Editing Fundamentals of Nursing – LPN Practice Questions

These practice questions cover [[Fundamentals of Nursing]] at licensed practical or vocational nurse level, with emphasis on safe and correct performance of basic care skills, patient safety during assistance with activities of daily living, focused data collection, and prompt reporting to the registered nurse. Answers are given by option number as the list renders on the page.

==Question 1==
The licensed practical nurse is giving a bed bath to an older adult. Which action is correct?
# Wash the entire body with the same section of the washcloth to save time.
# Wash each eye from the outer canthus toward the inner canthus.
# Wash from the cleanest areas to the most soiled areas, leaving the perineum for last.
# Leave the patient fully uncovered to make the bath faster.

'''Answer:''' 3. Wash from the cleanest areas to the most soiled areas, leaving the perineum for last.

''Rationale:'' Bathing proceeds from clean to dirty and from head to toe so that organisms are not carried from soiled areas to clean ones, and the perineum is washed last. Option 1 spreads organisms across body regions. Option 2 reverses the correct direction; the eye is washed from the inner canthus to the outer canthus, using a different portion of the cloth for each eye. Option 4 violates the patient's dignity and privacy and promotes chilling, especially in older adults who lose heat quickly.

==Question 2==
Before assisting a patient into a tub bath, the licensed practical nurse should take which actions? '''Select all that apply.'''
# Check the water temperature with a thermometer or the inner wrist before the patient enters.
# Ensure a nonskid mat is in place and the grab bars are secure.
# Leave the patient alone in the tub if the patient asks for privacy, even if the patient is weak.
# Place the call light within the patient's reach.
# Assist the patient with transfer using a gait belt if the patient is unsteady.
# Fill the tub with the hottest tolerable water to promote circulation.

'''Answer:''' 1, 2, 4, and 5.

''Rationale:'' Verifying water temperature prevents burns, particularly in older adults and patients with diabetes or neuropathy whose thermal sensation is reduced. Nonskid surfaces, secure grab bars, an accessible call light, and gait belt assisted transfer all address the high fall risk of a wet bathroom. Option 3 is unsafe; a weak or unsteady patient must not be left alone, and privacy can be preserved by staying just outside the curtain within hearing distance. Option 6 is unsafe and risks scald injury.

==Question 3==
The licensed practical nurse is assisting a patient with right sided weakness to transfer from the bed to a wheelchair. Which action is correct?
# Position the wheelchair on the patient's right side and lock the wheels.
# Position the wheelchair on the patient's left side at a slight angle and lock the wheels.
# Have the patient stand quickly to avoid fatigue.
# Grasp the patient under the arms to lift.

'''Answer:''' 2. Position the wheelchair on the patient's left side at a slight angle and lock the wheels.

''Rationale:'' The patient should move toward the stronger side, which in right sided weakness is the left, so the chair is placed on the left at a slight angle to shorten the pivot. Locking the wheels prevents the chair from rolling away. Option 1 forces the transfer toward the weak side. Option 3 risks orthostatic hypotension; the patient should dangle at the bedside first and rise slowly. Option 4 risks shoulder injury and brachial plexus damage; a gait belt around the waist is the correct handhold.

==Question 4==
The licensed practical nurse measures an adult patient's vital signs and obtains a temperature of 38.6 degrees Celsius (101.5 degrees Fahrenheit), a pulse of 112 beats per minute, respirations of 24 breaths per minute, blood pressure of 96 over 58 millimeters of mercury, and oxygen saturation of 91 percent on room air. The patient's morning values were normal. What should the nurse do first?
# Document the values and recheck them in four hours.
# Report the findings to the registered nurse promptly.
# Encourage the patient to drink fluids and rest.
# Ask assistive personnel to repeat the vital signs.

'''Answer:''' 2. Report the findings to the registered nurse promptly.

''Rationale:'' This is a significant change from the patient's own baseline across several parameters and suggests possible infection or sepsis. Prompt reporting to the registered nurse allows assessment, provider notification, and timely treatment. Option 1 delays care through a dangerous window. Option 3 is a supportive measure that does not address the acute change. Option 4 delays escalation and assigns the recheck of an unstable patient to unlicensed staff, which is inappropriate.

==Question 5==
The licensed practical nurse is preparing to administer a cleansing enema. Which position should the patient be placed in?
# Left lateral Sims position with the upper leg flexed.
# Right lateral position with both legs extended.
# High Fowler position.
# Prone position with the head turned to the side.

'''Answer:''' 1. Left lateral Sims position with the upper leg flexed.

''Rationale:'' The left lateral Sims position uses gravity and follows the anatomic curve of the sigmoid and descending colon, allowing the solution to flow and be retained. The tip is lubricated and inserted about 7.5 to 10 centimeters (3 to 4 inches) in an adult, directed toward the umbilicus, and the solution is instilled slowly. Options 2, 3, and 4 do not follow the colon's anatomy, reduce retention, and increase discomfort and the chance of the solution being expelled immediately.

