LPN Med-Surg Specialty Eexam, LPN HESI Exit Exam and LPN NCLEX Licence Exam

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Sample questions from LPN Med-Surg Specialty Eexam, LPN HESI Exit Exam and LPN NCLEX Licence Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client hospitalized with heart failure suddenly develops severe dyspnea, pink frothy sputum, and an oxygen saturation of 82%. Which action should the nurse take first?

   • A.Place the client upright and administer oxygen while activating emergency assistance.
   • B.Obtain a daily weight and compare it with the admission weight.
   • C.Administer the prescribed oral maintenance dose of furosemide.
   • D.Restrict oral fluids and reassess lung sounds in 30 minutes.

   Rationale: These findings suggest acute pulmonary edema, requiring immediate support of oxygenation and emergency assistance. A daily weight helps monitor fluid status but does not address the immediate threat. Oral maintenance furosemide acts too slowly for this emergency, and fluid restriction with delayed reassessment is inadequate. The exam takeaway is to address airway and breathing before routine monitoring or longer-term fluid management.

2. 2.A client with COPD and a history of chronic carbon dioxide retention has an oxygen saturation of 84% on room air and increased work of breathing. Which intervention is most appropriate?

   • A.Withhold oxygen until arterial blood gas results are available.
   • B.Apply oxygen at 10 L/min by simple face mask regardless of response.
   • C.Begin controlled oxygen therapy and titrate toward a saturation of 88% to 92% as prescribed.
   • D.Have the client breathe into a paper bag to slow the respiratory rate.

   Rationale: Controlled oxygen therapy treats hypoxemia while allowing careful titration in a client at risk for hypercapnic respiratory failure. Withholding oxygen permits dangerous hypoxemia, while an unadjusted high concentration may worsen carbon dioxide retention. Paper-bag breathing can further reduce oxygen availability and is unsafe. The exam takeaway is to treat hypoxemia promptly and monitor the response rather than withholding oxygen because the client has COPD.

3. 3.A client admitted with an acute ischemic stroke is alert but has facial drooping and slurred speech. Oral aspirin is prescribed. What should the nurse do before administering it?

   • A.Give the aspirin with a full glass of water.
   • B.Verify that the client has passed an approved swallowing screen.
   • C.Crush the aspirin and mix it into thin juice.
   • D.Ask whether the client had swallowing problems before the stroke.

   Rationale: A swallowing screen is needed before oral intake because an acute stroke can cause dysphagia and aspiration. Water and thin juice may be aspirated, and crushing medication does not establish safe swallowing. A history of normal swallowing does not exclude a new stroke-related deficit. The exam takeaway is to maintain nothing-by-mouth status until swallowing safety is established.

4. 4.An alert client with diabetes is diaphoretic and shaky. The blood glucose is 54 mg/dL, and the client can swallow safely. Which action should the nurse take?

   • A.Administer the scheduled rapid-acting insulin.
   • B.Give peanut butter crackers and recheck glucose in 1 hour.
   • C.Administer intramuscular glucagon immediately.
   • D.Give 4 oz of regular juice and recheck glucose in 15 minutes.

   Answer and rationale are in the full material.

5. 5.A client with kidney failure has a potassium level of 6.8 mEq/L and peaked T waves. Which prescribed medication should the nurse anticipate administering first?

   • A.Intravenous calcium gluconate.
   • B.Oral sodium zirconium cyclosilicate.
   • C.Subcutaneous epoetin alfa.
   • D.Oral calcium acetate.

   Answer and rationale are in the full material.