LPN Physiological Adaptation 2 — Questions and Answers
Question 1: A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which ECG change should the LPN anticipate?
- Peaked T waves (Correct answer)
- Prolonged PR interval only
- ST elevation
- Widened QRS only
Correct answer: Peaked T waves
Hyperkalemia first manifests on ECG as peaked (tall, narrow) T waves before progressing to widened QRS and sine-wave pattern.
Question 2: A patient develops sudden-onset wheezing, urticaria, and hypotension after receiving IV penicillin. The priority intervention is to administer:
- Epinephrine 1:1000 IM (Correct answer)
- Diphenhydramine IV
- Methylprednisolone IV
- Albuterol nebulizer
Correct answer: Epinephrine 1:1000 IM
Anaphylaxis requires immediate epinephrine 1:1000 IM (usually in the thigh) as the first-line life-saving intervention.
Question 3: Which assessment finding in a patient with liver cirrhosis indicates hepatic encephalopathy?
- Asterixis (flapping tremor) (Correct answer)
- Ascites
- Spider angiomata
- Gynecomastia
Correct answer: Asterixis (flapping tremor)
Asterixis, a flapping hand tremor elicited by wrist extension, is a hallmark neurological sign of hepatic encephalopathy due to ammonia accumulation.
Question 4: A patient with COPD is receiving oxygen therapy. The LPN should maintain SpO2 at which target range to avoid suppressing hypoxic drive?
- 88–92% (Correct answer)
- 95–100%
- 80–85%
- 93–95%
Correct answer: 88–92%
COPD patients rely on hypoxic drive; target SpO2 of 88–92% provides adequate oxygenation without eliminating the hypoxic stimulus to breathe.
Question 5: A post-operative patient reports sudden pleuritic chest pain and shortness of breath. The LPN notes tachycardia and decreased breath sounds on the right. These findings most suggest:
- Pulmonary embolism (Correct answer)
- Pneumonia
- Pleural effusion
- Atelectasis
Correct answer: Pulmonary embolism
Sudden pleuritic chest pain, dyspnea, tachycardia, and decreased breath sounds in a post-op patient are classic signs of pulmonary embolism.
Question 6: A patient with syndrome of inappropriate antidiuretic hormone (SIADH) will most likely exhibit which lab finding?
- Serum sodium 118 mEq/L (Correct answer)
- Serum sodium 148 mEq/L
- Urine specific gravity 1.001
- Serum potassium 6.0 mEq/L
Correct answer: Serum sodium 118 mEq/L
SIADH causes water retention and dilutional hyponatremia; a serum sodium below 135 mEq/L (often severely low) is the defining lab finding.
Question 7: Which intervention is most important when caring for a patient in thyroid storm?
- Apply cooling blankets and administer propylthiouracil (PTU) (Correct answer)
- Administer levothyroxine as ordered
- Provide a warm environment and increase fluid restriction
- Encourage ambulation to reduce metabolic rate
Correct answer: Apply cooling blankets and administer propylthiouracil (PTU)
Thyroid storm requires lowering the elevated metabolic rate with cooling measures and blocking thyroid hormone synthesis with PTU or methimazole.
LPN Physiological Adaptation 2
A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which ECG change should the LPN anticipate?