LPN Licensed Practical Nurse 2 — Questions and Answers
Question 1: A patient is prescribed digoxin 0.125 mg daily. Before administering, the LPN assesses an apical pulse of 52 bpm. What is the priority action?
- Administer the dose as prescribed
- Hold the medication and notify the provider (Correct answer)
- Administer half the dose
- Document and reassess in 30 minutes
Correct answer: Hold the medication and notify the provider
Digoxin is held and the provider notified when the apical pulse is below 60 bpm in adults, as bradycardia is a sign of toxicity.
Question 2: Which electrolyte imbalance most increases a patient's risk for digoxin toxicity?
- Hypernatremia
- Hypokalemia (Correct answer)
- Hypermagnesemia
- Hypercalcemia
Correct answer: Hypokalemia
Hypokalemia potentiates digoxin toxicity because low potassium increases myocardial sensitivity to the drug.
Question 3: An LPN is caring for a patient with a stage 2 pressure injury on the coccyx. Which dressing type is most appropriate?
- Dry gauze dressing
- Hydrocolloid dressing (Correct answer)
- Wet-to-dry dressing
- Alginate dressing
Correct answer: Hydrocolloid dressing
Hydrocolloid dressings maintain a moist wound environment and are recommended for stage 2 pressure injuries with minimal to moderate exudate.
Question 4: A patient is 24 hours post-operative from abdominal surgery. The LPN notices the wound edges are separated and the bowel is visible. What is the priority intervention?
- Apply a dry sterile dressing
- Cover the wound with saline-moistened sterile gauze (Correct answer)
- Push the bowel back and apply pressure
- Document and notify the charge nurse at shift change
Correct answer: Cover the wound with saline-moistened sterile gauze
Evisceration requires immediate coverage with sterile saline-moistened gauze while the provider is notified emergently.
Question 5: Which finding in a patient receiving a blood transfusion requires the LPN to stop the infusion immediately?
- Mild fatigue
- Temperature rise of 1°F within 15 minutes of starting (Correct answer)
- Blood pressure 128/80 mmHg
- Urine output of 40 mL/hr
Correct answer: Temperature rise of 1°F within 15 minutes of starting
A temperature increase of 1°F or more during a transfusion signals a possible transfusion reaction and requires the infusion to be stopped immediately.
Question 6: A patient with COPD is receiving oxygen therapy. Which oxygen flow rate is safest to initiate?
- 6-8 L/min via simple mask
- 10-12 L/min via non-rebreather
- 1-2 L/min via nasal cannula (Correct answer)
- 15 L/min via non-rebreather
Correct answer: 1-2 L/min via nasal cannula
COPD patients rely on hypoxic drive, so low-flow oxygen (1-2 L/min) via nasal cannula is used to avoid suppressing their respiratory stimulus.
Question 7: The LPN is preparing to administer a subcutaneous insulin injection. Which site should be avoided in a patient who is about to exercise their legs?
- Abdomen
- Upper arm
- Thigh (Correct answer)
- Upper back
Correct answer: Thigh
Insulin injected into the thigh is absorbed faster during leg exercise, which can cause hypoglycemia, so the abdomen is preferred before leg activity.
LPN Licensed Practical Nurse 2
A patient is prescribed digoxin 0.125 mg daily.
Before administering, the LPN assesses an apical pulse of 52 bpm.
What is the priority action?