LPN Ultimate 3 — Questions and Answers
Question 1: A patient with diabetes mellitus type 2 presents with Kussmaul respirations, fruity breath, and blood glucose of 420 mg/dL. These findings are most consistent with:
- Hyperosmolar hyperglycemic state (HHS)
- Diabetic ketoacidosis (DKA) (Correct answer)
- Severe hypoglycemia
- Lactic acidosis
Correct answer: Diabetic ketoacidosis (DKA)
DKA presents with Kussmaul respirations (compensatory hyperventilation for acidosis), fruity breath from ketones, and hyperglycemia.
Question 2: The LPN is caring for a patient in Buck's traction. Which assessment is most important?
- Skin integrity under the traction boot (Correct answer)
- Bowel sounds every 4 hours
- Pupillary response bilaterally
- Level of consciousness hourly
Correct answer: Skin integrity under the traction boot
Skin integrity under the traction boot is the priority because continuous pressure can cause pressure ulcers, skin breakdown, and neurovascular compromise.
Question 3: A patient taking lithium reports nausea, tremor, and blurred vision. The LPN recognizes these as signs of:
- A therapeutic lithium level
- Lithium toxicity (Correct answer)
- An allergic reaction to lithium
- Serotonin syndrome
Correct answer: Lithium toxicity
Nausea, tremors, and blurred vision are early signs of lithium toxicity, which has a narrow therapeutic index (0.6–1.2 mEq/L).
Question 4: When teaching a patient about iron supplement administration, the LPN should instruct the patient to take it:
- With milk to reduce GI upset
- On an empty stomach or with vitamin C (Correct answer)
- At bedtime to maximize absorption
- With antacids to neutralize stomach acid
Correct answer: On an empty stomach or with vitamin C
Iron is best absorbed on an empty stomach, and vitamin C (ascorbic acid) enhances iron absorption by keeping it in the ferrous state.
Question 5: A patient with a history of COPD is admitted with increased dyspnea. Which oxygen delivery method should the LPN anticipate using?
- Non-rebreather mask at 15 L/min
- Venturi mask at a controlled FiO2 (Correct answer)
- Nasal cannula at 6 L/min
- Simple face mask at 10 L/min
Correct answer: Venturi mask at a controlled FiO2
COPD patients require controlled, low-concentration oxygen via a Venturi mask to avoid suppressing their hypoxic respiratory drive.
Question 6: Which electrolyte imbalance is most likely in a patient who has been vomiting for 3 days?
- Hyperkalemia and metabolic acidosis
- Hypokalemia and metabolic alkalosis (Correct answer)
- Hypernatremia and respiratory acidosis
- Hyponatremia and respiratory alkalosis
Correct answer: Hypokalemia and metabolic alkalosis
Prolonged vomiting causes loss of hydrochloric acid and potassium, resulting in hypokalemia and metabolic alkalosis.
Question 7: A postpartum patient is at highest risk for hemorrhage when:
- The uterus is firm and midline at the umbilicus
- The uterus is boggy and displaced to the right (Correct answer)
- Lochia is rubra with small clots on the first day
- The fundus is one fingerbreadth below the umbilicus at 24 hours
Correct answer: The uterus is boggy and displaced to the right
A boggy (atonic) uterus cannot contract to compress bleeding vessels; displacement may also indicate bladder distension impeding contraction.
LPN Ultimate 3
A patient with diabetes mellitus type 2 presents with Kussmaul respirations, fruity breath, and blood glucose of 420 mg/dL.
These findings are most consistent with: