LPN Ultimate 5 — Questions and Answers
Question 1: A nurse aide reports that a confused elderly patient stated 'the night nurse hit me last night.' Under mandatory reporting requirements, the LPN should:
- Document the statement and monitor the patient for further complaints
- Report the allegation to the charge nurse and/or appropriate authority immediately (Correct answer)
- Investigate independently before involving administration
- Dismiss the claim because the patient is confused
Correct answer: Report the allegation to the charge nurse and/or appropriate authority immediately
LPNs are mandatory reporters; allegations of abuse must be reported immediately to the charge nurse and appropriate authority regardless of the patient's cognitive status.
Question 2: A patient with a new colostomy refuses to look at the stoma or participate in care. The LPN's best therapeutic response is:
- 'You'll need to learn this before discharge.'
- 'I understand this is difficult. Would you like to watch while I care for it today?' (Correct answer)
- 'Many patients feel the same way at first, but you'll get used to it.'
- 'Your family can take care of this for you at home.'
Correct answer: 'I understand this is difficult. Would you like to watch while I care for it today?'
Acknowledging the patient's feelings and offering a gradual approach (observing first) respects autonomy and facilitates adaptation to the body change.
Question 3: A patient with chronic heart failure is prescribed furosemide. Which daily assessment is most important for monitoring fluid status?
- Blood pressure sitting and standing
- Daily weight at the same time each morning (Correct answer)
- Intake and output every 8 hours
- Respiratory rate every 4 hours
Correct answer: Daily weight at the same time each morning
Daily weights taken consistently in the morning before eating and after voiding provide the most accurate reflection of fluid retention or loss.
Question 4: A patient is ordered morphine 4 mg IV push for pain. After administration, the patient's respiratory rate drops to 8 breaths/min. The LPN's priority action is to:
- Apply supplemental oxygen and reposition the patient
- Administer naloxone (Narcan) per standing orders and notify the provider (Correct answer)
- Document the finding and reassess in 15 minutes
- Withhold the next scheduled dose of morphine
Correct answer: Administer naloxone (Narcan) per standing orders and notify the provider
A respiratory rate of 8/min indicates opioid-induced respiratory depression; naloxone must be administered immediately to reverse the opioid effect.
Question 5: Which action by the LPN best demonstrates understanding of HIPAA regulations?
- Discussing a patient's condition with the family in the hallway when no other patients are nearby
- Sharing login credentials with a coworker to access lab results quickly during a code
- Logging out of the electronic health record after reviewing a patient's chart (Correct answer)
- Faxing medical records without a cover sheet to another facility
Correct answer: Logging out of the electronic health record after reviewing a patient's chart
Logging out of the EHR after use protects patient data from unauthorized access, which is a core HIPAA privacy and security requirement.
Question 6: A patient with Clostridium difficile (C. diff) infection requires which type of isolation precautions?
- Airborne precautions with N95 respirator
- Droplet precautions with surgical mask
- Contact precautions with gown and gloves (Correct answer)
- Neutropenic (reverse) isolation precautions
Correct answer: Contact precautions with gown and gloves
C. diff spreads via the fecal-oral route through spores on surfaces; contact precautions (gown and gloves) and handwashing with soap and water are required.
Question 7: A patient with myasthenia gravis is in crisis and has increasing difficulty swallowing and speaking. The LPN's immediate priority is to:
- Administer the next scheduled dose of pyridostigmine
- Assess and protect the airway and notify the provider immediately (Correct answer)
- Encourage the patient to rest and reassess in one hour
- Obtain a stat chest X-ray
Correct answer: Assess and protect the airway and notify the provider immediately
Myasthenic crisis causes progressive respiratory muscle weakness; airway compromise is life-threatening and requires immediate provider notification and airway management.
LPN Ultimate 5
A nurse aide reports that a confused elderly patient stated 'the night nurse hit me last night.' Under mandatory reporting requirements, the LPN should: