LPN Ultimate 2 — Questions and Answers
Question 1: A patient on warfarin reports eating large amounts of leafy green vegetables daily. What is the primary concern?
- Increased bleeding risk due to vitamin K deficiency
- Decreased anticoagulant effect due to high vitamin K intake (Correct answer)
- Renal toxicity from oxalate accumulation
- Hyperkalemia from excess potassium
Correct answer: Decreased anticoagulant effect due to high vitamin K intake
Vitamin K antagonizes warfarin's anticoagulant effect, so high intake of leafy greens can decrease INR and increase clot risk.
Question 2: When performing a sterile dressing change, the LPN accidentally touches the sterile field with an ungloved hand. What is the correct action?
- Continue the procedure quickly to minimize contamination time
- Discard the contaminated supplies and obtain a new sterile setup (Correct answer)
- Apply an antiseptic to the touched area and proceed
- Document the breach and monitor for infection
Correct answer: Discard the contaminated supplies and obtain a new sterile setup
Any break in sterile technique requires discarding contaminated materials and starting fresh to prevent infection.
Question 3: A patient's oxygen saturation drops to 88% while sleeping. Which position change should the LPN implement first?
- Trendelenburg position
- High Fowler's position (Correct answer)
- Left lateral decubitus position
- Prone position
Correct answer: High Fowler's position
High Fowler's position (60–90°) maximizes lung expansion and improves oxygenation by reducing pressure on the diaphragm.
Question 4: A patient with end-stage renal disease is prescribed aluminum hydroxide antacids. What is the therapeutic purpose in this population?
- Treating gastric ulcers
- Binding dietary phosphate in the GI tract (Correct answer)
- Correcting metabolic acidosis
- Preventing constipation
Correct answer: Binding dietary phosphate in the GI tract
In ESRD, aluminum hydroxide binds phosphate in the gut to reduce hyperphosphatemia, a common complication of renal failure.
Question 5: Which assessment finding in a postoperative patient requires immediate reporting to the charge nurse?
- Urine output of 35 mL/hour
- Temperature of 99.2°F at 24 hours post-op
- Blood pressure of 88/52 mmHg (Correct answer)
- Mild incisional pain rated 3/10
Correct answer: Blood pressure of 88/52 mmHg
A blood pressure of 88/52 mmHg indicates hypotension, a sign of possible hemorrhage or shock requiring immediate intervention.
Question 6: A patient receiving enteral tube feedings develops diarrhea. Which intervention should the LPN implement first?
- Discontinue the tube feeding immediately
- Check the rate and concentration of the formula (Correct answer)
- Administer an antidiarrheal medication
- Obtain a stool culture
Correct answer: Check the rate and concentration of the formula
Verifying the rate and concentration of formula is the first step, as too rapid infusion or hypertonic formula commonly causes diarrhea.
Question 7: During a blood transfusion, the patient develops chills, fever, and low back pain 15 minutes into the infusion. The LPN's priority action is to:
- Slow the transfusion rate and monitor closely
- Stop the transfusion and maintain IV access with normal saline (Correct answer)
- Administer acetaminophen and continue the transfusion
- Obtain a repeat blood type and crossmatch
Correct answer: Stop the transfusion and maintain IV access with normal saline
Signs of a transfusion reaction require immediately stopping the blood and maintaining IV access with normal saline while notifying the provider.
LPN Ultimate 2
A patient on warfarin reports eating large amounts of leafy green vegetables daily.
What is the primary concern?