LPN Med-Surg

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Sample questions from LPN Med-Surg

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

1. 1.A client with heart failure reports suddenly worsening shortness of breath while lying flat. The client is breathing 30 times/min and has an oxygen saturation of 86% on room air. What should the practical nurse do first?

   • A.Raise the head of the bed, apply oxygen according to protocol, and promptly notify the RN.
   • B.Ask the client to describe the usual pattern of shortness of breath.
   • C.Offer a low-sodium snack and recheck the client in 30 minutes.
   • D.Document the findings and wait for the next scheduled assessment.

   Rationale: Raising the head of the bed and providing protocol-approved oxygen support breathing while the PN promptly reports acute hypoxemia and respiratory distress. Asking about the usual pattern does not address the immediate threat, and a snack or delayed reassessment is unsafe. The exam takeaway is to support breathing and rapidly report an acute change.

2. 2.A client with diabetes is awake, shaky, and diaphoretic; the blood glucose is 58 mg/dL. The client can swallow safely. What is the best action?

   • A.Give 15 g of a rapid-acting oral carbohydrate and recheck glucose in 15 minutes per protocol.
   • B.Administer the scheduled long-acting insulin to prevent rebound hyperglycemia.
   • C.Give a high-fat snack and check glucose at the next meal.
   • D.Keep the client NPO and notify the RN before giving anything by mouth.

   Rationale: A conscious client who can swallow should receive rapid-acting carbohydrate for hypoglycemia, followed by a glucose recheck per protocol. Long-acting insulin can worsen hypoglycemia, and a high-fat snack acts too slowly; withholding oral treatment is unnecessary when swallowing is safe. The exam takeaway is to treat symptomatic hypoglycemia promptly with fast-acting carbohydrate when permitted.

3. 3.A client taking warfarin tells the practical nurse that the client's stools have been black and tarry since yesterday. What is the priority response?

   • A.Promptly report the finding to the RN because it may indicate gastrointestinal bleeding.
   • B.Reassure the client that dark stools are an expected effect of warfarin.
   • C.Encourage the client to eat more leafy green vegetables today.
   • D.Hold all future doses of warfarin without contacting the RN or provider.

   Rationale: Black, tarry stools can indicate gastrointestinal bleeding and require prompt reporting, especially in a client taking an anticoagulant. Reassurance and dietary changes do not evaluate a possible bleed, while independently changing the medication plan is outside the PN's role. The exam takeaway is to report possible bleeding promptly and not independently alter prescribed therapy.

4. 4.A client with a new prescription for furosemide reports leg cramps and weakness. The latest potassium level is 2.9 mEq/L. What should the practical nurse do?

   • A.Report the symptoms and potassium result promptly to the RN or provider.
   • B.Give the next dose with a glass of water and reassess tomorrow.
   • C.Encourage the client to walk to relieve the cramps.
   • D.Document the result as expected with diuretic therapy and take no further action.

   Answer and rationale are in the full material.

5. 5.A client with chronic obstructive pulmonary disease becomes more short of breath during morning care. The oxygen saturation is 88%, compared with a usual 92%. What should the practical nurse do?

   • A.Stop the activity, position the client to ease breathing, and promptly report the change.
   • B.Increase oxygen substantially without an order and leave the client to finish dressing.
   • C.Ask the client to lie flat and use slow, shallow breaths.
   • D.Complete the care quickly so the client can rest afterward.

   Answer and rationale are in the full material.