Docmoates: Create Nursing Education wiki structure

2026-09-09T10:54:35Z

Create Nursing Education wiki structure

New page

These practice questions are written at NCLEX-PN level. They emphasize data collection, routine care of stable patients with predictable outcomes, reinforcement of teaching, standard postoperative and chronic disease care, and recognizing abnormal findings that must be reported promptly to the registered nurse or provider. Options are numbered; the answer identifies the option by number and restates it.

==Question 1==
A licensed practical nurse is collecting data on a patient two days after abdominal surgery. Which finding should be reported to the registered nurse right away?
# The patient reports incisional pain of 4 out of 10 before the scheduled analgesic.
# The abdominal dressing has a small amount of dried serosanguineous drainage from yesterday.
# The patient's oral temperature is 101.8 degrees Fahrenheit with new purulent drainage from the incision.
# The patient has not had a bowel movement since surgery but is passing flatus.

'''Answer:''' Option 3, the temperature of 101.8 degrees Fahrenheit with new purulent drainage.

''Rationale:'' Fever combined with new purulent wound drainage suggests a surgical site infection and must be reported promptly. Option 1 is expected pain that is managed with the prescribed analgesic. Option 2 describes normal, old drainage. Option 4 is expected; passing flatus is a reassuring sign that bowel function is returning, and a bowel movement often does not occur for a few days after abdominal surgery.

==Question 2==
The licensed practical nurse is reinforcing teaching for a patient newly prescribed a metered-dose albuterol inhaler and an inhaled corticosteroid. Which statement by the patient indicates that the teaching was understood?
# "I will use the steroid inhaler first because it is the stronger medicine."
# "I will use the albuterol first, wait as instructed, then use the steroid, and rinse my mouth afterward."
# "I will use the albuterol only at bedtime to prevent problems overnight."
# "I do not need to rinse my mouth as long as I brush my teeth at night."

'''Answer:''' Option 2, using the albuterol first, then the steroid, and rinsing the mouth afterward.

''Rationale:'' The short-acting bronchodilator opens the airways so the corticosteroid can reach deeper into the lungs. Rinsing the mouth after the corticosteroid prevents oral fungal infection (thrush). Option 1 reverses the order. Option 3 misuses a rescue medication, which is taken for symptoms or as prescribed before exercise. Option 4 leaves steroid residue in the mouth for hours and increases the risk of thrush.

==Question 3==
While collecting data on a patient with heart failure, the licensed practical nurse notes several findings. Which findings should be reported to the registered nurse? '''Select all that apply.'''
# Weight gain of 3 pounds since yesterday morning.
# New crackles heard in both lung bases.
# The patient sleeps on two pillows, as he has for the past year.
# Oxygen saturation of 88 percent on room air, down from 96 percent.
# Ankle edema that decreases overnight, unchanged from admission.

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

''Rationale:'' A gain of 2 to 3 pounds in one day indicates acute fluid retention. New crackles indicate fluid backing up into the lungs. A drop in oxygen saturation to 88 percent is significant and must be reported. Options 3 and 5 describe chronic, unchanged findings that are already known and expected in heart failure, so they are documented rather than reported urgently.

==Question 4==
The licensed practical nurse is caring for a patient with an indwelling urinary catheter. Which action is correct?
# Place the drainage bag on the bed beside the patient during transport.
# Keep the drainage bag below the level of the bladder and off the floor.
# Disconnect the tubing to obtain a urine sample from the drainage bag.
# Coil extra tubing under the patient's hip to keep it out of the way.

'''Answer:''' Option 2, keep the drainage bag below the level of the bladder and off the floor.

''Rationale:'' Gravity drainage prevents urine from flowing back into the bladder, which reduces infection risk, and keeping the bag off the floor avoids contamination. Option 1 places the bag above the bladder and allows reflux. Option 3 breaks the closed system and introduces bacteria; samples are drawn from the designated sampling port using aseptic technique. Option 4 causes kinking and obstruction and places tubing under pressure.

==Question 5==
A patient with type 1 diabetes is alert and able to swallow and reports feeling shaky and sweaty. The fingerstick glucose is 54 mg/dL. What should the licensed practical nurse do first?
# Give 15 grams of a fast-acting carbohydrate such as 4 ounces of juice.
# Give the scheduled dose of rapid-acting insulin.
# Have the patient lie down and recheck the glucose in one hour.
# Notify the registered nurse and wait for further direction before acting.

'''Answer:''' Option 1, give 15 grams of a fast-acting carbohydrate.

