Pharmacology

1. An insulin-dependent diabetic patient receives regular insulin dosed at 100units/ml.

Which of the following precautions would be inappropriate for administering S.C regular insulin?

A. Respecting an administration time of 45min before meals

B. Checking for signs of hypoglycemia
C. Keeping the needle in place at the injection site for at least 5 seconds
D. Checking the last injection site before administering the insulin

2. An LPN must prepare medication in an ampule for a suffering beneficiary

The MAR indicates the following: Opioid analgesics (morphine) 5mg IM q4h PRN 10mg/ml
Which asepsis principle should be respected when preparing medication in an ampoule?

A. Disposing of the rest of the medication in the appropriate location

B. Snapping off the ampule’s neck with an alcohol swab
C. Inserting the needle into the ampoule and pressing on its rim
D. Disinfecting the ampule’s neck with a swab of chlorexidine

3. At 8:15 am, an LPN must prepare insulin for a hospitalized patient in the medical unit with unbalanced type 2
diabetes.
The MAR indicates the following: 10 units regular insulin + 12 units slow-acting insulin subcutaneously in the
morning.
Select the appropriate precaution for preparing an insulin mixture.

A. Shaking the vial of cloudy insulin

B. Changing the needle after drawing from the first vial
C. Having the dose of each type of insulin checked in the syringe before administration
D. Not using any insulin that’s been open for more than 7 days

4. 74 year old beneficiary at a CHSLD must received the influenza vaccine. After verifying the prescription, the LPN
must prepare several vaccines, as there are other patients who will be vaccinated that day.
Select the appropriate precaution for preparing an influenza vaccine.

A. Conserving the remaining amount of the immunizing agent at room temperature

B. Using two vials of the same product fro the same batch to meet the required dose
C. Preparing multiple doses before starting the vaccination
D. Administering the immunizing agent without shaking the vial

5. A 62-year-old patient is hospitalized in the medical unit for hepatic encephalopathy. The MAR indicates the
following: Osmotic laxative (lactulose) 30 ml PO TIC 667 mg/ml
Which of the following precautions would be inappropriate for preparing a liquid medication?

A. Putting surplus medication back in the bottle

B. Placing the medicine cup on a flat surface
C. Wiping the neck of the bottle after use
D. Holding the bottle with the label upwards to pour the medicine

6. A pediatric LPN must administer medication via inhaler to a three-year-old child hospitalized for a severe
bronchospasm. She must administer the following medications:
• Bronchodilator (salbutamol) 2 inhalations TID 100 mcg/inh.
• Corticosteroids (fluticasone) 2 inhalations BID 50 mcg/inh.
 Which of the following actions would be inappropriate for administering metered-dose inhaler medication?
A. Having the patient wait one minute between inhalations
B. Having the patient lean their head back slightly
C. Using chamber
D. Having the patient take a quick inhalation and it in

7. A six-year-old child weighing 10.9kg is admitted to the pediatric care unit for heart failure. The LPN must
administer the following prescription: antiarrhythmic (digoxin) 30mcg/kg PO BID 0.05mg/ml
Calculate the exact dose in ml of the antiarrhythmic medication to be administered.

A. 0.15
B. 6.5
C. 7
D. 327

8. An 18 month old child weighing 22lbs receives an operation in day chargers for a radial fracture. Upon returning
from the recovery room, the child is crying his eyes out while holding his arm. The LPN consults the file and finds
the following prescription: Analgesic (ibuprofen) 40mg/kg/day in divided doses, to administer 4 times a day
100mg/5ml.
Calculate the exact dose in ml of the medication to be administered in a single dose.

A. 2
B. 5
C. 20
D. 44

9. A patient is hospitalized in palliative care and has abundant secretions in his airways. Yesterday, he received a
STAT prescription of 2ml of an anticholinergic (glycopyrrolate), which greatly relieved him. The physician then
prescribed the following medication to be administered on a regular bassi: Anticholinergic (glycopyrrolate) 0.2mg
S.C. Q4H PRN if bronchial discomfort 0.2mg/ml.
Calculate the exact dose in ml of the medication to be administered

A. 0.2
B. 1
C. 2
D. 4

10. An 82 year old beneficiary at a CHSLD must receive an antibiotic to treat a urinary tract infection. The patient has
a gastrostomy and cannot take anything by mouth. The LPN must administer the first dose of antibiotic according
to the following prescription: Antibiotic (ampicillin) 0.5g q6h by gastrostomy x14days 125mg/ml.
Calculate the exact dose in ml of the medication to be administered.

A. 1.25
B. 2
C. 4
D. 20

11. A 28 year old patient is admitted to the psychiatric unit for schizophrenia with paranoid delusions. He’s been
having visual hallucinations for the past hour. He speaks loudly and threatens another patient in the unintended.
The RN asked the LPN to administer an injectable antipsychotic according to the following prescription:
Antipsychotic (haloperidol) 4mg IM STAT 5mg/ml.
Calculate the exact dose in ml of the medication to be administered.
 A. 0.8
B. 1
C. 1.25
D. 20

12. In the medical unit, a 71 year old patient is hospitalized for dehydration related to gastroenteritis. The physician
gives the following prescription: NaCl 0.9% 1000ml 8hrs as a bolus.
Calculate the flow rate in gtt/min for an IV infusion of 15gtt/ml.

A. 21
B. 31
C. 42
D. 234

13. At the day surgery unit, an LPN must install an IV infusion to a patient who will soon leave the department for
surgery. The physician gives the following prescription: Lactated Ringer’s solution for KVO (30ml/hr).
Calculate the flow rate in gtt/15sec for an IV infusion of 60 gtt/ml.

A. 2
B. 3
C. 8
D. 30

14. One hour after returning from the recovery room, a patient experiences hypotension. The physician the
prescribes a bolus of solution according to the following prescription: 250ml Lactated Ringer’s solution to be
administered over 30 minutes.
Calculate the flow rate in gtt/15 sec for an IV infusion of 10 gtt/ml.

A. 21
B. 31
C. 42
D. 83

15. A list of the most common classes of medication can be found below. Match each class of medication with its
indications. Choose your answers from the list below (each answer can only be used once). Write the letter
corresponding to your answer.

A. Control hyperglycemia
B. Prevention and treatment of angina attacks
C. Prevention and treatment of thromboembolism and treatment of unstable angina and myocardial infarction
D. Reduction in frequency and severity of epileptic seizures
E. Relief on moderate or severe pain
F. Relief of extrapyramidal side effects
G. Treatment of primary hypercholesterolemia and mixed dyslipidemia
H. Treatment of hypertension and edema due to heart failure and other causes
I. Treatment of hypertension, angina pectoris and heart failure.
J. Treatment of reversible airway obstruction due to asthma and COPD
K. Treatment of various forms of mood disorders
L. Treatment of mild to moderate pain, fever and various inflammatory diseases
M. Treatment of nausea and vomiting
N. Treatment of acute and chronic psychosis, and treatment of schizophrenia
O. Treatment of GAD
 1. Opioid analgesic E 2. Antiplatelet C 3. Anti anginal B
4. Anticonvulsant D 5. Antidepressant K 6. Antidiabetic A
7. Antiemetic M 8. Non-steroidal anti- 9. Antiparkinsonian F
inflammatory (NSAID) L
10. Antipsychotic N 11. Anxiolytic O 12. Beta blocker I
13. Bronchodilator J 14. Diuretic H 15. Lipopenic G

16. A patient has been hospitalized in the medical unit since this morning. She is suffering from kidney failure as a
result of complications caused by diabetes. She also has a history of cholesterol and hypertension problems. The
LPN verifies the MARS, which indicates the following:

Diuretic (furosemide) 40mg PO BID 40mg/co.

Lipopenic (atorvastatin) 20mg PO die 20mg/co.
Beta-blockers (bisoprolol) 2mg PO BID 2mg/co.
Opioid analgesic (codeine) 30mg PO q6h PRN 30mg/co.

In the table below, the column on the left lists different classes of medication, and the column on the right lists
side effects.

1. Diuretic A. Hypokalemia
2. Beta-blockers B. CNS depression
3. Lipopenic C. Bradycardia
4. Opioid analgesic D. Abdominal distention

Match each class of medication with its corresponding side effect.

A. 1-a, 2-c, 3-d, 4-b

B. 1-a, 2-d, 3-b, 4-c
C. 1-d, 2-c, 3-a, 4-b
D. 1-d, 2-a, 3-b, 4-c

17. A 68 year old beneficiary living in a CHSLD is suffering from chronic bronchitis, hypertension and peptic ulcers.
The LPN arrives to administer the following medications:

Bronchodilator (salbutamol) 200 mcg inh q4h PRN 100 mcg/inh

Corticosteroid in combination (budesonide) 200 mcg (formoterol) 6 mcg 2 inh die HS
Anti ulcer (pantoprazole) 40 mg PO die 30 min A.C. 40 mg PO/co.
Antihypertensice (diltiazem) 120 mg PO die 120mg/co.

