Free Licensed Practical Nurse-PN Questions and Answers — Questions and Answers
Question 1: A nurse is caring for an infant who has a high bilirubin level and is receiving phototherapy. Which of the following is the priority finding in this newborn?
- Sunken fontanels (Correct answer)
- Bronze skin discoloration
- Maculopapular skin rash
- Conjunctivitis
Correct answer: Sunken fontanels
Sunken fontanels are a critical sign of dehydration in an infant. Phototherapy, used to treat high bilirubin levels, can increase insensible water loss, making infants susceptible to dehydration. Recognizing and addressing dehydration promptly is a priority to prevent serious complications in the newborn.
Question 2: The nurse who works in the behavioral health unit is creating a client's plan of care. The client is socially awkward, won't participate in group therapy sessions, and has a history of hurling objects at other clients. Which nursing diagnostic for the client is of the utmost importance?
- Ineffective coping
- Social isolation
- Impaired social interaction
- Risk for other-directed violence (Correct answer)
Correct answer: Risk for other-directed violence
The client's history of 'hurling objects at other clients' directly indicates a potential for harm to others. In nursing, client and staff safety is always the highest priority. Therefore, 'Risk for other-directed violence' is the most crucial nursing diagnosis as it addresses the immediate potential for physical harm to individuals in the environment.
Question 3: A nurse is reinforcing teaching regarding colon cancer to a group of women ranging from 45 to 65 years of age. Which of the following is an appropriate statement by the nurse?
- An endoscopy provides a definitive diagnosis of colon cancer
- A sigmoidoscopy is recommended every 5 years beginning at age 60
- Colonoscopies for individuals with no family history of cancer should begin at age 40
- Fecal occult blood tests should be done annually beginning at age 50 (Correct answer)
Correct answer: Fecal occult blood tests should be done annually beginning at age 50
Current guidelines recommend annual fecal occult blood tests (FOBT) or fecal immunochemical tests (FIT) starting at age 50 for individuals at average risk for colon cancer. These tests help detect hidden blood in the stool, which can be an early sign of colorectal cancer or polyps. Regular screening is vital for early detection and improving treatment outcomes.
Question 4: A nurse is reinforcing teaching with a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following should be included in the teaching?
- Drink at least one glass of water with each meal
- Eat three moderate-sized meals a day
- Eat a bedtime snack that contains a milk product
- Increase protein in the diet (Correct answer)
Correct answer: Increase protein in the diet
For clients with dumping syndrome, increasing protein and fat in the diet helps slow gastric emptying and reduce the rapid shift of fluids into the small intestine. Protein-rich foods are digested more slowly, which can alleviate symptoms like nausea, diarrhea, and dizziness. This dietary modification is a cornerstone of managing dumping syndrome.
Question 5: A client in the manic phase of bipolar disorder will not sit down to eat. Which can the nurse do to ensure adequate nutrition and improved self-care of this client? Select all that apply. <br> <br> A) Discuss finger-food options with the dietitian <br> B) Use a jacket restraint at meal times <br> C) Ask the healthcare provider if intravenous feedings would be applicable <br> D) Provide frequent nutritious snacks <br> E) Provide a sedative before meals
- Applying intermittent pneumatic compression stockings
- Discuss finger-food options with the dietitian and Provide frequent nutritious snacks (Correct answer)
- The PO pentoxifylline (Trental) to the client who has intermittent claudication
- Use simple, short sentences accompanied by visual cues to enhance comprehension
Correct answer: Discuss finger-food options with the dietitian and Provide frequent nutritious snacks
Clients in the manic phase of bipolar disorder often have excessive energy and difficulty sitting still for meals, leading to inadequate nutritional intake. Offering finger foods allows them to eat while moving, and providing frequent nutritious snacks ensures they receive necessary calories and nutrients throughout the day. These strategies promote adequate nutrition without requiring prolonged sitting.
Question 6: Several weeks after a stroke, a patient has urinary incontinence resulting from an impaired awareness of bladder fullness. For an effective bladder training program, which nursing intervention will be best to include in the plan of care?
- Limit fluid intake to 1200 mL daily to reduce urine volume
- Perform intermittent catheterization after each voiding to check for residual urine
- Use an external "condom" catheter to protect the skin and prevent embarrassment
- Assist the patient onto the bedside commode every 2 hours (Correct answer)
Correct answer: Assist the patient onto the bedside commode every 2 hours
For a patient with impaired awareness of bladder fullness, a scheduled toileting program is crucial for effective bladder training. Assisting the patient to the bedside commode every 2 hours helps establish a routine, prevents incontinence, and ensures regular bladder emptying. This intervention helps retrain the bladder and improve continence by proactively managing voiding times.
Question 7: A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea, vomiting, and scant prune-colored discharge. She has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect?
- Preterm labor
- Threatened abortion
- Hyperemesis gravidarum
- Hydatidiform mole (Correct answer)
Correct answer: Hydatidiform mole
The classic signs of a hydatidiform mole (gestational trophoblastic disease) include persistent nausea and vomiting, scant prune-colored discharge, and a fundal height that is larger than expected for gestational age. These symptoms are indicative of the abnormal growth of placental tissue. The combination of these findings strongly suggests a hydatidiform mole.
Question 8: The RN is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside (Nipride). Which of the following nursing actions can the nurse delegate to an experienced LPN?
- Assess the patient's environment for adverse stimuli that might increase BP
- Evaluate the effectiveness of nitroprusside therapy on BP
- Titrate nitroprusside to maintain BP at 160/11 mmHg
- Set up the automatic blood pressure machine to take BP every 15 minutes (Correct answer)
Correct answer: Set up the automatic blood pressure machine to take BP every 15 minutes
Setting up equipment and performing routine vital sign measurements, such as blood pressure, are within the scope of practice for an experienced LPN. Titrating medications, evaluating the effectiveness of therapy, and assessing for adverse stimuli require advanced assessment and critical thinking skills, which are responsibilities of the Registered Nurse. The LPN can collect data but not independently make critical adjustments to medication.
Question 9: A nurse is caring for a client who has dyspnea and is to receive oxygen continuously. Which of the following oxygen devices should the nurse use to deliver a precise amount of oxygen to the client?
- Nasal cannula
- Nonrebreather mask
- Simple face mask
- Venturi mask (Correct answer)
Correct answer: Venturi mask
A Venturi mask is specifically designed to deliver a precise and consistent concentration of oxygen, regardless of the client's breathing pattern. It achieves this by using different adapters that mix oxygen with room air in specific proportions. This makes it the ideal choice when a precise oxygen delivery is required for the client.
Question 10: A nurse is assisting with the management of a client who is in active labor. Which of the following findings should the nurse report following epidural placement?
- 2+ pedal edema
- Fetal heart rate 160
- Early decelerations
- Blood pressure 89/54 mmHg (Correct answer)
Correct answer: Blood pressure 89/54 mmHg
Hypotension is a common and serious complication following epidural anesthesia, as it can cause vasodilation and a significant decrease in blood pressure. A blood pressure of 89/54 mmHg is dangerously low and can compromise uteroplacental perfusion, potentially harming the fetus. This finding requires immediate nursing intervention to restore adequate blood pressure.
Question 11: The nurse is providing care to a client who is diagnosed with a personality disorder. Which finding indicates the treatment plan has been beneficial for this client?
- The client eats sporadically and reports being told she has been bad and does not deserve to eat
- The client sits with others in the lounge area conversing about current affairs (Correct answer)
- The client asks others for money because the client's was stolen
- The client has ceased self-mutilating behavior and bathes once a week
Correct answer: The client sits with others in the lounge area conversing about current affairs
A key goal in treating personality disorders, especially those involving social difficulties, is to improve social interaction and engagement. The client conversing with others about current affairs demonstrates improved social skills, appropriate engagement, and a reduction in isolation. This indicates a beneficial treatment plan that is helping the client integrate more effectively into social settings.
Question 12: A nurse is reinforcing teaching on the manifestation of complications to a client who has acute glomerulonephritis. Which of the following complications should the client report to the provider?
- Pitting edema (Correct answer)
- Temperature of 36.8C (98.4 F)
- Weight gain of 2lb in 1 week
- Dry cough
Correct answer: Pitting edema
Acute glomerulonephritis often leads to fluid retention due to impaired kidney function, resulting in edema. Pitting edema is a significant manifestation of fluid overload and indicates worsening renal function. This finding should be reported to the provider promptly as it can signal potential complications like hypertension or heart failure.
Question 13: A nurse is reviewing the health record of a client who is being admitted with a suspected tumor of the jejunum. The nurse should anticipate a prescription for which of the following tests?
- Serum alpha-fetoprotein
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Gastrointestinal x-ray with contrast (Correct answer)
- Urine bilirubin
Correct answer: Gastrointestinal x-ray with contrast
A gastrointestinal x-ray with contrast, such as a barium swallow or small bowel follow-through, is a common diagnostic test used to visualize the structure and function of the GI tract, including the jejunum. This helps identify tumors, strictures, or other abnormalities. It is the most appropriate initial test for a suspected jejunum tumor.
Question 14: The nurse is planning care for an adolescent client experiencing the manic phase of bipolar disorder. Which intervention would address hallucinations?
- Explain that hallucinations are not real (Correct answer)
- Discuss a homework assignment
- Keep isolated in a quiet room
- Encourage spending time with others
Correct answer: Explain that hallucinations are not real
When a client is experiencing hallucinations, the most appropriate nursing intervention is to gently and calmly explain that the hallucinations are not real. This helps orient the client to reality without directly confronting or arguing with their experience. Providing reality orientation helps to reduce distress and confusion associated with the hallucination.
Question 15: A client admitted with a personality disorder is observed pulling another clients hair and pushing clients out of their chairs. Which is the priority nursing intervention for this client?
- Placing the client in a jacket restraint
- Asking the client what purpose is served by disrupting others
- Establishing a therapeutic nurse-client relationship
- Removing the client from the room and addressing the behavior privately (Correct answer)
Correct answer: Removing the client from the room and addressing the behavior privately
When a client exhibits aggressive or disruptive behavior like pulling hair and pushing, the priority is to ensure the safety of all clients and staff. Removing the client from the situation and addressing the behavior privately helps de-escalate the situation and maintain a therapeutic environment for others. This approach allows for a focused intervention with the client while protecting others.
Question 16: A nurse is providing care for a client who has a placenta previa at 32 weeks of gestation. The nurse notes that the client is actively bleeding. The nurse should anticipate that the provider will prescribe which of the following types of medications?
- Methylergonovine (Methergine)
- Nifedipine (Adalat)
- Betamethasone (Celestone) (Correct answer)
- Indomethacin (Indocin)
Correct answer: Betamethasone (Celestone)
Betamethasone is a corticosteroid administered to the mother to accelerate fetal lung maturity when preterm birth is anticipated. In a client with placenta previa who is actively bleeding at 32 weeks, there is a high risk of preterm delivery. Therefore, administering betamethasone is crucial to improve the newborn's respiratory outcomes and reduce the risk of respiratory distress syndrome.
Free Licensed Practical Nurse-PN Questions and Answers
A nurse is caring for an infant who has a high bilirubin level and is receiving phototherapy.
Which of the following is the priority finding in this newborn?