LPN Physiological Adaptation 3 — Questions and Answers
Question 1: A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the most common adverse effect the LPN should monitor?
- Hypokalemia (Correct answer)
- Hypernatremia
- Hypercalcemia
- Hypermagnesemia
Correct answer: Hypokalemia
Furosemide is a loop diuretic that causes significant urinary potassium loss, leading to hypokalemia as its most common electrolyte adverse effect.
Question 2: A patient with acute pancreatitis has a serum calcium of 7.0 mg/dL. Which assessment finding is consistent with hypocalcemia?
- Positive Trousseau's sign (Correct answer)
- Hypoactive bowel sounds
- Bradycardia
- Constipation
Correct answer: Positive Trousseau's sign
Trousseau's sign (carpal spasm when BP cuff is inflated) is a classic bedside test for hypocalcemia indicating neuromuscular excitability.
Question 3: A patient develops respiratory alkalosis. Which condition is the most likely cause?
- Hyperventilation due to anxiety (Correct answer)
- Opioid overdose
- Diabetic ketoacidosis
- Renal failure
Correct answer: Hyperventilation due to anxiety
Hyperventilation blows off CO2, raising pH and causing respiratory alkalosis; anxiety is a common precipitating cause.
Question 4: A patient with burns over 40% of the body surface area is in the emergent phase (first 24 hours). The priority fluid replacement is:
- Lactated Ringer's solution (Correct answer)
- D5W
- 0.45% normal saline
- Albumin
Correct answer: Lactated Ringer's solution
Lactated Ringer's is the standard isotonic crystalloid for burn resuscitation in the emergent phase to replace fluid lost from capillary leakage.
Question 5: Which clinical finding indicates increased intracranial pressure (ICP) in an adult patient?
- Cushing's triad: hypertension, bradycardia, and irregular respirations (Correct answer)
- Hypotension, tachycardia, and shallow breathing
- Fever, tachycardia, and diaphoresis
- Hypotension, bradycardia, and apnea
Correct answer: Cushing's triad: hypertension, bradycardia, and irregular respirations
Cushing's triad (widened pulse pressure with hypertension, bradycardia, and irregular respirations) is a late, ominous sign of severely elevated ICP.
Question 6: A patient with type 1 diabetes presents with Kussmaul respirations, fruity breath, and blood glucose of 450 mg/dL. These findings indicate:
- Diabetic ketoacidosis (DKA) (Correct answer)
- Hyperosmolar hyperglycemic state (HHS)
- Hypoglycemic coma
- Lactic acidosis
Correct answer: Diabetic ketoacidosis (DKA)
DKA is characterized by the triad of hyperglycemia, metabolic acidosis, and ketonemia; Kussmaul breathing and fruity breath are compensatory and diagnostic signs.
Question 7: A patient recovering from a spinal cord injury at T6 suddenly develops pounding headache, bradycardia, and blood pressure of 210/110 mmHg. The LPN should first:
- Sit the patient upright and identify the noxious stimulus (Correct answer)
- Administer an antihypertensive as prescribed
- Place the patient supine and call the provider
- Apply a warming blanket
Correct answer: Sit the patient upright and identify the noxious stimulus
Autonomic dysreflexia requires immediately sitting the patient upright (lowers BP) and removing the triggering stimulus (most often a full bladder or bowel).
LPN Physiological Adaptation 3
A patient with heart failure is prescribed furosemide.
Which electrolyte imbalance is the most common adverse effect the LPN should monitor?