LPN Licensed Practical Nurse 4 — Questions and Answers
Question 1: Which laboratory value is the LPN most concerned about in a patient receiving long-term heparin therapy?
- Complete blood count showing WBC 9,000/µL
- Platelet count dropping from 250,000 to 60,000/µL (Correct answer)
- Serum sodium of 138 mEq/L
- Hemoglobin of 13.5 g/dL
Correct answer: Platelet count dropping from 250,000 to 60,000/µL
A significant drop in platelets during heparin therapy indicates heparin-induced thrombocytopenia (HIT), a life-threatening complication requiring immediate provider notification.
Question 2: An LPN is performing a sterile dressing change. After opening the sterile field, which action contaminates it?
- Holding sterile supplies above waist level
- Reaching across the sterile field to place an item (Correct answer)
- Adding sterile saline directly to the sterile field
- Keeping the outer 1-inch border of the sterile drape unsterile
Correct answer: Reaching across the sterile field to place an item
Reaching across a sterile field allows microorganisms from clothing or non-sterile areas to fall onto it, breaking sterile technique.
Question 3: A patient with diabetes mellitus reports shakiness, diaphoresis, and confusion. The blood glucose reads 52 mg/dL. The patient is conscious. What is the priority intervention?
- Administer IV dextrose 50%
- Give 15-20 grams of fast-acting carbohydrates orally (Correct answer)
- Call the provider immediately before acting
- Administer glucagon IM
Correct answer: Give 15-20 grams of fast-acting carbohydrates orally
The 15-15 rule states that a conscious hypoglycemic patient should receive 15-20 grams of fast-acting carbohydrates orally, then recheck glucose in 15 minutes.
Question 4: When performing tracheostomy suctioning, what is the maximum recommended suction duration per pass?
- 30 seconds
- 20 seconds
- 10 seconds (Correct answer)
- 45 seconds
Correct answer: 10 seconds
Each suction pass should not exceed 10 seconds to prevent hypoxia, trauma, and vagal stimulation.
Question 5: The LPN is caring for a patient in alcohol withdrawal. Which medication class does the LPN expect to be ordered for symptom management?
- Opioid analgesics
- Benzodiazepines (Correct answer)
- Antipsychotics
- Beta-blockers
Correct answer: Benzodiazepines
Benzodiazepines are the first-line treatment for alcohol withdrawal because they cross-react with the GABA receptor system and prevent seizures and delirium tremens.
Question 6: A patient is admitted with suspected appendicitis. Which assessment finding requires the LPN to notify the provider immediately?
- Right lower quadrant pain rated 5/10
- Nausea without vomiting
- Temperature of 98.6°F
- Sudden relief of pain followed by a rigid abdomen (Correct answer)
Correct answer: Sudden relief of pain followed by a rigid abdomen
Sudden pain relief followed by a board-like rigid abdomen signals appendix rupture and peritonitis, a surgical emergency requiring immediate notification.
Question 7: A patient with a chest tube is being ambulated. The LPN accidentally disconnects the drainage tubing from the chest tube. What is the immediate action?
- Clamp the chest tube with a hemostat
- Reconnect the tubing as quickly as possible and assess the patient
- Place the end of the chest tube in a cup of sterile water and call for help (Correct answer)
- Remove the chest tube and apply a pressure dressing
Correct answer: Place the end of the chest tube in a cup of sterile water and call for help
If the chest tube separates from the drainage system, the tube end should be placed in sterile water to create a water seal while help is summoned, then reconnected.
LPN Licensed Practical Nurse 4
Which laboratory value is the LPN most concerned about in a patient receiving long-term heparin therapy?