In the table below, the column on the left lists classes of medication, and the column on the right lists side
effects.

1. Antihypertensive A. Oral candidiasis

2. Anti ulcer B. Constipation
3. Short-acting bronchodilator C. Hypotension
4. Corticosteroid D. Shaking

Match each class of medication with its corresponding side effect.

A. 1-c, 2-b, 3-d, 4-a

 B. 1-d, 2-b, 3-a, 4-c
C. 1-c, 2-d, 3-b, 4-a
D. 1-d, 2-a, 3-b, 4-c

18. During her home visit to a 55 year old client complaining of various aliments, an LPN noticed, that the client takes
several medication, some of which are over-the-counter.
In the table below, the column on the left lists classes of medication, and the column on the right lists side
effects.

1. Antacid A. Headache
2. Antiplatelet B. Constipation
3. Antianginal C. Gastrointestinal bleeding
4. Antiemetic D. Drowsiness

Match each class of medication with its corresponding side effect.

A. 1-d, 2-a, 3-c, 4-b

B. 1-b, 2-c, 3-a, 4-d
C. 1-d, 2-c, 3-a, 4-b
D. 1-b, 2-a, 3-c, 4-d

19. Around 4:30 pm, an LPN who has just begun her shift at a CHSLD must take a beneficiary’s vital signs and give her
her medication with a large glass of water. The MAR indicates the following:
Cholinesterase inhibitors (donepezil) 10mg PO HS 10mg/co.
Anti diabetic (metformin) 500mg PO TID 500mg PO/co.
Anticoagulant (warfarin) 2mg PO die 2mg/co.
Antibiotic (moxifloxacin) 1 drop in both eyes TID

In the table below, the column on the left lists classes of medication, and the column on the right lists side
effects.

1. Antibiotic A. Administer in the conjunctival sac

2. Oral antidiabetic B. Checking for bruising
3. Cholinesterase inhibitors C. Regularly check BP & pulse
4. Anticoagulant D. Check for signs of hyperglycemia

Match each class of medication with its corresponding side effect.

A. 1-c, 2-b, 3-a, 4-d

B. 1-c, 2-d, 3-a, 4-b
C. 1-a, 2-b, 3-c, 4-d
D. 1-a, 2-d, 3-c, 4-b

20. A patient is hospitalized for diverticulitis. She says she feels a swelling in her stomach accompanied by cramps.
She also says she has been constipated for a few days and is anxious because of the exams she underwent this
morning. The MARS indicates the following:

Anticholinergic (scopolamine) 10mg PO TID PRN 10mg/co.

Stool softener (doc usage) 100 mg PO HS 100mg/caps.
Analgesic (acetaminophen) 650mg PO q4h PRN if abdominal pain 325mg/co.
Anxiolytics (clonazepam) 0.5mg PO STAT 0.5mg/co.
 In the table below, the column on the left lists classes of medication, and the column on the right lists side
effects.

1. Analgesic A. Advise the patient to frequency rinse

her mouth
2. Anticholinergic B. Document pain before administering
3. Anxiolytic C. Noting the degree of sedation
4. Stool softener D. Monitoring abdominal distention

Match each class of medication with its corresponding side effect.

A. 1-c, 2-a, 3-b, 4-d

B. 1-b, 2-a, 3-c, 4-d
C. 1-b, 2-d, 3-c, 4-a
D. 1-c, 2-d, 3-b, 4-a

21. At a CHSLD, a 74 year old beneficiary with mild neurocognitive disorder, type 2 diabetes, and a history of heart
disease is seated in the living room, the LPN knows that the physician has recently made changes to the
beneficiary’s medication to decrease certain symptoms or stabilize his condition. The MAR indicates the
following:

Antidiabetic (metformin) 500mg PO BID 500mg/co.

Anxiolytic (lorazepam) 0.5mg PO die 0.5mg/co.
Antidepressant (citalopram) 20mg PO die 20mg/co.
Laxative (docusate sodium) 200mg PO die 200mg/caps.

In the table below, the column on the left lists classes of medication, and the column on the right lists side
effects.

1. Antidepressant A. Weight gain

2. Antidiabetic B. Light cramps
3. Anxiolytic C. Hypotension
4. Laxative D. Shaking

Match each class of medication with its corresponding side effect.

A. 1-c, 2-b, 3-a, 4-d

B. 1-a, 2-d, 3-c, 4-b
C. 1-a, 2-b, 3-c, 4-d
D. 1-c, 2-d, 3-a, 4-b

22. A diabetic beneficiary uses a wheelchair because she has numbness in her left foot and joint when she rises. The
LPN must administer the beneficiary’s morning medications. The MARS indicates the following:
Antidiabetic (insulin 30/70) 21 units S.C. BID
NSAID (ibuprofen) 400mg PO q6h PRN 200mg/co.
Antiarrhythmic (metoprolol) 50mg PO BID 50mg/co.
Antiulcer (cimetidine) 400mg PO HS 400mg/co.

In the table below, the column on the left lists classes of medication, and the column on the right lists side
effects.
 1. NSAID A. Asking the beneficiary if her joint
pain has decreased
2. Antiarrhythmic B. Having a colleague verify the dose
before administration
3. Antidiabetic C. Verifying the apical pulse before
administration
4. Antiulcer D. Verifying whether the beneficiary’s
epigastric pain is still present

Match each class of medication with its corresponding side effect.

A. 1-a, 2-b, 3-c, 4-d,

B. 1-a, 2-c, 3-b, 4-d
C. 1-d, 2-c, 3-b, 4-a
D. 1-d, 2-b, 3-c, 4-a

23. A 75 year old patient with a BMI of 31 is admitted to the cardiology unit for angina. Upon arrival, the patient’s
vital signs are the following: BP @ 159/90, Pulse @ 80 bpm, respiratory rate at 16 bpm, Sp02 at 96%, and buccal
temperature at 39.3. The LPN fills out the admissions questionnaire. The patient has joint pain that is more
intense in the morning, as well as urinary burning. The MARS indicates the following:

NSAID (naproxen) 500mg PO BID 500mg/co.

Beta-blocker (metoprolol) 50mg PO BID 50mg/co.
Antiulcer (pantoprazole) 20mg PO PRN 20mg/co.
Antihypertensive diuretic (hydroclorothiazide) 25mg PO die 25mg/co.

Given the patient’s condition, what is the purpose of administering the once-a-day prescription?

A. Decreasing chest pain causes by hypertension

B. Relieving the pain caused by urinary burning
C. Increasing the effect of the antihypertensive in order to reduce BP
D. Controlling joint pains that increase BP

24. A 78 year old hemiplegic beneficiary fell the night before. This morning he wanted to rise up from his chair to
have breakfast. Although he has enough strength to stand up, he has muscular rigidity which prevents him from
taking steps. The beneficiary complains of unusual fatigue and dizziness. The LPN takes his vital signs, which are
as follows: BP @ 86/50, P @ 70bpm, RR 16bpm, SpO2 at 97%, an buccal temperature at 36.4. The LPN must
administer the following medication:
Anticoagulant (warfarin) 3mg PO as per INR die at 6pm
Loop diuretic (furosemide) 40mg PO TID 40mg PO/co.
Antiarrhythmic (digoxin) 0.125mg PO die morning 0.125mg/co.
Urinary antispasmodic (tolterodine) 2mg PO BID 2mg/co.

Given the beneficiary’s condition, why is a diuretic not being administered?

A. The patient’s BP is too low

B. There is an increase in dieresis
C. The beneficiary is severely tired
D. The beneficiary has bradycardia

25. A 72 year old patient is hospitalized in the geriatric unit as a result of food poisoning. He has occasional vomiting
and difficulty urinating. While going over the admissions questionnaire, the LPN notes a painful necrotic wound
on the coccyx and in the lower limbs, and shaking. The patient admits to having very poor eating habits. He also
 says he consumes a lot of alcohol and has occasional memory loss. Moreover, the patient is thin and has dry skin.
The physician gives the following prescription: Vitamin B1 10mg PO TIC 10mg/co.
Given the patient’s condition, what is the purpose of administering the prescribed medication?

A. Helping to heal the coccyx wound

B. Reducing symptoms related to alcohol withdrawal
C. Increasing skin hydration
D. Helping to eliminate toxins

Applying Infection Control Measures

26. In the medical unit, the LPN is taking care of eight patients with different pathologies. This morning, her priority is
to administer cortisone to a 42 year old intellectually disabled patient who has severe dermatitis. She must apply
the following care techniques: taking vital signs, administering medications and checking the flow of aseptic
solution in order to minimize the risk of spreading infections. During treatment, one of the LPNs other patients
requires immediate assistance.
What are the 2 principles of hygiene and asepsis associated with hand hygiene?

1. Changing gloves in between two interventions for the same patient

2. Disinfecting the gloves with hydro-alcoholic solution before touching the other patient
3. Performing hand hygiene before making contact with the first patient
4. Performing hand hygiene before touching the other patient

A. 1&2
B. 1&3
C. 2&4
D. 3&4

27. At a CHSLD, a 78 year old beneficiary is suffering from Alzheimer’s dementia. He has a pressure wound on the
coccyx, and the LPN is about to reapply his sterile dressing.
Select the appropriate asepsis principle regarding the use of sterile gloves.

A. Putting on new sterile gloves if the beneficiary touches them

B. Removing the sterile gloves if the beneficiary touches them, and the continuing to provide care
C. Putting on sterile gloves in order to remove the dressing
D. Keeping the gloves on if the beneficiary touches them, and then continuing to provide care while making
sure to not contaminate the wound

28. A patient is admitted to the medical unit for lower body and and leg paralysis following an off-road vehicle
accident. The physician requests that an indwelling bladder catheter be installed “STAT” before carrying out
diagnostic tests. The LPN prepares the work area according to the rules and principles of asepsis. While installing
the catheter, the LPN drops a single-use packet of lubricating jelly on the floor.
What principle of hygiene and asepsis should be respected when a packet of lubricating jelly in contaminated?

A. Disinfecting the packet of lubricating jelly before continuing the procedure

B. Continue the procedure without lubricating jelly
C. Picking up the packet of lubricating jelly and putting on a new pair of gloves
D. Using another complete and sterile installation of bladder catheterization equipment

29. An LPN must install a short peripheral intravenous catheter of less than 7.5cm for a 27 year old woman who has
spastic cerebral palsy and who must undergo an emergency hysterectomy because of a fibroid. The LPN begins
applying an aseptic care technique.
 In what order should the principles of hygiene and asepsis be applied when installing an intravenous
catheter?
A. Performing hand hygiene, putting gloves, and disinfecting the site of insertion with swabs of 0.5%
chlorhexidine in 70% alcohol for a minimum of 30 seconds on a surface of 5 to 8 cm
B. Performing hand hygiene, putting on gloves, and disinfecting the site of insertion on a circumference of
10cm with an alcohol swab
C. Performing hand hygiene, disinfecting the site of insertion with swabs of 0.5% chlorhexidine in 70% alcohol
for a minimum of 30 seconds, and putting on gloves
D. Performing hand hygiene, putting on gloves, disinfecting the site of insertion on a circumference of 10cm
with an alcohol swab, and putting on gloves

30. A diabetic patient is admitted to the medical unit. According to the TNP, the LPN must clean the wound with
0.9% NaCl, perform high-pressure irrigation, and apply a sterile dressing to the LLE.
Which principle of surgical asepsis was correctly applied while preparing the dressing kit?

A. Gently squeezing the edge of the sterile and pulling the flap now more than 2.5cm
B. Pouring a solution that’s been open for 48 hours while holding the label in the palm of you hand
C. Adjusting the work surface so that its below waist level and then cleaning or disinfecting it
D. Emptying and arranging the material found in the dressing tray with non-sterile gloved hands

31. A five-month-old baby is admitted to the paediatric unit for bronchiolitis due to a respiratory virus. The RN has
implemented additional droplet and contact precautions. The LPN must take the baby’s vital signs every 2 hours.
The baby has hyperthermia with a temperature of 39.1, has a wet cough with clear yellow nasal discharge, and
becomes dyspenic during feeding. The baby’s mother has to leave and asks the LPN to console her child after she
goes. The LPN gives the baby a bath, changes the bedding, and ricks her to sleep.
What principles should be followed when implementing additional contact and droplet precautions?

A. 1. Removing the gown, gloves and surgical mask when outside the room
2. Replacing care equipment at the appropriate locations in the care unit

B. 1. Removing the gloves, high-efficiency mask, and gown before leaving the room
2. Cleaning care equipment using a disinfectant and while wearing gloves

C. 1. Removing the gloves, gown and surgical mask before leaving the room
2. Cleaning care equipment using a disinfectant and while wearing gloves

D. 1. Removing the gloves, gown and high-efficiency mask when outside the room
2. Replacing care equipment at the appropriate locations in the care unit

32. A patient who received a knee prosthesis operation six days ago is experiencing complications. The LPN has
observed redness around the wound as well as a yellowish discharge. After the physician requests a wound
sampling, the LPN also observes a clear nasal discharge. The physician suspects the presence of vancomycin-
resistant enterococci (VRE) in the wound. The LPN therefore implements additional contact precautions.
What principle should be followed when implementing additional contact precautions?

A. Practising proper hand hygiene with soap and water

B. Closing the door of the room
C. Putting the gown before entering the room
D. Prohibit the presence of visitors

33. An LPN works in long-term care at a CHSLD. Throughout the day, three patents from a unit of 30 beds suddenly
develop a fever and cough. The unit physician and infection control nurse are notified of the situation, and
influenza is highly suspected. Furthermore, an employee was removed from the workplace two days, as she also
 developed a sudden fever and cough. An outbreak is suspected and additional infection control measures are
immediately implemented.
Determine the principles to be follow when implementing additional contact and droplet precautions.

A. 1. Continuing routine practices with all beneficiaries, including those experiencing symptoms
2. Wearing a mask for all direct provided to beneficiaries
3. Allowing a limited number of visits

B. 1. Continuing routine practices with all beneficiaries, including those experiencing symptoms
2. Wearing a mask for all direct care provided to beneficiaries
3. Dedicating healthcare equipment to beneficiaries who have a fever and cough

C. 1. Taking additional precautions against droplet and contact transmission with all beneficiaries
2. Dedication healthcare equipment to beneficiaries who have a fever and cough
3. Allowing a limited number of visits

D. 1. Taking additional precautions against droplet transmission with symptomatic patients all beneficiaries
2. Continuing routine practices with other beneficiaries
3. Allowing a limited number of visits

34. During a postoperative home visit for a 72 year old client, the LPN realizes that the patient has viral
gastroenteritis. Vomiting accompanied by diarrhea began the previous night.
What personal protective equipment is recommended for when a home patient has gastroenteritis?

1. Gown
2. Gloves
3. Mask
4. N95

A. 1&2
B. 1&3
C. 2&3
D. 2 &4

35. A patient has just been admitted to the medical unit. His laboratory results indicate the presence of vancomycin-
resistant enterococci (VRE). For 48 hours, he has been feverish and presents flu-like symptoms. Additional
droplet and contact precautions have been implemented. The LPN is asked to accompany the patient to a
diagnostic examination.
Among the following additional precautions, indicate the order that must be followed when moving this
patient.

A. 1. Put PPE (gown, gloves and mask) before entering the room
2. Have the patient perform hand hygiene
3. Cover the patient with a clean blanket
4. Have the patient put on a procedural mask
5. Remove PPE upon exiting the room
6. Perform hang hygiene

B. 1. Put on PPE (mask and gloves) before entering the room

2. Have the patient perform hand hygiene
3. Have the patient put on a procedural mask
4. Remove the PPE upon exiting the room
5. Perform hand hygiene
 C. 1. Put on PPE (gown and gloves) before entering the room
2. Cover the patient with a clean blanket
3. Have the patient put on a procedural mask
4. Perform hand hygiene
5. Remove PPE upon exiting the room

D. 1. Put on PPE (gown, gloves and mask) before entering the room
2. Have the patient perform hand hygiene
3. Have the patient put on a procedural mask
4. Have the patient wear a gown
5. Remove the PPE upon exiting the room
6. Perform hand hygiene

36. An LPN works in the short-term care unit, where a patient has been admitted for pneumonia. Antibiotic
treatment is prescribed. After three days of hospitalization, the patient develops a foul smelling and mucous
diarrhea. The physician suspects Clostridium difficile-associated diarrhea (CDAD) and request additional contact
precautions.
Given the patient’s condition, which explanation justifies the implementation of additional precautions?

A. Visits should be prohibited in order to prevent contamination of the unit and the other patients.
B. Care equipment should only be used on this patient so as not to contaminate the others
C. The door should be closed to prevent microorganisms from spreading in the unit and to the other patients
D. Visitors should be instructed to put on sterile gloves so as not to spread microorganisms in the unit

37. An LPN works in a rehabilitation center, where a patient is hospitalized in a myelopathy unit with 26 beds. The
patient is morbidly obese, which makes mobilization difficult, and is paralyzed in her two lower limbs following a
spinal cord injury. Since she suffers from venous insufficiency, sores have appears at her ankles. The monthly
screening for MRSA has come back positive in her nasal cavity, urine and wounds. The patient practices very few
infection control measures, and her personal hygiene is inadequate. The LPN worries about the pother patients
becoming contaminated and applies the additional precautions requested by the RN.
Give the patient’s condition, what explanation best justifies the implementation of additional precautions?

A. Personal protective equipment should be removed before leaving the room to avoid spreading bacteria
B. The wounds should be left without a dressing to accelerate healing and this prevent bacteria from being
transmitted by physical contact
C. Since the patient is in rehabilitation, she must be allowed to move freely as this will speed up healing
process
D. The patient should be told to perform proper hand hygiene so as not to contaminate other people

38. An LPN works in long-term care in a CHSLD where four beneficiaries have a flu-like syndrome (fever and cough).
The physician recommends additional droplet precautions for these four beneficiaries. A reminder of routine
practices is established for all other beneficiaries who do not show flu-like symptoms. Unvaccinated staff
members are strong l’y encourage to get vaccinated.
Given the patient’s condition, what explanation best justifies the implementation of additional precautions?

A. Since the microorganisms in this environment are viable, surfaces which the beneficiaries frequently come
into contact with must be cleaned and disinfected
B. The doors and windows of the symptomatic beneficiaries’ rooms should absolutely be closed to keep the
microorganisms contained
C. Visitors should not be allowed at the bedside of beneficiaries with symptoms, as well as other beneficiaries
in the unit, so as not to contaminate staff
 D. Unvaccinated caregivers must be prohibited from entering the room so as not to contaminate the other
beneficiaries

Communications

39. At the rehabilitation unit, an LPN visits a patient who has just returned from his physiotherapy session. It is 10
am, and the patient is discouraged and in tears. He says he will never be able to get through life with only one
leg. Two weeks ago, his left leg was amputated just above the knee as a result of diabetes. The patient says that
his leg is very sore and rates his pain at 8/10. He says he feels a stinging sensation, as if he has needles under his
bandage and in the thigh. He says he has been feeling this way ever since he woke up this morning, but the pain
has gotten worse since going to physiotherapy. He refuses to look at his leg and wants to stay in his chair. He also
grimaces at every movement. The elastic bandage at the stump is clean.
Which of the following progress notes meets the requirements for describing pain caused by amputation?

A. 10 am RRL pain at 8/10 in the form of a stinging sensation. Discouraged, in tears, says will never be able to
get through life with only one leg. Refuses to look at his leg.
B. 10 am Returns from physiotherapy. Complains of +++ pain at the RLL stump in the form of a stinging
sensation radiating to the thigh. Discouraged, in tears, refuses to look at his wound.
C. 10 am Pain at the RLL stump radiating to the thigh, rated at 8/10 and described as a stinging sensation,
began upon awakening, increased since physiotherapy session. Grimaces at each movement. Discouraged,
in tears, says he will never be able to get through life with only one leg. Refuses to look at his leg.
D. 10 am Significant pain post-physiotherapy. Clean elastic at RLL stump. Analgesic given.

40. A beneficiary from the prosthetics unit is very agitated at lunchtime. She constantly gets out of her chair follows
LPN everywhere and speaks loudly. She yelled another beneficiary to shut up until another to stop looking at her
she repeatedly shouts “Mom! Mom!”. She also wants to have her coat and calls and LPN a “big fat idiot”. At 1
PM the beneficiaries, and smiling she is rocking chair in her room.
Which of the following progress notes meets the requirements for describing of behavioral follow-up?

A. 12 PM: agitated, constantly gets out of chair yells at another beneficiary and insults the LPN shouts “Mom,
Mom!”, and wants to have her coat. Settled into her room for lunch, comforting words soft music. 1 PM:
smiling, calm, rocking gently in her room.
B. 12 PM: very agitated and disturbs everyone has lunch in her room disoriented. 1 PM: smiling, rocking gently
in her room
C. 12 PM: agitated constantly, gets out of chair, yells at under other beneficiaries and insults the LPN. Shouts
“Mom! Mom!”, wants to have her coat. Settled into her room for lunch, comforting words, soft music. 1 PM:
agreeable mood, rocking gently in her room.
D. 12 PM: agitated, yelled at other beneficiaries and insults the LPN. Shouts “Mom!, Mom!”, wants to have her
coat. has lunch in her room, soft music. 1 PM: smiling calm, rocking gently in her room.

41. A paraplegic patient has a long at the top of her left foot. The patient says she feels a burning sensation while the
dressing is being changed. The LPN changes the dressing which was soiled at 25% with clear liquid, she estimates
her pain 6/10.
The LPN wraps the new dressing according to the instructions in the TNP. She then goes to the workstation to write her
progress note.
Which of the following progress notes meet the requirements for describing wound care?

A. Foot dressing removed, soiled at 25% wound same as yesterday, burning pain rated 6/10 during treatment
B. Left foot dressing changed, clean wound, sanitary periphery, dressing re-wrapped according to TNP. Pain
during treatment, relief afterwards
C. Left dressing changed, soiled at 25% serous fluid, bed of wound bright red, pink periphery. Dry dressing.
Burning pain at 6/10 during treatment
D. Left foot dressing soiled at 25% serous liquid. Wound cleaned with NaCl, bed of wound bright red, pink
periphery, dry dressing applied as prescribed

42. A 38-year-old man is hospitalized in the surgery unit to treat an pneumothorax caused by falling in his shower. He
has two broken ribs on his right side. He receives 02 at 1 L/minute via nasal cannula as well as a solution of 5%
dextrose and 0.45% NACL at 80 ml/hour. he also has a chest drain on his right side.
The LPN makes her first round and upstairs at the dressing at the side of the chest drain is clean. There is no
liquid in the drain circuit. The patient says that the skin under his right armpit is soft and swollen and that he
hears the crackling sound when he presses his fingers on the swollen skin. The LPN delineates the swollen part
of using a pen. The patient asked the LPN when he can go outside to smoke.
Which of the following problems notes and meets the requirements for describing information related to a
chest drain?

A. Chest drain in place on suction at 20 cm H2O, ++ subcutaneous emphysema, right arm pit delineated. Asks
to go outside smoke.
B. Chest drain right side. Drainage 0 ml, not suffering, dressing okay, asks when he can smoke
C. Chest drain right side suction at 20 cm H2O, dressing intact, no drainage subcutaneous emphysema and
right arm pit, not suffering wants to smoke.
D. Right chest drain section at 20 cm H2O, clean dressing, no drainage, delineated subcutaneous emphysema
right armpit, no pain, wants to smoke

43. A 76-year-old woman is hospitalized after falling on the outside staircase of the residence. She has a fracture in
her right hip arthroplasty is plan for the next day the patient is diabetic, and is receiving a solution of 5% Dextros
and 0.45% NaCl by pump at 80ml/hr. At 5 AM, she receives a dose of narcotic analgesic, which provides relief.
At 5:30 am, the LPN monitors the patient’s vital signs and her capillary blood glucose. The results are as follows:
BP at 110/70, pulse at 88 bpm, RR 16bpm, SpO2 97% and blood glucose at 4.3 mmol/L.
The LPN completes her night shift at the surgery unit and informs the RN of the patient’s condition.
What is the most important information that should be given to the RN before leaving the unit?

A. The patient’s pain relief

B. The patient’s vital signs
C. The results of the capillary blood glucose monitoring
D. The patient’s allergies
44. A 37-year-old patient is admitted to the psychiatric unit for depression with suicidal thoughts. Her martial
situation is difficult. The patient says that her husband does not look after her and that he spends their money
without consulting her, even though he is currently unemployed and she is a stay-at-home mother of four-year-
old, a two-and-a-half year old and a ten-month-old. She would like to take couples therapy sessions with her
husband, but he refuses. While speaking to the LPN, the patient says that before calling the friend who brought
her to the hospital, she had thrown a tantrum in the shower. She says that she shouted so much, she developed
a sore throat. Her throat feels a bit better today, but she does not give more information.

The patient says that when she was at home, she noticed many sharp objects and became afraid of what she
could do. She says that she understands why some mothers kill their children and take their own lives. She
admires them and wishes she had the courage to be like them. She says she feels safe in the hospital, but knows
that she can’t stay there forever and will eventually have to leave.
Which of the following notes describe the situation accurately and clearly to the physician?

A. Admission of a 37-year-old woman hospitalized for depression with suicidal thoughts. Expresses herself well
during interview with me. Feels safe in the hospital.
B. 37-year-old woman hospitalized for depression with suicidal thoughts. Verbalized her suicidal thoughts
today. Said she saw many sharp objects at home and became afraid of hurting her children. Throat pain
diminished.
C. Admission of a 37-year-old patient for depression with suicidal thoughts. Wife and mother of three young
children. Contentious relationship with husband. Was afraid of what she could have done yesterday while
she was very angry. She noticed many sharp objects. Says she admires the mothers who kill their children
and take their own lives. Feels safe in the hospital.
D. Admission for depression with suicidal thoughts. She is a wife and mother of three children. Contentious
relationship with her husband. Verbalized ++ during interview with me. No suicidal thoughts today. Feels
safe in the hospital.

