Professional Nursing and Legalities
An LPN is working under the supervision of an RN in the hospital. Which of the following tasks can the LPN perform?
A) Administer IV chemo.
B) Develop a nursing diagnosis and care plan.
C) Administer oral medications and monitor vital signs.
D) Independently initiate blood transfusion therapy.
C.
LPNs are trained to provide basic nursing care, which includes administering oral medications and monitoring vital signs. However, they cannot independently develop care plans, administer IV chemotherapy, or initiate blood transfusions, as these tasks require an RN’s level of training.
The LPN is caring for an unconscious client who requires oral hygiene. Which action is most important?
A. Place the client supine in bed
B. Brush teeth twice daily with a hard-bristled toothbrush
C. Position the client in a side-lying position
D. Rinse with an alcohol-based mouthwash
Correct Answer: C. Position the client in a side-lying position
Side-lying positioning prevents aspiration of saliva or oral secretions during care
A confused patient keeps trying to get out of bed without assistance. What is the best action for the LPN?
A. Apply physical restraints immediately to prevent injury.
B. Move the patient to a room closer to the nurses’ station and use a bed alarm.
C. Lower all four bedrails to make it easier for the patient to get out of bed.
D. Leave the patient alone to allow them to settle down.
Correct Answer: B
Rationale: Preventing falls is a key patient safety goal. Using a bed alarm and keeping the patient closer to supervision helps ensure safety while avoiding unnecessary restraint use, which should only be used as a last resort.
When communicating with a patient who speaks a different language, what should the LPN do?
A. Speak louder and slowly to help the patient understand.
B. Use gestures to explain the message.
C. Use an interpreter to ensure accurate communication.
D. Assume that the patient understands if they nod in agreement.
Correct Answer: C
Rationale: Using an interpreter ensures that communication is accurate and clear, reducing the risk of misunderstandings and promoting patient safety. Speaking loudly or using gestures may not guarantee comprehension, and assuming understanding can lead to errors in care.
The LPN is caring for a patient diagnosed with a Clostridium difficile (C. diff) infection. Which of the following actions by the LPN is correct?
A. Use alcohol-based hand sanitizer after patient contact.
B. Use contact precautions and wash hands with soap and water.
C. Place the patient on airborne precautions.
D. Disinfect the room with a regular disinfectant after patient discharge.
Correct Answer: B
Rationale: C. diff is resistant to alcohol-based hand sanitizers, so soap and water are required for hand hygiene after patient contact. Contact precautions should be used, and the room must be disinfected with bleach-based products to kill the bacteria. Airborne precautions are not necessary for C. diff, as it spreads via spores.
A patient is recovering from surgery and is prescribed a clear liquid diet. Which of the following foods is appropriate for this diet?
A. Creamed soup
B. Chicken broth
C. Mashed potatoes
D. Custard
Correct Answer: B
Rationale: A clear liquid diet includes liquids that are transparent and free from solid particles, like chicken broth. Creamed soups and mashed potatoes are not clear and contain solids, while custard contains dairy, which is generally not part of a clear liquid diet.
Which of the following is not an essential part of the admission process?
A) Identify the patient and ensure the correct wristband is in place.
B) Complete an initial assessment
C) Prepare the room for the patient's arrival.
D) Provide a bed bath upon arrival to the unit.
E) Document a height and weight.
Correct answer: D
Rationale: While some patient's might benefit from a bed bath upon admission, it is not a required step.
The nurse is assessing a patient who reports shortness of breath. Which of the following actions should the nurse take first?
A. Ask the patient to rate the shortness of breath on a scale from 0 to 10
B. Check the patient’s oxygen saturation using a pulse oximeter
C. Auscultate lung sounds for adventitious breath sounds
D. Review the patient’s medical record for a history of respiratory disease
Correct Answer: B
Rationale: According to the nursing process, you must collect data first. C is also important, but option B quickly assesses the ABCs which is a priority
In a healthcare team, which of the following actions by an LPN requires immediate intervention by an RN?