==Question 6==
The licensed practical nurse is caring for a patient with an indwelling urinary catheter. Which observation requires action?
# The drainage bag is hanging on the bed frame below the level of the bladder.
# The tubing is secured to the patient's thigh with a securement device.
# The drainage bag is resting on the floor beside the bed after the patient returned from the bathroom.
# The urine is clear and pale yellow.

'''Answer:''' 3. The drainage bag is resting on the floor.

''Rationale:'' A drainage bag on the floor is contaminated and must be lifted, cleaned per policy, and rehung on the bed frame below bladder level. Placement on the floor introduces organisms and, if the bag is later raised above the bladder, urine can flow back toward the bladder. Options 1 and 2 describe correct practice that prevents backflow and urethral traction. Option 4 describes normal urine and requires no action.

==Question 7==
Which findings should the licensed practical nurse report to the registered nurse immediately? '''Select all that apply.'''
# An adult patient with a total urine output of 60 milliliters over the past four hours.
# A new area of nonblanchable redness over the patient's right heel.
# A patient who coughs and develops a wet, gurgly voice after sipping water.
# A patient who reports mild soreness at a healing incision that is relieved by repositioning.
# An apical pulse of 52 beats per minute in a patient scheduled to receive digoxin.
# A patient who had a soft, formed bowel movement this morning.

'''Answer:''' 1, 2, 3, and 5.

''Rationale:'' Option 1 is roughly 15 milliliters per hour, well below the minimum acceptable adult output of about 30 milliliters per hour, and suggests dehydration or renal compromise. Option 2 is a stage 1 pressure injury requiring immediate pressure relief and a revised plan. Option 3 is a sign of dysphagia and aspiration risk requiring the patient to be kept upright, oral intake held, and a swallowing evaluation obtained. Option 5 requires holding digoxin and notifying the provider, because the adult apical rate is below 60. Options 4 and 6 are expected findings within normal recovery and require routine documentation only.

==Question 8==
The licensed practical nurse is repositioning a patient who is on bed rest. Which action best prevents pressure injury?
# Massage the reddened area over the sacrum with lotion.
# Reposition the patient at least every two hours and float the heels on pillows placed under the calves.
# Place a donut shaped ring cushion under the sacrum.
# Elevate the head of the bed to 60 degrees for most of the day for comfort.

'''Answer:''' 2. Reposition at least every two hours and float the heels on pillows placed under the calves.

''Rationale:'' Repositioning at least every two hours in bed relieves capillary pressure, and placing pillows lengthwise under the calves lifts the heels completely off the mattress, which is the only reliable way to offload the heel. Option 1 is contraindicated, because massaging a reddened bony prominence can worsen damaged tissue. Option 3 is contraindicated, because ring cushions concentrate pressure around the rim and reduce circulation. Option 4 increases shear at the sacrum; head elevation should generally be kept at or below 30 degrees except during meals and feeding.

==Question 9==
The licensed practical nurse is performing oral care for an unconscious patient. Which action is correct?
# Place the patient supine with the head of the bed flat.
# Place the patient in a side lying position with the head turned to the side and suction available.
# Use a large volume of mouth rinse to flush the mouth thoroughly.
# Place a gloved finger in the mouth to hold the cheek open.

'''Answer:''' 2. Place the patient in a side lying position with the head turned to the side and suction available.

''Rationale:'' Side lying with the head turned allows secretions and fluid to drain out of the mouth rather than into the airway, and suction must be immediately available because the unconscious patient cannot protect the airway. Option 1 promotes aspiration. Option 3 uses excessive fluid, which increases aspiration risk; a small amount of fluid on a swab or toothbrush is safer. Option 4 risks a bite injury to the nurse; a padded tongue blade or bite block is used instead.

==Question 10==
The licensed practical nurse is reinforcing teaching for a patient learning to use a cane after a left hip injury. Which patient statement indicates correct understanding?
# "I will hold the cane in my left hand and move it with my right leg."
# "I will hold the cane in my right hand, move the cane and my left leg together, then step with my right leg."
# "I will lead with my left leg when I go up the stairs."
# "I will lean forward over the cane to take weight off my hip."

'''Answer:''' 2. Hold the cane in the right hand, move the cane and the left leg together, then step with the right leg.

''Rationale:'' The cane is held on the strong or unaffected side, which with a left hip injury is the right. The cane and the weak leg advance together so they share the load, then the strong leg steps through. Option 1 places the cane on the weak side, which does not offload the injured hip. Option 3 is incorrect because the strong leg leads going up and the weak leg leads going down, remembered as "up with the good, down with the bad." Option 4 shifts the center of gravity forward and increases fall risk; the patient should stand upright with the cane close to the body.

