1. A positive over-the-counter pregnancy test is considered a:
Correct Response: C
A positive pregnancy test and changes in the reproductive organs are both considered probable signs of pregnancy. Presumptive signs include amenorrhea, frequent urination and pigment changes in skin. Determining the estimated day of birth or delivery (EDB or EDD) is considered to be a positive sign of pregnancy.
2. The recommended daily caloric intake for sedentary older men, active adult women and children is:
Correct Response: D
Sedentary older men, active adult women and children should all have 6 ounces of grains, 2½ cups of vegetables, 2 cups of fruits, and 3 cups of milk to help make up their 2000 calorie requirement. Sedentary adolescents require 2400 calories, sedentary women and children require 1600 calories and active adolescents need 2800 calories daily.
3. Ill health, malnutrition, and wasting as a result of chronic disease are all associated with:
Correct Response: C
Ill health, malnutrition, and wasting as a result of chronic disease are all associated with cachexia. Cachexia can also result from dehiscence of a surgical incision or rupture of wound closure. Surgical asepsis refers to using a sterile technique to protect against infection before, during, and after surgery. The breakdown of tissue, especially after severe trauma or crush injuries is known as catabolism. Venous stasis is a disorder related to pooling of blood in a vein of the body; venous stasis typically occurs in the lower extremities and it is one of the many hazards, or complications, of immobilization.
4. Select all the possible opportunistic infections that adversely affect HIV/AIDS infected patients.
Correct Response: B, D, F
Kaposi’s sarcoma, tuberculosis, toxoplasma gondii, mycobacterium avium, herpes simplex, histoplasmosis and salmonella infections are HIV/AIDS associated opportunistic infections. Although many affected patients can experience blindness and peripheral neuropathy, these disorders result from impaired nervous system damage rather than an infection. Lastly, Wilms’ tumor is a pediatric form of kidney cancer and it is neither an infection nor something that typically affects the patient with HIV/AIDS.
5. What can help reduce a patient’s anxiety and postsurgical pain?
Correct Response: A
Patient teaching before surgery not only helps to reduce a patient’s anxiety and postsurgical pain but it also decreases the amount of anesthesia needed and a lack of anxiety additionally speeds up wound healing. Preoperative checklists are a form of nursing documentation that is used to guide and document the care of the patient before surgery. Psychological counseling is typically NOT necessary except under highly unusual circumstances and preoperative medication can decrease the amount of anesthetic needed and respiratory tract secretions but it does not help with postoperative pain.
6. Select the member of the healthcare team that is paired with one of the main functions of this team member.
Correct Response: C
Speech and language therapists assess and treat patients with a swallowing disorder; they also assess and treat patients with speech and communication problems as often occurs after a cerebrovascular accident, or stroke. Occupational therapists assist patients with their activities of daily living and they also provide patients with assistive devices to facilitate eating and dressing. Physical therapists perform rehabilitation and restorative care including help with ambulation and balance/gait exercises. Lastly, case managers coordinate care along the continuum of care and they manage insurance reimbursements.
7. When caring for an infant during cardiac arrest, which pulse must be palpated to determine cardiac function?
Correct Response: B
The brachial pulse is the most accessible pulse on an infant and, therefore, it is the site of choice. The carotid pulse may be difficult to palpate due to the fatty tissue that typically, and often, surrounds an infant’s neck. Lastly, the radial and pedal pulses may not be reliable indicators of cardiac function.
8. The patient should be sitting when deep breathing and coughing because this position:
Is physically more comfortable for the patient
Helps the patient to support their incision with a pillow
Loosens respiratory secretions
Allows the patient to observe their area and relax
Correct Response: B
The patient should be sitting when deep breathing and coughing because this position allows the patient to be better able to splint the incision with a pillow which provides abdominal support during coughing. It also allows the lungs to more fully expand because the diaphragm drops. The most comfortable position for the patient is the supine position; however, this position does not permit the lungs to fully expand. There is no association or correlation between loosening respiratory secretions or relaxation with this sitting position.
9. Which procedures necessitate the use of surgical asepsis techniques? Select all that apply.
Intramuscular medication administration
Central line intravenous medication administration
Donning gloves in the operating room
Neonatal bathing
Foley catheter insertion
Emptying a urinary drainage bag
Correct Response: B,C,E
Surgical asepsis is used when managing central line intravenous medication administration, when donning sterile gloves in the operating room and when inserting an indwelling Foley catheter. Medical asepsis, or clean technique, is used when bathing a neonate, when emptying a urinary drainage bag and when administering an intramuscular medication injection.
10. What is the ultimate purpose and goal of performance improvement activities?
To increase efficiency
To contain costs
To improve processes
To improve policies
Correct Response: C
The ultimate purpose of quality improvement activities is to identify process flaws and then to change the process so that it is fail proof. Fail proof processes prevent human error and possible patient harm. Although these process improvements and changes may also increase efficiency and decrease costs, the ultimate goal of quality improvement activities is to prevent future occurrences with process changes and not costs and efficiency. Lastly, it is known that processes, not policies, are the root cause of many medical errors.
11. Which disease decreases the metabolic rate?
Cancer
Hypothyroidism
Chronic obstructive pulmonary disease
Cardiac failure
Correct Response: B
Hypothyroidism causes a decreased metabolic demand, so fewer calories are required. Cancer, chronic obstructive pulmonary disease, or cardiac failure all increase the metabolic demands and the need for added calories.
12. What intervention is the best to relieve constipation during pregnancy?
Increasing the consumption of fruits and vegetables
Taking a mild over-the-counter laxative
Lying flat on back when sleeping
Reduction of iron intake by half or more
Correct Response: A
Dietary roughage (or fiber) with sufficient fluids and exercise may help relieve constipation. Over-the-counter medications should be avoided during pregnancy. The supine position can place additional pressure on the aorta and vena cava, leading to vena cava syndrome. A reduction of iron supplements during pregnancy may reduce hemoglobin production and result in a less than an effective immune system.
13. You are the LPN working on 2 east with adult medical surgical patients. Your unit has been instructed to perform a horizontal evacuation of your patients because there is a fire on 1 east. Where will you evacuate your patients to?
3 west
3 east
2 west
1 west
Correct Response: C
You would evacuate your patients to west. A horizontal evacuation is the movement of patients to another area of the same floor. A vertical evacuation is the movement of patients to a different floor or level of the building. Patient evacuations are done to prevent patient injury. Under no circumstances should the elevators be used for evacuations.
14. Which electrolyte is essential for enzyme and neurochemical activities?
Correct Response: B
Magnesium is essential for enzyme and neurochemical activities and it is also needed for cardiac and skeletal muscle excitability. Chloride is the most abundant negatively charged ion in extracellular fluid with potassium being the most abundant positively charge ion. Phosphate assists in acid-base regulation.
15. Number the choices below to reflect the correct sequence for using a fire extinguisher:
Correct Response: D, A, B, C
The correct sequence of action for using a fire extinguished is easily remembered by keeping the PASS acronym in mind. P is pulling out the pin to activate the fire extinguisher; A is to aim the fire extinguisher at the base of the fire; S is to squeeze the handle to discharge the contents of the fire extinguisher; and S is sweep back and forth over the base of the fire while discharging the contents.
Correct Response: D
Nurses and other healthcare providers are mandated by law to report all suspected abuse and neglect. You do NOT have to be certain about it; an expert will perform the investigation. You do not contact the police or the security department; the charge nurse will follow established procedures for notifications not the licensed practical nurse.
17. The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is:
Correct Response: C
The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is legally mandated by the states and NOT the American Nurses Association and a nursing certification is not mandated. To practice nursing without a current and valid license is contrary to the law. Nursing licenses are renewed every two years and nursing certifications are typically renewed every three years, however, this may vary according to the particular certification.
18. Which nursing theorist believes that most patients are capable of performing self care?
Correct Response: A
Dorothea Orem developed the Self Care theory or model. This theory maintains that some patients are completely compensatory and totally dependent on the nurse for care, other patients are partially compensatory and need only assistance by the nurse and others are totally independent in terms of their self care needs. Madeleine Leininger developed the Transcultural Nursing theory; Martha Rogers developed the Science of Unitary Human Beings theory and Sister Callista Roy developed the Adaptation theory of nursing practice.
19. What element is minimally assessed during a basic prenatal physical examination?
Correct Response: C
A urinalysis is considered routine during the prenatal examination. Assessment of the cervix, vagina, anus, rectum, and palpation and auscultation of the abdomen may not be checked until a complete gynecologic examination is done by the doctor.
20. Which of the following is the World Health Organization’s (WHO) definition of health?
The World Health Organization (WHO) defines health as a holistic (wholistic) state of wellbeing. This state of wellbeing is far more than the absence of illness, diseases and comorbidities. Lastly, the use of health promotion activities does promote health but these activities do not define health according to the World Health Organization.
- Possible sign of pregnancy.
- Presumptive sign of pregnancy.
- Probable sign of pregnancy.
- Positive sign of pregnancy.
Correct Response: C
2. The recommended daily caloric intake for sedentary older men, active adult women and children is:
- 2400 calories
- 1600 calories
- 2800 calories
- 2000 calories
Correct Response: D
Sedentary older men, active adult women and children should all have 6 ounces of grains, 2½ cups of vegetables, 2 cups of fruits, and 3 cups of milk to help make up their 2000 calorie requirement. Sedentary adolescents require 2400 calories, sedentary women and children require 1600 calories and active adolescents need 2800 calories daily.
3. Ill health, malnutrition, and wasting as a result of chronic disease are all associated with:
- Surgical asepsis
- Catabolism
- Cachexia
- Venous stasis
Correct Response: C
Ill health, malnutrition, and wasting as a result of chronic disease are all associated with cachexia. Cachexia can also result from dehiscence of a surgical incision or rupture of wound closure. Surgical asepsis refers to using a sterile technique to protect against infection before, during, and after surgery. The breakdown of tissue, especially after severe trauma or crush injuries is known as catabolism. Venous stasis is a disorder related to pooling of blood in a vein of the body; venous stasis typically occurs in the lower extremities and it is one of the many hazards, or complications, of immobilization.
4. Select all the possible opportunistic infections that adversely affect HIV/AIDS infected patients.
- Visual losses
- Kaposi’s sarcoma
- Wilms’ sarcoma
- Tuberculosis
- Peripheral neuropathy
- Toxoplasma gondii
Correct Response: B, D, F
Kaposi’s sarcoma, tuberculosis, toxoplasma gondii, mycobacterium avium, herpes simplex, histoplasmosis and salmonella infections are HIV/AIDS associated opportunistic infections. Although many affected patients can experience blindness and peripheral neuropathy, these disorders result from impaired nervous system damage rather than an infection. Lastly, Wilms’ tumor is a pediatric form of kidney cancer and it is neither an infection nor something that typically affects the patient with HIV/AIDS.
5. What can help reduce a patient’s anxiety and postsurgical pain?
- Preoperative teaching
- Preoperative checklist
- Psychological counseling
- Preoperative medication
Correct Response: A
Patient teaching before surgery not only helps to reduce a patient’s anxiety and postsurgical pain but it also decreases the amount of anesthesia needed and a lack of anxiety additionally speeds up wound healing. Preoperative checklists are a form of nursing documentation that is used to guide and document the care of the patient before surgery. Psychological counseling is typically NOT necessary except under highly unusual circumstances and preoperative medication can decrease the amount of anesthetic needed and respiratory tract secretions but it does not help with postoperative pain.