A. Reinforcing patient education after the RN has provided initial teaching
B. Performing a sterile dressing change on a surgical wound
C. Initiating a plan of care for a newly admitted patient
D. Collecting data for an RN to use in patient assessment
Correct Answer: C
LPNs assist in patient care but do not have the authority to initiate a care plan. Only RNs are responsible for assessing patients and formulating initial care plans. While LPNs can reinforce education, perform some sterile procedures, and collect data, they must work under RN supervision.
Mr. Visser, age 70, is admitted to the medical-surgical unit and requires assistance with shaving. He is on anticoagulant therapy for atrial fibrillation. Which action by the LPN is most appropriate when assisting Mr. Visser with shaving?
A. Use an electric razor to shave him
B. Use a straight-edge razor with shaving cream
C. Shave quickly with a disposable razor to minimize discomfort
D. Explain to the patient that he should not shave.
Correct Answer: A.
The nurse enters a patient’s room and finds the bed in the highest position with the side rails down. The patient is confused and trying to climb out. What should the nurse do first?
A. Raise the side rails and lower the bed to the lowest position.
B. Apply a vest restraint.
C. Reorient the patient and leave the room.
D. Notify the provider of confusion.
Correct Answer: A
An LPN is caring for an elderly patient who seems withdrawn and avoids eye contact. How should the nurse respond to ensure effective communication?
A. Assume that the patient is uninterested and focus on other tasks.
B. Encourage the patient to talk but avoid making direct eye contact.
C. Sit at the patient’s level, speak slowly and clearly, and allow time for responses.
D. Ask the patient directly why they are avoiding communication.
Correct Answer: C
Rationale: Sitting at the patient’s level and allowing time for responses creates an environment where the patient feels comfortable, respected, and heard. Speaking slowly and clearly helps ensure the patient understands, especially if there are hearing or cognitive concerns.
An LPN observes a fellow nurse failing to wash their hands before a procedure. What is the most appropriate action?
A. Ignore it, assuming the other nurse knows best.
B. Immediately report the nurse to the state board of nursing.
C. Remind the nurse about proper hand hygiene and patient safety.
D. Tell the patient that their nurse is not following infection control protocols.
C
Patient safety and infection control are legal and ethical responsibilities of nurses. Addressing the issue with the colleague first promotes professional accountability and teamwork. If the behavior continues, it should be reported to the appropriate supervisor.
A diabetic patient asks why they should limit carbohydrate intake. Which of the following is the best explanation for this recommendation?
A. "Carbohydrates cause your blood sugar to rise quickly, which can lead to hyperglycemia."
B. "Carbohydrates cause your blood pressure to rise, which can lead to hypertension."
C. "Carbohydrates are not as important as protein in managing diabetes."
D. "Carbohydrates are essential for energy, so they should be avoided entirely to control blood sugar."
Correct Answer: A
Rationale: Carbohydrates are broken down into glucose in the body, which can cause a rapid increase in blood sugar levels, especially in diabetic patients. Limiting carbohydrate intake helps in managing blood glucose levels and preventing hyperglycemia. The statement about avoiding carbohydrates entirely is incorrect, as they are an essential energy source, but moderation is key.
An LPN is preparing a patient for discharge after treatment for a stroke. Which of the following is an essential step in the discharge process for this patient?
A. Ensure the patient has a follow-up appointment with a neurologist.
B. Recommend that the patient drive to their follow-up appointments.
C. Provide the patient with an exercise regimen to be followed immediately.
D. Instruct the patient to discontinue medications unless otherwise instructed.
Correct Answer: A
Rationale: A follow-up appointment with a neurologist or appropriate healthcare provider is critical after a stroke to monitor recovery and prevent future complications. The patient may need adjustments in medications or therapy, and driving may not be safe right after a stroke. An exercise regimen should be prescribed carefully and gradually. Medications should never be discontinued without physician approval.
When performing an abdominal assessment, the LPN knows that the correct order of assessment is: Inspection, Auscultation, Palpation, and Percussion. Why is auscultation performed before palpation?
A. Palpating the abdomen before auscultating may alter bowel sounds.
B. Percussion must be done first to assess the organ size.
C. Palpation will help locate the areas where bowel sounds should be heard.
D. Inspection should always be done after palpation to observe any changes.
Correct Answer: A
Rationale: Palpating the abdomen before auscultating can alter the bowel sounds due to the movement and pressure applied to the abdomen. To get accurate auscultation findings, the abdomen should be palpated after auscultation.
The LPN is working on a medical-surgical unit. A RN asks the LPN to assist with care for a newly admitted client who has unstable vital signs and is being evaluated for sepsis. Which action is appropriate for the LPN to perform based on the state regulations?
A. Perform the initial comprehensive assessment of the client’s condition
B. Develop and revise the client’s plan of care
C. Collect and report data about the client’s vital signs and symptoms to the RN
D. Independently initiate IV antibiotic therapy for the client
C. Collect and report data about the client’s vital signs and symptoms to the RN
Mr. Peterson, age 68, is admitted with limited mobility and requires assistance with personal hygiene. He reports occasional eye dryness and mild crusting in the morning. Which action by the LPN is most appropriate when providing routine eye care?
A. Use a clean, damp washcloth to wipe the eyes from inner to outer canthus
B. Apply gentle pressure directly to the eyeball to remove crusting
C. Clean the eyelids with soap or alcohol-based solution
D. Wipe both eyes with the same cloth to save time
Answer: A
The LPN is reinforcing discharge instructions for a patient taking anticoagulants. Which statement by the patient indicates a need for further teaching?
A. "I will use an electric razor instead of a regular one to prevent cuts."
B. "I should avoid contact sports and activities that could cause injury."
C. "I can take aspirin for headaches if needed."
D. "I need to watch for signs of unusual bleeding, such as nosebleeds or bruising."
Correct Answer: C
Rationale: Aspirin is a blood thinner and can increase bleeding risk in patients taking anticoagulants. This requires further teaching to ensure patient safety.
The LPN is communicating a patient's vital signs to the healthcare provider over the phone. Which of the following is the most appropriate way to communicate this information?
A. Provide all the patient's history, including family background, before stating the vital signs.
B. Be brief, state the facts, and offer to provide additional information as needed.
C. Use medical terminology only, assuming the provider is familiar with the patient's condition.
D. Leave out details about the vital signs if they seem normal to avoid overwhelming the provider.
Correct Answer: B
Rationale: Effective communication involves providing clear, concise, and relevant information. Being brief and to the point ensures the healthcare provider receives the necessary details without unnecessary background, but is still able to request additional information if needed.
An LPN is assisting an RN with a central line dressing change. The LPN observes the RN touch a sterile field with their bare hand. What should the LPN do?
A. Ignore it since the RN is responsible for sterile technique.
B. Inform the RN immediately that the sterile field is contaminated.
C. Continue with the procedure but report the incident later.
D. Take over the dressing change to prevent further contamination.
Correct Answer: B
Rationale: Maintaining sterility is a shared responsibility in patient safety. The LPN must immediately inform the RN so they can correct the issue and prevent infection.
The LPN is caring for a patient with kidney disease. Which of the following foods would be considered an appropriate choice for this patient?
A. Grilled chicken breast.
B. A boiled egg.
C. A serving of beans.
D. A baked potato.
Correct Answer: D
Rationale: Baked potatoes are low in protein and can be part of a restricted protein diet for kidney disease. Grilled chicken, eggs, and beans are all high-protein foods and may be limited in patients with kidney disease to prevent the buildup of waste products.
A patient is being discharged after successful surgery. The LPN provides discharge instructions, including information about medication use and follow-up appointments. Which of the following should the LPN do next?
A. Ask the patient if they have any questions.
B. Document the discharge instructions in the medical record.
C. Complete the discharge paperwork.
D. Review the instructions with the family and sign the forms.
Correct Answer: A
Rationale: After providing discharge instructions, it is important to ask the patient if they have any questions to ensure understanding. This helps to identify any gaps in the patient's knowledge about their care after discharge. Documentation and completing the necessary paperwork should follow once the patient confirms understanding.
The LPN is conducting a neurological assessment on a patient. Which of the following findings would indicate the need for immediate follow-up?
A. The patient responds with slurred speech
B. The patient’s pupils are reactive to light.
C. The patient is alert and oriented to person, place, and time.
D. The patient is unable to recall the date and time but remembers family members.
Correct Answer: A
Rationale: Slurred speech indicate a neurological deficit or worsening condition. This requires immediate follow-up to assess further and prevent complications. The other options indicate normal or relatively mild findings, though they should still be noted.
Who established the first nursing philosophy based on restoration and health maintenance.
Florence Nightingale
Mrs. Allen, age 74, is admitted to a medical-surgical unit after hip replacement surgery. She is dependent for personal hygiene and requires assistance with perineal care. Which of the following are appropriate nursing interventions for providing perineal care for a dependent client? (Select All That Apply):
A. Use warm water and mild soap to clean the perineal area
B. Always wipe from front to back in female clients
C. Provide privacy by covering the client with a bath blanket or towel
D. Use strong, scented soap to thoroughly disinfect the perineal area
E. Pat the area dry gently to prevent skin irritation
Correct Answer: A, B, C, E
A patient with dementia has been attempting to leave the facility multiple times. The nurse has already tried verbal redirection, providing engaging activities, and moving the patient closer to the nurses’ station. What is the next best intervention?
A. Apply a vest restraint to prevent the patient from wandering.
B. Request a physician’s order for a sedative to calm the patient.
C. Implement a bed alarm and assign a sitter for close supervision.
D. Lock all exit doors to prevent the patient from leaving.
Correct Answer: C
Rationale: Restraints should only be used as a last resort. Using a bed alarm and providing close supervision (such as a sitter) maintains safety while respecting the patient’s rights and dignity.
A patient’s family member becomes upset and expresses anger toward the nurse, stating, "You never told me my mom was deteriorating! Why didn’t you warn me?" How should the LPN respond?
A. Defend the care provided and explain that the patient's condition worsened suddenly.
B. Apologize for the perceived lack of communication and offer to provide more information about the patient’s condition.
C. Tell the family member to calm down and avoid raising their voice in the hospital.
D. Ignore the family member’s concerns and continue caring for the patient.
Correct Answer: B
Rationale: Active listening and empathy are key to effective communication. The LPN should acknowledge the family member's frustration, apologize for any misunderstanding, and offer to explain the patient's condition in detail. This response helps to de-escalate the situation and fosters trust between the nurse and family member.
The LPN is caring for a patient with a central venous catheter (CVC) who develops signs of infection, including fever and redness around the insertion site. What is the nurse’s priority action?
A. Discontinue the catheter and notify the healthcare provider.
B. Clean the site with an alcohol swab and apply a new dressing.
C. Fully assess the catheter site and notify the healthcare provider of findings.
D. Administer the prescribed antibiotics before taking any further action.
Correct Answer: C
Rationale: The LPN should assess the catheter site for signs of infection (redness, swelling, drainage) and immediately notify the healthcare provider. Prompt assessment is essential for identifying any complications. The healthcare provider may order cultures or antibiotics based on the assessment.
A patient has an NG tube and is receiving tube feeds. The patient asks for the head of the bed to be flat so he can take a nap. How should the LPN respond?
Do not lie the patient flat. HOB must be at least 30* to reduce aspiration.
