Practice Test

  1. Directions: Each question or incomplete statement below is followed by four suggested answers or completions. In each case, HIGHLIGHT the statement that best answers the question or completes the statement. Allot 3 hours of uninterrupted time to take the practice test.
  2. The LPN/LVN is gathering data from a client who is being treated for obsessive-compulsive disorder (OCD). Which of the following is the MOST important question the LPN/LVN should ask this client?
    1. “Do you find yourself forgetting simple things?”
    2. “Do you find it hard to stay on a task?”
    3. “Do you have trouble controlling upsetting thoughts?”
    4. “Do you experience feelings of panic in a closed area?”
  3. The LPN/LVN is caring for a client who states, “I just want to die.” The LPN/LVN should examine the client’s medical record for which of the following documents?
    1. Advance directives
    2. Power of attorney
    3. “Do not resuscitate” order
    4. Living will
  4. A newly admitted client with a history of convulsions suddenly says to the LPN/LVN, “I hear drums.” Which of the following should the LPN/LVN do FIRST?
    1. Tell the client to ignore the drums.
    2. Place the client in a darkened room away from the nurses’ station.
    3. Continue to question the client.
    4. Insert an oral airway in the client.
  5. A client diagnosed with multiple myeloma is admitted to the unit after developing pneumonia. When the LPN/LVN enters the client’s room wearing a mask, the client says, in an irritated tone of voice, “Why are you wearing that mask?” Which of the following responses by the LPN/LVN is BEST?
    1. “The chest x-ray taken this morning indicates you have pneumonia.”
    2. “What have you been told about the x-rays that were taken this morning?”
    3. “You have been placed on contact precautions due to your infection.”
    4. “I am trying to protect you from the germs in the hospital.”
  6. A nursing team consists of an RN, an LPN/LVN, and an NAP. The LPN/LVN should be assigned to which of the following clients?
    1. A 72-year-old client with diabetes who requires a dressing change for a stasis ulcer
    2. A 42-year-old client who has cancer of the bone and is reporting pain
    3. A 55-year-old client with terminal cancer who is being transferred to hospice home care
    4. A 23-year-old client who has a fracture of the right leg and asks to use the urinal
  7. To determine the structural relationship of one hospital department with another, the LPN/LVN should consult which of the following?
    1. Organizational chart
    2. Job descriptions
    3. Personnel policies
    4. Policies and procedures manual
  8. A client reports pain in his right lower extremity. The physician orders codeine 60 mg and aspirin grains X PO every 4 hours, as needed for pain. Each codeine tablet contains 15 mg of codeine. Each aspirin tablet contains 325 mg of aspirin. Which of the following should the LPN/LVN administer?
    1. 2 codeine tablets and 4 aspirin tablets
    2. 4 codeine tablets and 3 aspirin tablets
    3. 4 codeine tablets and 2 aspirin tablets
    4. 3 codeine tablets and 3 aspirin tablets
  9. The LPN/LVN cares for a client receiving paroxetine. It is MOST important for the LPN/LVN to report which of the following to the physician?
    1. The client states there is no change in her appetite.
    2. The client states she has started taking digoxin.
    3. The client states she applies sunscreen before going outside.
    4. The client states she drives her car to work.
  10. A client with a DNR (do not resuscitate) physician’s order experiences a cardiac arrest. Which of the following is the FIRST action the LPN/LVN should take?
    1. Administer lifesaving medications.
    2. Assess the client for signs of death.
    3. Open the airway and give 2 breaths.
    4. Summon the emergency code team.
  11. An LPN/LVN is working in the newborn nursery. Which of the following client-care assignments should the LPN/LVN question?
    1. A 2-day-old infant lying quietly alert with a heart rate of 185
    2. A 1-day-old infant crying with the anterior fontanel bulging
    3. A 12-hour-old infant being held; respirations 45 breaths per minute and irregular
    4. A 5-hour-old infant sleeping with hands and feet blue bilaterally
  12. While inserting a nasogastric tube, the LPN/LVN should use which of the following protective measures?
    1. Gloves, gown, goggles, and surgical cap
    2. Sterile gloves, mask, plastic bags, and gown
    3. Gloves, gown, mask, and goggles
    4. Double gloves, goggles, mask, and surgical cap
  13. The LPN/LVN is caring for clients in the outpatient clinic. Which of the following clients should the LPN/LVN see FIRST?
    1. A client with hepatitis A who states, “My arms and legs are itching.”
    2. A client with a cast on the right leg who states, “I have a funny feeling in my right leg.”
    3. A client with osteomyelitis of the spine who states, “I am so nauseous that I can’t eat.”
    4. A client with rheumatoid arthritis who states, “I am having trouble sleeping.”
  14. Which of the following client assignments should an LPN/LVN question?
    1. A client with a chest tube who is ambulating in the hall
    2. A client with a colostomy who requires assistance with a colostomy irrigation
    3. A client with a right-sided cerebrovascular accident (CVA) who requires assistance with bathing
    4. A client who is refusing medication to treat cancer of the colon
  15. The LPN/LVN is caring for a client with hepatitis B. The client is to be discharged the next day. The LPN/LVN would be MOST concerned if the client made which of the following statements?
    1. “I must not share eating utensils with my family.”
    2. “I must use my own bath towel.”
    3. “I’m glad that my husband and I can continue to have intimate relations.”
    4. “I must eat small, frequent feedings.”
  16. The LPN/LVN carries out the plan for care of a client with anemia who is reporting weakness. Which of the following tasks could be assigned to the nursing assistive personnel (NAP)?
    1. Listen to the client’s breath sounds.
    2. Set up the client’s lunch tray.
    3. Obtain a diet history.
    4. Instruct the client on how to balance rest and activity.
  17. The LPN/LVN is caring for clients on the surgical floor and has just received report from the RN. Which of the following clients should the LPN/LVN see FIRST?
    1. A 35-year-old admitted 3 days ago with a gunshot wound; 1.5-cm area of dark drainage noted on the dressing
    2. A 43-year-old who had a mastectomy 2 days ago; 23 mL of serosanguinous fluid noted in the Jackson-Pratt drain
    3. A 59-year-old with a collapsed lung due to an accident; no drainage noted in the previous 8 hours
    4. A 62-year-old who had an abdominal-perineal resection 3 days ago; client reports chills
  18. A client scheduled for a cardiac catheterization says to the LPN/LVN, “I know you were in here when the doctor had me sign the consent form for the test. I thought I understood everything, but now I’m not so sure.” Which of the following responses by the LPN/LVN is BEST?
    1. “Why didn’t you listen more closely?”
    2. “You sound as if you would like to ask more questions.”
    3. “I’ll get you a pamphlet about cardiac catheterization.”
    4. “That often happens when this procedure is explained to clients.”
  19. A 1-day-old newborn diagnosed with intrauterine growth retardation is observed by the LPN/LVN to be restless, irritable, and fist-sucking, and has a high-pitched, shrill cry. Based on this data, which of the following actions should the LPN/LVN take FIRST?
    1. Massage the infant’s back.
    2. Tightly swaddle the infant in a flexed position.
    3. Schedule feeding times every 3–4 hours.
    4. Encourage eye contact with the infant during feedings.
  20. The LPN/LVN visits a neighbor who is at 20 weeks’ gestation. The neighbor reports nausea, headache, and blurred vision. The LPN/LVN notes that the neighbor appears nervous, is diaphoretic, and is experiencing tremors. It would be MOST important for the LPN/LVN to ask which of the following questions?
    1. “Are you having menstrual-like cramps?”
    2. “When did you last eat or drink?”
    3. “Have you been diagnosed with diabetes?”
    4. “Have you been lying on the couch?”
  21. The LPN/LVN notes that a child newly admitted to the pediatric unit is scratching her head almost constantly. It would be MOST important for the LPN/LVN to take which of the following actions?
    1. Discuss basic hygiene with the parents.
    2. Instruct the child not to sleep with her dog.
    3. Inform the parents that they must contact an exterminator.
    4. Observe the scalp for small white specks.
  22. The client diagnosed with major depressive disorder who was admitted to the psychiatric unit for treatment and observation a week ago suddenly appears cheerful and motivated. The LPN/LVN should be aware of which of the following?
    1. The client is probably sleeping well because of the medication.
    2. The client has made new friends and has a support group.
    3. The client may have finalized a suicide plan.
    4. The client is responding to treatment and is no longer depressed.
  23. The LPN/LVN is caring for clients in the GYN clinic. A client reports an off-white vaginal discharge with a curdlike appearance and vulvar itching. It would be MOST important for the LPN/LVN to ask which of the following questions?
    1. “Do you douche?”
    2. “Are you sexually active?”
    3. “What kind of birth control do you use?”
    4. “Have you taken any cough medicine?”
  24. The physician orders an Ace bandage wrap for a client’s left leg from toes to mid-thigh. The LPN/LVN should do which of the following?
    1. Increase friction between the skin and bandage surfaces.
    2. Leave a small distal part of the extremity exposed.
    3. Use multiple pins to secure the bandage.
    4. Position the left leg in abduction.
  25. A client recovering from a laparoscopic laser cholecystectomy says to the LPN/LVN, “I hate the thought of eating a low-fat diet for the rest of my life.” Which of the following responses by the LPN/LVN is MOST appropriate?
    1. “I will ask the dietician to come talk to you.”
    2. “What do you think is so bad about following a low-fat diet?”
    3. “It may not be necessary for you to follow a low-fat diet for that long.”
    4. “At least you will be alive and not suffering that pain.”
  26. The LPN/LVN is caring for clients in a pediatric clinic. The mother of a 14-year-old male privately tells the LPN/LVN that she is worried about her son because she unexpectedly walked into his room and discovered him masturbating. Which of the following responses by the LPN/LVN is MOST appropriate?
    1. “Tell your son he could go blind doing that.”
    2. “Masturbation is a normal part of sexual development.”
    3. “He’s really too young to be masturbating.”
    4. “Why don’t you give him more privacy?”
  27. A client begins to breathe very rapidly. Which of the following actions by the LPN/LVN would be the MOST appropriate?
    1. Assess the apical pulse.
    2. Measure blood pressure and pulse.
    3. Notify the physician.
    4. Obtain an oxygen saturation.
  28. The LPN/LVN plans morning care for a client hospitalized after a cerebrovascular accident (CVA) resulting in left-sided paralysis and homonymous hemianopia. During morning care, the LPN/LVN should do which of the following?
    1. Provide care from the client’s right side.
    2. Speak loudly and distinctly when talking with the client.
    3. Reduce the level of lighting in the client’s room to prevent glare.
    4. Provide all of the client’s care to reduce his energy expenditure.
  29. A primigravid woman comes to the clinic for her initial prenatal visit. She is at 32 weeks’ gestation and says that she has just moved from out of state. The client says that she has had periodic headaches during her pregnancy, and that she is continually bumping into things. The LPN/LVN notes numerous bruises in various stages of healing around the client’s breasts and abdomen. Vital signs are: BP 120/80, pulse 72, resp 18, and FHT 142. Which of the following responses by the LPN/LVN is BEST?
    1. “Are you battered by your partner?”
    2. “How do you feel about being pregnant?”
    3. “Tell me about your headaches.”
    4. “You may be more clumsy due to your size.”
  30. The LPN/LVN is providing care for a client with chronic lung disease who is receiving oxygen through a nasal cannula. The LPN/LVN should expect which of the following to occur?
    1. Arterial blood gases will be drawn q 2 hours.
    2. The client’s oral intake will be restricted.
    3. The client will be on strict bed rest.
    4. The oxygen flow rate will be set at 3 L/min or less.
  31. The LPN/LVN cares for a child who is in a leg cast for treatment of a fractured right ankle. It is MOST important for the LPN/LVN to reinforce which of the following activities after discharge?
    1. The child performs isometric exercises of the right leg.
    2. The mother gently massages the child’s right foot with emollient cream.
    3. The mother cleans the leg cast with mild soap and water.
    4. The mother elevates the right leg on several pillows.
  32. The LPN/LVN is caring for a client who had a thyroidectomy 12 hours ago for treatment of Graves’ disease. The LPN/LVN would be MOST concerned if which of the following were observed?
    1. The client’s blood pressure is 138/82, pulse 84, respirations 16, and oral temp 99° F (37.2° C).
    2. The client supports his head and neck when turning his head to the right.
    3. The client spontaneously flexes his wrist when the blood pressure is obtained.
    4. The client is drowsy and reports a sore throat.
  33. A client is admitted who reports severe pain in the right lower quadrant of the abdomen. To assist with pain relief, the LPN/LVN should take which of the following actions?
    1. Encourage the client to change positions frequently in bed.
    2. Massage the right lower quadrant of the abdomen.
    3. Apply warmth to the abdomen with a heating pad.
    4. Use comfort measures and pillows to position the client.
  34. Which of the following actions by the LPN/LVN would be considered negligence?
    1. Administering subQ (subcutaneous) heparin into a client’s abdomen without first aspirating for blood.
    2. Crushing furosemide and adding to a teaspoon of applesauce for an elderly client.
    3. Lowering the bed side rails after administering meperidine and hydroxyzine to a client preoperatively.
    4. Placing a used syringe and needle in a sharps container in a client’s room.
  35. The LPN/LVN teaches an elderly client with right-sided weakness how to use a cane. Which of the following behaviors by the client indicates that the teaching was effective?
    1. The man holds the cane with his right hand, moves the cane forward followed by the right leg, and then moves the left leg.
    2. The man holds the cane with his right hand, moves the cane forward followed by his left leg, and then moves the right leg.
    3. The man holds the cane with his left hand, moves the cane forward followed by the right leg, and then moves the left leg.
    4. The man holds the cane with his left hand, moves the cane forward followed by his left leg, and then moves the right leg.
  36. The LPN/LVN has been caring for a 72-year-old client for the past 2 days. The client’s vital signs have been within normal limits. This morning her vital signs are: tympanic temperature 103.6° F (39.8° C), pulse 82 regular and strong, respirations 14 shallow and unlabored, BP 134/88. What should the LPN/LVN’s next action be?
    1. Call the physician immediately to report the vital signs.
    2. Proceed with the client’s care.
    3. Record the vital signs on the graphic record in the chart.
    4. Retake the temperature with a different thermometer.
  37. A 46-year-old man is admitted to the hospital with a fractured right femur. He is placed in balanced suspension traction with a Thomas splint and Pearson attachment. During the first 48 hours, the LPN/LVN should gather data related to which of the following complications?
    1. Pulmonary embolism
    2. Fat embolism
    3. Avascular necrosis
    4. Malunion
  38. The LPN/LVN is helping an NAP provide a bed bath to a comatose client who is incontinent. The LPN/LVN should intervene if which of the following actions is noted?
    1. The NAP answers the phone while wearing gloves.
    2. The NAP log-rolls the client to provide back care.
    3. The NAP places an incontinence diaper under the client.
    4. The NAP positions the client on the left side, head elevated.
  39. A 70-year-old woman is transferred to the orthopedic unit from the emergency room for treatment after being found on the floor by her daughter. X-rays reveal a displaced subcapital fracture of the left hip and osteoarthritis. When comparing the legs, the LPN/LVN would most likely make which of the following observations?
    1. The client’s left leg is longer than the right leg and externally rotated.
    2. The client’s left leg is shorter than the right leg and internally rotated.
    3. The client’s left leg is shorter than the right leg and adducted.
    4. The client’s left leg is longer than the right leg and is abducted.
  40. The LPN/LVN is caring for a client with a cast on the left leg. The LPN/LVN would be MOST concerned if which of the following is observed?
    1. Capillary refill time is less than 3 seconds.
    2. Client reports discomfort and itching.
    3. Client reports tightness and pain.
    4. Client’s foot is elevated on a pillow.
  41. The LPN/LVN is assisting with discharging a client from an inpatient alcohol treatment unit. Which of the following statements by the client’s wife indicates that the family is coping adaptively?
    1. “My husband will do well as long as I keep him engaged in activities that he likes.”
    2. “My focus is learning how to live my life.”
    3. “I am so glad that our problems are behind us.”
    4. “I’ll make sure that the children don’t give my husband any problems.”
  42. An LPN/LVN is caring for clients in the mental health clinic. A woman comes to the clinic reporting insomnia and anorexia. The client tearfully tells the LPN/LVN that she was laid off from a job that she had held for 15 years. Which of the following responses by the LPN/LVN is MOST appropriate?
    1. “Did your company give you a severance package?”
    2. “Focus on the fact that you have a healthy, happy family.”
    3. “Tell me what happened.”
    4. “Losing a job is common nowadays.”
  43. A client with a history of alcohol use disorder is transferred to the unit in an agitated state. He is vomiting and diaphoretic. He says he had his last drink 5 hours ago. The LPN/LVN would expect to administer which of the following medications?
    1. Chlordiazepoxide hydrochloride
    2. Disulfiram
    3. Methadone hydrochloride
    4. Naloxone hydrochloride
  44. The LPN/LVN cares for a client diagnosed with terminal colon cancer. The spouse of the client says, “We have been married for so long. I am not sure how I can go on now.” What is the MOST appropriate response by the LPN/LVN?
    1. “It sounds like your children will be there to help during your time of grieving.”
    2. “I know this is difficult. Tell me more about what you are feeling now.”
    3. “Think about the pain and suffering your spouse has experienced lately.”
    4. “I will call the hospice nurse to talk to you about this.”
  45. The LPN/LVN reinforces how to use a standard aluminum walker with an elderly client. Which of the following behaviors by the client indicates that the teaching was effective?
    1. The client slowly pushes the walker forward 12 inches, then takes small steps forward while leaning on the walker.
    2. The client lifts the walker, moves it forward 10 inches, and then takes several small steps forward.
    3. The client supports his weight on the walker while advancing it forward, then takes small steps while balancing on the walker.
    4. The client slides the walker 18 inches forward, then takes small steps while holding onto the walker for balance.
  46. An LPN/LVN is providing care for a group of elderly clients in a residential home setting. The LPN/LVN knows that the elderly are at greater risk of developing sensory deprivation for which of the following reasons?
    1. Increased sensitivity to the side effects of medications
    2. Decreased visual, auditory, and gustatory abilities
    3. Isolation from their families and familiar surroundings
    4. Decreased musculoskeletal function and mobility
  47. The LPN/LVN would expect which of the following clients to be able to sign a consent form for nonemergent medical treatment?
    1. A 10-year-old with a right tibia and fibula fracture
    2. A 21-year-old requiring surgery for acute appendicitis
    3. A 35-year-old who is confused after an automobile accident
    4. A 73-year-old who has been legally declared incompetent
  48. An LPN/LVN is assisting with the discharge of a client with a diagnosis of hepatitis of unknown etiology. The LPN/LVN knows that teaching has been successful if the client makes which of the following statements?
    1. “I am so sad that I am not able to hold my baby.”
    2. “I will eat after my family eats.”
    3. “I will make sure that my children don’t eat or drink from my dishware.”
    4. “I’m glad that I don’t have to get help taking care of my children.”
  49. The LPN/LVN checks the IV flow rate for a postoperative client. The client is to receive 3,000 mL of Ringer’s lactate solution IV to run over 24 hours. The IV infusion set has a drop factor of 10 drops per milliliter. The LPN/LVN would expect the client’s IV to be running at how many drops per minute?
    1. 18
    2. 21
    3. 35
    4. 40
  50. A client with emphysema becomes restless and confused. Which of the following actions should the LPN/LVN take next?
    1. Encourage the client to perform pursed-lip breathing.
    2. Check the client’s temperature.
    3. Assess the client’s potassium level.
    4. Increase the client’s oxygen flow rate to 5 L/min.
  51. The LPN/LVN cares for a client following surgery for removal of a cataract in the right eye. The client reports severe eye pain in her right eye. Which of the following activities should the LPN/LVN do FIRST?
    1. Administer an analgesic to the client.
    2. Recheck the client in 30 minutes.
    3. Document the finding in the client’s chart.
    4. Report the finding to the RN.
  52. The LPN/LVN is caring for a client 4 hours after intracranial surgery. Which of the following actions should the LPN/LVN take immediately?
    1. Turn, cough, and deep-breathe the client.
    2. Place the client with the neck flexed and head turned to the side.
    3. Perform passive range-of-motion exercises.
    4. Move client to the head of the bed using a turning sheet.
  53. A 6-year-old child with a congenital heart disorder is admitted with congestive heart failure. Digoxin 0.12 mg is ordered for the child. The bottle contains 0.05 mg of digoxin in 1 mL of solution. Which of the following amounts should the LPN/LVN administer to the child after validating the dose with the RN?
    1. 1.2 mL
    2. 2.4 mL
    3. 3.5 mL
    4. 4.2 mL
  54. The LPN/LVN is caring for a client diagnosed with chronic lymphocytic leukemia, hospitalized for treatment of hemolytic anemia. The LPN/LVN should expect to implement which of the following actions?
    1. Encourage activities with other clients in the day room.
    2. Isolate the client from visitors.
    3. Provide a diet high in vitamin C.
    4. Maintain a quiet environment.
  55. The LPN/LVN is caring for a client with cervical cancer. The LPN/LVN notes that the radium implant has become dislodged. Which of the following actions should the LPN/LVN take FIRST?
    1. Grasp the implant with a sterile hemostat and carefully reinsert it into the client.
    2. Wrap the implant in a blanket and place it behind a lead shield.
    3. Ensure the implant is picked up with long-handled forceps and placed in a lead container.
    4. Obtain a dosimeter reading on the client and report it to the physician.
  56. The LPN/LVN comes to the home of a client with cellulitis of the left leg to perform a daily dressing change. The client tells the LPN/LVN that the nursing assistive personnel (NAP) changed the dressing earlier that morning. Which of the following actions by the LPN/LVN is BEST?
    1. Tell the client that the NAP did a good job with the dressing change.
    2. Notify the RN supervisor of the situation.
    3. Ask the client to describe the dressing change.
    4. Report the NAP to the home care agency.
  57. The LPN/LVN is caring for a client with pernicious anemia. The LPN/LVN reinforces teaching about the plan of care. The LPN/LVN should report which of the following statements to the RN?
    1. “In order to get better, I will need to take iron pills.”
    2. “I am going to attend smoking cessation classes.”
    3. “I will learn how to perform IM injections.”
    4. “I need to eat a balanced diet.”
  58. The LPN/LVN is caring for clients on a general medical/surgical unit of an acute care facility. Four clients have been admitted in the last 20 minutes. Which of the admissions should the LPN/LVN see FIRST?
    1. A client reporting vomiting and diarrhea
    2. A client with third-degree burns to the face
    3. A client with a fractured left hip
    4. A client reporting epigastric pain
  59. The LPN/LVN is caring for a client with a diagnosis of COPD, bronchitis-type, in the long-term care facility. The client is wheezing, and his oxygen saturation is 85 percent. Four hours ago, the oxygen saturation was 88 percent. It is MOST important for the LPN/LVN to take which of the following actions?
    1. Administer beclomethasone, 2 puffs per metered-dose inhaler.
    2. Listen to breath sounds.
    3. Increase oxygen to 4 L per mask.
    4. Administer albuterol, 2 puffs per metered-dose inhaler.
  60. The LPN/LVN is caring for a client hospitalized for observation following a fall. The client states, “My friend fell last year, and no one thought anything was wrong. She died 2 days later!” Which of the following responses by the LPN/LVN is BEST?
    1. “This happens to quite a few people.”
    2. “We are monitoring you, so you’ll be okay.”
    3. “Don’t you think I’m taking good care of you?”
    4. “You’re concerned that it might happen to you?”
  61. The LPN/LVN is caring for clients on the pediatric unit. An 8-year-old client with second- and third-degree burns on the right thigh is being admitted. The LPN/LVN should expect the new client to be placed with which one of the following roommates?
    1. A 2-year-old with chickenpox
    2. A 4-year-old with asthma
    3. A 9-year-old with acute diarrhea
    4. A 10-year-old with methicillin-resistant Staphylococcus aureus (MRSA)
  62. In order to evaluate the effectiveness of a client’s heparin therapy, the LPN/LVN should monitor which of the following laboratory values?
    1. Platelet count
    2. Partial thromboplastin time
    3. Bleeding time
    4. Prothrombin time
  63. The LPN/LVN is reinforcing teaching with a client who is scheduled for a paracentesis. Which of the following statements by the client indicates that teaching has been successful?
    1. “I will be in surgery for less than an hour.”
    2. “I must not void prior to the procedure.”
    3. “The physician will remove 2 to 3 liters of fluid.”
    4. “I will lie on my back and breathe slowly.”
  64. The LPN/LVN is performing chest physiotherapy on an elderly client in long-term care with chronic airflow limitations (CAL). Which of the following actions should the nurse take FIRST?
    1. Perform chest physiotherapy prior to meals.
    2. Auscultate the chest prior to beginning the procedure.
    3. Administer bronchodilators after the procedure.
    4. Percuss each lobe prior to asking the client to cough.
  65. In which of the following situations would it be MOST appropriate for the LPN/LVN to wear a protective gown and clean gloves?
    1. Administering oral medications to a client with AIDS
    2. Assisting in the care of a car accident victim who is bleeding
    3. Bathing a client with an abdominal wound infection
    4. Changing the linen of a client with sickle-cell anemia
  66. A client is receiving 1,000 mL of 5% dextrose in 0.45 NaCl intravenous solution in an 8-hour period. The intravenous set delivers 15 drops per milliliter. The LPN/LVN should expect the flow rate to be how many drops per minute?
    1. 15
    2. 31
    3. 45
    4. 60
  67. A client is admitted to the hospital reporting seizures and a high fever. A brain scan is ordered. Before the scan, the client asks the LPN/LVN what position he will be in while the procedure is being done. Which of the following statements by the LPN/LVN is MOST accurate?
    1. “You will be in a side-lying position, with the foot of the bed elevated.”
    2. “You will be in a semi-upright sitting position, with your knees flexed.”
    3. “You will be lying on your back with a small pillow under your head.”
    4. “You will be flat on your back, with your feet higher than your head.”
  68. A client with a diagnosis of delirium is admitted to the hospital. To evaluate the cause of the client’s delirium, blood is sent to the laboratory for analysis. The results are as follows: Na+ 156, Cl– 100, K+ 4.0, HCO3 21, BUN 86, glucose 100. Based on these laboratory results, the LPN/LVN would expect to see which of the following nursing diagnoses on the client’s care plan?
    1. Alteration in patterns of urinary elimination
    2. Fluid volume deficit
    3. Nutritional deficit: less than body requirements
    4. Self-care deficit: feeding
  69. A client is to receive 3,000 mL of 0.9% NaCl IV in 24 hours. The intravenous set delivers 15 drops per milliliter. The LPN/LVN would expect the flow rate to be how many drops of fluid per minute?
    1. 21
    2. 28
    3. 31
    4. 42
  70. The LPN/LVN cares for a client diagnosed with asthma. The physician orders neostigmine IM. Which of the following actions by the LPN/LVN is MOST appropriate?
    1. Administer the medication.
    2. Check the blood pressure and pulse.
    3. Ask the pharmacy if the medication can be given orally.
    4. Notify the physician.
  71. The LPN/LVN cares for a client with a history of Addison’s disease who has received steroid therapy for several years. The LPN/LVN would expect the client to exhibit which of the following changes in appearance?
    1. Buffalo hump, girdle-obesity, gaunt facial appearance
    2. Tanning of the skin, discoloration of the mucous membranes, alopecia, weight loss
    3. Emaciation, nervousness, breast engorgement, hirsutism
    4. Truncal obesity, purple striations on the skin, moon face
  72. The LPN/LVN is caring for a client who is jaundiced due to pancreatic cancer. The LPN/LVN should give the HIGHEST priority to which of the following needs?
    1. Nutrition
    2. Self-image
    3. Skin integrity
    4. Urinary elimination
  73. An 8-year-old boy is seen in a clinic for treatment of attention-deficit/hyperactivity disorder (ADHD). Medication has been prescribed for the child along with family counseling. The LPN/LVN reinforces the teaching plan about the medication and discusses parenting strategies with the parents. Which of the following statements by the parents indicates that further teaching is necessary?
    1. “We will give the medication at night so it doesn’t decrease his appetite.”
    2. “We will provide a regular routine for sleeping, eating, working, and playing.”
    3. “We will establish firm but reasonable limits on his behavior.”
    4. “We will reduce distractions and external stimuli to help him concentrate.”
  74. The teenage client with anorexia nervosa is admitted to the hospital. Which of the following statements by the client requires immediate follow-up by the LPN/LVN?
    1. “My gums were bleeding this morning.”
    2. “I’m getting fatter every day.”
    3. “Nobody likes me because I’m so ugly.”
    4. “I’m feeling dizzy and weak today.”
  75. A client is admitted to the hospital for treatment of Pneumocystis jiroveci pneumonia and Kaposi’s sarcoma. The client tells the LPN/LVN that he has been considering organ donation when he dies. Which of the following responses by the LPN/LVN is BEST?
    1. “What does your family think about your decision?”
    2. “You will help many people by donating your organs.”
    3. “Would you like to speak to the organ donor representative?”
    4. “That is not possible based on your illness.”
  76. The LPN/LVN is caring for a client 2 days after a pancreatectomy for cancer of the pancreas. The LPN/LVN notes that there is minimal drainage from the nasogastric (NG) tube. It is MOST important for the LPN/LVN to take which of the following actions?
    1. Notify the physician.
    2. Monitor vital signs q 15 minutes.
    3. Check the tubing for kinks.
    4. Replace the NG tube.
  77. The LPN/LVN plans to administer furosemide 20 mg PO to a client diagnosed with renal failure. The client asks the LPN/LVN why he is receiving this medication. Which of the following responses by the LPN/LVN is BEST?
    1. “To increase the blood flow to your kidney.”
    2. “To decrease your circulating blood volume.”
    3. “To increase excretion of sodium and water.”
    4. “To decrease the workload on your heart.”
  78. The LPN/LVN is reinforcing discharge teaching for a client with Parkinson’s disease. To maintain safety, the LPN/LVN should make which of the following suggestions to the family?
    1. Install a raised toilet seat.
    2. Obtain a hospital bed.
    3. Instruct the client to hold his arms in a dependent position when ambulating.
    4. Perform an exercise program during the late afternoon.
  79. The LPN/LVN is reinforcing discharge teaching for a client with chronic pancreatitis. Which of the following statements by the client indicates that further teaching is necessary?
    1. “I do not have to restrict my physical activity.”
    2. “I should take pancrelipase before meals.”
    3. “I will eat 3 meals per day.”
    4. “I am not allowed to drink any alcoholic beverages.”
  80. Following a laparoscopic cholecystectomy, the client reports abdominal pain and bloating. Which of the following responses by the LPN/LVN is BEST?
    1. “Increase your intake of fresh fruits and vegetables.”
    2. “I’ll give you the prescribed pain medication.”
    3. “Why don’t you take a walk in the hallway?”
    4. “You may need an indwelling catheter.”
  81. The nursing team consists of an RN, an NAP, and an LPN/LVN. The LPN/LVN would expect to be assigned to which of the following clients?
    1. A client scheduled for an MRI
    2. An unconscious client who requires a bed bath
    3. A client with a fracture who is in balanced suspension traction
    4. A client with diabetes who needs help bathing

  82. The physician orders 1 L of D5 1/2 NS to run over 8 hours. The drip factor stated on the IV tubing is 15 gtt/mL. How many milliliters should the LPN/LVN expect to be infused every hour?

    mL

  83. A client has a vagotomy with antrectomy to treat a duodenal ulcer. Postoperatively, the client develops dumping syndrome. Which of the following statements by the client indicates to the LPN/LVN that further dietary teaching is necessary?
    1. “I should eat bread with each meal.”
    2. “I should eat smaller meals more frequently.”
    3. “I should lie down after eating.”
    4. “I should avoid drinking fluids with my meals.”
  84. The LPN/LVN reinforces discharge teaching with a client with emphysema. Which of the following statements by the client indicates that teaching was successful?
    1. “Cold weather will help my breathing problems.”
    2. “I should eat 3 balanced meals but limit my fluid intake.”
    3. “My outside activity should be limited when pollution levels are high.”
    4. “An intensive exercise program is important in regaining my strength.”
  85. A client has been taking aluminum hydroxide daily for 3 weeks. The LPN/LVN should be alert for which of the following side effects?
    1. Nausea
    2. Hypercalcemia
    3. Constipation
    4. Anorexia
  86. The LPN/LVN hears a client calling for help. The LPN/LVN enters the room and finds an elderly client in bilateral wrist restraints with a cool, pale right hand with no palpable radial pulse. Which of the following would be the most appropriate action for the LPN/LVN to take FIRST?
    1. Leave to find the client’s nurse.
    2. Massage the client’s wrist and hand.
    3. Remove the right wrist restraint.
    4. Reposition the client to reduce pressure.
  87. The LPN/LVN is reinforcing discharge teaching for a client with a new colostomy. The LPN/LVN knows teaching was successful when the client chooses which of the following menu options?
    1. Sausage, sauerkraut, baked potato, and fresh fruit
    2. Cheese omelet with bran muffin and fresh pineapple
    3. Pork chop, mashed potatoes, turnips, and salad
    4. Baked chicken, boiled potato, cooked carrots, and yogurt
  88. A client is admitted to the unit to rule out acute renal failure. The LPN/LVN would be MOST concerned if the client made which of the following statements?
    1. “My urine is often pink-tinged.”
    2. “It is hard for me to start the flow of urine.”
    3. “It is quite painful for me to urinate.”
    4. “I urinate in the morning and again before dinner.”
  89. The LPN/LVN is implementing the protocol for teaching a new mother how to breastfeed her newborn. The LPN/LVN knows that teaching has been successful if the client makes which of the following statements?
    1. “My baby’s weight should equal her birthweight in 5 to 7 days.”
    2. “My baby should have at least 6 to 8 wet diapers per day.”
    3. “My baby will sleep at least 6 hours between feedings.”
    4. “My baby will feed for about 10 minutes per feeding.”
  90. A client is admitted to the telemetry unit for evaluation of reporting chest pain. Eight hours after admission, the client goes into ventricular fibrillation. The physician defibrillates the client. The LPN/LVN understands that the purpose of defibrillation is to do which of the following?
    1. Increase cardiac contractility and cardiac output.
    2. Cause asystole so the normal pacemaker can recapture.
    3. Reduce cardiac ischemia and acidosis.
    4. Provide energy for depleted myocardial cells.
  91. The LPN/LVN is caring for a client who suddenly reports chest pain. The LPN/LVN knows that which of the following symptoms would be MOST characteristic of an acute myocardial infarction?
    1. Colic-like epigastric pain
    2. Sharp, well-localized, unilateral chest pain
    3. Severe substernal pain radiating down the left arm
    4. Sharp, burning chest pain moving from place to place
  92. The physician orders packing for a nonhealing open surgical wound. Which of the following is the FIRST action by the LPN/LVN?
    1. Identify wound size, shape, and depth.
    2. Observe for wound drainage or discharge.
    3. Plan to set up for clean technique.
    4. Select the proper dressing material.
  93. A client returns to the clinic 2 weeks after discharge from the hospital. He is taking wafarin sodium 2 mg PO daily. Which of the following statements by the client to the LPN/LVN indicates that further teaching is necessary?
    1. “I have been taking an antihistamine before bed.”
    2. “I take aspirin when I have a headache.”
    3. “I use sunscreen when I go outside.”
    4. “I take Mylanta if my stomach gets upset.”
  94. To enhance the percutaneous absorption of nitroglycerin ointment, it would be MOST important for the LPN/LVN to select a site that is which of the following?
    1. Muscular
    2. Near the heart
    3. Non-hairy
    4. Over a bony prominence
  95. When assisting the RN in planning care for a postoperative client, which of the following should be the FIRST choice of the LPN/LVN to reduce the client’s risk for pooled airway secretions and decreased chest wall expansion?
    1. Chest percussion
    2. Incentive spirometry
    3. Position changes
    4. Postural drainage
  96. Which of the following actions by the LPN/LVN would be MOST helpful in preventing injury to elderly clients in a health care facility?
    1. Closely monitor the temperature of hot oral fluids.
    2. Keep unnecessary furniture out of the way.
    3. Maintain the safe function of all electrical equipment.
    4. Use safety protection caps on all medications.
  97. Which of the following statements by a client during a group therapy session requires immediate follow-up by the LPN/LVN?
    1. “I know I’m a chronically compulsive liar, but I can’t help it.”
    2. “I don’t ever want to go home; I feel safer here.”
    3. “I don’t really care if I ever see my girlfriend again.”
    4. “I’ll make sure that doctor is sorry for what he said.”
  98. A client newly diagnosed with major neurocognitive disorder (NCD) due to Alzheimer’s disease is admitted to the unit. Which of the following actions by the LPN/LVN is BEST?
    1. Place the client in a private room away from the nurses’ station.
    2. Ask the family to wait in the waiting room while the nurse admits the client.
    3. Assign a different nurse daily to care for the client.
    4. Ask the client to state today’s date.
  99. A female client visits the clinic reporting right calf tenderness and pain. It would be MOST important for the LPN/LVN to ask which of the following questions?
    1. “Do you exercise excessively?”
    2. “Have you had any fractures in the last year?”
    3. “What type of birth control do you use?”
    4. “Are you under a lot of stress?”
  100. Which of the following should be the LPN/LVN’s FIRST priority in providing care for a client who has terminal ovarian cancer and has been weakened by chemotherapy?
    1. Assess if the client is experiencing pain.
    2. Determine if the client is hungry or thirsty.
    3. Explore the client’s feelings about dying.
    4. Observe the client’s self-care abilities.
  101. The LPN/LVN in the postpartum unit cares for a client who delivered her first child the previous day. The LPN/LVN notes multiple varicosities on the client’s lower extremities. Which of the following actions should the LPN/LVN perform?
    1. Teach the client to rest in bed when the baby sleeps.
    2. Encourage early and frequent ambulation.
    3. Apply warm soaks for 20 minutes every 4 hours.
    4. Perform passive range-of-motion exercises 3 times daily.
  102. The LPN/LVN cares for a client with a fracture of the left femur. A cast is applied. The nurse knows that which of the following exercises would be MOST beneficial for this client?
    1. Passive exercise of the affected limb
    2. Quadriceps setting of the affected limb
    3. Active range-of-motion exercises of the unaffected limb
    4. Passive exercise of the upper extremities
  103. In preparation for a dressing change, the LPN/LVN puts on sterile gloves. Where should the LPN/LVN initially grip the first sterile glove?

  104. A client is being discharged from the hospital following a right total hip arthroplasty. The LPN/LVN reinforces discharge teaching. Which of the following statements by the client indicates that teaching was successful?

    1. “I can bend over to pick up something on the floor.”
    2. “I should not cross my ankles when sitting in a chair.”
    3. “I need to lie on my stomach when sleeping in bed.”
    4. “I should spread my knees apart to put on my shoes.”

  105. The LPN/LVN cares for a client with continuous bladder irrigation. At 7 a.m., the LPN/LVN notes 4,200 mL of normal saline left in the irrigation bags. During the next shift (7 a.m. to 3 p.m.), the LPN/LVN hangs another 3,000 mL and empties a total of 5,625 mL from the urine drainage bag. At 3 p.m., there are 2,300 mL of irrigant left hanging. What is the actual urine output for the client from 7 a.m. to 3 p.m.?

    mL

  106. The LPN/LVN observes activities on a medical/surgical unit. The LPN/LVN should intervene if which of the following is observed?

    1. A client’s wife disposes of her husband’s used tissue in the bedside container before opening the roommate’s milk carton.
    2. An NAP removes her gloves and washes her hands for 15 seconds after emptying an indwelling urinary catheter.
    3. An LPN/LVN puts on a gown, gloves, mask, and goggles prior to inserting a nasogastric tube.
    4. A visitor talks with a client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) wound infection while he eats his lunch.

  107. A client is admitted to the unit reporting nausea, vomiting, and abdominal pain. He is a type 1 diabetic (IDDM). Four days earlier, he reduced his insulin dose when flu symptoms prevented him from eating. The LPN/LVN observes the client and finds poor skin turgor, dry mucous membranes, and fruity breath odor. The LPN/LVN should be alert for which of the following problems?

    1. Hypoglycemia
    2. Viral illness
    3. Ketoacidosis
    4. Hyperglycemic hyperosmolar nonketotic coma

  108. The LPN/LVN knows that it is MOST important for which of the following clients to receive his scheduled medication on time?

    1. A client diagnosed with myasthenia gravis receiving pyridostigmine bromide
    2. A client diagnosed with bipolar disorder receiving lithium carbonate
    3. A client diagnosed with tuberculosis receiving isonicotinic acid hydrazide
    4. A client diagnosed with Parkinson’s disease receiving levodopa

  109. An 11-year-old boy is admitted to the hospital for evaluation for a kidney transplant. The LPN/LVN learns that the client received hemodialysis for 3 years due to renal failure. The LPN/LVN knows that his illness can interfere with this client’s achievement of which of the following?

    1. Intimacy
    2. Trust
    3. Industry
    4. Identity

  110. The LPN/LVN notes that a 67-year-old client has an unsteady gait. The LPN/LVN should do which of the following? Select all that apply.

    1. Apply a chest or vest restraint at night.
    2. Help the client put on nonskid shoes for walking.
    3. Keep the call light within the client’s reach.
    4. Lower the bed and raise all 4 side rails.
    5. Provide adequate lighting.
    6. Remove obstacles and room clutter.

  111. Haloperidol 5 mg tid is ordered for a client with schizophrenia. Two days later, the client reports “tight jaws and a stiff neck.” The LPN/LVN should recognize that these complaints are which of the following?