45. A patient has been hospitalized for four days because his diabetes is unbalanced. He has a wound on the first toe
of his left foot and on the outer malleolus of his right foot. The dressings are clean and in place. Le LPN wonders
if she needs to replace the dressing today.
Which of the following documents should be consulted before applying a dressing?

A. the MARS
B. the wound care guide
C. the progress note
D. the TNP

46. At the CLSC, a woman must receive a vaccine prescribed by her physician, as she plans to take a trip abroad soon.
The LPN prepares to administer the prescription in the presence of an RN.
Which of the following document should be consulted before administering the vaccine?

A. the medication administration record sheet

B. the compendium of pharmaceuticals and specialities
 C. the therapeutic nursing plan
D. the protocole d’immunisation du Quebec

47. An LPN has just taken a blood glucose measurement for a hospitalized surgery patient. The patient has insulin-
dependent diabetes, and the endocrinologist has just prescribed a QID adjustment protocol.
Which of the following documents should be consulted before preparing the insulin?

A. The collective prescription

B. The medical prescription
C. The MARS
D. The TPN

48. An LPN who has just begun her 8:30 am shift is about to administer an inter-dose injection of opioid analgesic to
a young boy in palliative care.
Which of the following documents should be consulted before preparing the opioid analgesic?

A. The MARS
B. The collective prescription
C. The TPN
D. The narcotic registry

49. In the palliative care unit, an 89-year-old woman has terminal lung cancer with bone metastasis. She has
constant generalized pain that varies between 2 and 4 on a scale of 10, despite regular administration of
analgesics.
It is 8:30 pm, and the woman is very uncomfortable. Her breathing is shallow at 36 breaths / min. she has
intercostal indrawing, with an audible presence of bronchial secretions. At the RNs request, the LPN consults the
patient’s MAR to prepare medication according to respiratory distress protocol.

The MAR indicates the following:

- Narcotic analgesic (morphine) 5 mg S.C. q. 4h 5 mg/ml reg. respecting sleep
- Narcotic analgesic (morphine) 2.5 mg S.C. q. 2h 5 mg/ml between doses
- Anticholinergic (scopolamine) 0.4 mg S.C. 0.4 mg/ml PRN if bronchial discomfort

Respiratory distress protocol indicates the following:

- Sedative (midalozam) 5 mg S.C. 5 mg/ml
- Narcotic analgesic (morphine) 10 mg S.C. 10 mg/ml
- Anticholinergic (scopolamine) 0.4 mg S.C. 0.4 mg/ml
-
Given the patient’s condition, which interpretation of the medical prescription is accurate?

A. Administer 2.5 mg S.C. of narcotic analgesic and 0.4 mg S.C. of scopolamine

B. Administer 5 mg S.C. of narcotic analgesic and0.4 mg S.C. of scopolamine
C. Administer 5 mg S.C. of sedative, 2.5 mg of morphine sulphate S.C., and 0.4 mg S.C. of scopolamine
D. Administer 5 mg S.C. of sedative, 10mg S.C. of narcotic analgesic, 0.4 mg S.C. of anticholinergic
50. A patient is hospitalized for pneumonia treatment. He is dyspneic and has a wet cough with blood sputum. At 9
am, the LPN monitors the patient’s vital signs and the results are as follows: BP at 120/74, pulse at 98 bpm, resp.
rate at 26 bpm, SpO2 at 85% and buccal temperature 38.9. At 10 am, the patient complains of chest pain when
coughing. When the LPN places him in the semi-fowler’s positon, he says that he feels dizzy. At the moment, his
BP is 86/54. The patient’s medical prescription is as follows:
i. Antibiotic (cephalosporin) 500mg PO BID at 8h00 & 20h00, 500mg/co
ii. O2 via nasal cannula at 3L/min if SpO2 lower than 90%
What of the following actions will occur in accordance with the medical prescription?

A. Installing oxygen
B. Administering the antibiotic
C. Seating the patient in bed
D. Taking vital signs

51. A young woman is hospitalized in the medical unit for bovine spongiform encephalopathy (mad cow disease). She
has also had type 1 diabetes for the past few years. It is 8 pm, and the LPN has just monitored the young
woman’s blood capillary glucose. The result is 10 mmol/L. She then consults the medical prescription in the
patient’s file.

Medical prescription:
Allergies: iodine
Weight: 84kg
Height: 1m 50

Date Time Medications

2017-04-02 9h30 am Antidiabetic (regular insulin) S/C TID
Morning= 10 units Noon= 8 units Dinner= 6 units
Antidiabetic (regular insulin) S/C according to scale QID and ½ dose HS
If blood glucose between 8 and 10 mmol/L = 4 units
10.1 and 13 mmol/L = 6 units
13.1 and 16 mmol/L = 8 units
16.1 and 20 mmol/L = 10 units
>20 mmol/L = 12 units
Jean-Daniel Lajoie MD

Given the patient’s condition, which interpreting of the medical prescription is accurate?

A. Administer 4 units of regular insulin

B. Administer 2 units of regular insulin
C. Administer 6 units of regular insulin
D. Administer 10 units of regular insulin

52. A 98-year-old woman awaiting accommodation it, is hospitalized due to deterioration of her general condition
and repeated falls. A week ago, she fell during the night, resulting in a fractured coccyx. She is suffering and often
changes position. Although she asked the staff at least once every hour to bring her to the commode chair to
urinate, she often does not urinate. The LPN just left the room five minutes ago, and the woman has rung again.
Which of the following skills are necessary for establishing a therapeutic relationship in this situation?

A. Making eye contact with the patient and observing whether there is physical or psychological discomfort
B. Ignoring the request at the moment to make the patient understand that she is unavailable
C. Speaking to the patient in a firm and supportive tone and explaining her unavailability
D. Respond to the patient in the doorway to politely demonstrate her lack of time and availability
53. An 84-year-old man has been living in a CHSLD for a month. He has several health problems, and was diagnosed
with depression by a physician a few weeks before arriving at the residence. He eats very little, isolates himself,
and refuses to participate in activities. The LPN approaches the beneficiary and asks him about the interests and
hobbies he has prior to his arrival.
Which of following demonstrates the necessary skills and attitudes for establishing a therapeutic relationship
in this situation?

A. Jovially telling the beneficiary that he will participate in the next activity
B. Leading the beneficiary to a cooking activity
C. Having the beneficiary choose an activity in which to participate
D. Respecting the beneficiary’s refusal to participate in activities

54. Yesterday, a 67-year-old man underwent an operation to have a total knee prosthesis installed. It is 4pm, and the
patient is visited by the LPN at the beginning her shift. The patient is angry, speaks loudly and complains of not
receiving any care. He says he rang several times to get help, but no one came. He ended up using his urinal,
which eventually spilled on him. His jacket and bed are now wet. He is also humiliated by the situation and is
cold.
Which of the following demonstrates the necessary skills and attitude for establishing a therapeutic
relationship in this situation?

A. Downplaying the situation and making jokes

B. Explaining the change in shift
C. Asking the patient to lower their tone of voice
D. Using active listening

55. A young mother has undergone a thyroidectomy due to the presence of a malignant tumor. The LPN is about to
enter the room to provide care, but notices that the patient has her head down and she is crying.
Which of the following demonstrates the necessary skills and attitudes for establishing a therapeutic
relationship in this situation?

A. Quickly providing care

B. Asking the patient to verbalize her feelings
C. Trying to change the patient’s mind
D. Coming back later to provide care
Health Promotion

56. A five-year-old patient is hospitalized for pneumonia. He is asthmatic and has several allergies: cat saliva, horses,
penicillin, nuts and kiwis. He enjoys playing video games and spends lots of time watching television. He is slightly
overweight and does little exercise. He is also prone to respiratory infections and gets eight to ten colds a year
that often require antibiotics. The LPN observes that the patient has dry lips and a pale complexion. He is set to
be released from the hospital tomorrow. He no longer has a fever, and his sputum is clear. The LPN informs the
patient’s parents about the benefits of physical activity.
Given the patient’s condition, what information concerning physical activity should the LPN provide to the
parents?

A. Physical activity helps to reduce asthma attacks

B. Physical activity helps to strengthen the respiratory system
C. Physical activity helps to prevent shortness of breath
D. Physical activity helps to reduce allergies

57. A client arrives at a CLSC because she is worried. She has pregnancy diabetes and is unable to lose the excess
weight caused by her pregnancy. The patient’s father has had type 2 diabetes for several years, which she knows
increase her risk of becoming diabetic. The LPN provides some information about the benefits of eating fruits,
nuts, whole grains and legumes.
What information should be provided to the client regarding her condition?

A. She should maintain her blood glucose levels between 4 and 7 mmol/L
B. She must maintain a healthy body weight
C. She must eat foods that will raise her BP
D. She must lower her cholesterol

58. A 41-year-old mother of three teenagers is hospitalized after falling on the ice. The physician wants to assess the
risk of osteoporosis. The woman measures 1m57, and weighs 52kg with a BMI of 21. She is a non-smoker, takes
anovulants, consumes alcohol every week, drinks four coffees a day, and does not exercise regularly. The LPN
gives her some information on ways to reduce coffee intake.
What information should be provided to the patient regarding her condition?

A. Caffeine lowers estrogen levels

B. Caffeine promotes osteoblast growth
C. Caffeine lowers heart rate
D. Caffeine can accelerate bone loss

59. A 56-year-old woman is hospitalized in the medical unit. She has type 2 diabetes and a history of hypothyroidism
and hypercholesterolemia. She lost 10 kg in one month. She often experiences hypoglycaemia in the morning and
hyperglycemia at the end of the day. He is always thirsty, and her vision is sometimes blurred. The physician
prescribes the following blood tests: TSH, Urea, Creatinine, Glucose, liver function, Glycated hemoglobin
Given the patient’s conditions, what purpose does the HbA1c test serve?

A. Analyzing red blood cells

B. Detecting anemia
C. Following up on treatment for diabetes
D. Adjusting treatment for hyperthyroidism

60. A 48-year-old man is admitted to the emergency unit for retrosternal chest pain. During the four months prior to
his hospitalization, the patient had chest pains that would radiate to the neck and jaw upon effort, yet disappear
when the patient ceased activity or relaxed. The patient receives an IV infusion of 0.9% NaCl, 1000ml at 30ml/hr,
 and an O2 supply 2L/min by nasal cannula. The doctor prescribes routine blood tests, as well troponin and ECG
tests STAT.
Given the patient’s condition, what purpose does the troponin test serve?

A. Detecting acute coronary syndrome

B. Evaluating the level of myocardial necrosis
C. Representing electrical pulses
D. Detecting a previous infarction

61. A 38-year-old woman is hospitalized in the gynaecological unit for severe menorrhagia. She is also very tired and
has difficulty concentrating. For a few weeks, she has noticed that she is losing her hair and her skin is often dry.
Even though her appetite is diminishing, she has put on 5kg in a month. The doctor prescribes the following
blood tests: Hb-HT, Serum iron, TSH.
Given the patient’s condition, what purpose does the TSH serve?

A. Detecting a thyroid abnormality

B. Evaluating the ovarian function
C. Determining the cause of hair loss
D. Detecting an abnormality of growth hormone release

62. A 52-year-old patient is hospitalized in the cardihematology unit. When he walks continuously for more than ten
minutes, he feels pain and cramps in his right calf that become increasingly intense and cease upon rest.
Although the patient’s neurovascular signs are normal, the popliteal, pedis, and posterior tibial of his right leg are
distinctly lower than those of his left leg. The patient also has poor hair growth on his right leg. The physician has
prescribed a femoral arteriogram of the right leg.
Given the patient’s condition, what purpose will the arteriogram serve?

A. Detecting an occlusion of the femoral artery

B. Modifying the circulation in the lower limbs
C. Locating venous occlusion in the right lower limb
D. Relieving nerve compression in the lower right limb

63. A 71-year-old patient is hospitalized following a left hip fracture. She was operated three days ago for a left hip
nailing procedure. She has begun physiotherapy but she is still suffering. The patient is worried and wonders if
she has any other fractures or even bone cancer. She regularly takes painkillers every four hours. The physician
has prescribed an osteodensitometry that will be performed in 2 months.
Given the patient’s condition, what purpose will the osteodensitometry serve?

A. Ruling out a diagnosis of bone cancer

B. Evaluating bone solidification
C. Searching for other fractures
D. Determining bone mineral content

64. A 55-year-old woman has perniscious anemia. She has been a vegetarian for ten years, and her BMI is 20. She
walks for 30 minutes, three times a week. Before the patient is discharged, the LPN provides dietary
recommendations about vitamin B12 to help promote her condition.
What recommendation should be given before the patient returns home?

A. Eating more offal

B. Eating more legumes
C. Starting to add tofu to meals
D. Drinking more soy beverages
65. A 41-year-old patient has just been discharged from the hospital. He recently suffered a TIA and was hospitalized
for three days to undergo several exams following two episodes of lipothymia at his home. The patient is a postal
worker and walks five to six hours a day. He eats breakfast every morning and has several snacks before noon. He
also has a heavy meal in the evening and often nibbles on various “munchies” (nuts, chips, etc.) while watching
TV at night. He drinks two large bottles of water and four to five soft drinks a day. The physician recommends
that the patient lose weight because his waist circumference is 95.5 cm.
Which of the following recommendations is appropriate to this situation?

A. Drinking diet soft drinks

B. Eating evening snacks that have fewer calories
C. Eating a balanced breakfast every morning
D. Avoiding eating nuts

66. A 58-year-old patient has just been discharged from the hospital. She is diabetic and has been taking oral
hypoglycemic drugs since the age of 40. She has been blind for five years and lives alone in a big home. During
her stay in the hospital, she contracted a urinary tract infection, which means she has to take antibiotic tablets
for another seven days. The patient says she has a weak stomach and easily gets heartburn and diarrhea, which
she fears will happen form taking the antibiotic. The LPN gives her some recommendations before she leaves on
how to lessen the side effects of the antibiotic.
Which of the following recommendations should be given to the patient returning home?

A. Taking probiotics with the antibiotic at the same

B. Taking the antibiotic with meals
C. Taking an antiacid as needed
D. Measuring blood glucose levels more often

67. A 48-year-old patient will leave the hospital today with a prescription from the cardiologist for an anticoagulant
(warfarin). His heart rhythm is in atrial fibrillation. The patient’s wife is present and both are nervous about him
taking anticoagulants. The couple owns a restaurant and often work more than 60 hours a week. They regularly
eat a heavy meal late at night accompanied by a bottle of wine since they say it’s their best meal of the day. To
have more energy, the take over-the-counter health products. The patient also sometimes takes NSAIDs
(ibuprofen) whenever he has a headache. The LPN recommends certain precautions to follow when taking an
anticoagulant.
Which of the following recommendations is appropriate to this situation?

A. Continuing using natural health products

B. Taking NSAIDs as needed
C. Avoiding alcohol consumption
D. Eating foods that are rich in vitamin K

68. A 54-year-old patient will leave the hospital in the afternoon. He suffered a myocardial infarction a week ago,
which left him with mild heart failure. He underwent a coronary angiography with arthroplasty and had three
coronary stents installed in his coronary arteries. Before the patient leaves, the LPN makes a few
recommendations to avoid complications.
Which of the following recommendations should be given to the patient returning home?

A. Practicing physical activity a soon as possible

B. Taking hot baths
C. Regularly monitoring BP
D. Driving short distances

69. A 10-year-old patient has just been discharged from the hospital. He underwent an operation to reduce a double
fracture of the right radius and ulna. He has a long plaster cast on his arm, which goes from the upper part of the
armpit fold to the palmar fold. The elbow is immobilized at a right angle. The patient has an intellectual disability
and does not understand the instructions given to him. He is preparing to leave the hospital with his parents, and
the LPN gives them recommendations regarding the cast.
Which of the following recommendations should be given to the patient returning home?

A. Having the child regularly wiggle his fingers

B. Supporting the cast with a sling at all times
C. Putting powder inside the cast is odors occur
D. Cleaning the cast with mild soap and water
Pathology

70. A 60-year-old patient is hospitalized for chest pain under the left clavicle, rated 8/10 and irradiating in the left
scapular area. The patient tells the LPN that he has trouble breathing when he turns over in the bed and that the
pain increases while coughing. He feels relief, however, when he adopts a sitting position. The LPN notes that the
patient’s face is pale and that he is complaining of nausea without vomiting. She takes the patient’s vital signs,
which are as follows: BP at 175/100, pulse at 112 bpm, resp at 32 bpm, SpO2 at 95% and temperature at 38.8. An
ECG and a blood culture are requested STAT because the doctor suspects pericarditis.
Which of the following clinical manifestations relates to the patient’s condition?

A. Bradypnea
B. Hypertension
C. Hyperthermia
D. Gastric discomfort

71. A 52-year-old patient with a history of high blood pressure is hospitalized in the medical unit for congestive heart
failure (CHF). Although he did not weigh himself, he tells the LPN that he’s gained weight since he can no longer
button his pants. At the beginning of the evening shift, the LPN observes that the patient has swollen feet and
clammy skin. He has no problem answering questions. The patient’s vital signs are as follows: BP at 148/92, pulse
at 108 bpm, resp at 28 bpm and SpO2 at 90%. A fluid restriction of 1500 ml per day is prescribed.
Which of the following clinical manifestations relates to the LPNs concerns?

