Answers:

1. The answer is A. Aneurysm precautions include placing the client on bed rest in a quiet setting. Lights are kept dim to minimize environmental stimulation. Any activity that could increase the intracranial pressure by increasing the blood pressure (BP) or impeding the venous return from the brain is prohibited. Examples of such activities are pushing, pulling, sneezing, coughing or straining. The nurse provides all physical care to the client for the same reasons, and limits or prohibits visitors, radio, television and reading materials. Stimulants such as caffeine and nicotine are totally prohibited. Decaffinated coffee or tea may be used.

2. The answer is D. When a corneal donor dies, the eyes are closed and gauze pads wet with saline are placed over them with a small ice pack. Within 2 to 4 hours the eyes are enucleated. The cornea is usually transplanted within 24 to 48 hours. The head of the bed should also be elevated.

3. The answer is D. Allopurinol (Zyloprim) is an antigout medication that may increase the effect of oral anticoagulants. Warfarin sodium is an anticoagulant, and if this medication was prescribed for the client, the nurse should verify the order. The dosage of warfarin sodium may need to be decreased. Adenosine is an antidysthythmic. Digoxin is a cardiac glycoside. Ergonovine maleate (Ergotrate) is an antimigraine medication.

4. The answer is C. Living wills are required to be in writing and signed by the client. The client's signature must be either witnessed by specified individuals or notarized. Many states prohibit any employee, including a nurse of a facility where the declaring is receiving care from being a witness.  Option B is nontherapeutic and not a helpful response. The nurse should seek the assistance of the nursing supervisor.

5. The answer is D. The cerebellum is responsible for balance and coordination. A walker provides stability for the client during ambulation. A raised toliet seat is useful if the client does not have sufficient mobility or ability to flex the hips. A slider board is used in transferring a client with weak or paralyzed legs from a bed to stretcher or wheelchair. Adaptive eating utensils are beneficial if the client has partial paralysis of the hand.

I will check tomorrow and see if anyone wants more questions.

These are great questions.  I was stumped on 3 of them.  I have just been studying in a PN book, but any other help will be appreciated.  I am set to take the PN test on Aug 6.

That was great.  Are these just for the LPN NCLEX boards???

6. The nurse is assigned to care for a newly admitted client and is reviewing the physician's orders. The nurse notes that the physician has prescribed a medication dose that is twice the amount that the client reports taking prior to admission. The most approiate nursing action is to:

a. Question the client regarding the accuracy of the reported dosage

b. Consult with the registered nurse (RN)

c. Adminster the medication as prescribed

d. Adminster half of the prescribed dose and then notify the RN

7. The nurse is providing instructions to a mother of a toddler regarding the safe use of a car seat. The nurse determines that the mother understands the safe use of the car seat if the mother states which of the following?

a. The car seat can be placed in a face-forward position when the height of the toddler is 27 inches

b. The car seat should never be placed in a face-forward position

c. The seat can be placed in a face-forward position at any time

d. The car seat is suitable for the toddler until the toddler reaches the weight of 40 lbs.

8. The nurse is caring for a client with severe cardiac disease. While caring for the client, the client states to the nurse "If anything should happen to me, please make sure that the doctors do not try to push on my chest and revive me". The most approiate nursing action is to:

a. Tell the client that this procedure cannot legally be refused by a client if the physician feels that it is necessary to save the client's life

b. Tell the client that it is necessary to notify the physician of the client's request

c. Tell the client that the family must agree with the request

d. Plan a client conference with the nursing staff to share the client's request.

9. The client with osteoarthritis is receiving diclofenac sodium (Voltaren). The LPN reviewing the clients's medication order sheet would plan to verify the order with the registered nurse (RN) if which of the following other medications was listed?

a. Primidone (mysoline)

b. Calcium carbonate (Tums)

c. Warfarin (coumadin)

d. vitamin C supplement

10. The nurse has made an error in documenting an assessment finding on a client and obtains the clients record to correct the error. The nurse corrects the error by:

a. Trying to erase the error for space to write in the correct data.

b. Using white correction fluid to delete the error and writing in the correct data

c. Drawing one line through the error, intialing, and dating the line, and then providing the correct information

d. Documenting a late entry into the client's record.

11. The client has an impairment of cranial nerve (CN) II. The nurse tells the client's spouse to do which of the following to maintain client safety in the home?

a. Speak to the client in a loud voice

b. Serve food that is not too hot or too cold

c. Keep traveled paths in the home free of clutter

d. Lower the temperature setting of the water heater

I know that some of these questions seem basic and mostly common sense and you are right. But you would be surprised of how many people get them wrong.

Even though the questions are based upon a LPN's role in the medical field, these questions can easily be changed for an RN role. It is still good practice regardless. I also have another NCLEX RN preparation book that is required for my program. Would anyone be interested in this area and presenting the questions as well for this? Let me know and I will make a point of checking in on a daily basis to do this. Good luck and see you tomorrow! I have my test date so this will help me in studying as well

Answers to yesterdays questions:

6.The answer is B. If the nurse determines that a physicians order is unclear or if the nurse has a question about an order, the nurse should consult with the RN, who will then contact the physician prior to implementing the order. Under no circumstances should the nurse carry out the order unless the order is clarified. Questioning the client regarding accuracy of the dosage if the medication may seem like a viable option, but this action may also cause the client to become upset. The nurse would not adminster the medication nor would the nurse adminster an altered dosage.

7. The answer is d. Once a toddler is able to sit up alone, car safety seats can be adjusted to face forward in an upright position. The car safety seat is suitable for the growing toddler until the toddler reaches the weight of 40 lbs. Options a,b,and c are incorrect.

8. The answer is b. External cardiac massage is one type of treatment that a client can refuse. The most approiate nursing action is to notify the physician because a written "Do Not Resuciatate" (DNR) order from the physician must be present on the client's record. The DNR order must be reviewed or renewed on a regular basis per agency policy. Options a and c are inaccurate. Option d may be appropriate, but only after the physician is contacted and notified of the clients request.

9. The answer is c. Voltaren is a nonsteroidal antiinflammatory (NSAID) medication, Interactions may occur with anticoagulants such as warfarin, resulting in increased risk of bleeding. The nurse should consult with the RN regarding a potential medication interaction. The other medications do not interact with Voltaren. Mysoline is a anticonvulsant, calcium carbonate is an antiacid, and vitamin C is a nutritional supplement. These medications are not contraindicated when adminstering Voltaren.

10. The answer is c. If the nurse makes an error in documenting in the clients record, the nurse should follow agency policies to correct the error. This includes drawing one line through the error, initialing and dating the line and then providing the correct information. Erasing data from the client's record and using white correction fluid are prohibited. A late entry is used to document additional information not remembered at the initial time of documentation.

11. The answer is c. CN II is the optic nerve, which governs vision. The nurse can enhance client safety by encouraging the family to keep pathways free of clutter to prevent falls. Lowering the temperature of the water heater would be useful if the client had peripheral nerve damage. Speaking to the client in a loud voice may help compensate for deficity of CN VIII (vestibulocochlear). CN VII (facial) and CN IX (glossopharyngeal)control taste from the anterior one-third of the tongue, respectively.

Remember for the LPN, always check with your nurse, for the RN it is checking with the physician when it comes to clarifying orders.

Will post more questions later. Thanks for the interest. It helps me to do this for studying as well.

Here are the answers:

12. The answer is a. Although many methods have been used to collect urine from an infant, the most reliable method is the urine collection device. This device is a plastic bag that has an opening that is lined with adhesive so that it may be attached to the perineum. Urine for certain tests, such as specific gravity, may be obtained from a diaper by collection of the urine with a syringe. Urinary catheterization is not to be done unless specifically prescribed because of the risk of infection. It is not reasonable to try to identify the time of the next voiding to attempt to collect the specimen.

13. The answer is a.  Defamation takes place when something untrue is said (slander) or written (libel) about a person resulting in injury to that person's good name and reputation. An assault occurs when a person puts another person in fear of a harmful or an offensive contact. Negligence involves the actions of professionals that fall below the standard of care for a specific professional group.

14. The answer is B. Dolobid may be given with water, milk or meals. However, the tablets should not be crushed or broken open. The LPN should consult with the RN. If the client has difficulty swallowing, the physician should be notified. It could be dangerous to offer large volumes of water and a capsule to a client with impaired swallowing. This could result in aspiration.

15. The answer is a. The incident report should contain the client's name, age, and diagnosis. It should contain a factual description of the incident, any injuries experienced by those involved, and the outcome of the situation.  Option 1 is the only option that described the facts as observed by the nurse. Options 2,3 and 4 are interpretations of the situation and are not factual data as observed by the nurse.

16. The answer is b. The client should not have smoked tobacco or drunk a beverage containing caffeine for 30 minutes before having the BP measured. The bladder of the cuff should encircle at least 80% of the limb being measured. The client should be seated with the arm bared, positioned with support, and at heart level. The client should sit with legs on floor and feet uncrossed, and should not speak during the recording. The client should rest quietly for 5 minutes before the reading is taken.

17. The answer is a. Nurses need their own liability insurance for protection against malpractice lawsuits. Nurses erroneously assume that they are protected by an agency's professional liability policies. Usually when a nurse is sued, the employer is also sued for the nurse's actions or inactions. Even though this is the norm, nurses are encouraged to have their own malpractice insurance.

18. The answer is c. While on a cooling blanket, the child should be covered lightly to maintain privacy and reduce shivering. Options 1,2, and 4 are important and correct interventions to prevent shivering, frostbite and skin breakdown.

19. The answer is d. Nurse practice acts require reporting impaired nurses. The board of nursing has jurisdiction over the practice of nursing and may develop plans for treatment and supervision. This incident needs to be reported to the nursing supervisor, who will then report to the board of nursing and other authorities as required. Option 3 is an inappropriate and unsafe action. Security may be called if a disturbance occurs, but there is no data in the question to support this. Therefore, this is not the initial action.

Will post more tomorrow.

Will not be posting questions for awhile. Setting for boards in a couple of days and will be concentrating on that. I am sure that there are other people that have some great questions as well to post to help quiz others for the boards. Will let everyone know how I did soon!

Just got the word, passed with flying colors!!!!  

YAHOOOOOOOOOO!!!!!!!

yA

COngradulations :)

jUST FOUND YOUR QUESTION THEY ARE GREAT.  aLREADY LPN, IN SCHOOL NOW FOR RN WILL FINISH 12/2010 PLEASE CONTINUE.  AT THE END OF EACH QUARTER I HAVE TO TAKE THE HESI MUST SCORE 850 OR HIGH TO CONT IN PROGRAM, YOUR QUESTIONS REALLY HELP.  AGAIN THANKS

good informative one

Congrats to you IFINALLY PASSED!

I loved the questions!!!!!!!!! They make you think of how more than 1 answer can be correct. You're picking the most correct.