    1. Common side effects of antipsychotic medications that will diminish over time
    2. Early symptoms of extrapyramidal reactions to the medication
    3. Psychosomatic symptons resulting from a delusional system
    4. Permanent side effects of haloperidol

  112. A client is receiving a continuous gastric tube feeding at 100 mL per hour. The LPN/LVN checks for feeding residual and finds 90 mL in the client’s stomach. Which of the following actions should the LPN/LVN take?

    1. Discard the residual and continue the tube feeding.
    2. Discard the residual and stop the tube feeding.
    3. Return the residual to the stomach and continue the tube feeding.
    4. Return the residual to the stomach and stop the tube feeding.

  113. The LPN/LVN opens several sterile 4 × 4s on the client’s over-bed table. The LPN/LVN knows that the sterile dressings will be contaminated if she does which of the following?

    1. Does not allow the dressings prolonged exposure to the air.
    2. Keeps sterile 4 × 4s inside the border of the sterile packaging.
    3. Positions the top of the table at or above waist level.
    4. Pours sterile saline onto the opened sterile 4 × 4s on the table.

  114. A client has adamantly refused all hygiene measures over the last 3 days. The LPN/LVN and the client are finally able to collaborate to achieve the hygiene goal of “self-administration of a complete bath once a day while in the hospital.” To evaluate if this goal is met, the LPN/LVN should do which of the following?

    1. Ask the client if he has performed his daily bath.
    2. Bathe the client to be sure the hygiene goal is met.
    3. Observe the client performing portions of his daily bath.
    4. Remind the client to take his bath, providing the needed supplies.

  115. The LPN/LVN is caring for a client in labor. The MD palpates a firm, round form in the uterine fundus, small parts on the woman’s right side, and a long, smooth, curved section on the left side. Based on these findings, where should the LPN/LVN anticipate auscultating the fetal heart?

    1. A
    2. B
    3. C
    4. D

  116. When completing data collection of an immobilized client, the LPN/LVN knows that he is most likely to observe edema in which of the following?

    1. Abdomen
    2. Feet and ankles
    3. Fingers and wrists
    4. Sacrum

  117. A client is preparing to take her 1-day-old infant home from the hospital. The LPN/LVN discusses the test for phenylketonuria (PKU) with the mother. The LPN/LVN’s teaching should be based on an understanding that the test is MOST reliable in which of the following circumstances?

    1. After a source of protein has been ingested
    2. After the meconium has been excreted
    3. After the danger of hyperbilirubinemia has passed
    4. After the effects of delivery have subsided

  118. The LPN/LVN is caring for an Rh-negative mother who has delivered an Rh-positive child. The mother states, “The doctor told me about RhoGAM, but I’m still a little confused.” Which of the following responses by the LPN/LVN is MOST appropriate?

    1. “RhoGAM is given to your child to prevent the development of antibodies.”
    2. “RhoGAM is given to your child to supply the necessary antibodies.”
    3. “RhoGAM is given to you to prevent the formation of antibodies.”
    4. “RhoGAM is given to you to encourage the production of antibodies.”

  119. A woman is hospitalized with a diagnosis of bipolar disorder. While she is in the client activities room on the psychiatric unit, she flirts with male clients and disrupts unit activities. Which of the following approaches would be MOST appropriate for the LPN/LVN to take at this time?

    1. Set limits on the client’s behavior and remind her of the rules.
    2. Distract the client and escort her back to her room.
    3. Instruct the other clients to ignore this client’s behavior.
    4. Tell the client that she is behaving inappropriately and send her to her room.

  120. A client is brought to the emergency room bleeding profusely from a stab wound in the left chest area. The client’s vital signs are blood pressure 80/50, pulse 110, and respirations 28. The LPN/LVN should expect which of the following potential problems?

    1. Hypovolemic shock
    2. Cardiogenic shock
    3. Neurogenic shock
    4. Septic shock

  121. A client is admitted to the hospital for surgical repair of a detached retina in the right eye. In implementing the plan of care for this client postoperatively, the LPN/LVN should encourage the client to do which of the following?

    1. Perform self-care activities.
    2. Maintain patches over both eyes.
    3. Limit movement of both eyes.
    4. Refrain from excessive talking.

  122. The LPN/LVN cares for a client receiving a balanced complete food by tube feeding. The LPN/LVN knows that the MOST common complication of a tube feeding is which of the following?

    1. Edema
    2. Diarrhea
    3. Hypokalemia
    4. Vomiting

  123. A 6-week-old infant is brought to the hospital for treatment of pyloric stenosis. The following nursing diagnosis is on the infant’s care plan: “fluid volume deficit related to vomiting.” The LPN/LVN would expect to see which of the following findings to support this diagnosis?

    1. The infant eagerly accepts feedings.
    2. The infant vomited once since admission.
    3. The infant’s skin is warm and moist.
    4. The infant’s anterior fontanel is depressed.

  124. The LPN/LVN cares for a 4-year-old diagnosed with a fractured pelvis due to an auto accident. The LPN/LVN prepares the child for the application of a hip spica cast. It is MOST important for the LPN/LVN to take which of the following actions?

    1. Obtain a doll with a hip spica cast in place.
    2. Tell the child that the cast will feel cold when it is put on her skin.
    3. Reassure the child that the cast application is painless.
    4. Introduce the child to another child who has a hip spica cast.

  125. A woman comes to the clinic because she thinks she is pregnant. Tests are performed and the pregnancy is confirmed. The client’s last menstrual period began on September 8 and lasted for 6 days. The LPN/LVN calculates that her expected date of confinement (EDC) is which of the following?

    1. May 15
    2. June 15
    3. June 21
    4. July 8

  126. A 2-month-old infant is brought to the pediatrician’s office for a well-baby visit. During the examination, congenital subluxation of the left hip is suspected. The LPN/LVN would expect to see which of the following symptoms?

    1. Lengthening of the limb on the affected side
    2. Deformities of the foot and ankle
    3. Asymmetry of the gluteal and thigh folds
    4. Plantarflexion of the foot

  127. After completing data collection, the LPN/LVN observes that a client is exhibiting early symptoms of a dystonic reaction related to the use of an antipsychotic medication. Which of the following actions by the LPN/LVN would be MOST appropriate?

    1. Reality test with the client and assure her that her physical symptoms are not real.
    2. Teach the client about common side effects of antipsychotic medications.
    3. Explain to the client that there is no treatment that will relieve these symptoms.
    4. Notify the physician and obtain an order for IM diphenhydramine.

  128. The LPN/LVN is preparing to perform mouth care for an unconscious client. Which of the following actions should the LPN/LVN take FIRST?

    1. Assess for the presence of a gag reflex.
    2. Place the client into Sims’ position.
    3. Separate the teeth with a padded tongue blade.
    4. Suction secretions from the oral cavity.

  129. As a client nears death, the client’s husband says, “I wish I could do something for her.” Which of the following responses by the LPN/LVN is MOST appropriate?

    1. “It may be comforting to your wife if you talk to her calmly and clearly.”
    2. “Your wife does not know that you are here, but you can sit here with her.”
    3. “Unfortunately, there is little that you can do at this point.”
    4. “Why don’t you take a break? It is just a matter of time now.”

  130. The LPN/LVN provides care to clients in a long-term care facility. Four meal choices are available to the clients. The LPN/LVN should ensure that a client on a low-cholesterol diet receives which of the following meals?

    1. Egg custard and boiled liver
    2. Fried chicken and potatoes
    3. Hamburger and french fries
    4. Grilled flounder and green beans

  131. The LPN/LVN removes a client’s breakfast tray and notes that the client consumed 4 oz. of pudding, 4 oz. of gelatin, 6 1/2 oz. of tea, and 5 oz. of apple juice. How many milliliters should the LPN/LVN record for the client’s breakfast intake?

    mL

  132. The LPN/LVN cares for a client diagnosed with cholecystitis. The client says to the LPN/LVN, “I don’t understand why my right shoulder hurts when the gallbladder is not by my shoulder!” Which of the following responses by the LPN/LVN is BEST?

    1. “Sometimes small pieces of the gallstones break off and travel to other parts of the body.”
    2. “There is an invisible connection between the gallbladder and the right shoulder.”
    3. “The gallbladder is on the right side of the body and so is that shoulder.”
    4. “Your shoulder became tense because you were guarding against the gallbladder pain.”

  133. A woman comes to the clinic at 32 weeks’ gestation. A diagnosis of pregnancy-induced hypertension (PIH) is made. The LPN/LVN reinforces teaching performed by the RN. Which of the following statements by the client indicates that further teaching is required?

    1. “Lying in bed on my left side is likely to increase my urinary output.”
    2. “If the bed rest works, I may lose a pound or two in the next few days.”
    3. “I should be sure to maintain a diet that has a good amount of protein.”
    4. “I will have to keep my room darkened and not watch much television.”

  134. The LPN/LVN collects data about a client’s fluid balance. Which of the following findings MOST accurately indicates to the LPN/LVN that the client has retained fluid during the previous 24 hours?

    1. Edema is found in both ankles.
    2. Fluid intake is equal to fluid output.
    3. Intake of fluid exceeds output by 200 mL.
    4. Weight gain of 4 lbs is noted.

  135. The LPN/LVN cares for a group of residents in a dependent-living facility. The LPN/LVN determines which of the following clients is MOST at risk to develop pneumonia?

    1. A 72-year-old female with left-sided hemiparesis after a cerebrovascular accident
    2. A 76-year-old male with a history of hypertension and type 2 diabetes
    3. An 80-year-old female who walks 1 mile every day and has a history of depression
    4. An 87-year-old male who smokes and has a history of lung cancer

  136. The LPN/LVN is caring for a client diagnosed with bipolar disorder. Which of the following behaviors by the client indicates that a manic episode is subsiding?

    1. The client tells several jokes at a group meeting.
    2. The client sits and talks with other clients at mealtimes.
    3. The client begins to write a book about his life.
    4. The client initiates an effort to start a radio station on the unit.

  137. A mother brings her 4-year-old daughter to the pediatrician for treatment of chronic otitis media. The mother asks the LPN/LVN how she can prevent her child from getting ear infections so often. The LPN/LVN’s response should be based on an understanding that the recurrence of otitis media can be decreased by which of the following?

    1. Cover the child’s ears while bathing.
    2. Treat upper respiratory infections quickly.
    3. Administer nose drops at bedtime.
    4. Isolate her child from other children.

  138. A man calls the suicide prevention hotline and states that he is going to kill himself. Which of the following questions should the LPN/LVN ask FIRST?

    1. “What happened to cause you to want to end your life?”
    2. “How do you plan to kill yourself?”
    3. “When did you start to feel as though you wanted to die?”
    4. “Do you want me to prevent you from killing yourself?”

  139. Prior to the client undergoing a scheduled intravenous pyelogram (IVP), it would be MOST important for the LPN/LVN to ask which of the following questions?

    1. “Do you have difficulty voiding?”
    2. “Do you have any allergies to shellfish or iodine?”
    3. “Do you have a history of constipation?”
    4. “Do you have frequent headaches?”

  140. The LPN/LVN is assigned to a newly admitted elderly client in the hospital setting who states that she has no living relatives and only friends of her own age. One of the LPN/LVN’s most immediate considerations for this client will be to help the RN implement which of the following?

    1. A concept map
    2. A critical pathway
    3. A discharge plan
    4. A utilization group

  141. A woman delivers a 6 lb., 10 oz. baby girl. The mother observes the LPN/LVN in the delivery room place drops in her daughter’s eyes. The mother asks the LPN/LVN why this was done. Which of the following responses by the LPN/LVN is BEST?

    1. “The drops constrict your baby’s pupils to prevent injury.”
    2. “The drops will remove mucus from your baby’s eyes.”
    3. “The drops will prevent infections that might cause blindness.”
    4. “The drops will prevent neonatal conjunctivitis.”

  142. The LPN/LVN cares for a client admitted for a possible herniated intervertebral disk. Ibuprofen, propoxyphene hydrochloride, and cyclobenzaprine hydrochloride are ordered PRN. Several hours after admission, the client reports pain. Which of the following actions should the LPN/LVN take FIRST?

    1. Administer ibuprofen.
    2. Call the physician to determine which medication should be given.
    3. Gather more information from the client about the complaint.
    4. Allow the client some time to rest to see if the pain subsides.

  143. The LPN/LVN is completing a client’s preoperative checklist prior to an early morning surgery. The LPN/LVN obtains the client’s vital signs: temperature 97.4° F (36° C), radial pulse 84 strong and regular, respirations 16 and unlabored, and blood pressure 132/74. Which of the following actions should the LPN/LVN take FIRST?

    1. Notify the physician of the client’s vital signs.
    2. Obtain orthostatic blood pressures lying and standing.
    3. Lower the side rails and place the bed in its lowest position.
    4. Record the data on the client’s preoperative checklist.

  144. The LPN/LVN expects to see which of the following physiological changes in a client experiencing an episode of acute pain?

    1. Decreased blood pressure
    2. Decreased heart rate
    3. Decreased skin temperature
    4. Decreased respirations

  145. A client is transferred to an extended-care facility following a cerebrovascular accident (CVA). The client has right-sided paralysis and has been experiencing dysphagia. The LPN/LVN observes an aide preparing the client to eat lunch. Which of the following situations would require an intervention by the LPN/LVN?

    1. The client is in bed in high Fowler’s position.
    2. The client’s head and neck are positioned slightly forward.
    3. The aide puts the food in the back of the client’s mouth on the unaffected side.
    4. The aide waters down the pudding to help the client swallow.

  146. During the LPN/LVN’s morning data collection, a client’s blood pressure is 146/92 with labored respirations of 24. There is red drainage on the client’s IV dressing, and the client reports pain in the left hip, depression, and hunger. The LPN/LVN identifies which of the following as subjective data? Select all that apply.

    1. Blood pressure
    2. Depression
    3. Hip pain
    4. Hunger
    5. IV drainage
    6. Respirations