Q-Bank (SET B)

The LPN/LVN monitors the client's intravenous infusion. The order is for 1,000 mL D5W to infuse over 6 hours. The drip factor is 15. The LPN/LVN knows the IV is infusing correctly if how many drops per minute are dripping?

Ratio/Proportion 1,000 mL / 6 hr = 166.6666 mL/hr 166.6666 / 60 min X 15 = 2.777777 X 15 = 41.66666 or 42 gtt/min Dimensional Analysis x gtt/min = 15 gtt / 1 mL X 1,000 mL / 6 hr X 1 hr / 60 min X 1 min / 1 = 15,000 / 360 = 41.6666 or 42 gtt/min

The client diagnosed with irritable bowel syndrome is to receive mesalamine 1,000 mg daily divided in 2 doses. The medication is available in 250 mg capsules. How many capsule(s) does the LPN/LVN give the client for each dose? Do not round. Place the number in the blank.

Ratio/Proportion 1,000 mg / 2 doses = 500 mg per dose 500 mg / 250 mg = 2 capsules Dimensional Analysis x capsules = 1 cap / 250 mg X 1,000 mg / 2 doses X 1 dose / 1 = 1,000 / 500 = 2 capsules

The LPN/LVN cares for the client at home. The client has limited mobility and spends much of each day sitting in a reclining chair. Which is the most important recommendation for the LPN/LVN to make for this client? 1. Get up to the bathroom every hour and walk around the room. 2. Change the angle of recline and shift position every 2 hours. 3. Lie down for two hours every two hours. 4. Buy a lift chair to make getting up easier.

Strategy: "Most" indicates discrimination is required. Think about immobility and the results. 1) toileting every hour is too often and the client is likely to be unable to walk that much 2) CORRECT — moving and changing position helps prevent pressure areas on hips and upper legs 3) lying down for 2 hours every 2 hours will interfere with other activities and is impractical 4) a lift chair may be helpful but is not the priority action, and finances may prohibit the purchase of this type of chair; it does not help with pressure areas

The LPN/LVN cares for the client who is 18 weeks pregnant. The client asks about the changes occurring in the cardiovascular system. Which information does the LPN/LVN give the client? Select all that apply. 1. Blood volume increases significantly. 2. Blood pressure rises during first trimester. 3. Cardiac output decreases in second trimester. 4. Hemoglobin decreases during pregnancy. 5. White blood cells increase in last two trimesters. 6. Heart rate decreases in third trimester.

1) CORRECT — blood volume increases by 40-50% 2) no blood pressure increase should occur in first trimester 3) cardiac output increases throughout pregnancy 4) CORRECT — hemoglobin decreases as the plasma increases 5) CORRECT — there is an increase in the white cell count after the first trimester 6) the heart rate increases slightly throughout pregnancy

The LPN/LVN monitors the adult client for signs of infection. The client has pruritus with constant scratching. Which observation requires the LPN/LVN to notify the RN? 1. Temperature 101.8oF (38.78oC). 2. Pulse 88 bpm. 3. Respirations 14 breaths per minute. 4. Blood pressure 118/72 mm Hg.

1) CORRECT — temperature increase above 100oF (37.78oC) indicates a possible infection 2) pulse is within normal range of 60-100 bpm 3) respirations are within normal range of 12-20 breaths per minute 4) blood pressure is within normal of 120/80 mm Hg

The LPN/LVN cares for the client having difficulty becoming pregnant. The LPN/LVN knows which lifestyle behavior may be contributing to infertility for both the client and the partner? 1. Inadequate exercise. 2. Eating large amounts of protein. 3. Smoking. 4. Drinking small amounts of caffeine.

1) inadequate exercise is not likely a cause of infertility 2) large amounts of protein is not likely a cause of infertility 3) CORRECT — smoking may cause problems with ovulation and sperm production 4) large amounts of caffeine have been linked with possible infertility

The client begins using pilocarpine hydrochloride for open-angle glaucoma. The LPN/LVN observes the client for which reaction? 1. Irritation of eyelids or eye. 2. Diarrhea and loss of appetite. 3. Changes in vision including blurring. 4. Headache, pruritus, and chest pain.

1) irritation is not an adverse effect of pilocarpine 2) diarrhea and changes in appetite are not adverse effects of pilocarpine 3) CORRECT — visual changes are adverse effects of pilocarpine and the medication may need to be changed 4) these are not adverse effects of pilocarpine

The LPN/LVN visits the client in the home. The client is hearing and visually impaired and requires assistance with activities of daily living. The LPN/LVN observes the client in bed in dirty clothing with a soiled adult diaper. The refrigerator is empty. No care giver is present. The client asks for food and water. Which action does the LPN/LVN take next after giving the client water? 1. Contacts adult protective services. 2. Calls the client's health care provider. 3. Asks the RN to make a home visit. 4. Requests a home health aide be provided.

1) CORRECT — any suspected elder abuse and/or neglect is reported to adult protective services immediately 2) the first action is to contact adult protective services; the health care provider would be required to do the same 3) a home visit by the RN may be appropriate as a next step but would slow the process of getting help for the client 4) a home health aide may be appropriate, but not as the first step

The LPN/LVN cares for the older adult who retains fluid in the lower extremities. The health care provider orders compression stockings to be worn during the day. The LPN/LVN assists the client with practicing how to apply the stockings. Which client statement indicates the client understands the application process? 1. "I will put the stockings on before I get out of bed in the morning." 2. "I can take the stocking off while I am sitting quietly in my chair." 3. "I can take the stockings off when I need to wash them." 4. "I will put my foot in and then pull the rest up to my knees.

1) CORRECT — apply stockings before arising to prevent edema from forming 2) sitting places legs in dependent position and edema is likely to form 3) the client needs two pairs so one can be washed while wearing the other pair 4) the client needs to roll the leg part on; pulling the stocking on is very difficult

The LPN/LVN cares for the newborn infant with a respiratory infection. The infant remains in the hospital after the mother has been discharged. The LPN/LVN takes which precaution to prevent abduction? 1. Compares the names and numbers on the newborn's bracelet with the parent's bracelet. 2. Asks the parent to give the newborn's name and birth date before holding the child. 3. Requests the parent show the newborn's birth certificate before rocking the child. 4. Allows the grandparent to hold the newborn when the parent gives verbal permission.

1) CORRECT — discharged parents must retain the bracelet so comparisons can be made to ensure only authorized persons handle the newborn 2) asking the name and birth date is not a sufficient safeguard for newborn identification 3) the birth certificate does not provide safeguards; birth certificates are usually not provided to parents until at least 6 weeks after birth 4) the parent must first be identified before any permissions can be granted; this is not a primary prevention

The psychiatric client hallucinates and decides to stop taking the antipsychotic medications. Which is the priority action for the LPN/LVN to take? 1. Discuss the treatment plan with the client and respect the client's wishes. 2. Tell the client the medication is required if treatment is to be continued. 3. Inform the health care provider the client is ready to terminate treatment. 4. Force the client to take the medication because the client signed the treatment consent.

1) CORRECT — every client has the right to make treatment decisions unless that decision is likely to cause harm to the client or someone else 2) every client has the right to refuse treatment including medication; refusal does not mean treatment will not be given 3) the client has not decided to terminate treatment, only the medication 4) the client cannot be forced to take medication unless it is absolutely necessary to prevent harm to the client or others

The LPN/LVN cares for the client who experiences difficulty sleeping. Which findings contribute to the client's sleep issues? Select all that apply. 1. Client's bedroom is kept at a very warm temperature. 2. Client reads books for an hour before bedtime. 3. Client eats large amount of food before bedtime. 4. Client exercises for an hour before going to bed. 5. Client drinks warm milk before going to bed. 6. Client practices relaxation exercises before going to bed.

1) CORRECT — extreme temperatures may make sleep difficult 2) reading will encourage sleep for most people 3) CORRECT — eating a large meal just before bed often causes sleep difficulties 4) CORRECT — exercising increases heart rate and adds endorphins which make sleep difficult 5) warm milk helps with sleep for most people 6) relaxation helps with sleep

The LPN/LVN assists with planning an in-service program for staff about chronic kidney failure. Which nursing interventions does the LPN/LVN recommend for inclusion in the program? Select all that apply. 1. Control fluid and electrolyte balance. 2. Preserve protein stores. 3. Provide diet high in calories. 4. Prevent injury to the integument. 5. Provide diet high in potassium. 6. Provide salt substitutes for meals.

1) CORRECT — fluid and electrolyte balance is required to protect the client from loss and excess of any component 2) CORRECT — protein is needed but produces products the kidneys need to clear and have little capacity to do so 3) CORRECT — client needs between 2,500 and 3,000 calories daily; most should come from carbohydrates and polyunsaturated fats 4) CORRECT — skin needs to be protected to prevent injury and infection 5) potassium needs to be restricted as it builds up in the system 6) salt substitutes are usually potassium based and should not be used; the client needs some sodium

The LPN/LVN participates on a home health care agency committee tasked with keeping costs low. There has been a rise in infections in diabetic clients recently. The committee determines which action is appropriate to present to the unit? 1. Assist clients to maintain good glycemic control. 2. Provide education for home health nurses about infection management. 3. Teach good hand washing practices to all care givers. 4. Promote liberal use of antibiotics as prevention measures.

1) CORRECT — good glycemic control helps prevent complications of diabetes such as infections 2) management of infections is not prevention; the focus needs to be on preventing infections 3) while good hand washing is appropriate, it is not the most important 4) antibiotics are not used as prevention measures

The LPN/LVN cares for the 2-year-old child with croup. The child's grandparent tells the LPN/LVN the child's parent is in jail and the child has been living with the grandparent. The grandparent asks for specific information about the child's care and treatment. There is no authorization in the record for the grandparent to be given information. Which is the priority action for the LPN/LVN to take? 1. Tell the grandparent that no information can be given without authorization. 2. Talk to the charge nurse about getting authorization for the grandparent. 3. Try to call the parent to see if the parent is in jail and if authorization can be obtained. 4. Ask the house supervisor to talk to the grandparent and explain the situation.

1) CORRECT — it is unclear if the parent is in jail or not; authorization is needed to give information to persons not authorized to receive it; the child's confidentiality needs to be protected 2) the priority is to keep the child's information confidential; if authorization is obtained, then information can be given to the grandparents 3) the priority is to keep the child's information confidential; the authorization needs to be obtained before any information is given to the grandparent 4) talking to the supervisor is not the first action; it may be necessary if the grandparent becomes out of control

The client reports having difficulty sleeping while hospitalized. The LPN/LVN helps plan care for the client. Which implementations does the LPN/LVN recommend? Select all that apply. 1. Dim the lights in the client's room. 2. Assist the client into a comfortable position. 3. Encourage client to exercise just before bedtime. 4. Provide client with a comfortable environmental temperature. 5. Assure client is not in pain. 6. Keep night light on and door open.

1) CORRECT — keep the room as dark as possible for best sleep 2) CORRECT — the position of comfort will help the client sleep 3) exercise should happen earlier in the day as exercising just before bedtime increases metabolism and results in difficulty sleeping 4) CORRECT — an environment that is too cold or hot makes sleep difficult 5) CORRECT — pain will keep the client awake 6) night lights are important for both client and staff; the door should be closed to prevent outside noises

The LPN/LVN cares for the client following thyroid removal due to cancer. The client chooses foods that contain no pork and only meats that are halal. When told not to drink alcohol with a certain medication, the client states no alcohol is consumed. The LPN/LVN knows this client practices which faith? 1. Islam (Muslim). 2. Jehovah's Witness. 3. Roman Catholic. 4. Quaker.

1) CORRECT — meat must be killed and blessed in a certain way; no pork or alcohol are allowed 2) no restriction of meats is practiced; persons are discouraged from using alcohol and tobacco 3) there are no dietary restrictions except during Lent for some individuals 4) there are no dietary restrictions

The LPN/LVN assists with student health assessments. The class of 7 years olds is evaluated for abnormalities. Which assessment information causes the LPN/LVN to identify a child for further observations? Select all that apply. 1. Respiratory rate is 35 breaths per minute. 2. No increase in height or weight from previous year. 3. Collects "treasures" for safe keeping. 4. Plays soccer at recess. 5. Poor fine motor coordination. 6. Falls that cause scrapes and abrasions to the knees and elbows.

1) CORRECT — respiratory rate should be between 22 and 24 2) CORRECT — the child should increase about 2 inches and 4.5 to 6.5 pounds each year 3) collecting treasures is normal, expected behavior 4) playing sports is normal behavior; the child need to exercise to grow muscles and bones properly 5) CORRECT — by age 7, the child should have a steady hand ready to print words 6) falls are common at this age as motor coordination is not yet complete

The LPN/LVN visits the client in the home. The client is visually and hearing impaired, uses a walker to ambulate, and has fallen several times in the past week. Which observations indicate the environment is safe for the client? 1. There are no rugs on the floor, the shoes have rubber soles, and there is adequate lighting in the bathroom. 2. The top and bottom steps are painted the same color as the stairs, and a light flashes when the door bell is rung. 3. The bathroom is free of grab bars and rugs, there is a path between furniture, and the phone has large numbers. 4. There are bath mats in the shower, there are electric cords strung around the room for adequate lighting.

1) CORRECT — rugs can be trip hazards, rubber soled shoes provide stability and prevent slipping, and adequate lighting helps prevent tripping and falling 2) the top and bottom steps should be of a different color from the other stairs to help distinguish these steps and a flashing light helps with hearing impairment when someone comes to the door 3) grab bars should be installed around toilets and in showers or tubs, clutter should be removed to provide room to move about the room, and large numbers on the phone help with vision impairment 4) bath mats help prevent falls, and electric cords should be moved to the edges of the room and secured to prevent tripping and falling

The LPN/LVN evaluates the client for possible community assistance. The client who lives alone has limited vision and hearing and uses a walker to ambulate. Which recommendation does the LPN/LVN most likely make for this client? 1. Home delivery of meals. 2. Health aide for bathing. 3. Financial counseling services. 4. Companion.

1) CORRECT — the client likely has difficulty preparing meals and inadequate nutrition may be an issue 2) the client is not likely to need help with bathing; make sure the bathroom is safe and the client can manage 3) there is no information to indicate help is needed with finances but the LPN/LVN may need to assess this 4) a companion may be helpful, but not the most likely need

The client receives 30 mg of prednisone daily for 6 weeks. The client asks the LPN/LVN when to take the recommended zoster vaccine. Which response is most appropriate? 1. Wait for at least 1 month after discontinuing the prednisone. 2. May have the vaccination at any time. 3. Check with the health care provider for vaccination schedule. 4. Follow recommendations of the local immunization clinic.

1) CORRECT — the client needs time for the immune system to return to normal functioning before the immunization is effective 2) immunizations should be at least 1 month after the last prednisone unless directed by health care provider 3) the vaccination schedule set by the CDC indicates to wait 1 month after last prednisone 4) the local immunization clinic should use CDC guidelines

The LPN/LVN cares for the client who sustained a head injury. The client was hospitalized and is now home. The LPN/LVN makes a home visit to evaluate the neurological status. Which observations indicate the client has neurological impairment? Select all that apply. 1. Oriented X 2. 2. Short-term memory accurate. 3. Unable to calculate simple math. 4. Able to move all four extremities. 5. Pupils equal and constrict rapidly. 6. Glasgow Coma Scale score of 11.

1) CORRECT — the client should be oriented X 4 (person, place, time, and purpose) 2) intact short-term memory does not indicate neurological impairment 3) CORRECT — the client should be able to do simple math problems such as 100-75 = 25 4) the ability to move all extremities does not indicate neurological impairment 5) pupils that are unequal or do not constrict to bright light indicate neurological impairment 6) CORRECT — a Glasgow Coma Scale score of less than 15 indicates some degree of neurological impairment

The LPN/LVN assists the RN with a blood transfusion for the client following a childbirth hemorrhage. Which is the most important observation for the LPN/LVN to make? 1. Frequent blood pressure during the first 15 minutes. 2. Tubing was flushed with NS solution before starting blood. 3. Client was NPO for 4 hours before blood is started. 4. Indwelling urinary catheter was inserted before blood started.

1) CORRECT — the first 15 minutes is the time when a reaction is most likely to occur 2) correct fluid for flushing tubing but this is not within the scope of practice for the LPN/LVN 3) NPO is not necessary 4) catheter is not required; however, it would be helpful if client unconscious or unable to void

The LPN/LVN gives a vaccination to the client at the clinic. The client suddenly begins to have difficulty breathing, becomes apprehensive, and hives appear on the arms and legs. Which nursing action is the priority for the LPN/LVN to take? 1. Inject epinephrine 1:1000 per protocol. 2. Obtain a set of vital signs. 3. Instruct client to wear medical alert identification. 4. Provide epinephrine pen for client to carry.

1) CORRECT — these are signs of anaphylaxis; treat immediately with epinephrine and summon medical assistance or take to emergency department 2) obtaining vital signs is important, but not the priority 3) this is important for the future, but not the priority at this time 4) this is important for the future, but not the priority right now

The LPN/LVN observes dark, concentrated urine; rapid, weak, thread pulse; and a slight temperature elevation in the client. The older client reports weight loss, dizziness, weakness, constipation, and dry skin. Which action is the priority for this client? 1. Plan for increased fluid intake. 2. Anticipate orders for full cardiac workup. 3. Request a physical therapy consultation. 4. Consult with the dietitian.

1) CORRECT — these are signs/symptoms of dehydration in the elderly client 2) these signs/symptoms are probably not related to cardiac problems; dehydration is common in the elderly client 3) physical or occupational therapy may be required if the client is unable to obtain, pour, or drink easily alone 4) a dietary consult is not the priority although it may be helpful to determine appropriate intake of fluids

The LPN/LVN and the nursing assistive personnel (NAP) care for a group of clients. Which client tasks does the LPN/LVN assign to the NAP? Select all that apply. 1. Assisting the client diagnosed with a stroke and who needs help eating. 2. Ambulating the client in the hallway on the second day after surgery. 3. Assisting the health care provider with a dressing change. 4. Providing medicated eye drops to the client diagnosed with glaucoma. 5. Emptying the indwelling urinary catheter bag and recording on I & O sheet. 6. Assisting the new diabetic client to order meals for the day.

1) CORRECT — this is a standard, unchanging procedure requiring no judgment 2) CORRECT — this is a standard, unchanging procedure requiring no judgment 3) assisting the health care provider may require judgment and is not a standard procedure 4) medications are not a task for the NAP and requires a licensed person 5) CORRECT — this is a standard, unchanging procedure requiring no judgment 6) planning a menu requires supervision and assessment to determine understanding about nutrition

The client has an indwelling urinary catheter and a peripheral IV line. During the previous 8 hours, the client has become confused and pulled both the catheter and IV line out twice. No persons are available to stay with the client constantly. The health care provider orders wrist restraints for the client for 24 hours. Which is the responsibility of the LPN/LVN regarding the restraints? 1. Document loosening of restraints and position change at least every 2 hours. 2. Tie restraints to the bed side rails and remove every 2 hours. 3. Document changing wrist restraints to vest restraint when sitting in chair. 4. Tie restraints as tightly as possible to the wrists to prevent removal.

1) CORRECT — this is appropriate care and documentation; agency policy must be followed, but these actions must be done at least every 2 hours 2) restraints must be tied to the bed frame, not the bed rails 3) use only the restraint ordered by the health care provider; new orders are needed to change the type of restraint; the least restrictive restraint must be used 4) tie restraints snugly, but not tightly as this can decrease circulation to the wrists

The LPN/LVN cares for the client diagnosed with severe diarrhea. The client has an IV of normal saline for rehydration. The LPN/LVN reports probable rehydration to the RN when which observation is made? 1. Urine specific gravity is 1.015. 2. Skin is shiny and smooth. 3. Urine output is 15 mL per hour. 4. Ordered IV volume is infused.

1) CORRECT — this specific gravity is within the normal range for hydration 2) this is not related to hydration; skin turgor is often used as a measure of hydration 3) normal urine output is about 30 mL per hour so this would be dehydration 4) infusing the volume does not indicate rehydration and the client may need more fluids

The LPN/LVN cares for the client who reports very itchy skin on the right arm. It is determined there is no underlying cause, and the itching is related to stress the client is experiencing. Which observation indicates to the LPN/LVN the client's stress is resolving? 1. The client stops scratching the arm. 2. The client begins to scratch the legs. 3. The client begins to sleep during the day. 4. The client uses lotion to soothe the skin.

1) CORRECT — when scratching stops, itching is resolving and since the cause is stress, the stress is resolving also 2) scratching the leg indicates increased stress as a new area is becoming itchy 3) while sleepiness may indicate stress resolution, it is not part of the client's problem; sleepiness may be due to other causes 4) soothing the skin with lotion may decrease the itchiness, but does not indicate stress reduction

The LPN/LVN cares for clients on the postpartum unit. In which situation does the LPN/LVN complete an incident report? 1. Every 4 hour PRN medication given after 5 hours. 2. Baby sleepy and did not take feeding at 10:00. 3. Baby A given to mother B during 03:00 feeding. 4. Mother has hematoma in perineal area 6 hours postpartum.

1) PRN medications can be given at any time after the allotted time frame 2) babies do not always eat when given to the mother for feeding; this is not an incident 3) CORRECT — babies given to the incorrect mother constitutes an incident and should be documented in the client record and an incident report completed 4) hematomas, while uncomfortable, are not considered incidents and occur frequently; document in the client record

The LPN/LVN assists the family caring for the client in the home. The client is immobilized due to multiple fractures. It is most important for the LPN/LVN to reinforce teaching the family to use which equipment? 1. Gait belt. 2. Roller board and slider. 3. Mechanical lifting device. 4. Transfer chair.