''Rationale:'' Treating symptomatic hypoglycemia in a conscious patient who can swallow is standard, expected care within the practical nurse's scope. The nurse gives 15 grams of fast-acting carbohydrate, rechecks the glucose in 15 minutes, repeats if still low, and then reports. Option 2 would worsen the hypoglycemia and is dangerous. Option 3 delays treatment far too long. Option 4 delays urgent, well-established care; the nurse treats and then reports.

==Question 6==
The licensed practical nurse is assisting a patient with a new colostomy. Which stoma appearance should be reported to the registered nurse immediately?
# Beefy red and moist.
# Slightly swollen during the first few days after surgery.
# Dusky purple with a dark, dry appearance.
# Producing soft, formed brown stool.

'''Answer:''' Option 3, dusky purple with a dark, dry appearance.

''Rationale:'' A healthy stoma is beefy red and moist because it is well perfused. A dusky, purple, or black stoma indicates impaired blood supply and possible necrosis, which is an emergency requiring immediate reporting. Option 1 describes a normal stoma. Option 2 describes expected early postoperative edema. Option 4 describes expected output from a colostomy.

==Question 7==
The licensed practical nurse is reinforcing teaching for a patient starting oral iron supplements for iron deficiency anemia. Which statements should be included? '''Select all that apply.'''
# "Your stools may turn dark green or black, and that is expected."
# "Take the iron with orange juice or another source of vitamin C to help absorption."
# "Take the iron with milk or an antacid to prevent stomach upset."
# "Increase fluids and fiber, because iron commonly causes constipation."
# "If you take a liquid form, use a straw and rinse your mouth to protect your teeth."

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

''Rationale:'' Dark stools are an expected and harmless effect, vitamin C enhances iron absorption, constipation is common and is prevented with fluid and fiber, and liquid iron stains the teeth, so a straw and rinsing are advised. Option 3 is incorrect, because milk, antacids, and calcium reduce iron absorption; iron is best absorbed on an empty stomach, and if stomach upset occurs the patient should report it rather than pairing the dose with dairy or antacids.

==Question 8==
The licensed practical nurse is preparing to give a scheduled dose of digoxin. The apical pulse, counted for a full minute, is 54 beats per minute. What should the nurse do?
# Give the dose, since the pulse is only slightly low.
# Hold the dose and notify the registered nurse.
# Give half of the prescribed dose.
# Recheck the radial pulse and give the dose if it is above 60.

'''Answer:''' Option 2, hold the dose and notify the registered nurse.

''Rationale:'' Digoxin is withheld in an adult when the apical pulse is below 60 beats per minute, because the drug slows conduction further and may cause dangerous bradycardia. The nurse holds the dose, reports, and documents. Option 1 ignores the parameter. Option 3 is outside the nurse's scope, because a nurse never alters a prescribed dose. Option 4 is incorrect, because the apical pulse counted for a full minute is the required measurement and a radial pulse may be lower than the apical rate.

==Question 9==
A patient with chronic obstructive pulmonary disease is short of breath. Which nursing action is most appropriate for the licensed practical nurse to take?
# Increase the oxygen flow rate to 6 liters per minute by nasal cannula.
# Position the patient upright and coach pursed-lip breathing.
# Have the patient lie flat to rest and conserve energy.
# Encourage rapid, deep breaths through the mouth.

'''Answer:''' Option 2, position the patient upright and coach pursed-lip breathing.

''Rationale:'' Upright or tripod positioning allows fuller lung expansion, and pursed-lip breathing keeps small airways open longer during exhalation so trapped air can escape. Option 1 changes a prescribed oxygen rate without an order, and high flow oxygen can be harmful in some patients with chronic obstructive pulmonary disease. Option 3 worsens breathing by allowing abdominal contents to press on the diaphragm. Option 4 promotes air trapping and does not help.

==Question 10==
The licensed practical nurse is collecting data on a patient who had a total hip replacement using a posterior approach. Which observation requires immediate reporting?
# An abduction pillow is in place between the legs.
# The operative leg appears shorter than the other leg and is turned outward, and the patient reports sudden severe pain.
# The patient is using a raised toilet seat.
# The patient rates hip pain as 3 out of 10 after physical therapy.

'''Answer:''' Option 2, the shortened, externally rotated leg with sudden severe pain.

''Rationale:'' Shortening with external rotation and sudden severe pain are classic signs of hip prosthesis dislocation and must be reported immediately; the nurse keeps the patient still and does not attempt to reposition the leg. Options 1 and 3 describe correct measures that maintain hip precautions. Option 4 describes expected, manageable postoperative discomfort after therapy.

==Question 11==
The licensed practical nurse is reinforcing teaching for a patient prescribed levothyroxine for hypothyroidism. Which statement indicates correct understanding?
# "I will take it in the morning on an empty stomach, before breakfast."
# "I will stop taking it once my energy level returns to normal."
# "I will take it at bedtime with my calcium supplement."
# "I will take an extra dose on days when I feel very tired."

'''Answer:''' Option 1, taking it in the morning on an empty stomach before breakfast.

''Rationale:'' Levothyroxine is absorbed best on an empty stomach and is taken in the morning to avoid insomnia, with food delayed at least 30 to 60 minutes. Option 2 is unsafe, because therapy is lifelong and feeling better means the dose is working. Option 3 is incorrect, because calcium and iron significantly reduce absorption. Option 4 is unsafe, because self-adjusting the dose can cause symptoms of excess thyroid hormone, including palpitations and dysrhythmias.

==Question 12==
A patient is on contact precautions for ''Clostridioides difficile'' infection. Which action by the licensed practical nurse is correct?
# Use alcohol-based hand rub after removing gloves.
# Wash hands with soap and water after removing gloves.
# Wear only gloves when entering the room to deliver a meal tray.
# Wear an N95 respirator when providing direct care.

'''Answer:''' Option 2, wash hands with soap and water after removing gloves.

''Rationale:'' ''C. difficile'' forms spores that alcohol-based hand rub does not kill, so soap and water with mechanical friction are required. Option 1 leaves spores on the hands. Option 3 is incomplete, because contact precautions require both a gown and gloves for room entry and patient contact. Option 4 describes airborne precautions, which are not indicated for this organism.

==Question 13==
The licensed practical nurse is helping a patient who had a stroke to eat lunch. Which action is correct?
# Position the patient upright at 90 degrees and place food on the unaffected side of the mouth.
# Offer thin liquids through a straw to make swallowing easier.
# Allow the patient to recline for comfort during the meal.
# Encourage the patient to eat quickly before becoming fatigued.

'''Answer:''' Option 1, position the patient upright at 90 degrees and place food on the unaffected side of the mouth.

''Rationale:'' Upright positioning and placing food on the stronger side reduce the risk of aspiration, which is a leading complication after stroke. Option 2 is unsafe, because thin liquids are the hardest to control and straws increase aspiration risk; thickened liquids are used when prescribed. Option 3 increases aspiration risk. Option 4 is unsafe, because rushing increases the chance of choking; the patient is given small bites, adequate time, and is checked for food pocketing in the cheek.

==Question 14==
While assisting a patient out of bed on the fifth postoperative day, the licensed practical nurse observes that the abdominal wound has separated and a loop of intestine is protruding through the incision. What should the nurse do first?
# Attempt to gently push the intestine back into the abdomen.
# Cover the area with sterile gauze moistened with sterile normal saline and call for help.
# Apply a dry pressure dressing and tape it firmly in place.
# Return the patient to a standing position and walk to the chair as planned.

'''Answer:''' Option 2, cover the area with sterile gauze moistened with sterile normal saline and call for help.

''Rationale:'' This is evisceration, a surgical emergency. Moist sterile coverings keep the exposed tissue from drying out and reduce contamination. The nurse also places the patient in low Fowler position with the knees slightly bent to reduce tension on the abdomen, keeps the patient nothing by mouth, stays with the patient, monitors for shock, and ensures the surgeon is notified immediately. Option 1 is never done and can cause serious injury and contamination. Option 3 damages tissue and does not keep it moist. Option 4 worsens the separation and delays emergency care.

==Question 15==
The licensed practical nurse is collecting data on a patient with an arteriovenous fistula in the left arm for hemodialysis. Which finding should be reported to the registered nurse immediately?
# A palpable thrill is felt over the fistula.
# A whooshing bruit is heard on auscultation over the fistula.
# No thrill is palpated and no bruit is heard.
# The patient reports mild fatigue on the day after dialysis.

'''Answer:''' Option 3, no thrill is palpated and no bruit is heard.

''Rationale:'' A thrill (a vibration felt on palpation) and a bruit (a whooshing sound heard on auscultation) are the expected signs of blood flowing through a patent fistula. Their absence suggests the access has clotted and requires immediate reporting to preserve it. Options 1 and 2 are the normal expected findings. Option 4 is a common, expected experience after a dialysis treatment. The nurse also remembers never to take blood pressure, draw blood, or start an intravenous line in the fistula arm.

[[Category:Medical-Surgical Nursing]]
[[Category:Licensed Practical Nurse (NCLEX-PN)]]
{{Disclaimer}}

Medical-Surgical Nursing – LPN Practice Questions - Revision history

Docmoates: Create Nursing Education wiki structure