LPN Study question set #1

Which of the following is the best worded expected outcome? "The nurse will provide for adequate hydration" "The nurse will insure that the patient is safe" "The patient will cough and deep breathe every two hours" "The patient will value health"

"The patient will cough and deep breathe every two hours" "The patient will cough and deep breathe every two hours" is the best worded expected patient outcome. This outcome or goal is specific, measurable, achievable, realistic, within a specified timeframe, trackable and it should be agreed to by the patient. All expected outcomes are worded in terms of what the patient, not the nurse, will do and it should also be specific and measurable. "The patient will value health" is not measurable.

The nurse knows that litigation involving nurses is common because of which reasons?

1. Clients are better educated about health care. 2. Clients are better informed about their rights. 3. Clients have a higher expectation about the care they receive.

Which of the following is the World Health Organization's (WHO) definition of health?

A holistic state of wellbeing The World Health Organization (WHO) defines health as a holistic (wholistic) state of wellbeing. This state of wellbeing is far more than the absence of illness, diseases and comorbidities. Lastly, the use of health promotion activities does promote health but these activities do not define health according to the World Health Organization.

Which of the following are necessary elements of malpractice? Select all that apply. A. A breach of duty B. An intentional act C. A nonintentional act D. Forseeability E. Patient harm F. Causation

A,D,E,F The necessary elements of malpractice are a duty to the patient, a breach of duty, foreseeability, causation, and patient harm. The breach of duty can be intentional or nonintentional.

Which of the following is a vector of infection?

An infectious fly An infectious fly is an example of a vector that can transmit infection. Other vectors, or nonhuman living beings that can transmit infections to humans, include mice, vermin and mosquitoes. Inanimate items that can spread infection by contact are referred to as fomites. Examples of fomites include a contaminated thermometer, balls and door knobs. An infected human being is a host according to the chain of infection and not a vector.

The nurse is reinforcing instructions to a Native-American client regarding the procedure for collecting a urine sample. The nurse observes that the client continually stares at the floor during the instructional session. The nurse interprets this as being indicative of which behavior?

Attentiveness

Which car safety device should be used for a child who is 8 years old and is 4 feet tall?

Booster seat

When caring for an infant during cardiac arrest, which pulse must be palpated to determine cardiac function?

Brachial The brachial pulse is the most accessible pulse on an infant and, therefore, it is the site of choice. The carotid pulse may be difficult to palpate due to the fatty tissue that typically, and often, surrounds an infant's neck. Lastly, the radial and pedal pulses may not be reliable indicators of cardiac function.

Select the following fire emergency interventions in correct sequential order. A. Pull the fire alarm. B. Contain the fire. C. Rescue patients in danger. D. Extinguish the fire.

C,A,B,D The RACE acronym is used to prioritize and sequence the steps that must be followed when a fire occurs. R stands for rescue patients; A is pulling the fire alarm; C is to contain the fire by closing doors, etc.; and E is extinguishing the fire with a fire extinguisher when possible.

A client with breast cancer is being treated with cyclophosphamide. The nurse plans care, knowing that this medication fits which classification?

Cell cycle phase nonspecific

The nurse is caring for a client in labor. The nurse reviews the health care provider's prescriptions and notes that the client has a prescription for butorphanol tartrate. The nurse understands that the action of this medication is to have which effect?

Decrease pain.

The nurse is collecting admission data on the client with hepatitis. Which finding would be a direct result of this client's condition?

Drowsiness

The nurse witnesses an automobile accident and provides care at the scene of the accident to an open wound on a young child. The family is extremely grateful and insists that the nurse accept monetary compensation for the care provided to the child. Because of the family's insistence, the nurse accepts the compensation to avoid offending the family. The child develops an infection and sepsis and is hospitalized. The family files suit against the nurse who provided care to the child at the scene of the accident. The nurse understands that which is accurate regarding immunity from this suit?

Good Samaritan laws will not provide immunity from suit if the nurse accepted compensation for the care provided.

The patient should be sitting when deep breathing and coughing because this position:

Helps the patient to support their incision with a pillow The patient should be sitting when deep breathing and coughing because this position allows the patient to be better able to splint the incision with a pillow which provides abdominal support during coughing. It also allows the lungs to more fully expand because the diaphragm drops. The most comfortable position for the patient is the supine position; however, this position does not permit the lungs to fully expand. There is no association or correlation between loosening respiratory secretions or relaxation with this sitting position.

A client complains of stomach pain 30 minutes to 1 hour after eating. The pain is not relieved by further intake of food, although it is relieved by vomiting. A gastric ulcer is suspected. Which data would further support this diagnosis?

History of chronic obstructive pulmonary disease with weight loss

What intervention is the best to relieve constipation during pregnancy?

Increasing the consumption of fruits and vegetables Dietary roughage (or fiber) with sufficient fluids and exercise may help relieve constipation. Over-the-counter medications should be avoided during pregnancy. The supine position can place additional pressure on the aorta and vena cava, leading to vena cava syndrome. A reduction of iron supplements during pregnancy may reduce hemoglobin production and result in a less than an effective immune system.

A client was transferred to the nursing unit from the coronary care unit after experiencing a myocardial infarction (MI). When reviewing the client's serum creatinine phosphokinase (CPK) levels recorded in the chart, the nurse knows that an elevation of which enzyme was due to the MI?

MB

Which electrolyte is essential for enzyme and neurochemical activities?

Magnesium Magnesium is essential for enzyme and neurochemical activities and it is also needed for cardiac and skeletal muscle excitability. Chloride is the most abundant negatively charged ion in extracellular fluid with potassium being the most abundant positively charge ion. Phosphate assists in acid-base regulation.

Avulsed teeth should be placed in:

Milk Avulsed teeth should be immediately placed in milk. An avulsed tooth is the traumatic loss of a tooth. In addition to placing the tooth in milk, the tooth should only be handled at the crown and not the root of the tooth. These interventions preserve the tooth for reimplantation.

The nurse was assigned to care for five clients and spent most of the day caring for one of these clients who had just returned from surgery. The nurse did not ask for assistance and did not regularly check on the other clients. During the day, one of the nurse's other clients got out of bed without calling for assistance and fell, breaking his arm. Which possible charges could this nurse face with this situation? Select all that apply.

Negligence Malpractice Abandonment of care

The nurse notes that meloxicam (Mobic) is prescribed for a client. The nurse anticipates the client to have which diagnosis?

Osteoarthritis

A licensed practical nurse (LPN) is assisting in the care of a pregnant teenaged client with preeclampsia receiving magnesium sulfate. The LPN plans to notify the registered nurse immediately if which sign of magnesium toxicity is noted?

Respiratory rate of 10 breaths per minute

Which test should the nurse expect to have done for a client suspected of having pernicious anemia?

Schilling test

The nurse caring for the older adult client understands that dosages of many medications are reduced in this population because of which fact?

Serum albumin levels are decreased.

The nurse in the newborn nursery is assisting in monitoring a preterm newborn for respiratory distress syndrome (RDS). Which findings, if noted in the newborn, should alert the nurse to the possibility of this syndrome?

Tachypnea and retractions

The nurse is reviewing the health record of a child who has been recently diagnosed with glomerulonephritis. Which finding noted in the child's record is associated with the diagnosis of glomerulonephritis?

The child had a streptococcal throat infection 2 weeks before diagnosis.

The nurse is caring for a newborn diagnosed with Down syndrome. The parents are asking questions about the disorder. The nurse should provide which information when discussing Down syndrome?

The condition is congenital and results in moderate to severe retardation and has been linked to an extra chromosome 21 (group G).

The nurse reviews the client's health record and notes that based on Leopold's maneuvers, the fetus is in a cephalic presentation. The nurse understands that this characterizes which type of presentation?

The most common presentation

A client receiving nifedipine (Procardia) for angina complains of feeling listless, with generalized weakness and no energy. The nurse recognizes that which statement is true in regard to these symptoms?

These symptoms are expected effects of the medication.

You are working in a pediatric unit of the hospital and caring for a six year old boy who is hospitalized with cystic fibrosis and respiratory compromise. Which developmental task is the challenge for this boy at his age?

To develop initiative and a sense of purpose According to Erik Erikson, a developmental psychologist, the preschool child is challenged with initiative, the development of confidence and a sense of purpose. The other age groups along the life span and their developmental tasks are listed below: Infant: Trust Toddler: Autonomy, self control and will power School Age Child: Industry, self-confidence and competency Adolescent: Identity formation and a sense of self Young Adult: Intimacy, affection and love Middle Aged Adult: Generativity, productivity and concern about others Older Adults: Ego integrity, wisdom and satisfaction with life

What element is minimally assessed during a basic prenatal physical examination?

Urinalysis for glucose, protein and ketones A urinalysis is considered routine during the prenatal examination. Assessment of the cervix, vagina, anus, rectum, and palpation and auscultation of the abdomen may not be checked until a complete gynecologic examination is done by the doctor.

The health care provider prescribes laboratory studies for an infant of a woman positive for human immunodeficiency virus (HIV) to determine the presence of HIV antigen in the infant. The nurse anticipates that which laboratory study will be prescribed for the infant?

p24 antigen assay

After your patient has been told that they have Cushing's syndrome, the patient asks you what Cushing's syndrome is. How would you respond to this patient's question? A. Cushing's syndrome is a type of irritable bowel syndrome." B. "Cushing's syndrome is a disorder of the adrenal gland." C. "Cushing's syndrome often occurs among patients who are getting radiation therapy." D. "Cushing's syndrome often occurs among patients who are chemotherapy."

B Cushing's syndrome is a disorder of the adrenal gland. It results from the chronic hypersecretion of glucocorticoids from the adrenal cortex. It is Crohn's disease, not Cushing's syndrome, that is a type of irritable bowel syndrome and, there is no relationship between Cushing's syndrome and radiation or chemotherapy.

3. Ill health, malnutrition, and wasting as a result of chronic disease are all associated with:

Cachexia Ill health, malnutrition, and wasting as a result of chronic disease are all associated with cachexia. Cachexia can also result from dehiscence of a surgical incision or rupture of wound closure. Surgical asepsis refers to using a sterile technique to protect against infection before, during, and after surgery. The breakdown of tissue, especially after severe trauma or crush injuries is known as catabolism. Venous stasis is a disorder related to pooling of blood in a vein of the body; venous stasis typically occurs in the lower extremities and it is one of the many hazards, or complications, of immobilization.

The nurse is reading a computer printout of the results of a cerebrospinal fluid (CSF) analysis performed on an adult client who underwent lumbar puncture. The nurse knows that a reported value of 0 is normal for which substance in CSF?

Red blood cells

During which phase of the nursing process does data get collected and validated with the patient and/or family members by the nurse?

The assessment phase Subjective, objective, primary and secondary data is collected and validated with the patient and/or family members by the nurse during the assessment phase of the nursing process. The implementation phase is the actual care of the patient; the evaluation phase includes the comparison of current data to expected outcomes to determine if the patient has achieved the pre-established goals and the planning phase consists of priority setting and care planning.

What is the ultimate purpose and goal of performance improvement activities?

To improve processes The ultimate purpose of quality improvement activities is to identify process flaws and then to change the process so that it is fail proof. Fail proof processes prevent human error and possible patient harm. Although these process improvements and changes may also increase efficiency and decrease costs, the ultimate goal of quality improvement activities is to prevent future occurrences with process changes and not costs and efficiency. Lastly, it is known that processes, not policies, are the root cause of many medical errors.

The embryonic period during pregnancy takes place from:

Weeks 6 to 10. The embryonic period begins around week 6, following the ovulation period of weeks 1 to 2 and the cell division and implantation period from weeks 3 to 5. The first trimester runs from week 1 until week 12.

A client asks the nurse to describe how her developing baby will get enough blood and oxygen. The nurse responds that the fetal circulatory system accomplishes this task by which means?

1. Bypassing the fetal lungs to circulate oxygen rich blood 2. Using the fetus's beating heart to pump blood in the circulatory system 3. Carrying more oxygen on fetal hemoglobin than maternal hemoglobin 4. Making the fetal cardiac output higher per unit of body weight than the maternal cardiac output

A licensed practical nurse has decided to purchase disciplinary defense insurance and is aware that this type of insurance would provide which type of benefits? Select all that apply.

1. Representation by a qualified attorney 2. Reimbursement for travel to the state board of nursing 3. Payment of all legal fees for defense of a nursing license

The recommended daily caloric intake for sedentary older men, active adult women and children is:

2000 calories Sedentary older men, active adult women and children should all have 6 ounces of grains, 2½ cups of vegetables, 2 cups of fruits, and 3 cups of milk to help make up their 2000 calorie requirement. Sedentary adolescents require 2400 calories, sedentary women and children require 1600 calories and active adolescents need 2800 calories daily.

Number the choices below to reflect the correct sequence for using a fire extinguisher:

A.Aim at the base of the fire B.Squeeze the handle C.Sweep back and forth D.Pull the pin D, A, B, C The correct sequence of action for using a fire extinguished is easily remembered by keeping the PASS acronym in mind. P is pulling out the pin to activate the fire extinguisher; A is to aim the fire extinguisher at the base of the fire; S is to squeeze the handle to discharge the contents of the fire extinguisher; and S is sweep back and forth over the base of the fire while discharging the contents.

A lethargic, pale child is brought to the health care provider's office with symptoms of periorbital edema and reduced quantity of urine output. The urine is cloudy and smoky in color. The nurse asks the mother if the child has had any recent infections, to which the mother responds that the child had a very sore throat a few weeks ago. The health care provider suspects that the child might have acute poststreptococcal glomerulonephritis. Which laboratory test would rule out a past streptococcal infection in the child?

Antistreptolysin titer

Which oral disorder appears as yellow or white spots on the oral mucosa that are not possible to scrape off without bleeding?

Candidiasis Oral candidiasis is characterized with yellow or white spots on the oral mucosa that are not possible to scrape off without bleeding, therefore, no attempts to remove these spots should be done. Herpes simplex is marked with tingling and burning of the lips and mouth areas as well as blisters and a sore throat. Alphthous ulcers, or canker sores, are sore oral lesions; and oral leukoplakia leads to thickened, white patches on the cheeks, tongue, lower lip, or on the floor of the mouth.

The nurse understands that which is a correct guideline for adult cardiopulmonary resuscitation (CPR) for a health care provider?

Each rescue breath should be given over 1 second and should produce a visible chest rise.

Select all of the signs and symptoms of hyperthyroidism

Heat intolerance Insomnia Increased appetite Palpitations The signs and symptoms of hyperthyroidism include heat intolerance, increased appetite, palpitations and insomnia among others such as thinning hair, the loss of hair, increased sweating, weight loss, emotional instability and diarrhea.

Which disease decreases the metabolic rate?

Hypothyroidism Hypothyroidism causes a decreased metabolic demand, so fewer calories are required. Cancer, chronic obstructive pulmonary disease, or cardiac failure all increase the metabolic demands and the need for added calories.

The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is:

Is legally mandated by the states and a nursing certification is not. The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is legally mandated by the states and NOT the American Nurses Association and a nursing certification is not mandated. To practice nursing without a current and valid license is contrary to the law. Nursing licenses are renewed every two years and nursing certifications are typically renewed every three years, however, this may vary according to the particular certification. Passing the NCLEX examination and receiving a nursing license indicates that the graduate has at least the minimal competency necessary to provide safe patient care. Nursing certifications, on the other hand, validate expertise in a particular area of nursing practice.

A client has had a midline episiotomy. In relation to clients with other types of episiotomies, the nurse anticipates that the client will generally experience which?

Less pain

5. What can help reduce a patient's anxiety and postsurgical pain?

Preoperative teaching Patient teaching before surgery not only helps to reduce a patient's anxiety and postsurgical pain but it also decreases the amount of anesthesia needed and a lack of anxiety additionally speeds up wound healing. Preoperative checklists are a form of nursing documentation that is used to guide and document the care of the patient before surgery. Psychological counseling is typically NOT necessary except under highly unusual circumstances and preoperative medication can decrease the amount of anesthetic needed and respiratory tract secretions but it does not help with postoperative pain.