MSITX - LVN / LPN EXAM

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LVN / LPN EXAM

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1. Mrs. Fellows who is on complete bedrest has not had a bowel movement in five days. Since yesterday she has had frequent, watery stools. Based upon this observation you would expect that the patient has: *	a) Diarrheab) Hemmorrhoidsc) A fecal impactiond) Constipation
2. While you are giving an enema to Mrs. Fellows, she complains of stomach cramps. The BEST action to take at this time is to: *	a) Continue to allow the enema solution to flow in since this is a normal occurenceb) Discontinue the flow of the solution for a moment and instruct the patient to open her mouth and pant.c) Lower the enema container and give the solution at a slower rate.d) Discontinue the enema and tell the patient you will give it to her later.
3. Mrs. Jackson has an indwelling catheter in place. Which of the following nursing actions would help to prevent a bladder infection? *	a) Restrict the fluid intake of the patientb) Irrigate the catheter with acetic acid t.i.d.c) Position the drainage bag below the level of the bladderd) Both A and B are true
4. The FIRST action to be taken by the nurse when a patient has collapsed is: *	a) Establish an open airwayb) Determine if the patient is unconsciousc) Check the carotid pulsed) Assess patient for bleeding
5. Which of the following should be done when assessing the patient in pain: *	a) The patient should be asked to describe in writing his experience so that details will be clear.b) The family should be asked about the patients pain so the patient will not be disturbed.c) The nurse should ask the patient to rate his pain on a scale of 0-10 none to worst.d) The physician should verify the nurses assessment of the patient.
6. When caring for a patient who has a freshly applied cast to an extremity, the nurse should: *	a) Apply heat to cast to hasten the drying process.b) Observe the extremity for signs of circulatory impairment.c) Keep the extremity elevated to prevent the development of edema.d) B and C
7. When an abnormal cardiac rhythm (heart rate) is identified or suspected, the nurse should assess: *	a) Blood pressure.b) Mentation.c) Presence or absence of chest pain.d. All of the above.
8. A patient is admitted with a diagnosis of actue myocardial infarction (M(), He is cold and clammy and has severe chest pain with dyspnea. Which of the following nursing diagnosis has the HIGHEST priority: *	a) Altered body temperature.b) Impaired gas exchange.c) Fluid volume deficitd) Acute pain
9. Ms. Nunex has an allergic reaction to a blood transfusion. Your FIRST nursing intervention is to: *	a) Administer Benadryl IVb) Stop the transfusionc) Call the doctord) Collect a urine specimen to check for hematuria
10. The nurse can promote the prevention of thrombophlebitis by: *	a) Encouraging the patient to tighten and relax his leg muscles several times a day while in bedb) Massaging the calves of the patients leg strenuously t.i.d.c) Raising the knee gatch while the patient is in bedd) All of the above
11. The nurse should watch for complications in the patient undergoing a femoral angiogram. Which of the following is a complication: *	a) Warmth and flushing occur as the dye is injectedb) Marked diuresis occurs after the testc) Distal pulses are absent 30 minutes after dye is injectedd) The site does not bleed after 15 minutes
12. When planning care for a patient receiving patient controlled analgesia (PCA) the nurse should anticipate the following disadvantage: *	a) Slow onset of pain reliefb) Patient titrates his own comfortc) Ineffective management of pain if patient is asleep or not alertd) Development of chronic pain
13. Identify risk factors for coronary heart disease related to lifestyle habits that the nurse will include in the teaching plan for the patient just discharged to home after hospitalization for coronary artery disease: *	a) Cigarette smokingb) Physical inactivityc) Obesityd) All of the above
14. Mr. Daniels diagnosis is congestive heart failure, a term commonly used when referring to both left and right sided heart failure. Which of the following are the primary symptoms(s) of right sided heart failure: *	a) Dyspnea and cyanosisb) Peripheral edemac) Distended neck veinsd) B and C
15. Symptoms of left sided heart failure include: *	a) Orthopneab) Paroxysmal nocturnal dyspneac) Dependent edemad) A and B
16. If a patients total parenteral nutrition (TPN) solution is absorbed before the next volume of TPN is provided by the pharmacy, the nurse should: *	a) Discontinue the system and flush the catheter with heparin and salineb) Leave the system intact and notify the pharmacy immediatelyc) Run D10W at the same rate as the ordered TPN until the TPN solution arrivesd) Run normal saline at a TKO rate
17. Mrs. Nelson is diagnosed as having primary or essential hypertension which has no identifiable medical cause. The nurses assessment and intervention requires the following: *	a) Careful monitoring of blood pressure at frequent intervalsb) Determination of nosebleeds; anginal pain; dyspnea; alterations in vision; vertigo or headachesc) Education of patient and significant other regarding treatment regimend) All of the above
18. A 75 year old man was found on the floor by his daughter. He did not recognize her; was unable to move his left arm or leg; and was incontinent of urine. He was admitted to the hospital with a diagnosis of cerebrovascular accident. To promote rehab *	a) Turn and position patient every 2 hoursb) Perform passive range of motion of affected extremities four or five times a dayc) Insert an indwelling urinary catheterd) Secure patients attention and speak slowly and simply and allow patient time to process
19. Patients with congestive heart failure may experience which of the following: *	a) Fatigue and muscular weaknessb) Tachycardiac) Edema-unexplained weight gaind) All of the above
20. Which of the following potential post operative complications will the nurse be monitoring for a patient who had lower extremity vascular surgery for arterial occlusive disease: *	a) Deep vein thrombosis and dysrhythmias b) Bleeding and vascular occlusion c) Septicemia and atelectasis d) Pulmonary embolus and venous stasis
21. Symptoms of dehydration may include: *	a) Reduced urinary outputb) Dry; cracked lipsc) Hypertensiond) A and B
22. The patient is scheduled for an intravenous pyelogram-IVP. If the patient experiences any of the following reactions after injection of the contrast material for the IVP, which one would the nurse report immediately: *	a) Feeling of warmthb) Flushing of the facec) Salty taste in the mouthd) Urticaria
23. The patient diagnosed with Type One: Insulin-dependent diabetes mellitus would: *	a) Be restricted to a 1200 calorie American Diabetic Association diet:b) Have no damage to the islet cells of the pancreasc) Need exogenous insulind) Need to receive daily doses of a hypoglycemic agent
24. How does morphine sulfate relieve the symtoms of acute pulmonary edema: *	a) Causes renal vasoconstriction b) Causes coronary artery vasodilation c) Decreases peripheral resistance so blood can redistribute from pulmonary circulation to periphery d) Increases the volume of circulating blood
25. Symptoms of hypoglycemia include all of the following EXCEPT: *	a) Sweatingb) Nervousnessc) Tremord) Flushed skin
26. The nurse should expect that insulin therapy my be temporarily substituted for oral hypoglycemic therapy if the diabetic: *	a) Develops an infection with fever b) Suffers trauma c) Undergoes major surgery d) Develops any or all of the above
27. The nurse would NOT expect to find which symptom(s) of Diabetic Ketoacidosis: *	a) Acetone breath - a fruity odorb) Kussmaul respirationsc) Cold; clammy; pale skind) Nausea; vomiting and or abdominal pain
28. NPH Insulin administered to the patient at 7:30 am reaches its peak action: *	a) Between 10 am and 12 noonb) Between 1:30 pm and 7:30 pmc) between 10 pm and 12 midnightd) 7:30 am the next day
29. The single most important means of preventing the spread of infection is: *	a) Antibiotic therapyb) Wearing gloves for all patient contactc) Handwashingd) Gowning and wearing masks
30. Nursing care of the patient who has had a renal angiogram should include: *	a) Giving medication for painb) Assessing pedal pulsec) Encouraging ambulationd) Encouraging coughing and deep breathing
31. In teaching the patient safe, self-administration of Prednisone, you would include all of the following EXCEPT: *	a) Take the medication with foodb) Protect yourself from infectionsc) You may need to increase your salt intaked) Never stop the medication abruptly
32. A fractured bone may produce the following signs and symptoms: *	a) Pain and swellingb) Loss of functionc) Shortening of limbd) All of the above
33. Following a head injury which of the following symptoms should be reported to the charge nurse *	a) A change in the pupils to lightb) Change in motor abilityc) Recurrent and projectile vomitingd) All of these should be reported
34. Should a patient experience a convulsion, the nurse should: *	a) Protect the patient from injuryb) Restrain the patientc) Assess the extent of the convulsiond) A and C
35. A draining pressure ulcer which involves the epidermis and dermis with persistent edema and necrosis would be classified and treated as: *	a) Stage I - dry sterile dressingb) Stage II - Transparent membrane - Op-site and Tegadermc) Stage III - hydrocolloid dressingsd) Stage IV - betadine and hibiclens soaked sterile dressings
36. Radiation therapy is given for the following purpose(s): *	a) Palliationb) Curec) A and Bd) Experimentation
37. Your patient has had a thoracotomy. She returns to the unit with a closed chest drainage system. You should FIRST check the following: *	a) Amount and color of drainageb. If tidaling is occurringc) If system is positioned below the level of the patients chestd) All of the above
38. Which of the following assessments does NOT indicate possible wound infection: *	a) Serious drainage frrom a penrose drainb) Oral temperature of 99 degrees Fc) Erythema around incisional sited) Tenderness in the incisional area
39. Nursing care of the patient with a Hemovac includes all of the following EXCEPT: *	a) Noting color and amount of drainageb) Emptying Hemovac if half full or morec) Increasing suction by attaching to continuous wall suction when drainage decreasesd) Maintaining suction by compressing evacuator after emptying
40. The physician orders Heparin 7500 units subcutaneously q 8 hours. You have available Heparin 10,000 units/mL. How many mL will you give: *	a) 0.75 mLb) 0.50 mLc) 0.10 mLd) None of the above because Heparin is not given subcutaneously