts = 49.9999 or 50 gtt/min Dimensional Analysis: x gtt/min = 15 gtt / 1 mL X 1000 mL / 5 hr X 1 hr / 60 min X 1 min / 1 = 15,000 / 300 = 50 gtt/min

The LPN/LVN administers a nasogastric (NG) tube feeding by continuous drip. Place the steps of the procedure in the correct order starting with the first step.

Strategy: Think about giving a tube feeding. 1) first, check for tube placement 2) second, replace gastric content 3) third, clamp tubing and attach formula bag 4) fourth, unclamp tubing and prime tubing 5) fifth, set rate of feeding 6) sixth, flush tubing with 30-60 mL tap water