LPN Licensed Practical Nurse-RN 2 — Questions and Answers
Question 1: An LPN is caring for a patient with a nasogastric tube for enteral feeding. Before administering the feeding, the nurse should first:
- Flush the tube with 30 mL of water
- Verify tube placement by checking gastric aspirate pH (Correct answer)
- Warm the formula to body temperature
- Elevate the head of the bed to 90 degrees
Correct answer: Verify tube placement by checking gastric aspirate pH
Checking gastric aspirate pH (less than 5) confirms NG tube placement in the stomach before feeding.
Question 2: A patient is prescribed potassium chloride 40 mEq IV. The LPN should:
- Administer it as an IV push over 2 minutes
- Mix it in 100 mL NS and infuse over 1 hour
- Refuse to administer and notify the charge nurse (Correct answer)
- Add it directly to the existing IV bag at the bedside
Correct answer: Refuse to administer and notify the charge nurse
LPNs are not authorized to administer IV potassium chloride; this requires an RN due to the risk of fatal cardiac arrhythmias.
Question 3: Which finding in a patient receiving heparin therapy requires IMMEDIATE reporting to the RN?
- aPTT of 60-100 seconds
- Urine output of 40 mL/hour
- New-onset petechiae and oozing from IV site (Correct answer)
- Heart rate of 78 beats per minute
Correct answer: New-onset petechiae and oozing from IV site
Petechiae and bleeding from IV sites indicate possible heparin-induced thrombocytopenia (HIT) or overdose requiring immediate intervention.
Question 4: An LPN is performing a sterile dressing change. The nurse accidentally touches the sterile field with an ungloved hand. The correct action is to:
- Continue the dressing change carefully
- Apply an alcohol swab to the contaminated area and continue
- Discard the sterile field and start over with new supplies (Correct answer)
- Ask another nurse to complete the procedure
Correct answer: Discard the sterile field and start over with new supplies
Once a sterile field is contaminated, it must be discarded and a new sterile setup established to prevent infection.
Question 5: A patient with Type 1 diabetes reports shakiness, diaphoresis, and confusion. The LPN checks the blood glucose and gets a reading of 48 mg/dL. The patient is conscious and able to swallow. The first intervention is:
- Administer 1 mg glucagon intramuscularly
- Give 15-20 grams of fast-acting carbohydrates orally (Correct answer)
- Start a D50 IV bolus immediately
- Call the physician before doing anything
Correct answer: Give 15-20 grams of fast-acting carbohydrates orally
The 15-15 rule: give 15 g of fast-acting carbohydrates orally to a conscious hypoglycemic patient, then recheck glucose in 15 minutes.
Question 6: When performing tracheostomy care, the LPN should change the tracheostomy ties when:
- The ties are completely dry and intact
- A second person is available to hold the tube in place (Correct answer)
- The patient is in a supine position with neck flexed
- The tube has been in place for less than 72 hours
Correct answer: A second person is available to hold the tube in place
A second person must hold the tracheostomy tube securely during tie changes to prevent accidental decannulation.
Question 7: An LPN is caring for a postoperative patient 4 hours after abdominal surgery. The patient's blood pressure drops from 118/76 to 88/54 mmHg and heart rate increases from 80 to 118 bpm. The LPN's priority action is to:
- Reposition the patient to the left lateral position
- Administer the ordered PRN pain medication
- Notify the RN immediately and stay with the patient (Correct answer)
- Increase the IV fluid rate per standing orders
Correct answer: Notify the RN immediately and stay with the patient
Hypotension with compensatory tachycardia in a postoperative patient may indicate hemorrhage or shock, requiring immediate RN/provider notification.
LPN Licensed Practical Nurse-RN 2
An LPN is caring for a patient with a nasogastric tube for enteral feeding.
Before administering the feeding, the nurse should first: