LPN Licensed Practical Nurse-RN 3 — Questions and Answers
Question 1: A patient tells the LPN they want to leave the hospital against medical advice (AMA). The LPN's first action should be to:
- Lock the patient's room door to prevent departure
- Notify the RN and charge nurse immediately (Correct answer)
- Ask the patient to sign the AMA form right away
- Call security to detain the patient
Correct answer: Notify the RN and charge nurse immediately
The LPN must immediately notify the RN and charge nurse so the provider can be notified, risks explained, and proper AMA procedures followed.
Question 2: When administering an intramuscular (IM) injection to an obese adult patient, the LPN should use a needle length of:
- 5/8 inch
- 1 inch
- 1.5 inches (Correct answer)
- 2-3 inches
Correct answer: 1.5 inches
A 1.5-inch needle is standard for IM injections in average adults; for obese patients, 1.5-2 inches is recommended to reach muscle tissue.
Question 3: A patient is ordered furosemide (Lasix) 40 mg IV. Which lab value should the LPN review BEFORE administration?
- Serum sodium
- Serum potassium (Correct answer)
- Serum calcium
- Serum magnesium
Correct answer: Serum potassium
Furosemide causes potassium wasting; hypokalemia must be identified before administration to prevent life-threatening cardiac arrhythmias.
Question 4: A patient in restraints must be assessed every:
- 30 minutes (Correct answer)
- 1 hour
- 2 hours
- 4 hours
Correct answer: 30 minutes
Patients in restraints require assessment every 30 minutes including circulation, skin integrity, and need for continued restraint per The Joint Commission standards.
Question 5: An LPN is preparing to administer a unit of packed red blood cells. Before hanging the blood, the nurse must verify with another nurse:
- The patient's most recent hemoglobin level and diagnosis
- The blood type, unit number, expiration date, and patient identification (Correct answer)
- That the patient has signed the blood transfusion consent form only
- The IV catheter gauge and site patency only
Correct answer: The blood type, unit number, expiration date, and patient identification
Two licensed nurses must verify blood type, unit number, expiration, and patient ID to prevent a potentially fatal transfusion reaction.
Question 6: A patient is receiving a blood transfusion and develops fever, chills, and lower back pain 15 minutes into the infusion. The LPN should FIRST:
- Slow the transfusion rate and administer acetaminophen
- Stop the transfusion and maintain IV access with normal saline (Correct answer)
- Notify the blood bank to send a replacement unit
- Increase the flow rate to complete the transfusion quickly
Correct answer: Stop the transfusion and maintain IV access with normal saline
Signs of a hemolytic transfusion reaction require immediately stopping the transfusion and maintaining IV access with NS while notifying the RN.
Question 7: A patient with a pressure injury stage II has a wound with a shallow open ulcer and a red-pink wound bed. The appropriate dressing for this wound is:
- Wet-to-dry gauze dressing
- Hydrocolloid or foam dressing (Correct answer)
- Dry sterile gauze
- Transparent film only over intact skin
Correct answer: Hydrocolloid or foam dressing
Stage II pressure injuries with moist wound beds are best managed with hydrocolloid or foam dressings that maintain a moist healing environment.
LPN Licensed Practical Nurse-RN 3
A patient tells the LPN they want to leave the hospital against medical advice (AMA).
The LPN's first action should be to: