Mixed Deck — All LPN Topics Flashcards

How does informed consent apply to nursing practice?

Answer: To ensure the patient understands treatment and risks

Informed consent in nursing practice ensures that a patient fully understands the proposed treatment, including its purpose, potential benefits, risks, and available alternatives, before agreeing to it. The nurse's role is to facilitate this understanding, clarify information, and confirm the patient's voluntary agreement. This process upholds the patient's right to autonomy and empowers them to make educated decisions about their own healthcare.

A client with stable angina asks the nurse about sexual activity. The LPN's best response is:

Answer: Sexual activity is generally safe if you can climb two flights of stairs without symptoms

The ability to climb two flights of stairs (or achieve 5 METs on a stress test) without chest pain or dyspnea is a general guideline indicating sufficient cardiac reserve for sexual activity.

A patient with a T4 spinal cord injury is being repositioned. The LPN notes erythema over the sacrum that does not blanch. This indicates:

Answer: Stage 1 pressure injury

Non-blanchable erythema over a bony prominence in intact skin is the defining characteristic of a Stage 1 pressure injury.

A patient with a stage 2 pressure injury on the coccyx has a moist wound base with no signs of infection. The most appropriate dressing choice is:

Answer: A hydrocolloid dressing to maintain a moist wound environment

Hydrocolloid dressings maintain a moist wound environment that promotes autolytic debridement and re-epithelialization in Stage 2 pressure injuries.

When cleansing a wound, the LPN should follow which primary principle?

Answer: Cleanse from the cleanest area to the most contaminated area

Wound cleansing proceeds from the least contaminated area (wound center) to the most contaminated area (surrounding skin) to prevent introducing bacteria.

A client is scheduled for a surgical procedure and expresses significant anxiety, stating, 'I'm so scared I won't wake up from the anesthesia.' Which therapeutic communication technique should the LPN use?

Answer: Using reflection by stating, 'It sounds like you're worried about the surgery's outcome.'

Reflection is a therapeutic technique where the nurse repeats back the emotional content of the client's message. This validates the client's feelings and encourages them to elaborate on their fears, fostering a trusting relationship.

A 6-year-old child is admitted with suspected lead poisoning. A blood lead level of 45 mcg/dL is confirmed. The LPN should expect the provider to order:

Answer: Chelation therapy with oral succimer (DMSA) and removal from lead source

Blood lead levels ≥45 mcg/dL indicate significant toxicity requiring chelation therapy with succimer (DMSA) in addition to removing the child from the lead source.

Which of the following clients is at the highest risk for developing accidental hypothermia?

Answer: An 82-year-old client with hypothyroidism who lives in a poorly heated home.

Older adults are at a higher risk for hypothermia due to a slower metabolism, a thinner subcutaneous fat layer, and a decreased ability to regulate body temperature. Chronic conditions like hypothyroidism further impair the body's ability to generate heat, and living in a cold environment is a major contributing factor.

The LPN notes that a patient's urine output has been less than 30 mL/hour for 2 consecutive hours during IV fluid therapy. What should the nurse do first?

Answer: Assess the patient for signs of dehydration or fluid overload

Urine output below 30 mL/hr may indicate inadequate perfusion or fluid imbalance, requiring immediate patient assessment before any intervention.

An LPN is preparing to administer a subcutaneous injection of heparin. Which of the following actions is appropriate for this procedure?

Answer: Administering the injection in the abdomen, at least 2 inches away from the umbilicus.

The abdomen is the preferred site for subcutaneous heparin injections because it has a consistent layer of subcutaneous fat, allowing for predictable absorption. Injecting at least 2 inches from the umbilicus avoids the umbilical veins and vascular areas. Aspirating and massaging the site are not recommended as they can cause hematoma formation.

A patient is ordered acetaminophen 650 mg PO q6h PRN for pain. The LPN knows the maximum safe daily dose of acetaminophen for a healthy adult is:

Answer: 4,000 mg/day

The maximum recommended daily dose of acetaminophen for healthy adults is 4,000 mg/day (4 g), with lower limits recommended for patients with liver disease or alcohol use.

A post-operative patient has a blood pressure of 88/54 mmHg and heart rate of 118 bpm. Which additional assessment finding would best confirm hypovolemic shock?

Answer: Cool, clammy skin with delayed capillary refill

Cool, clammy skin and delayed capillary refill indicate peripheral vasoconstriction from hypovolemia, confirming early hypovolemic shock.

A client with a cervical spine injury at C5-C6 is being bathed. Which finding requires the LPN to stop and immediately notify the charge nurse?

Answer: Sudden severe headache, sweating above the injury, and bradycardia

These are classic signs of autonomic dysreflexia, a life-threatening condition in clients with SCI at T6 or above, caused by an unrecognized stimulus below the injury level.

The LPN is preparing to administer an IM injection to an adult client. Which site is preferred to reduce the risk of injury to the sciatic nerve?

Answer: Ventrogluteal site

The ventrogluteal site is the preferred IM injection site for adults because it is free from major nerves and blood vessels, unlike the dorsogluteal site.

Which environmental condition increases the risk of electrical injury to patients?

Answer: Having wet or moist skin when touching electrical equipment

Wet or moist skin dramatically lowers electrical resistance, increasing the risk of shock when contacting electrical equipment.

A patient with a long leg cast reports sudden, severe pain in the casted leg that is unrelieved by opioid analgesia. What condition should the nurse suspect first?

Answer: Compartment syndrome

Pain unrelieved by analgesics is the hallmark early warning sign of compartment syndrome, a surgical emergency requiring immediate notification of the provider.

The LPN is caring for a client with a new diagnosis of amyotrophic lateral sclerosis (ALS). Which nursing diagnosis takes the highest priority?

Answer: Risk for aspiration related to bulbar involvement

Bulbar involvement in ALS causes dysphagia and dysarthria, dramatically increasing aspiration risk, which can cause pneumonia — the most common immediate cause of death in ALS.

A postpartum client reports her lochia changed from rubra to serosa on day 2. What is the nurse's best response?

Answer: This is normal and the lochia will become alba in about a week

Lochia rubra normally transitions to serosa by days 3–4 and then to alba by 10–14 days; early transition on day 2 can be normal variation.

A nurse is assessing a laboring client and finds the umbilical cord visible at the vaginal introitus. The LPN's immediate action is:

Answer: Place a gloved hand in the vagina to elevate the presenting part off the cord and call for emergency help

Cord prolapse is a life-threatening emergency. The LPN must manually elevate the presenting part off the cord to relieve compression and maintain this until emergency cesarean delivery.

A patient has a nursing diagnosis of impaired skin integrity related to urinary incontinence. Which intervention is the priority?

Answer: Apply a moisture barrier cream to protect perineal skin after each incontinent episode

Applying a moisture barrier cream after cleansing protects the skin from chemical irritation caused by urine and is the priority nursing intervention.