Med Surgical on Endocrine and Respiratory LPN

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Sample questions from Med Surgical on Endocrine and Respiratory LPN

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

1. 1.During a home visit, a client with type 1 diabetes reports vomiting and inability to keep fluids down. The client is alert, and the blood glucose is 286 mg/dL. Which action should the practical nurse take?

   • A.Tell the client to omit insulin until eating normally.
   • B.Notify the RN or health care provider promptly about the vomiting and elevated glucose.
   • C.Encourage the client to exercise to lower the blood glucose.
   • D.Arrange a routine follow-up appointment for next week.

   Rationale: Vomiting with elevated glucose can signal worsening illness and risk for diabetic ketoacidosis, so prompt reporting is needed. Exercise can worsen dehydration, and omitting insulin without a prescription can be dangerous for a client with type 1 diabetes. A routine appointment does not address the client's current risk.

2. 2.At change of shift, the practical nurse receives report on four clients. Which client should be reported to the RN first?

   • A.A client with diabetes who asks when the next meal will arrive.
   • B.A client with COPD whose oxygen saturation is 90% on the prescribed oxygen and is at the documented baseline.
   • C.A client with hypothyroidism who reports feeling tired after breakfast.
   • D.A client with asthma who is newly drowsy and has an oxygen saturation of 86% after using a rescue inhaler.

   Rationale: New drowsiness and low oxygen saturation after rescue medication may indicate worsening respiratory status and require immediate escalation. The COPD client's saturation is at the documented baseline, while fatigue in hypothyroidism and a request for a meal are not as urgent. The practical nurse should report the change promptly rather than independently changing oxygen or medication orders.

3. 3.A client with newly diagnosed asthma is preparing to leave the clinic with a prescribed metered-dose inhaler and spacer. Which instructions should the practical nurse reinforce from the teaching plan? Select all that apply.

   • A.Breathe in slowly as the medication is released into the spacer.
   • B.Clean the spacer according to the manufacturer's instructions.
   • C.Rinse the mouth after using an inhaled corticosteroid.
   • D.Shake the inhaler before each puff if the medication instructions specify this.
   • E.Take several puffs in rapid succession without pausing.

   Rationale: Shaking the inhaler when directed and coordinating a slow inhalation with medication release help deliver the dose. Rinsing after an inhaled corticosteroid lowers the risk of oral thrush, and proper spacer cleaning supports safe use. Rapidly taking several puffs without the prescribed interval can reduce effective delivery and is not appropriate.

4. 4.In the pediatric clinic, a parent of a 6-year-old with type 1 diabetes says the child will begin attending an after-school program. Which action by the practical nurse best supports continuity of care?

   • A.Encourage the parent to provide the program with the child's diabetes care plan and emergency contact information.
   • B.Recommend that the child skip snacks during program days.
   • C.Tell the parent that the child should manage all insulin decisions independently.
   • D.Advise the parent to change the child's insulin dose before the program begins.

   Answer and rationale are in the full material.

5. 5.A client's potassium level is 6.1 mEq/L before a scheduled dose of spironolactone for heart failure and hyperaldosteronism. What should the practical nurse do?

   • A.Offer a potassium-rich snack with the medication.
   • B.Administer the medication with food as prescribed.
   • C.Hold the medication and promptly report the laboratory result to the RN or provider.
   • D.Document the result and recheck it at the next scheduled visit.

   Answer and rationale are in the full material.