A. Orthopnea
B. Bradycardia
C. Pitting edema
D. Red face

72. A 58-year-old woman is sitting in the waiting room of a clinic. She has a personal history of cardiac troubles,
hypercholesterolemia and anxiety disorders are known in her paternal family, she has been taking hypolipidemic
medication, and has had pain in her legs ever since. She also feels tense, which is a sensation she has never felt
before. Suddenly, the woman feels pain in her sternum irradiating in her left arm, accompanied by diaphoresis.
Her face is getting increasingly pale. The LPN working at the clinic places the woman on a stretcher. An
ambulance is immediately called to transfer the woman to the emergency room. The LPN begins administering
nitroglycerin spray according to clinic protocol. The physician suspects a myocardial infarction.
Which of the following clinical manifestations relates to the patient’s condition?

A. Epigastric pain
B. Muscle pain
C. Retrosternal pain
D. Nervousness

73. A patient is admitted to the surgical unit for a hysterectomy caused by a uterine fibroid. She explains to the LPN
that a few months after giving birth, her menstrual periods have become very heavy and abnormally long (15
days out of 30), and that her stools are hard and dry. The patient mentions that she also feels a lump on her left
abdominal region and feels dizziness and shortness of breath.
Which of the following clinical manifestations relates to the patient’s condition?

A. Dyspnea
B. Dizziness
C. Mennorrhagia
D. Pollakiuria
74. A 66-year-old patient is admitted to a medicine care unit for prostatic hypertrophy. He tells the LPN that he is
always thirsty and has little energy. He has difficulty keeping his diabetes under control and admits to not
following the diet suggested by his nutritionist, which has left to blurred vision over time. In addition, the patient
tells the LPN that although he often goes to the bathroom to urinate, he passes only a small amount of urine,
painlessly and the stream is weak.
Which of the following clinical manifestations relates to the patient’s condition?

A. Pollakiuria
B. Polydipsia
C. Polyuria
D. Blurred vision

75. a paraplegic client is waiting for a right kidney ablation after being diagnosed with kidney cancer. The LPN from
the CLSC visits the client every week to monitor his vital signs. The client mentions that although his urine is
becoming increasingly red during bladder catheterization, he does not feel any pain related to his condition. He
uses a wheelchair to get around and remains autonomous in self-care. During the visit, the LPN observes swelling
in the client’s right side.
Which of the following clinical manifestations relates to the patient’s condition?

A. Hematuria
B. Pain
C. Pyuria
D. Weight loss

76. A 25-year-old patient is admitted to the psychiatric unit for schizophrenia. Since his arrival, the patient has been
inexpressive and looking callous, and has made no visual contact with the nursing staff. The LPN notes that since
being admitted, the patient has been speaking loudly to himself and is constantly moving around. The LPN also
observes several bruises on the patient’s arms. The patient says that the Mafia is chasing after him and that he
wants to leave the hospital to find a place where he will never be heard from again.
Which of the following clinical manifestations relate to the patient’s condition?

1. Apathy
2. Delirium
3. Ecchymosis
4. Soliloquy

A. 1 and 2
B. 1 and 3
C. 2 and 4
D. 3 and 4

77. This morning, an LPN from the CLSC arrives to perform a blood test on a 51 year-old man. The client has a
moderate intellectual disability and suffers from obesity. He has difficulty sleeping and becomes easily irritable
when afraid. The LPN explains to the client the procedure for performing the blood test. He does not cooperate
and does not want to be touched. Upon seeing the syringe, he becomes anxious and aggressive, while incessantly
hitting his thighs and speaking incomprehensibly. His mother has to intervene to calm him down.
Which of the following clinical manifestations relates to the client’s condition?

A. Thick fingers
B. Insomnia
C. Weight gain
D. Communication difficulties
78. A patient has been hospitalized in the short-term psychiatric unit for the past month. He suffers from major
depression as a result of his son’s recent death. He has trouble sleeping and constantly feels tired. He is always
sad and no longer enjoys playing golf, a sport he used to love. During the multidisciplinary team meeting, the LPN
indicates that the patient’s condition is not improving. Later, a group therapy activity is organized. The patient
has permission to participate, but he refuses. The LPN respects his decision, but enquires about the reasons for
his refusal.
Which of following clinical manifestations relates to the patient’s condition?

A. Hallucinations
B. Hypersomnia
C. Loss of interest
D. Suicidal thoughts

79. A one-year-old child has just been admitted to the pediatric unit. The child has skin lesions filled with a yellowish
liquid on the face and hands. The mother explains to the LPN that her child often cries, in inclined to rub his right
ear, and is running a fever. He has had a temperature of 38.5 for the past 24 hours. The mother also adds that
her son refuses to eat and drink. Upon physical examination, the physician observes an outbreak of red patches
and prescribes an antibiotic for impetigo.
Which of the following clinical manifestations relates to the young patient’s condition?

A. Dehydration
B. Hyperthermia
C. Pruritus
D. Protruding vesicles and scabs

80. An LPN working in the long-term care unit must apply a dressing to an 80-year-old beneficiary’s bottom wound.
The nursing care and treatment plan indicates that it’s necessary to alternate lateral positioning q2h. The
beneficiary has a buccal temperature of 38.5 and says that he sweats a lot. He also feels pain in the area of his
dressing. While replacing the dressing, the LPN notes the increasing presence of sero-sanguinous exudate and
foul smelling odors emanating from the dressing.
Which of the following clinical manifestations relates to local infection?

A. Increased exudates
B. Loss of sensation
C. Diaphoresis
D. High body temperature

81. A patient is admitted to the medical unit for lesions filled with serous filled on her upper body. While reading the
patient’s file, the LPN notices that the patient is taking anti-ulcer for stomach problems and that she is
undergoing oral chemotherapy treatment, which weakens her. Three years ago, she was treated for breast
cancer and became immuno-deficient. While filling out the questionnaire, she indicates that she has intense pain
at 9/10 on her left torso as well as a rash on her nerve path. She complains of a burning sensation on the skin, as
well as stinging an electric tingling. The physician diagnoses shingles.
Which of the following clinical manifestations relate to the patient’s condition?

1. Neutropenia
2. Neuralgia
3. Papules
4. Vesicles

A. 1 and 2
B. 1 and 3
C. 2 and 4
 D. 3 and 4

82. A fourteen-year-old patient is admitted to the medical unit after losing consciousness on a soccer field. The LPN
observes that he has difficulty forming coherent sentences. She completes the admission questionnaire with the
patient’s parents. They tell the LPN that their son has always been very athletic. For some time, they have
noticed that he has become increasingly demotivated and tired, but that he still has a good appetite. The
physician requests a blood test STAT and confirms a diagnosis of type 1 diabetes.
Which of the following clinical manifestations relates to the patient’s condition?

A. Dysarthria
B. Weight loss
C. Polydipsia
D. Polyphagia

83. A 35-year-old patient arrives at the emergency room. She says she’s been feeling very agitated and irritable, in
addition to being unable to sleep and having a very quick heartbeat. Since she is experiencing a lot of stress at
work, she is afraid of suffering an infarction. Her appearance reveals a bulge in her neck, bulging eyes, and a
lower than average BMI. The physician requests a blood test and an ECG. The patient suffers from a TSH
imbalance (hyerpthyroidism).
Which of the following clinical manifestation relates to the patient’s condition?

A. Weight gain
B. Palpitations
C. Exopthalmos
D. Bradycardia

84. A 25-year-old woman arrives at the emergency room for abdominal pain, nausea, and vomiting that have been
increasing for two days. She confesses that although she has resumed taking amphetamines, she has not taken
anything for the past few days. The patient is skinny and has circles around her eyes; her pupils are dilated and
her hands are shaking. In addition, she has lost seven pounds and her condition is getting worse. The emergency
physician meets with the patient and tells that she’s suffering from acute pancreatitis.
Which of the following clinical manifestations relates to the patient’s condition?

A. Mydriasis
B. Weight loss
C. Nausea and vomiting
D. Shaky hands

85. A 53-year-old woman receives outpatient services for a sleeping disorder. Upon reading the woman’s file, the
LPN learns that she feels very tired when she wakes up and has trouble getting through her work day. She wakes
up several times a night due to episodes of suffocation, and has a BMI of 30. She says that seasonal allergies
often cause her to become congested. She also suffers from frequent headaches. The physician diagnoses sleep
apnea.
Which of the following clinical manifestations relates to the patient’s condition?

A. Attention deficit
B. Migraines
C. Nasal obstruction
D. Daytime somnolence
86. An eight-year-old child has had asthma a very young age. It is unusually kept under control with inhalation
medication.
Today, he is admitted to the pediatric unit since, for the past two days, he has had a constant cough sometimes
accompanied by vomiting. The worried parents explain to the LPN that their child seems to be out of breath at
the slightest effort, breathes noisily, and that, as of last night, his nostrils widen when he breathes.
The LPN takes the patient’s vital signs, which are as follows: B.P. at 112/62, pulse at 100 beats/minute, resp. at
28 breaths/min, SpO2 at 90% and buccal temperature at 36.7’C.
Which of the following clinical manifestations relates to the patient’s condition?