6. Select the member of the healthcare team that is paired with one of the main functions of this team member.
- Occupational therapist: Gait exercises
- Physical therapist: The provision of assistive devices to facilitate the activities of daily living
- Speech and language therapist: The treatment of swallowing disorders
- Case manager: Ordering medications and treatments
Correct Response: C
Speech and language therapists assess and treat patients with a swallowing disorder; they also assess and treat patients with speech and communication problems as often occurs after a cerebrovascular accident, or stroke. Occupational therapists assist patients with their activities of daily living and they also provide patients with assistive devices to facilitate eating and dressing. Physical therapists perform rehabilitation and restorative care including help with ambulation and balance/gait exercises. Lastly, case managers coordinate care along the continuum of care and they manage insurance reimbursements.
7. When caring for an infant during cardiac arrest, which pulse must be palpated to determine cardiac function?
- Carotid
- Brachial
- Pedal
- Radial
Correct Response: B
The brachial pulse is the most accessible pulse on an infant and, therefore, it is the site of choice. The carotid pulse may be difficult to palpate due to the fatty tissue that typically, and often, surrounds an infant’s neck. Lastly, the radial and pedal pulses may not be reliable indicators of cardiac function.
8. The patient should be sitting when deep breathing and coughing because this position:
Is physically more comfortable for the patient
Helps the patient to support their incision with a pillow
Loosens respiratory secretions
Allows the patient to observe their area and relax
Correct Response: B
The patient should be sitting when deep breathing and coughing because this position allows the patient to be better able to splint the incision with a pillow which provides abdominal support during coughing. It also allows the lungs to more fully expand because the diaphragm drops. The most comfortable position for the patient is the supine position; however, this position does not permit the lungs to fully expand. There is no association or correlation between loosening respiratory secretions or relaxation with this sitting position.
9. Which procedures necessitate the use of surgical asepsis techniques? Select all that apply.
Intramuscular medication administration
Central line intravenous medication administration
Donning gloves in the operating room
Neonatal bathing
Foley catheter insertion
Emptying a urinary drainage bag
Correct Response: B,C,E
Surgical asepsis is used when managing central line intravenous medication administration, when donning sterile gloves in the operating room and when inserting an indwelling Foley catheter. Medical asepsis, or clean technique, is used when bathing a neonate, when emptying a urinary drainage bag and when administering an intramuscular medication injection.
10. What is the ultimate purpose and goal of performance improvement activities?
To increase efficiency
To contain costs
To improve processes
To improve policies
Correct Response: C
The ultimate purpose of quality improvement activities is to identify process flaws and then to change the process so that it is fail proof. Fail proof processes prevent human error and possible patient harm. Although these process improvements and changes may also increase efficiency and decrease costs, the ultimate goal of quality improvement activities is to prevent future occurrences with process changes and not costs and efficiency. Lastly, it is known that processes, not policies, are the root cause of many medical errors.
11. Which disease decreases the metabolic rate?
Cancer
Hypothyroidism
Chronic obstructive pulmonary disease
Cardiac failure
Correct Response: B
Hypothyroidism causes a decreased metabolic demand, so fewer calories are required. Cancer, chronic obstructive pulmonary disease, or cardiac failure all increase the metabolic demands and the need for added calories.
12. What intervention is the best to relieve constipation during pregnancy?
Increasing the consumption of fruits and vegetables
Taking a mild over-the-counter laxative
Lying flat on back when sleeping
Reduction of iron intake by half or more
Correct Response: A
Dietary roughage (or fiber) with sufficient fluids and exercise may help relieve constipation. Over-the-counter medications should be avoided during pregnancy. The supine position can place additional pressure on the aorta and vena cava, leading to vena cava syndrome. A reduction of iron supplements during pregnancy may reduce hemoglobin production and result in a less than an effective immune system.
13. You are the LPN working on 2 east with adult medical surgical patients. Your unit has been instructed to perform a horizontal evacuation of your patients because there is a fire on 1 east. Where will you evacuate your patients to?
3 west
3 east
2 west
1 west
Correct Response: C
You would evacuate your patients to west. A horizontal evacuation is the movement of patients to another area of the same floor. A vertical evacuation is the movement of patients to a different floor or level of the building. Patient evacuations are done to prevent patient injury. Under no circumstances should the elevators be used for evacuations.
14. Which electrolyte is essential for enzyme and neurochemical activities?
- Chloride
- Magnesium
- Potassium
- Phosphate
Correct Response: B
Magnesium is essential for enzyme and neurochemical activities and it is also needed for cardiac and skeletal muscle excitability. Chloride is the most abundant negatively charged ion in extracellular fluid with potassium being the most abundant positively charge ion. Phosphate assists in acid-base regulation.
15. Number the choices below to reflect the correct sequence for using a fire extinguisher:
- Aim at the base of the fire
- Squeeze the handle
- Sweep back and forth
- Pull the pin
Correct Response: D, A, B, C
The correct sequence of action for using a fire extinguished is easily remembered by keeping the PASS acronym in mind. P is pulling out the pin to activate the fire extinguisher; A is to aim the fire extinguisher at the base of the fire; S is to squeeze the handle to discharge the contents of the fire extinguisher; and S is sweep back and forth over the base of the fire while discharging the contents.
16. As you are working you suspect that another licensed practical nurse is verbally and physically abusing a patient. What is the first thing that you will do?
- Nothing because you are not certain that it is occurring
- Nothing because you only suspect the abuse
- Call the police or the security department
- Report your suspicions to the charge nurse
Correct Response: D
Nurses and other healthcare providers are mandated by law to report all suspected abuse and neglect. You do NOT have to be certain about it; an expert will perform the investigation. You do not contact the police or the security department; the charge nurse will follow established procedures for notifications not the licensed practical nurse.
17. The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is:
- Insures competency and a nursing certification validates years of experience.
- Mandated by the American Nurses Association and a nursing certification are not.
- Is legally mandated by the states and a nursing certification is not.
- Renewed every two years and a nursing certification is renewed every five years.
Correct Response: C
The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is legally mandated by the states and NOT the American Nurses Association and a nursing certification is not mandated. To practice nursing without a current and valid license is contrary to the law. Nursing licenses are renewed every two years and nursing certifications are typically renewed every three years, however, this may vary according to the particular certification.
18. Which nursing theorist believes that most patients are capable of performing self care?
- Dorothea Orem
- Madeleine Leininger
- Martha Rogers
- Sister Callista Roy
Correct Response: A
Dorothea Orem developed the Self Care theory or model. This theory maintains that some patients are completely compensatory and totally dependent on the nurse for care, other patients are partially compensatory and need only assistance by the nurse and others are totally independent in terms of their self care needs. Madeleine Leininger developed the Transcultural Nursing theory; Martha Rogers developed the Science of Unitary Human Beings theory and Sister Callista Roy developed the Adaptation theory of nursing practice.
19. What element is minimally assessed during a basic prenatal physical examination?
- Palpation and auscultation of the abdomen
- Examination of the anus and rectum
- Urinalysis for glucose, protein and ketones
- Visual assessment of cervix and vagina
Correct Response: C
A urinalysis is considered routine during the prenatal examination. Assessment of the cervix, vagina, anus, rectum, and palpation and auscultation of the abdomen may not be checked until a complete gynecologic examination is done by the doctor.
20. Which of the following is the World Health Organization’s (WHO) definition of health?
- The absence of all illness and disease
- The absence of any comorbidities
- A holistic state of wellbeing
- A use of health promotion activities
The World Health Organization (WHO) defines health as a holistic (wholistic) state of wellbeing. This state of wellbeing is far more than the absence of illness, diseases and comorbidities. Lastly, the use of health promotion activities does promote health but these activities do not define health according to the World Health Organization.
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