LPN Ultimate 4 — Questions and Answers
Question 1: A patient with a pressure injury has a wound bed that is 75% yellow slough and 25% red granulation tissue. How should the LPN document this wound?
- Stage II pressure injury with granulation tissue
- Unstageable pressure injury
- Stage III pressure injury with 75% yellow, 25% red tissue (Correct answer)
- Deep tissue pressure injury
Correct answer: Stage III pressure injury with 75% yellow, 25% red tissue
Wound beds are documented by tissue type percentages; slough does not make a wound automatically unstageable unless the wound base is completely obscured.
Question 2: A patient is ordered 0.9% normal saline 125 mL/hr via gravity drip set calibrated at 15 gtt/mL. How many drops per minute should the LPN set?
- 21 gtt/min
- 25 gtt/min
- 31 gtt/min (Correct answer)
- 42 gtt/min
Correct answer: 31 gtt/min
Using the formula: (125 mL/hr × 15 gtt/mL) ÷ 60 min = 31.25, rounded to 31 gtt/min.
Question 3: When ambulating a patient with right-sided weakness using a cane, the LPN should instruct the patient to hold the cane on which side?
- The right (weak) side to support the affected limb
- The left (strong) side to bear weight during the weak leg's swing (Correct answer)
- Either side based on patient preference
- No preference — the cane should be used bilaterally
Correct answer: The left (strong) side to bear weight during the weak leg's swing
The cane is held on the stronger side to absorb weight-bearing stress when the weaker leg advances, improving balance and gait.
Question 4: A patient receiving heparin therapy has an aPTT result of 120 seconds (normal: 25–35 sec, therapeutic range: 60–100 sec). The LPN should:
- Continue heparin at the current rate
- Notify the provider immediately, as the level is supratherapeutic (Correct answer)
- Increase the heparin infusion rate
- Administer protamine sulfate without waiting for orders
Correct answer: Notify the provider immediately, as the level is supratherapeutic
An aPTT of 120 seconds is above the therapeutic range, indicating excessive anticoagulation and bleeding risk requiring provider notification.
Question 5: A patient with hypothyroidism is started on levothyroxine. Which symptom would indicate the medication is having a therapeutic effect?
- Increased weight gain and fatigue
- Improved energy level and normalization of heart rate (Correct answer)
- Development of heat intolerance and tremors
- Increased bradycardia
Correct answer: Improved energy level and normalization of heart rate
Levothyroxine replaces deficient thyroid hormone; therapeutic effects include improved energy, normalization of heart rate, and resolution of hypothyroid symptoms.
Question 6: The LPN is preparing to administer an IM injection in the ventrogluteal site. Which landmark correctly identifies this site?
- Greater trochanter, anterior superior iliac spine, and iliac crest (Correct answer)
- Center of the upper outer quadrant of the buttock
- Two fingerbreadths below the acromion process
- Lateral thigh midway between knee and hip
Correct answer: Greater trochanter, anterior superior iliac spine, and iliac crest
The ventrogluteal site is located using the greater trochanter, anterior superior iliac spine, and iliac crest, forming a triangle.
Question 7: A patient with a nasogastric tube to low wall suction reports cramping and nausea. Assessment reveals decreased bowel sounds. Which complication should the LPN suspect?
- Tube migration into the trachea
- Electrolyte imbalance from prolonged suctioning
- Tube clogging requiring irrigation
- Paralytic ileus (Correct answer)
Correct answer: Paralytic ileus
Absent or decreased bowel sounds combined with cramping after prolonged NGT suction suggests paralytic ileus, a serious GI complication.
LPN Ultimate 4
A patient with a pressure injury has a wound bed that is 75% yellow slough and 25% red granulation tissue.
How should the LPN document this wound?