1) a gait belt is used for helping the client ambulate; this client is immobile 2) a roller board or slide is used to move the client from one flat surface to another flat surface; this is unlikely needed in the home 3) CORRECT — mechanical lifting devices help move the client from bed to chair or other place in the most ergonomical way; this prevents caregiver injury 4) a transfer chair is used to move the client out of the home to ambulance, or other conveyance; it is not likely used by family

The LPN/LVN cares for the client with an IV and patient-controlled analgesia (PCA) pump. The LPN/LVN observes the PCA pump cord has gotten caught under the bed wheels. The cord is freed from the wheel. Which information is most important for the LPN/LVN to determine? 1. If the wheel is straight under the bed. 2. If there are any breaks in the cord. 3. If the pump continues to function. 4. If the bed is plugged into the socket.

1) a straight wheel is not important at this time 2) CORRECT — breaks in the cord could result in an electrical shock hazard 3) the pump may continue to function even if there is a break in the cord; this is not the most important 4) the bed plugged in is not the most important at this time

The 5-year-old child is hospitalized with a diagnosis of complications of pertussis. The LPN/LVN plans for which type of care? 1. Negative pressure room, wear N-95 mask. 2. Private room, wear gloves and gowns. 3. Standard room, wear protective eyewear. 4. Private room, wear mask in room.

1) airborne precautions are not required for pertussis 2) contact precautions are not required for pertussis 3) standard precautions are not sufficient for pertussis 4) CORRECT — pertussis requires droplet precautions, which include a private room, personal mask, and mask on the client when transporting outside the room

The older client takes warfarin following a pulmonary embolism. The LPN/LVN reinforces teaching about the medication when which client statement is made? 1. "I will not drink alcohol with this medication." 2. "I will take ibuprofen when I get a headache." 3. "I will not eat much asparagus, broccoli, or spinach." 4. "I will stop taking the garlic and ginger I have been taking."

1) alcohol may decrease the action of warfarin 2) CORRECT — ibuprofen may cause increased bleeding and increases effects of warfarin 3) large amounts may decrease effects of warfarin because they contain vitamin K 4) garlic and ginger increase bleeding risk when taken with warfarin

The LPN/LVN cares for clients in the psychiatric inpatient unit. The clients are offered yearly influenza immunizations. One client asks, "Why do we need to have a flu vaccination every year? Shouldn't one every 10 years be enough?" Which response by the LPN/LVN is most important? 1. "Your body only makes antibodies every year, so you need a new one." 2. "You only need protection during flu season which occurs in the fall." 3. "Because we think it is best for all clients in this unit." 4. "The strains of influenza change and evolve every year."

1) antibodies are produced all the time when antigens are encountered 2) influenza is present at all times and protection is helpful all year; flu season is most common during fall and winter 3) this is not therapeutic; it is condescending and authoritative 4) CORRECT — influenza is a virus that changes through time; many different viruses are in the environment and the yearly vaccination tries to incorporate the most likely viruses to be prevalent that year; this response gives appropriate information and answers the question

The client asks the LPN/LVN, "Which immunizations do I need? I am 65 years old next month." Which action does the LPN/LVN take next? 1. Asks the health care provider to give the client information about immunizations. 2. Gives the client a pamphlet about immunizations found in the clinic file. 3. Tells the client to ask the health care provider when they meet later. 4. Accesses the CDC website

1) asking the health care provider is passing the buck; the LPN/LVN can access the current information 2) the pamphlet may not be current; the LPN/LVN can access the current information 3) having the client ask the health care provider is passing the buck; the LPN/LVN can access the current information 4) CORRECT — the government website gives the current immunization schedules for adults and children and is kept up to date as changes are made; https://www.cdc.gov/vaccines/schedules.

The LPN/LVN assists the RN with planning an accident prevention program for parents of school-aged children. Which information does the LPN/LVN suggest for inclusion in the program? Select all that apply. 1. Use rear-facing car seat until age 4. 2. Wear appropriate helmet for bicycle riding. 3. Keep small objects away from child. 4. Supervise child when swimming. 5. Keep all firearms unloaded and in a locked cabinet. 6. Teach children to say "no" to drugs or alcohol.

1) car seats are not appropriate for school-aged children 2) CORRECT — helmets should always be used when riding a bicycle 3) keeping small objects away is not appropriate for school-aged children 4) CORRECT — children need to be supervised when swimming, including when lifeguard is present 5) CORRECT — firearm safety is very important to children because they are curious 6) CORRECT — "just say no" is important when related to drugs and alcohol

The RN makes assignments for the LPN/LVNs on the renal unit. Which assignment does the LPN/LVN question? 1. Change the dressing of the abdominal incision from a bladder revision. 2. Insert an indwelling urinary catheter prior to kidney surgery. 3. Give enema to client following a perineal prostatectomy. 4. Irrigate the indwelling urinary catheter of the client after a transurethral prostatectomy.

1) changing the dressing is an appropriate procedure for the LPN/LVN 2) inserting a catheter is an appropriate procedure for the LPN/LVN 3) CORRECT — enemas and rectal tubes are prohibited in this situation 4) irrigating a catheter is an appropriate procedure for the LPN/LVN

The LPN/LVN cares for the client with a patient-controlled analgesia (PCA) device. Which action is appropriate for the LPN/LVN to take? 1. Change the pain medication syringe when empty. 2. Program the PCA pump initially. 3. Teach client about PCA pump before initiation. 4. Ask client about pain relief using a pain scale.

1) changing the medication syringe is usually done by RN 2) programming the pump initially is usually done by RN 3) initial teaching is done by RN; LPN/LVN reinforces teaching 4) CORRECT — observing client for response to pain medication is within the LPN/LVN's scope of practice

The LPN/LVN works with the RN on the medical surgical unit. The LPN/LVN observes the nurse become jittery and anxious as the shift progresses. The smell of alcohol is on the RN's breath at times when there is less anxiousness. The LPN/LVN suspects the RN has a substance abuse problem. Which action does the LPN/LVN take first? 1. Asks the RN about what the LPN/LVN has observed. 2. Tells other staff to observe the RN for accurate information. 3. Reports the suspicions and objective data to the unit manager. 4. Informs the state board of nursing about observations.

1) confrontation is usually not a productive encounter as the RN will likely deny abusing a substance 2) while it is helpful to have additional information by others, the safety of the clients is most important and the supervisor should be notified immediately 3) CORRECT — the safety of the clients is most important and the supervisor should be notified and given the objective facts as observed 4) unless the RN gets help, the supervisor will contact the state board; the RN should be connected to the peer assistance program in the state

The LPN/LVN cares for the client. The client asks the LPN/LVN about behaviors that increase the risk for osteoporosis. Which behaviors does the LPN/LVN tell the client? Select all that apply. 1. Consuming adequate amounts of milk and milk products. 2. Smoking. 3. Participating in weight-bearing exercises. 4. Drinking large amounts of alcohol. 5. Eating a well-balanced diet. 6. Drinking a large number of drinks with caffeine.

1) consuming calcium sources is helpful to prevent osteoporosis 2) CORRECT — smoking decreases production of estrogen 3) weight-bearing exercise helps to strengthen bones and encourages bone growth 4) CORRECT — alcohol decreases calcium absorption and depresses new bone growth 5) a well-balanced diet is good for bone health 6) CORRECT — caffeine causes calcium and phosphorus imbalance

The LPN/LVN cares for the client diagnosed with Alzheimer's disease. The client confabulates when conversing. Which action does the LPN/LVN take? 1. Corrects the client before continuing the conversation. 2. Reprimands the client for giving false information. 3. Allows the client to continue with the conversation. 4. Reorients the client to person, place, and time.

1) corrections are not helpful; continue the conversation 2) cognitive impairment causes the client to think what is said is true; reprimanding is not appropriate 3) CORRECT — allow the client to continue the conversation as the client likely unaware of incorrect information and not able to process; this helps with self-esteem 4) reorientation not helpful as this is not an orientation problem

The client takes propranolol for a cardiac dysrhythmia. The LPN/LVN observes the client coughing and wheezing. Which action does the LPN/LVN take next? 1. No action as this is an expected outcome of the medication. 2. Asks the client how long the cough has been going on. 3. Gives the client the standing order cough medication. 4. Notifies the health care provider of an adverse reaction.

1) coughing and wheezing are not expected responses and need to be reported to health care provider 2) this may be an appropriate question, but action must be taken to change the medication 3) cough medication may be helpful short term, but the health care provider needs to be notified of the adverse effect 4) CORRECT — an adverse reaction is bronchospasm and the health care provider needs to be notified so a medication change can be made

The LPN/LVN cares for the client diagnosed with a pressure ulcer. The LPN/LVN completes documentation in the client's electronic record about the amount of healing that has occurred. Which is the most important action the LPN/LVN takes before leaving the client's room? 1. Completes documentation of the client's status. 2. Turns off the computer. 3. Turns off the computer screen. 4. Logs out of the computer system

1) documentation has already been done 2) since everyone uses the same computer, turning it off makes it more difficult for the next person; computers are not usually turned off 3) turning off the computer screen does not help secure the client's information as the next person who accesses the computer screen will be able to see what was already written 4) CORRECT — logging out is the most important; the next person must log on before records can be accessed

The LPN/LVN assists in teaching the client about a glucose tolerance test. The pregnant client is scheduled for a glucose tolerance test at 5 months gestation. Which information is most important to reinforce? 1. Restrict carbohydrates for 3 days prior to the test. 2. Remain NPO for 10-12 hours before test. 3. Drink 8 ounces of cola prior to the beginning of the test. 4. Remain awake for 12 hour before the test.

1) eat a normal, well-balanced diet 2) CORRECT — not fasting changes the results and will not give the required information 3) the laboratory will provide about 300 mL of a liquid containing a specific amount of glucose 4) this is not a sleep test and the client may sleep normally

The LPN/LVN is assigned to a group of clients on the postpartum unit. In which order does the LPN/LVN care for the clients? Place the clients in order starting with the first client to be seen. All options must be used.

1) first, complete routine postpartum check for client 2 hours after vaginal birth; this is time sensitive due to check schedule 2) second, help client with breastfeeding 24 hours after birth; the client needs help when the infant is ready to feed 3) third, reinforce teaching about perineal care prior to discharge in two hours; this is time sensitive, but there is some leeway 4) fourth, help client with 1st sitz-bath, which can be taken when client is ready; there is no specific time schedule 5) fifth, obtain vital signs on all clients; this requires some time and can be done based on other client needs

The LPN/LVN administers medications to the client through an enteral feeding tube. In which order does the LPN/LVN complete the procedure? Place the steps of the procedure in the correct order beginning with the first step. All options must be used.

1) first, prepare the medications 2) second, identify client and verify with medical administration record (MAR) 3) third, elevate head of bed at least 30 degrees 4) fourth, assess gastric residual volume; any residual needs to be refed to the client unless over 150 mL 5) fifth, flush tubing with 30 mL water; this makes sure the tube is patent and no residual will clog the tube when the medications are administered 6) sixth, administer medication using syringe

The LPN/LVN cares for a group of clients on the medical surgical unit. In which order does the LPN/LVN give care? Place in order starting with the first client to be seen. All options must be used.

1) first, the client with the IV of D5W with KCl reporting redness and pain at the insertion site; the LPN/LVN needs to determine if the site is infiltrated or still viable 2) second, the client requiring a glucose monitor reading before breakfast; this is done second because it is a routine intervention 3) third, the client needing a dressing change before going to physical therapy; this is not as pressing as the glucose or IV but has a time requirement 4) fourth, the client diagnosed with Crohn's disease asking for a mid-morning snack; this can be delegated if necessary

The client has a bacterially infected skin wound and is placed on contact precautions. The LPN/LVN prepares the client's environment in which way? 1. Places gloves and used needle box in room. 2. Prepares a pressurized air isolation room. 3. Prepares a private room with masks for caregivers and client transfer. 4. Provides gloves and gowns to be taken off before leaving the room.

1) gloves and needle boxes are standard for all client rooms 2) a pressurized room is used for airborne precautions 3) this setup is used for droplet precautions 4) CORRECT — contact precautions are used to prevent spread of infection from client to others in the environment

The LPN/LVN monitors the client's complete blood count (CBC). The client is diagnosed with heart failure. Which value helps confirm this diagnosis? 1. Hemoglobin 14.6 g/dL. 2. White cells 8,000/mm3. 3. Platelet count 170,000/mm3. 4. Erythrocytes 8.2 million/mm3.

1) hemoglobin is within the normal range of males 13.2-17.3 g/dL and females 11.7-15.5 g/dL 2) white cells are in the normal range of 5,000-10,000/mm3 3) platelets are in the normal range of 150,000-400,000/mm3 4) CORRECT — erythrocytes are elevated; normal for a male is 4.6-6.2 and a female is 4.2-5.4; erythrocytes are elevated in chronic hypoxemia as often occurs with heart failure

The LPN/LVN serves on the Quality Improvement Committee of the orthopedic unit. The LPN/LVN is likely to participate in which aspects of quality improvement? Select all that apply. 1. Identify data measurement indicators. 2. Identify possible indicators of care. 3. Gather evidence for monitoring. 4. Set data measurement standards. 5. Recommend ways to improve care. 6. Implement care improvement activities.

1) identifying data measurement indicators is done by other persons 2) CORRECT — care indicators are recommended by all persons on the committee 3) CORRECT — gathering evidence is done by health record audit and all persons can participate in this 4) data measurement standards are set by other persons 5) CORRECT — all persons can recommend ways to improve care based on collected data 6) CORRECT — when improvement activities are identified, all persons are tasked with implementing those new activities

The LPN/LVN collects data about the client's cardiac system. Which is the most appropriate data collection procedure? 1. Inspect the chest for variations in contour. 2. Auscultate the apical pulse for 60 seconds. 3. Percuss the abdominal area in all 4 quadrants. 4. Palpate the back while listening to the lungs.

1) inspection is not the most helpful to determine information about the heart 2) CORRECT — listening to the heart over the apex for 60 seconds is likely to reveal abnormalities in the heart rate and/or rhythm 3) percussing all 4 quadrants of the abdomen is not likely to reveal anything about the heart or cardiac system 4) palpating the back is not likely to give information about the heart or cardiac system; the technique for listening to the lungs includes listening to the back of the chest

The LPN/LVN cares for the client who has a nasogastric (NG) tube following duodenal surgery. The LPN/LVN monitors the NG tube and irrigates it every 8 hours per order. Which nursing action is most important? 1. Insert 30 mL of normal saline into tube. 2. Check tubing for kinks before instilling saline. 3. Aspirate tube for stomach contents. 4. Measure amount of fluid withdrawn

1) instilling saline is important, but not most important 2) checking for kinks is necessary only if resistance is met when aspirating 3) CORRECT — aspirating stomach contents is an indicator of correct placement of the tube and should be done first before irrigating 4) it is important to measure the fluid but is not most important

The LPN/LVN monitors the diabetic client in the immediate postoperative period on the nursing unit. Which nursing action is most beneficial in preventing atelectasis? 1. Using intermittent compression devices. 2. Assuring voiding in first 6-8 hours. 3. Turning, coughing, and deep breathing. 4. Providing adequate pain management.

1) intermittent compression devices help prevent venous stasis, but does not prevent atelectasis 2) it is important to prevent bladder distension, but that does not prevent atelectasis 3) CORRECT — turning, coughing, and deep breathing requires lung expansion and helps prevent atelectasis 4) pain management is helpful because client is able to breathe more deeply but is not the most important

The LPN/LVN cares for the older adult with a fractured femur. The leg is placed in balanced suspension skeletal traction. Which most important observation tells the LPN/LVN to intervene? 1. The client reports pain in the leg. 2. The weight is resting on the floor. 3. The pins are observed coming through the skin. 4. The heel is pink and blanches easily when pressed.

1) it is normal to have some leg pain that may require pain medication, but no intervention 2) CORRECT — weights need to be suspended and if on the floor, client needs to be moved up in bed or cord shortened so weight is suspended 3) pins should protrude from skin and need pin care 4) normal skin color is pink and blanching indicates good blood supply

The older adult client is diagnosed with inoperable cancer. The client says, "When the end comes, I don't want to be kept alive on a machine. I have told my family and they agree." Which response by the LPN/LVN is best? 1. "It sounds like you have covered the situation quite well." 2. "It would be best if you arranged for a durable power of attorney." 3. "A living will could be of help to make sure all your wishes are honored." 4. "I am sure your family will do what is best for you when the time comes."

1) just talking to family members is not sufficient as there may be some disagreement when it is time to make decisions 2) CORRECT — a durable power of attorney is the best way to see that wishes are carried out; the client should have conversations about those wishes with the designated person who can carry them out 3) a living will is helpful but may be difficult to interpret and does not cover every circumstance; a durable power of attorney is preferred 4) family members may have differences of opinion and may not carry out the client's wishes

The LPN/LVN cares for the client in the outpatient psychiatric clinic. The client says, "If I can't go back to work next week, I may lose my apartment. I am not sure what I am going to do." Which is the priority action for the LPN/LVN to take next? 1. Tell the client to try to get a short-term loan. 2. Arrange for a referral to the social worker. 3. Give the information to the health care provider. 4. Ask the client if family can help.

1) loans are difficult for clients to arrange while receiving psychiatric treatment and would likely require someone to cosign 2) CORRECT — helping clients with non-medical problems is part of the role of any health care person; social workers can help find financial resources for clients 3) this is passing the buck; referrals to the social worker are something the LPN/LVN can participate in; this is acting as a client advocate 4) while some families can be helpful, not all clients have that option; referral to the social worker is the best option here

The LPN/LVN assists with monitoring the laboring client. The client is 5 cm dilated, 90% effaced, and the presenting part is at 0 station. The client requests help with pain management but does not want any medication. Which action does the LPN/LVN take? 1. Show the client how to pant-breathe during contractions. 2. Help the client concentrate on shallow, rhythmic breathing. 3. Assist the client with deep, rhythmic abdominal breathing. 4. Help the client with pant-blow breathing during contractions.

1) panting helps prevent pushing later in labor 2) shallow, rhythmic breathing is often used in the beginning of labor and is not usually helpful in active labor 3) CORRECT — deep, rhythmic breathing is appropriate for active labor and before transition 4) pant-blow breathing is usually used during transition

The LPN/LVN participates as a member of the disaster planning committee. The task is to plan for evacuation of the clients from the respiratory unit if there is an internal disaster. The plan includes which information? 1. Preventing mass casualties from bioterrorism. 2. Client evacuation procedures and routes. 3. Which clients can be discharged early. 4. Risk factors for each type of emergency.

1) preventing casualties for bioterrorism is not part of the evacuation plan for respiratory clients 2) CORRECT — procedures for how to evacuate each type of client and which routes to take can be determined before an event 3) which clients to discharge cannot be determined until actual situation because each client must be evaluated at that time 4) risk factors cannot be determined in advance of a disaster; this is not part of the evacuation plan

The LPN/LVN is to remove the indwelling urinary catheter from the client following surgery. The LPN/LVN deflates the balloon. Which action does the LPN/LVN take when resistance is felt when removing the catheter? 1. Applies steady traction to catheter until it begins to slide out. 2. Cuts inflation valve to allow remaining water to drain out. 3. Inserts syringe into inflation valve again to remove remaining water. 4. Clamps catheter to place pressure on catheter to facilitate removal.

1) pulling is painful and will cause damage if the balloon is still partially inflated 2) this is not a good idea in case water does not drain out; the valve is needed to insert syringe to remove the remaining water 3) CORRECT — the balloon needs to be completely deflated before removal 4) added pressure is not helpful if the balloon is still partially inflated

The LPN/LVN observes the client yelling and picking a fight with a family member. The client has been told about a serious diagnosis with a poor prognosis. The LPN/LVN knows the client is using which type of defense mechanism? 1. Rationalization. 2. Displacement. 3. Identification. 4. Suppression

1) rationalization is a construction of some sort of explanation for what is happening 2) CORRECT — feelings are displaced from the client to someone else, in this case, the family member 3) identification incorporates characteristics of another person into the psyche 4) suppression is the exclusion of painful thoughts from the mind

The LPN/LVN cares for the client diagnosed with a T2 spinal cord injury. The client experiences both constipation and bowel incontinence. A bowel training program is instituted for the client in the home. The LPN/LVN knows the program is effective when the client makes which statement? 1. "My stools are soft now, and I am incontinent twice a week." 2. "My stools are hard, but I can pass them when I am incontinent." 3. "I am having bowel movements every day with no incontinence." 4. "I have bowel movements about once a week with no incontinence."

1) soft stools are desired, but not incontinence 2) hard stools are not desired and neither is incontinence 3) CORRECT — that is the goal of the bowel training program 4) the client should have stools more often than once a week

The LPN/LVN makes a home visit to the client following a myocardial infarction. The LPN/LVN observes the spouse smoking in another room. Which action does the LPN/LVN take next? 1. Tells the spouse to stop smoking in the house. 2. Asks the client why the spouse is smoking in the house. 3. Shares information about smoking cessation with the client and spouse. 4. Reports the observation to the RN in the home health office.

1) telling the spouse what to do is not an appropriate action; this is confrontational and not helpful 2) asking the client is not helpful and confrontational 3) CORRECT — the LPN/LVN needs to reinforce information already given during the hospitalization 4) telling the RN as a first action is passing the buck; the LPN/LVN needs to address the issues in a helpful way and then report findings to the RN

The LPN/LVN assists with an immunization clinic. The 5-year-old child has previously received all immunizations on time. Which immunizations does the LPN/LVN prepare? Select all that apply. 1. 1st dose of human papillomavirus. 2. 5th dose of DTaP. 3. 4th dose of inactivated poliovirus. 4. 1st dose of rotavirus. 5. 2nd dose of MMR. 6. 2nd dose of varicella.

1) the 1st dose is given between 7-10 years 2) CORRECT — last dose of DTaP; the next dose is given in 10 years and is Tdap 3) CORRECT — this is the final dose of poliovirus 4) the 1st dose is given at 2 months of age 5) CORRECT — this is the last scheduled dose of MMR 6) CORRECT — this is the last scheduled dose of varicella

The LPN/LVN assists with the admission of the laboring client. The client gives the LPN/LVN a copy of the labor plan prepared for the birthing experience. Which is the responsibility of the LPN/LVN related to this client? 1. Place the document in the client's medical record. 2. Tell the client which items can be honored during the birthing experience. 3. Recognize the client has the right to help make decisions about care. 4. Continue with the admission process and ignore the birthing plan.

1) the birth plan should be shared with health care providers involved with the client's care 2) discussing the birth plan is the responsibility of the health care provider 3) CORRECT — the client should be involved in decisions about care and has the right to refuse any or all treatment or interventions 4) the LPN/LVN needs to continue the admission process but needs to modify the process based on client's wishes, if possible

The 12-year-old child is scheduled for kidney surgery. The parents have talked to the health care provider. The LPN/LVN brings the informed consent for them to sign. The child suddenly says, "I don't want to have this surgery. I don't care if I do die." Which action does the LPN/LVN take next? 1. Calls the health care provider to cancel the surgery. 2. Allows the parents to make the decision to sign the informed consent. 3. Administers the preoperative medication as ordered. 4. Tells the child not to worry about the surgery as all will be well.

1) the child is too young to make the decision 2) CORRECT — the child is too young to make the decision; the child does not meet any of the criterion for emancipation 3) the LPN/LVN needs to resolve the decision before giving the medication 4) saying that all will be well may be false reassurance; the LPN/LVN may need to make time for child and parents to talk

The LPN/LVN cares for the client diagnosed with an itchy skin rash that has not resolved with antibiotics or other treatments. The client decides to try applying tea tree oil to the rash. The LPN/LVN knows this is helpful when which observation is made? 1. Client skin becomes reddened and secretes fluid. 2. Client skin becomes soft and absorbs the oil. 3. Client does not scratch skin after application of oil. 4. Client says itching is slightly less, but still red.

1) the skin may be reacting to the oil and is not an indication of healing 2) this observation does not say anything about healing the rash 3) CORRECT — the itching has been relieved, so the oil is helpful 4) some relief is helpful, but not complete relief as when the client does not scratch the skin

The LPN/LVN cares for the client with a chest tube attached to water-seal drainage. The LPN/LVN notices the level of fluid in the drainage container moves up and down as the client breathes. Which nursing action does the LPN/LVN take? 1. Notifies the health care provider to reinsert the tube. 2. Adds sterile water to the system. 3. Empties the drainage container. 4. Continues giving care to the client.

1) the system is intact and functioning properly; there is no need to notify the health care provider 2) there is no need to add water to the system as it is functioning properly 3) the drainage container should not be emptied unless it is in danger of overflowing 4) CORRECT — this is an expected observation and indicates the system is intact and working correctly

The LPN/LVN visits the client in the home. The elderly client is diagnosed with type 2 diabetes mellitus. The LPN/LVN observes the client for the ability to care for self. Which observation is most important to report? 1. Client moves about the room with the help of a walker. 2. Client is dressed appropriately in warm, older clothing. 3. Client telephones adult child to ask for help with housekeeping. 4. Client indicates help will be needed with meal preparation.

1) the walker is a great help and contributes to appropriate self-care 2) this observation indicates the client is able to dress self in appropriate clothing 3) the client can use the telephone and has help available for periodic assistance 4) CORRECT — meal preparation occurs at least 3 times a day; the client may need to locate outside resources for help with this activity as it is critical with diabetes

The LPN/LVN cares for the client diagnosed with hypertension and kidney failure. The LPN/LVN questions which health care provider order? 1. Captopril 12.5 mg twice daily PO. 2. Candesartan 16 mg daily PO. 3. Diltiazem 30 mg three times daily PO. 4. Metoprolol 75 mg daily PO.

1) there is no contraindication, but should be given carefully 2) CORRECT — candesartan should not be given to clients with kidney failure 3) there is no contraindication, but should be given carefully 4) there is no contraindication, but should be given carefully

The LPN/LVN cares for the client diagnosed with advanced macular degeneration. The client is told to expect nearly total blindness within the year. The client says, "I don't think I can live with blindness. I will find a way to end it all before that happens." The LPN/LVN knows which type of nursing diagnosis is the priority for this client? 1. Likely to hurt others because of unhappiness about the diagnosis. 2. Likely to commit suicide because of statements about ending it all. 3. Likely to be ready to manage own health because of impending loss of sight. 4. Likely to be hopeless because of expected blindness in next year.

1) there is no evidence that client will hurt others; client is most likely to hurt self 2) CORRECT — the client statement indicates a potential suicide attempt; the client needs to be monitored carefully 3) the client statements do not indicate any interest in managing health but indicate the potential for suicide 4) while hopelessness may be a possible nursing diagnosis, the suicide diagnosis is most important; hopelessness may be a secondary diagnosis

The LPN/LVN monitors the older client's oxygen saturation levels. The client's O2 sat level has a range of 84-92%. Which action does the LPN/LVN take next? 1. Increase the oxygen to 5 L per min. 2. Change client's position. 3. Increase client's daily fluid intake to 3,000 mL. 4. Notify the RN for further assessment.

1) there is no indication the client is on oxygen; increasing oxygen requires a health care provider order 2) changing positions may be helpful, but requires further assessment 3) increasing fluids is not helpful for oxygen saturation and may require a health care provider order 4) CORRECT — the range is at the lower end and below the normal level and requires further assessment

The LPN/LVN cares for the client in the home. The client has heart failure. Yesterday, the vital signs were pulse 80 bpm, respirations 20 breaths per minute, and BP 136/78 mm Hg. Today, the vital signs are pulse 110 bpm, respirations 30 breaths per minute, and BP 142/82 mm Hg. Additionally, +3 edema is noted in the feet and ankles. Which action does the LPN/LVN take next? 1. No action as these changes are common with heart failure. 2. Encourages the client to decrease the amount of fluid intake. 3. Has the client rest in an upright position for an hour. 4. Notifies the RN of the worsening of the client's condition.

1) these changes in vital signs indicate worsening of the client's condition and need to be reported 2) decreasing the amount of fluid intake will not improve the client's condition and may be detrimental 3) resting for 1 hour will not decrease heart failure 4) CORRECT — the LPN/LVN needs to collaborate with the RN regarding the changes in the client's condition so additional treatment can be planned

The LPN/LVN cares for the 4-month-old infant. The LPN/LVN plans to give the inactivated polio vaccine. Which action is most appropriate for the LPN/LVN to use? 1. Use 3-inch needle and inject in deltoid site. 2. Use 1-inch needle and inject in gluteus maximus site. 3. Use 5/8-inch needle and inject in vastus lateralis site. 4. Use 1/2-inch needle and inject in ventrogluteal site.

1) this combination is used with adults 2) this site not recommended for anyone currently 3) CORRECT — use tiny needle and the vastus lateralis is the preferred site for infants 4) this site is used with children 2 years and older because they need to walk to develop muscle first

The LPN/LVN cares for clients in a long-term care facility. For which clients does the LPN/LVN reinforce teaching about the use of assistive devices? Select all that apply. 1. Client uses a swing-through crutch gait to prevent weight bearing on the affected leg. 2. Client places weight on axilla when taking a step using crutches. 3. Client uses a Roll-A-Bout walker with a short leg cast. 4. Client places cane in the hand on the side of the affected leg. 5. Client uses a four-point crutch gait with no weight bearing on the affected leg. 6. Client uses a three-point crutch gait to prevent weight bearing on the affected leg.

1) this gait does not place any weight on the affected leg, which is a correct action 2) CORRECT — weight should be placed on the upper arms at the handgrip so this is an incorrect action 3) a rolling walker allows the client to move about easily without tiring as quickly and keeps the affected part of the leg from bearing weight 4) CORRECT — the cane should be placed in the hand on the side of the unaffected leg and moved with the affected leg so this is an incorrect action 5) CORRECT — a four-point gait requires weight bearing on the affected leg, which is an incorrect action 6) a three-point gait keeps the affected leg from bearing weight so this is a correct action

The LPN/LVN cares for the client diagnosed with type 2 diabetes. The LPN/LVN reinforces teaching about nutrition when the client makes which meal selection? 1. Grilled hamburger on half bun, lettuce salad with fat-free dressing, cooked carrots, and raw pear. 2. Poached salmon piece, rice, stir-fried vegetables, and canned peaches in water. 3. Baked chicken, baked potato, steamed green beans, and cherries canned in water. 4. Fried pork chop, mashed potatoes, creamy coleslaw, and grapes with cookies.

1) this has limited fat, appropriate carbohydrates and protein, and a good amount of fiber 2) this has limited fat, appropriate carbohydrates and protein, and a good amount of fiber 3) this has limited fat, appropriate carbohydrates and protein, and some fiber 4) CORRECT — this has high fat, high carbohydrates, appropriate protein, and a good amount of fiber.; the carbohydrates are too high

The LPN/LVN cares for the older adult who is dying of cancer. Which care is the most important for the LPN/LVN to give the client during this time? 1. Assure client that the cancer will be resolved soon. 2. Assist client to research alternative treatments for cancer. 3. Provide healthful foods the client enjoys eating. 4. Encourage client to talk about feelings related to death.

1) this is a false reassurance as the client is dying 2) this is a false reassurance; the client needs to be realistic for the best death experience 3) healthful foods may help the client feel cared for but will not help with dying process; the client should be given any food enjoyed and asked for 4) CORRECT — usually, discussions about death are helpful to the client and help staff know how to help and relate to the client

The LPN/LVN assists with care of the older client after a myocardial infarction. The client is being monitored. Strip showing sinus rhythm, 90 bpm. Which nursing action does the LPN/LVN take next when this monitor strip is observed? 1. Notifies the RN to review the monitor. 2. Continues with morning care. 3. Allows the client time to rest. 4. Increases oxygen according to orders

1) this is a normal sinus rhythm; there is no need for the RN to review 2) CORRECT — this is a normal sinus rhythm; the LPN/LVN should continue with current care 3) this is a normal sinus rhythm; there is no need for the client to rest based on the strip 4) this is a normal sinus rhythm; there is no need for additional oxygen

The client receives the diagnosis of cancer of the pancreas. The prognosis is about 2 months before death. The LPN/LVN observes the client crying and asks what help is needed. The client says, "I don't want to die so soon. I still have a lot to live for. Can't you help me?" Which action does the LPN/LVN take next? 1. Tells the client that all will be fine tomorrow. 2. Makes a psychiatric consult request. 3. Requests assistance from the RN. 4. Notifies the hospital chaplain to see client.

1) this is not accurate; the client will still have a short prognosis tomorrow 2) requesting a consult is not the responsibility of the LPN/LVN; the LPN/LVN needs to request a consult from the health care provider 3) CORRECT — the LPN/LVN is not prepared to assist the client in this situation and needs help from other health care staff 4) the client did not request a visit from the chaplain; the client may request someone to see, so LPN/LVN should ask

The LPN/LVN is assigned to care for clients in the geriatric clinic. The client is dehydrated. Another LPN/LVN says, "I am glad I don't need to care for those people. They shouldn't get good care like those in the other clinics." Which response by the first LPN/LVN is appropriate? 1. "I agree with you. We shouldn't have to care for them." 2. "I guess that is why we have the special clinic for them." 3. "I hope I don't need to work here very often." 4. "I believe all clients deserve the best care possible."

1) this is not an ethical statement; everyone deserves the best care possible 2) this is not appropriate; even though it is a special clinic, the clients deserve the best care possible 3) this is not an ethical statement; every nurse should give care to every client without discrimination 4) CORRECT — the code of ethics requires all health care staff to give care without discrimination

The LPN/LVN helps the older female client collect a mid-stream urine specimen. Which client statement causes the LPN/LVN to repeat the instructions? 1. "I will use the wipes to clean my perineum from front to back." 2. "I will not touch the container to my perineum." 3. "I will collect the first 30 mL of urine and put the lid on the container." 4. "I will finish urinating after I have collected the specimen."

1) this is the correct method of cleansing the perineum 2) this prevents bacteria from the skin from contaminating the specimen 3) CORRECT — the client is to urinate about 30 mL and then the specimen is collected from the stream (mid-stream) 4) the client finishes urinating after the specimen is collected

The LPN/LVN cares for the client recovering from surgery in the recovery area. The LPN/LVN places the client in which position to prevent aspiration of potential vomitus? 1. Head raised above chest with a pillow. 2. Head of bed elevated 45 degrees. 3. Trendelenburg to allow for adequate drainage. 4. Side lying with head flat.

1) this position may push neck forward and cause the tongue to occlude the airway 2) CORRECT — this position helps prevent aspiration and does not bend the neck which might reposition the tongue to occlude the airway 3) this position would be likely to cause vomiting; keep the head up to help maintain fluids in the stomach 4) this position will help prevent aspiration but is not the best position because it encourages vomiting

The LPN/LVN cares for the client diagnosed with type 2 diabetes mellitus. The client takes glipizide daily. The LPN/LVN knows the medication is effective if which observation is made? 1. Blood glucose range is 50-80 mg/dL. 2. Blood glucose range is 75-100 mg/dL. 3. Blood glucose range is 100-150 mg/dL. 4. Blood glucose range is 130-175 mg/dL.

1) this range is too low, and the client may have a hypoglycemic reaction below 70 mg/dL 2) CORRECT — this is a good range for a diabetic client in good control 3) this range is too high, and the client may have a hyperglycemic reaction 4) this range is too high, and the client may have a hyperglycemic response

The LPN/LVN changes a sterile dressing with a drain for the client following surgery. Which nursing action is most important to complete? 1. Use sterile gloves to remove the old dressing. 2. Cleanse the wound with tap water. 3. Clean the area around drain last. 4. Remove the old dressing one layer at a time.

1) use clean gloves to remove the old dressing 2) cleanse the wound with antiseptic solution 3) clean the drain area first as this is the most likely entry for bacteria 4) CORRECT — removing the dressing one layer at a time helps the LPN/LVN be less likely to pull out the drain

The LPN/LVN cares for the older adult who reports increasing nocturia resulting in loss of sleep. The client asks if there is anything that can be done to prevent awakening so often. Which response by the LPN/LVN is best? 1. Use a bedside commode during the night. 2. Limit the amount of fluid intake in the evening. 3. Plan bladder-stretching exercises during the day. 4. Take naps during the day to increase sleep time.

1) using a commode does not help reduce the number of times the client awakens to void 2) CORRECT — limiting fluids in the evening helps reduce the number of trips to the bathroom 3) no bladder stretching exercises are available 4) taking daytime naps may actually decrease sleeping at night