LPN LPN
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1. The client is scheduled to undergo a treadmill stress test. Which instruction should the client be reinforced with?
- A. Eat a light meal before the test.
- B. Wear comfortable shoes and clothing.
- C. Avoid all physical activity the morning of the test.
- D. Take prescribed medications right before the test.
Correct answer: B
Rationale: The correct answer is B: 'Wear comfortable shoes and clothing.' Wearing comfortable shoes and clothing is crucial for the client undergoing a treadmill stress test to ensure they can complete the test without discomfort. The right attire will help the client move freely and reduce the risk of any hindrance during the test, which requires physical activity. Choices A, C, and D are incorrect. A light meal before the test may be recommended, but it's not as crucial as wearing suitable attire. Avoiding physical activity the morning of the test is not necessary as the test requires physical activity. Taking prescribed medications right before the test instructions should be followed as per the healthcare provider's advice and not as a general rule for all clients undergoing the test.
2. While preparing a client for a cardiac catheterization, the client expresses a preference to speak with their doctor rather than the nurse. Which response by the nurse should be therapeutic?
- A. Your doctor expects me to prepare you for this procedure.
- B. That's fine, if that's what you want. I'll call your health care provider.
- C. So you're saying that you want to talk to your health care provider?
- D. I'm concerned with the way you've dismissed me. I know what I am doing.
Correct answer: C
Rationale: The therapeutic response by the nurse in this situation involves reflecting the client's feelings back to them, which demonstrates active listening and empathy. By restating the client's preference to talk to their doctor, the nurse acknowledges and validates the client's feelings, thereby fostering a positive therapeutic relationship and promoting open communication. Choices A and B do not acknowledge the client's preference and may come off as dismissive. Choice D is confrontational and defensive, which can lead to a breakdown in communication and trust between the nurse and the client.
3. The healthcare provider is preparing to assist in the care of a client who has just returned from coronary artery bypass graft (CABG) surgery. Which is the priority action?
- A. Monitor the client's urine output.
- B. Check the client's surgical dressing.
- C. Measure the client's blood pressure.
- D. Assess the client's level of consciousness.
Correct answer: D
Rationale: Assessing the client's level of consciousness is the priority action post-CABG surgery to monitor for signs of cerebral hypoxia or other complications that require immediate intervention. Changes in the client's level of consciousness can indicate neurological deterioration, which is critical to address promptly in this postoperative period. Monitoring urine output, checking surgical dressing, and measuring blood pressure are important aspects of postoperative care but assessing the client's level of consciousness takes precedence as it provides crucial information about the client's neurological status and the need for urgent intervention.
4. An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question best assists the nurse in discriminating pain caused by a non-cardiac problem?
- A. Can you describe the pain to me?
- B. Have you ever experienced this pain before?
- C. Does the pain get worse when you breathe in?
- D. Can you rate the pain on a scale of 1 to 10, with 10 being the worst?
Correct answer: C
Rationale: The correct answer is C. Pain that worsens with breathing in can indicate pleuritic chest pain, which is non-cardiac in nature. This specific question helps in differentiating non-cardiac causes from cardiac causes of chest pain, as cardiac pain typically does not worsen with breathing. Choices A, B, and D are less specific in discriminating between cardiac and non-cardiac chest pain.
5. A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which typical characteristic?
- A. Dark pink base
- B. Deep and painful
- C. Accompanied by very slight pain
- D. Brown pigmentation of surrounding skin
Correct answer: B
Rationale: Arterial ischemic ulcers are typically characterized by being deep and painful, often with a pale or necrotic base. The lack of adequate blood flow leads to tissue damage, resulting in these ulcers having a deep appearance and causing significant pain to the individual. The other options are not commonly associated with arterial ischemic ulcers; a dark pink base, very slight pain, or brown pigmentation of surrounding skin are not typical features of this type of ulcer.
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