LPN LPN
LPN Fundamentals Practice Questions
1. A client has major fecal incontinence and reports irritation in the perianal area. Which of the following actions should the nurse take first?
- A. Apply a fecal collection system
- B. Apply a barrier cream
- C. Cleanse and dry the area
- D. Check the client's perineum
Correct answer: D
Rationale: When a client with major fecal incontinence reports irritation in the perianal area, the nurse's initial action should be to assess the client's perineum to gather more information. By checking the perineum, the nurse can identify the extent and nature of the irritation, allowing for appropriate interventions to be initiated. This assessment is crucial in developing a comprehensive care plan and addressing the client's immediate needs effectively. Applying the nursing process priority-setting framework helps in planning care and prioritizing nursing actions, making assessment the initial step in this scenario. Applying a fecal collection system (choice A) would be premature without assessing the perineal area first. Similarly, applying a barrier cream (choice B) or cleansing and drying the area (choice C) should follow the assessment to ensure appropriate interventions are chosen based on the assessment findings.
2. A client is receiving continuous enteral feedings through a nasogastric tube. Which of the following actions should the nurse take?
- A. Elevate the head of the bed to 30°
- B. Flush the tube with 50 mL of water every 2 hours
- C. Replace the feeding bag and tubing every 72 hours
- D. Check the client's gastric residual every 8 hours
Correct answer: A
Rationale: Elevating the head of the bed to 30° is the correct action to take when a client is receiving continuous enteral feedings through a nasogastric tube. This position helps prevent aspiration of the enteral feedings into the lungs, reducing the risk of aspiration pneumonia. Additionally, elevating the head of the bed promotes proper digestion and absorption of the feedings by utilizing gravity to facilitate movement into the stomach and through the gastrointestinal tract. Flushing the tube with water every 2 hours (Choice B) is not necessary for continuous feedings and may disrupt the feeding schedule. Replacing the feeding bag and tubing every 72 hours (Choice C) is not the standard recommendation unless there are specific concerns or complications. Checking the client's gastric residual every 8 hours (Choice D) is important but not the immediate action needed to prevent aspiration during enteral feedings.
3. A client with celiac disease is being taught about dietary management. Which statement by the client indicates an understanding of the teaching?
- A. I should avoid foods that contain gluten.
- B. I should increase my intake of foods high in gluten.
- C. I should avoid foods that contain lactose.
- D. I should increase my intake of foods high in lactose.
Correct answer: A
Rationale: The correct answer is A: 'I should avoid foods that contain gluten.' Celiac disease requires the avoidance of gluten-containing foods to manage symptoms and prevent complications. Gluten is found in wheat, barley, and rye. Choices B, C, and D are incorrect as they do not align with the dietary requirements for managing celiac disease. Increasing intake of foods high in gluten or lactose would be detrimental for someone with celiac disease.
4. A client with hyperlipidemia is being taught about dietary management. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should increase my intake of foods high in saturated fats.
- B. I should decrease my intake of foods high in cholesterol.
- C. I should increase my intake of foods high in trans fats.
- D. I should decrease my intake of foods high in fiber.
Correct answer: B
Rationale: The correct answer is B. In hyperlipidemia management, decreasing the intake of foods high in cholesterol is crucial to improve lipid levels and reduce the risk of cardiovascular diseases. Choices A and C are incorrect as increasing intake of saturated fats or trans fats can raise cholesterol levels, worsening the condition. Choice D is incorrect because decreasing intake of foods high in fiber is not recommended as fiber-rich foods are beneficial for heart health, which is important in managing hyperlipidemia.
5. A client with chronic kidney disease is being educated by a nurse about dietary management. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should limit my intake of protein to prevent overworking my kidneys.
- B. I should increase my intake of potassium-rich foods.
- C. I should increase my intake of phosphorus-rich foods.
- D. I should increase my intake of calcium-rich foods.
Correct answer: A
Rationale: The correct answer is A. In chronic kidney disease, limiting protein intake is crucial to prevent overworking the kidneys. Excessive protein consumption can lead to the accumulation of metabolic waste products that the kidneys struggle to process, worsening kidney function. Therefore, by recognizing the need to restrict protein intake, the client demonstrates an understanding of the dietary management required for their condition. Choices B, C, and D are incorrect. Increasing intake of potassium-rich foods (Choice B) is not recommended in chronic kidney disease as it can lead to hyperkalemia. Similarly, increasing intake of phosphorus-rich foods (Choice C) is not advised because impaired kidneys struggle to excrete phosphorus, leading to elevated levels in the blood. Lastly, increasing intake of calcium-rich foods (Choice D) may not be necessary unless there is a specific deficiency or requirement, as calcium balance is often disrupted in chronic kidney disease.
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