Anatomy and Physiology – LPN Practice Questions

These questions apply anatomy and physiology at the level expected of the practical or vocational nurse candidate: recognizing expected versus unexpected findings, performing focused data collection, providing basic care, reinforcing teaching, and reporting promptly to the registered nurse. Content aligns with the shared article Anatomy and Physiology.

Question 1

A licensed practical nurse is taking vital signs on an adult patient. Which set of findings is within expected ranges for a healthy adult at rest?

1. Heart rate 108 beats per minute, respiratory rate 26 breaths per minute.
2. Heart rate 76 beats per minute, respiratory rate 16 breaths per minute.
3. Heart rate 48 beats per minute, respiratory rate 10 breaths per minute.
4. Heart rate 92 beats per minute, respiratory rate 30 breaths per minute.

Answer: 2 (B). Heart rate 76 beats per minute, respiratory rate 16 breaths per minute.

Rationale: The normal resting adult heart rate is 60 to 100 beats per minute and the normal respiratory rate is 12 to 20 breaths per minute, so option 2 falls within both ranges. Option 1 shows tachycardia and tachypnea, which are common early signs of hypoxia, fever, pain, or hypovolemia. Option 3 shows bradycardia and bradypnea, which may indicate oversedation or a neurologic problem. Option 4 shows marked tachypnea. Findings outside these ranges are collected accurately and reported to the registered nurse.

Question 2

A licensed practical nurse is monitoring urine output for an adult patient with an indwelling urinary catheter. Over the past 4 hours the patient has produced 70 mL of dark, concentrated urine. What is the most appropriate action?

1. Document the output and continue routine monitoring.
2. Report the finding to the registered nurse promptly.
3. Irrigate the catheter with sterile saline.
4. Increase the intravenous infusion rate.

Answer: 2 (B). Report the finding to the registered nurse promptly.

Rationale: An adult should produce at least 30 mL of urine per hour, or about 120 mL over 4 hours. Output of 70 mL over 4 hours is roughly 17 mL per hour and suggests inadequate kidney perfusion, dehydration, or obstruction, all of which require registered nurse assessment and provider notification. Option 1 fails to escalate a significant finding. Option 3 requires a prescription and is not the first response. Option 4 changes a therapy, which is outside the practical nurse's independent authority and requires a prescription.

Question 3

A licensed practical nurse is repositioning an immobile older adult and observes an area of nonblanchable redness over the sacrum with the skin intact. How should the nurse describe and act on this finding?

1. A stage 1 pressure injury; reposition off the area and report the finding to the registered nurse.
2. A stage 2 pressure injury; apply a dry sterile dressing and continue care.
3. A normal finding from lying supine; no action is needed.
4. A stage 3 pressure injury; document the depth and measure the wound.

Answer: 1 (A). A stage 1 pressure injury; reposition off the area and report the finding to the registered nurse.

Rationale: A stage 1 pressure injury is intact skin with localized nonblanchable erythema, meaning the redness does not fade with fingertip pressure because capillaries in the dermis have been damaged. Immediate pressure relief and prompt reporting allow a plan of care to be started before tissue loss occurs. Option 2 is incorrect because a stage 2 injury involves partial thickness loss of the epidermis and dermis, often appearing as an open shallow ulcer or an intact or ruptured blister. Option 3 is incorrect because normal blanchable redness fades within minutes of pressure relief. Option 4 is incorrect because stage 3 involves full thickness loss with visible subcutaneous fat.

Question 4

A licensed practical nurse is reinforcing teaching for an older adult who reports dizziness when getting out of bed. Which instruction is most appropriate?

1. "Get up quickly so the dizziness passes faster."
2. "Sit on the edge of the bed and dangle your legs for a minute before you stand."
3. "Hold your breath and bear down as you rise."
4. "Avoid drinking any fluids in the evening."

Answer: 2 (B). "Sit on the edge of the bed and dangle your legs for a minute before you stand."

Rationale: When a person stands, gravity pools blood in the legs and reduces venous return. Baroreceptors normally correct this within seconds, but this reflex becomes less responsive with aging, producing orthostatic hypotension and fall risk. Changing position gradually gives the cardiovascular system time to compensate. Option 1 increases the risk of syncope and falls. Option 3 describes the Valsalva maneuver, which further reduces venous return and can worsen dizziness. Option 4 promotes dehydration, which lowers blood volume and makes orthostatic hypotension worse.

Question 5

A licensed practical nurse is caring for a patient with a new arm cast. Which findings should be reported to the registered nurse immediately? Select all that apply.

1. Fingers that are cool and pale compared with the other hand.
2. Capillary refill of 5 seconds in the casted extremity.
3. Numbness and tingling in the fingers of the casted arm.
4. Mild itching under the cast.
5. Pain that increases sharply when the fingers are gently moved.

Answer: 1, 2, 3, and 5 (A, B, C, E).

Rationale: Neurovascular data collection distal to a cast checks whether the cast is compressing arteries and nerves. Coolness, pallor, capillary refill longer than 3 seconds, numbness or tingling, and pain on passive movement all suggest impaired circulation or nerve compression and must be reported at once, because prolonged compression causes permanent tissue and nerve damage. Option 4 is a common complaint that is uncomfortable but not an emergency; the patient is taught never to insert an object under the cast because it can injure the skin and cause infection.

Question 6

A licensed practical nurse is assisting a patient who had a stroke with the first meal after a swallow evaluation. Which observations should prompt the nurse to stop feeding and notify the registered nurse? Select all that apply.

1. Coughing repeatedly after swallowing a sip of liquid.
2. A wet or gurgling voice quality after swallowing.
3. Food pocketing in the cheek on one side of the mouth.
4. Taking about 25 minutes to finish the meal.
5. Drooling and inability to keep the lips closed.

Answer: 1, 2, 3, and 5 (A, B, C, E).

Rationale: Swallowing depends on cranial nerves that control the tongue, pharynx, and larynx. Coughing after swallowing, a wet or gurgling voice, food pocketing on one side, and drooling all suggest that these nerves are impaired and that food or liquid may be entering the airway, which risks aspiration pneumonia. Feeding should stop and the registered nurse should be notified. Option 4 is not by itself a danger sign; slower eating is common after a stroke, and the nurse should allow adequate time, keep the patient upright at 90 degrees, and have suction available.

Question 7

A licensed practical nurse is caring for a patient with heart failure. Which measurement is the most reliable daily indicator of the patient's fluid status?

1. Blood pressure taken each morning.
2. Weight measured at the same time each morning on the same scale.
3. Abdominal girth measured once weekly.
4. Oral temperature taken every 4 hours.

Answer: 2 (B). Weight measured at the same time each morning on the same scale.

Rationale: Fluid retained in the body has mass, and about 1 kilogram of weight gain corresponds to roughly 1 liter of retained fluid. Daily weight measured under consistent conditions, meaning the same time of day, the same scale, and similar clothing, after voiding, detects fluid retention earlier than visible edema does. The nurse reports a gain of about 1 kilogram, or 2 pounds, in a day or about 2.3 kilograms, or 5 pounds, in a week to the registered nurse. Option 1 is useful but reflects many factors besides volume. Option 3 is helpful in ascites but is measured less often. Option 4 does not measure fluid status.

Question 8

A licensed practical nurse notes that a patient who was previously alert has become restless and is picking at the bedsheets. The respiratory rate is 28 breaths per minute and the heart rate is 112 beats per minute. What should the nurse do first?

1. Reorient the patient and raise all four side rails.
2. Check the oxygen saturation and report the change to the registered nurse.
3. Document the behavior as sundowning and continue to observe.
4. Administer the prescribed as-needed sedative.

Answer: 2 (B). Check the oxygen saturation and report the change to the registered nurse.

Rationale: Brain tissue has a very high oxygen requirement and no meaningful oxygen reserve, so a change in mental status is often the earliest sign of hypoxia. Restlessness with tachypnea and tachycardia is a classic early hypoxia pattern, and cyanosis is a very late sign. Collecting objective data and reporting promptly allows the registered nurse to assess and intervene. Option 1 does not address the physiologic cause, and raising all four side rails is generally considered a restraint. Option 3 assumes a behavioral explanation without ruling out a physiologic one. Option 4 could depress respirations further and worsen hypoxia.

Question 9

A licensed practical nurse is reinforcing teaching about vitamin K for a patient taking warfarin. Which foods should the nurse identify as high in vitamin K? Select all that apply.

1. Spinach.
2. Kale.
3. Broccoli.
4. White rice.
5. Apples.

Answer: 1, 2, and 3 (A, B, C).

Rationale: The liver uses vitamin K to make clotting factors II, VII, IX, and X, and warfarin works by interfering with that process. Dark green leafy and cruciferous vegetables such as spinach, kale, and broccoli are high in vitamin K. The teaching point is consistency rather than avoidance: patients should keep their intake of these foods steady from week to week so the medication effect stays stable, and should report any large change in diet. White rice and apples are low in vitamin K.

Question 10

A licensed practical nurse is caring for a patient on bed rest. Which nursing measures help prevent the physiologic complications of immobility? Select all that apply.

1. Perform range-of-motion exercises to all joints as permitted.
2. Reposition the patient at least every 2 hours.
3. Encourage deep breathing and use of the incentive spirometer.
4. Keep the head of the bed flat at all times to promote rest.
5. Encourage adequate fluid intake unless it is restricted.

Answer: 1, 2, 3, and 5 (A, B, C, E).

Rationale: Immobility affects every system. Muscles atrophy and joints contract without movement, so range of motion is essential. Skin over bony prominences loses perfusion under sustained pressure, so repositioning every 2 hours is standard. Lung secretions pool and alveoli collapse when a patient lies still, so deep breathing and incentive spirometry prevent atelectasis and pneumonia. Immobility also causes bone resorption that releases calcium into the blood and urine, and urinary stasis, so adequate hydration helps prevent kidney stones and urinary tract infection. Option 4 is incorrect because lying flat continuously increases the risk of aspiration and atelectasis and does not relieve pressure.

Question 11

The liver performs many functions. Which of the following is not a normal function of the liver?

1. Production of albumin.
2. Production of clotting factors.
3. Production of erythropoietin.
4. Conversion of ammonia to urea.

Answer: 3 (C). Production of erythropoietin.

Rationale: Erythropoietin is produced mainly by the kidney in response to low oxygen levels and stimulates the bone marrow to make red blood cells, which is why patients with chronic kidney disease often become anemic. The liver produces albumin, which holds fluid inside the blood vessels, and produces the clotting factors that control bleeding, and it converts ammonia from protein breakdown into urea for the kidneys to excrete. Understanding these functions explains why a patient with liver disease may show edema, easy bruising and bleeding, and confusion.

Question 12

A licensed practical nurse is collecting data on a patient with a serum calcium level reported as low. Which findings would the nurse expect to observe? Select all that apply.

1. Tingling around the mouth and in the fingertips.
2. Muscle twitching or cramping.
3. Lethargy and constipation.
4. Positive Trousseau sign when the blood pressure cuff is inflated.
5. Deep, slow, easy respirations.

Answer: 1, 2, and 4 (A, B, D).

Rationale: Calcium helps stabilize nerve and muscle cell membranes. When the calcium level falls, nerves and muscles become overly excitable, producing perioral and fingertip tingling, muscle twitching and cramping, and positive Chvostek and Trousseau signs. The most dangerous consequence is laryngospasm, so any hoarseness, stridor, or difficulty breathing is reported immediately. Option 3 describes the sluggish picture of a high calcium level, in which nerves and muscles become less excitable. Option 5 is not a feature of hypocalcemia. The normal total serum calcium range in adults is about 9.0 to 10.5 mg/dL.

Question 13

A licensed practical nurse is preparing a patient with pneumonia in the right lower lobe for rest. Which position is generally most helpful for improving oxygenation?

1. Supine with the bed flat.
2. Lying on the right side.
3. Lying on the left side.
4. Prone with the head turned to the right.

Answer: 3 (C). Lying on the left side.

Rationale: Gravity increases blood flow to whichever lung is dependent, or lowest. Placing the healthier left lung down directs more blood to the area where air exchange is working best, which improves oxygenation. This is the "good lung down" principle. Option 2 would send more blood to the diseased lung, where the alveoli are filled with fluid and exudate, and would worsen the mismatch between ventilation and blood flow. Option 1 does not take advantage of gravity and increases the risk of secretion pooling. Option 4 is not routine basic care for pneumonia on a medical unit and requires specific prescription and monitoring. Elevating the head of the bed also helps by allowing the diaphragm to move more freely.

Question 14

A licensed practical nurse is assisting an older adult with morning care. Which age-related change should the nurse keep in mind when providing skin care?

1. The skin becomes thicker and more elastic with age.
2. Reduced subcutaneous fat and thinner skin increase the risk of skin tears and pressure injury.
3. Sweat production increases, so more frequent bathing is required.
4. Skin turgor checked on the back of the hand is the most accurate hydration measure in older adults.

Answer: 2 (B). Reduced subcutaneous fat and thinner skin increase the risk of skin tears and pressure injury.

Rationale: With aging, the epidermis thins, collagen and elastin decrease, and subcutaneous fat is lost, so the skin tears easily and has less padding over bony prominences. The nurse uses gentle handling, avoids friction and shearing during transfers, applies moisturizer, and avoids adhesive tape when possible. Option 1 is the opposite of what occurs. Option 3 is incorrect because sweat and oil gland activity decrease with age, so frequent bathing with hot water and harsh soap dries the skin further. Option 4 is incorrect because reduced elasticity makes hand turgor unreliable in older adults; the sternum or forehead is a better site.

Question 15

A licensed practical nurse is caring for a patient receiving intravenous fluids. Which findings should be reported to the registered nurse as possible signs of fluid overload? Select all that apply.

1. New crackles heard in the lung bases.
2. Distended neck veins with the head of the bed at 45 degrees.
3. A weight gain of 2.5 kilograms since yesterday.
4. Dry mucous membranes with a coated tongue.
5. New shortness of breath when lying flat.

Answer: 1, 2, 3, and 5 (A, B, C, E).

Rationale: Excess fluid in the vascular space raises pressure in the capillaries, pushing fluid into the lung tissue and producing crackles and shortness of breath that worsens when lying flat. Backed up volume on the right side of the heart shows as distended neck veins. Retained fluid also shows as rapid weight gain, since about 1 kilogram equals roughly 1 liter of fluid, so 2.5 kilograms overnight is a significant finding. Option 4 describes dehydration rather than overload. The nurse reports these findings, slows or maintains the infusion as directed, raises the head of the bed to ease breathing, and continues to monitor.

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