==Question 11==
A patient with a new prescription for morphine for postoperative pain asks the licensed practical nurse what to expect. Which statement is most accurate to reinforce?
# "Constipation usually goes away after a few days as your body adjusts."
# "You should wait until the pain is severe before asking for the medication."
# "Constipation is common and does not improve with time, so we will start a bowel program along with the medication."
# "If you feel sleepy, that is unrelated to your breathing."

'''Answer:''' 3. Constipation is common and does not improve with time, so a bowel program is started along with the medication.

''Rationale:'' Tolerance develops to most opioid side effects, but not to constipation, so a bowel regimen with increased fluid, fiber, activity, and prescribed stool softeners or laxatives should begin when the opioid begins. Option 1 is incorrect for that reason. Option 2 is incorrect because pain is easier to control when treated before it becomes severe. Option 4 is dangerous misinformation; increasing sedation is the earliest warning sign of opioid induced respiratory depression and must be reported to the registered nurse promptly.

==Question 12==
Which actions should the licensed practical nurse take when assisting a patient with dysphagia to eat? '''Select all that apply.'''
# Position the patient fully upright at 90 degrees during the meal.
# Offer large bites to shorten the length of the meal.
# Check for food pocketed in the cheeks during and after the meal.
# Keep the patient upright for at least 30 minutes after eating.
# Have the patient talk during swallowing to confirm the airway is clear.
# Minimize distractions and allow rest before the meal.

'''Answer:''' 1, 3, 4, and 6.

''Rationale:'' Full upright positioning, small bites, checking for pocketing, remaining upright after the meal, and a calm unhurried environment all reduce aspiration risk. Fatigue significantly worsens swallowing safety, so rest before eating matters. Option 2 is unsafe, because large bites overwhelm the impaired swallow. Option 5 is unsafe, because talking while swallowing opens the airway at exactly the wrong moment and promotes aspiration.

==Question 13==
The licensed practical nurse is providing foot care to a patient with diabetes. Which action is correct?
# Soak the patient's feet in warm water for 20 minutes to soften calluses.
# Apply a heating pad to the feet to improve circulation.
# Dry thoroughly between the toes and inspect the soles and between the toes for breaks in skin.
# Trim calluses with scissors and file corns smooth.

'''Answer:''' 3. Dry thoroughly between the toes and inspect the soles and between the toes for breaks in skin.

''Rationale:'' Daily inspection and thorough drying prevent maceration, fungal infection, and unnoticed ulceration in feet with reduced sensation. Option 1 is contraindicated, because soaking macerates skin and increases infection risk. Option 2 is dangerous, because neuropathy blunts heat perception and heating pads cause burns. Option 4 is outside safe practice for the patient with diabetes; calluses and corns are referred to a podiatrist, and cutting them risks a nonhealing wound.

==Question 14==
The licensed practical nurse is assisting an unsteady patient to ambulate when the patient's knees suddenly buckle. What should the nurse do?
# Try to hold the patient upright until help arrives.
# Ease the patient to the floor while protecting the head, then call for help and stay with the patient.
# Let go of the patient and run to get the registered nurse.
# Quickly move the patient into the nearest chair without assistance.

'''Answer:''' 2. Ease the patient to the floor while protecting the head, then call for help and stay with the patient.

''Rationale:'' Attempting to stop a fall in progress commonly injures both the patient and the nurse. The safe technique is to widen the stance, pull the patient close, support the head, and slide the patient down the nurse's leg to the floor in a controlled way, then call for help and remain with the patient until assessment is done. Option 1 risks a fall onto the nurse and a worse patient injury. Option 3 abandons a falling patient. Option 4 risks an uncontrolled drop and can worsen an undetected injury.

==Question 15==
The licensed practical nurse notes that a patient in soft wrist restraints has cool, dusky fingers with delayed capillary refill on the right hand. What should the nurse do first?
# Document the finding and recheck in one hour.
# Loosen or release the right restraint, assess circulation and skin, and notify the registered nurse.
# Tighten the left restraint to keep the limbs symmetrical.
# Remove both restraints permanently without notifying anyone.

'''Answer:''' 2. Loosen or release the right restraint, assess circulation and skin, and notify the registered nurse.

''Rationale:'' Cool, dusky fingers with delayed capillary refill indicate impaired circulation from a restraint that is too tight, which can cause nerve and tissue injury. The nurse relieves the compression immediately, assesses circulation, sensation, motion, and skin, and reports to the registered nurse. Restrained patients require circulation checks every 15 to 30 minutes per policy and release for range of motion, repositioning, toileting, and fluids at least every 2 hours. Option 1 delays care during active tissue compromise. Option 3 is not a legitimate intervention and worsens the risk. Option 4 removes a prescribed safety measure without assessment or communication, which is unsafe and outside independent decision making.

[[Category:Fundamentals of Nursing]]
[[Category:Licensed Practical Nurse (NCLEX-PN)]]
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