During a patient’s admission assessment, which of the following is the nurse's most important responsibility?
A. Obtain a detailed medical history and current medications.
B. Complete a head-to-toe physical assessment.
C. Assess the patient's understanding of the treatment plan.
D. Review and confirm the patient's insurance information.
Correct Answer: B
Rationale: The admission assessment involves completing a head-to-toe physical assessment to evaluate the patient’s condition upon admission. The LPN should focus on identifying any immediate health concerns. Obtaining a medical history, confirming insurance, and assessing understanding of the treatment plan are also important, but the physical assessment is the priority.
The LPN is caring for a client with impaired skin integrity. Which action reflects appropriate implementation of the nursing care plan?
A. Inspecting the wound dressing and change it if it is saturated.
B. Identifying potential nursing diagnoses related to skin breakdown
C. Updating the plan of care after evaluating wound healing progress
D. Developing goals for skin integrity improvement
Correct Answer: A
What regulates the scope of nursing practice and protects the public health?
The Nurse Practice Act
Mr. Smith, age 62, has type 2 diabetes and is being discharged home. The LPN is teaching him proper foot care to prevent complications. Which of the following statements by Mr. Smith indicate he understands proper diabetic foot care? (Select all that apply)
A. “I will inspect my feet every day for cuts, blisters, or redness.”
B. “I will wash my feet daily with mild soap and warm water, and dry them carefully, especially between the toes.”
C. “I will wear clean socks and properly fitting shoes at all times.”
D. “It’s safe to soak my feet in hot water every night to keep them clean.”
E. “I can cut corns or calluses myself with a razor or scissors.”
Correct: A, B, C
A post-operative patient is receiving intravenous hydromorphone via a patient-controlled analgesia (PCA) pump. During a routine assessment, the LPN finds the patient unresponsive with a respiratory rate of 7 breaths per minute and oxygen saturation of 82%. The patient's skin is cool and slightly cyanotic. What immediate nursing action should the LPN take to ensure patient safety?
Answers may vary!
Name one therapeutic communication technique and provide an example.
Active listening, empathy, silence, paraphrasing, reflection, summarizing, validation, open-ended questions, etc.
A patient is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) and requires wound care. Which PPE must the LPN wear when changing the patient’s dressing?
Contact precautions (gown and gloves)
A patient is diagnosed with dysphagia. The healthcare provider explains that the patient has level 2 dysphagia, which affects the ability to swallow certain foods and liquids. Which of the following types of foods would be most appropriate for a patient with level 2 dysphagia?
A. Pureed foods and thickened liquids.
B. Soft, moist foods that require minimal chewing.
C. Solid foods like meats, vegetables, and whole fruits.
D. Thin, clear liquids and crunchy snacks.
Correct Answer: B
Rationale: Level 2 dysphagia typically refers to the ability to swallow soft, moist foods that require minimal chewing. This includes foods like moist casseroles, tender meats, and soft vegetables. Pureed foods are more appropriate for level 1 dysphagia, while solid foods and thin liquids are more difficult for patients with level 2 dysphagia to swallow safely, increasing the risk of aspiration.
Ideally, when does the discharge process start?
At admission
An LPN is assessing a 60-year-old male patient who presents with unilateral leg swelling and redness, as well as complaints of pain in the affected leg. The patient has a history of deep vein thrombosis. Which of the following is the most critical finding in the patient?
A. Pain on dorsiflexion of the foot.
B. Presence of a positive Homans’ sign.
C. Decreased pedal pulses in the affected leg.
D. Leg swelling that is warm to the touch.
Correct Answer: C
Rationale: The presence of decreased pedal pulses in the affected leg could indicate a compromised blood flow, which is a serious complication of DVT. The LPN should prioritize this finding, as impaired circulation may lead to further complications such as pulmonary embolism. Pain with dorsiflexion (Homans' sign) and warmth are important but secondary to assessing circulation.