LPN Licensed Practical Nurse 5 — Questions and Answers
Question 1: Which statement by a patient indicates a need for further teaching about colostomy care?
- I will empty my pouch when it is one-third to one-half full.
- I should change my pouch system every 3-7 days or when leaking.
- I should not eat any foods that may cause gas. (Correct answer)
- I can shower with my pouch on or off.
Correct answer: I should not eat any foods that may cause gas.
Patients do not need to eliminate gas-producing foods entirely; they should identify personal triggers and manage their diet to minimize discomfort, not restrict all such foods.
Question 2: The LPN is caring for a patient in heart failure. Which assessment finding indicates that diuretic therapy is effective?
- Weight gain of 2 lb in 24 hours
- Increased bilateral crackles on auscultation
- Urine output of 200 mL over 8 hours
- Daily weight decreased by 2 lb and edema reduced (Correct answer)
Correct answer: Daily weight decreased by 2 lb and edema reduced
Effective diuresis in heart failure is demonstrated by weight loss (approximately 1 lb per liter of fluid lost) and reduced edema.
Question 3: A patient is receiving a continuous tube feeding and begins to vomit. What is the LPN's first action?
- Increase the head of bed to 90 degrees and continue the feeding
- Stop the feeding and turn the patient on their side (Correct answer)
- Slow the infusion rate and document
- Reposition the NG tube and continue feeding
Correct answer: Stop the feeding and turn the patient on their side
Stopping the feeding and turning the patient on their side prevents aspiration, which is the immediate life-threatening risk during vomiting.
Question 4: A patient is ordered a medication that has a narrow therapeutic index. Which nursing action is most important before administration?
- Administer quickly to avoid delays in treatment
- Verify the dose, time, route, and check current serum drug level if applicable (Correct answer)
- Ask the patient if they have taken the medication before
- Check the medication against a drug reference only
Correct answer: Verify the dose, time, route, and check current serum drug level if applicable
Medications with narrow therapeutic indices (e.g., digoxin, lithium, phenytoin) require verification of dose, route, timing, and current serum levels to prevent toxicity.
Question 5: Which pain assessment tool is most appropriate for a patient with moderate dementia who cannot verbally report pain?
- Numeric Rating Scale (NRS) 0-10
- Visual Analog Scale (VAS)
- PAINAD (Pain Assessment in Advanced Dementia) scale (Correct answer)
- Wong-Baker FACES scale
Correct answer: PAINAD (Pain Assessment in Advanced Dementia) scale
The PAINAD scale assesses pain through behavioral indicators such as breathing, vocalizations, facial expressions, body language, and consolability in patients who cannot self-report.
Question 6: A patient on a medical-surgical unit pulls out their peripheral IV while the LPN is out of the room. The LPN enters and finds the site bleeding. What is the first action?
- Reinsert the IV catheter immediately
- Apply firm direct pressure to the site (Correct answer)
- Call the provider for orders
- Document the incident and apply a bandage
Correct answer: Apply firm direct pressure to the site
Direct pressure on the site is the immediate intervention to control bleeding before other actions such as documentation or provider notification.
Question 7: The LPN is preparing to administer medications through a patient's jejunostomy tube (J-tube). Which action is correct?
- Crush all medications and mix them together before instilling
- Verify each medication is appropriate for jejunal delivery and flush between each (Correct answer)
- Administer medications rapidly to reduce tube clogging
- Mix medications with the enteral formula for ease of administration
Correct answer: Verify each medication is appropriate for jejunal delivery and flush between each
Each medication must be assessed for compatibility with J-tube delivery (some extended-release formulations cannot be crushed), and the tube must be flushed between each medication to prevent clogging and drug interactions.
LPN Licensed Practical Nurse 5
Which statement by a patient indicates a need for further teaching about colostomy care?