A. Wheezing
B. Nocturnal coughing
C. Regurgitation
D. Flaring of the alae nasi (nostrils)

87. A patient is hospitalized for a bronchial superinfection and is known COPD patient. His son is worried and tells the
LPN that his father’s condition has gotten worse since last week. He also surprised his father this morning when
he caught him urinating in the corner of his room, a behaviour he’s never displayed before. At home, the patient
receives oxygen 24 hours a day at a rate of 2L/min.
The LPN notes that the patient is more dyspneic, has a productive cough with green expectoration, and has
difficulty speaking. His voice has waned, and he’s out of breath when answering questions from the LPN, who
notices that the patient’s extremities are cold and bluish. The patient’s vital signs are as follows: B.P. at 90/42,
pulse at 112 beats/minute, resp. at 32 breaths/min, SpO2 at 85% and temperature at 38’C.
Which of the following clinical manifestations relates to the patient’s condition?

A. Confusion
B. Speech difficulty
C. Green expectorations
D. Cold and cyanosed extremities

88. A patient is hospitalized in the medical unit for abdominal cramps that have persisted for two weeks. He does not
any diarrhea or vomiting. While reading the 11:00 pm report, the LPN learns that the 27-year-old patient was
hospitalized during the day. His skin and urine are a dark yellow colour. He refuses to eat, as he says he has had
no appetite for several days. The patient has been on a drip since 7:00 pm and everything is going well. At 8:00
pm, his vital signs are as follows: B.P. at 130/70, pulse at 88 beats/minute, resp. at 24 breaths/min, SpO2 at 94%
and buccal temperature at 37’C.
The patient explains to the LPN that ever since he got back from his business trip abroad, he’s been feeling
feverish. He complains of GERD and nausea. The results of the laboratory tests confirm hepatisis A.
Which of the following clinical manifestations relates to the patient’s condition?

A. Hyperthermia
B. Jaundice
C. Pruritus
D. Gastric reflux
 89. A 23-year-old woman has just been admitted to the surgery unit for a sharp abdominal pain near the navel. The
mother of the young woman explains to the LPN that her daughter suffers from generalized pains. Her stomach is
hard and bloated to the touch, and the pain is more localized on the right. The LPN performs the requested
venipuncture STAT.
The patient tells the LPN that she did not eat during the day and that she is experiencing nausea and vomiting.
The LPN takes her vital signs, which are as follows: B.P. at 110/78, pulse at 80 beats/minute, resp. at 20
breaths/min, SpO2 at 97% and buccal temperature at 37%’C. Further to her lab results which indicates a high
level of white blood cells, the patient is sent to emergency surgery for acute appendicitis.
Which of the following clinical manifestations relate to the patient’s condition?

1. Diarrhea
2. Pain in the lower right quadrant
3. Hyperthermia
4. Nausea

Answer choices
A. 1 & 2
B. 1 & 3
C. 2 & 4
D. 3 & 4

90. A 77-year-old beneficiary has been living a CHSLD for a few years. Over the past three days, the LPN has noted
that the beneficiary has had diarrhea and rectal bleeding. Her incontinence briefs have needed to be changed 10
to 12 times a days. The LPN also observes irritation of the bottom and applies a protective ointment to this area.
She notifies the RN to asses the irritation and her observations in the TPN. The doctor suspects ulcerative colitis.
Which of the following clinical manifestations relates to the beneficiary’s condition?

A. Anorexia
B. Proctorrhagia –
C. Diaper rash
D. Intermittent tenesmus

91. A 36-year-old patient who loves running shows up at the hospital. A week ago, a weight of 100 lbs fell on him. He
now has shooting back pain and can only take small steps without moving his body. In the questionnaire, the LPN
notes that the patient is sweating and has trembling hands. He complains of numbness in the legs and a neck
pain rated at 8/10. He says that the painkillers he’s currently taking bring very little relief and that he consumes a
lot of energy drinks. The medical record mentions that the patient has already received a consultation for
tendonitis in the buttocks. An MRI is then requested by the physician, as he fears a lumbar discal hernia.
Which of the following clinical manifestations relates to the patient’s condition?

A. Cervical pain
B. Muscle inflammation
C. Paresthesia
D. Hand tremors

92. A 73-year-old beneficiary living in a CHSLD suffers from osteoporosis. She explains to the LPN that when bending
to tie her shoes, she felt a sharp pain in her lower back. She also suffers from a deformed spine and has a
stooped posture. The beneficiary mentions that she plays cards despite a hand deformation that makes her “all
thumbs.” She remains active by participating in an exercise session every week.
Which of the following clinical manifestations relate to the patient’s condition?

A. Back pain
 B. Muscle ache
C. Kyphosis
D. Joint stiffness

93. A woman who lives in a private residence is brought to the emergency room for a deterioration of her general
condition. The LPN receiving her fills out the admission questionnaire and writes that the patient is oriented in
the three spheres and has eaten little for two weeks. The patient complains of joint pain and has swollen red
fingers. She must be assisted in her ADLs (activities of daily living) because she can no longer use her hands as
well as before. Her weakness leads her to not want to move. She gets angry, uses profanity, and tries to hit the
LPN when she tries to place her in her chair for meals. The doctor diagnoses an arthritis attack. A prescription for
anti-inflammatory drugs and a blood test will soon follow.
Which of the following clinical manifestations relates to the patient’s condition?

A. Aggressiveness
B. Weakness
C. Edema
D. Pitting edema

94. A sixteen-year-old patient is hospitalized because she has had two epileptic seizures in 48 hours. During her meal,
she ecomes disorganized, and her gait is unstable. Her speech in inadequate and sometimes incomprehensible.
Her face is pale, and her gaze is fixed and empty. The patient begins to have tonic movements followed by
successive and irregular periods of muscle relaxation. The LPN places her on the floor with a pillow under her
head and asked for help.
Which of the following clinical manifestations relates to the patient’s condition?

A. Muscular pain
B. Unsteady gait
C. Severe hypertonia
D. Urinary incontinence

95. A 65-year-old beneficiary has been living in a CHSLD for two years because of Parkinson’s disease. She wears
hearing aids, and needs to be spoken to loudly so that she can hear. She has head and extremity tremors, that
increase during periods of stress. She uses a walker to move around and takes small steps. Its takes a long time
for her to carry her activities, and her movements are increasingly difficult and slow. Embarrassed by her
condition, she expresses herself with difficulty and eats less and less. The LPN notes that the risk of falling has
increased for this patient, due to a flu-like state that weakens her. This will be recorded in the TNP by the RN in
charge.
Which of the clinical manifestations relates to the beneficiary’s condition?

A. Bradykinesia
B. Hearing problems
C. Anorexia
D. Joint stiffness

96. A 77-year-old man who has worked with the public all his life will soon celebrate 60 years living with his spouse.
For some time, his children have noticed major changes in their father. He has difficulty sleeping despite he
medication he takes at bedtime. He is inclined to forget certain facts, such as appointments and the names of
experiences perceptual problems and when he describes what he sees and is then corrected by those around
him, he gets angry and becomes anxious. The patient is assessed at the geriatric unit. The geriatrician announces
to the family that it will be impossible for their father to return home because he is suffering from a dementia
with Lewy bodies. Whenever the patient meets the LPN, he acts familiar with her because he believes she’s his
daughter.
Which of the following clinical manifestations relate to the patient’s condition?
 1. Hallucinations
2. Urinary incontinence
3. Insomnia
4. Mood swings

A. 1 and 2
B. 1 and 4
C. 2 and 3
D. 3 and 4
Interventions of Care

97. A 15-year-old adolescent suffering from prolonged malnutrition shoes up crying in the emergency room with a
clean wet towel around his left arm. His mother quickly explains the situation to the LPN attending to them. The
patient was handling a container of boiling water left on the counter and all of its contents fell on his arm. When
the LPN removes the towel from the patient’s arm, she sees that the epidermis has completely disappeared. The
LPN quickly informs the nurse, who is nearby. Second to third degree burns are extending from the left arm to
the joints. The patient’s arm is hypersensitive to air, and his face is very pale. The patient’s vital signs are as
follows: BP at 76/50, pulse at 140 bpm, resp. at 44 bpm, SpO2 at 92% in room air, and rectal temp at 37. The
patient is almost unresponsive to speech, and his dressings are rapidly being soaked thought by his bodily fluids.
The physician asked the LPN to install an IV infusion and begin a Lactated Ringers solution afterwards.
Which intervention should take priority in this situation?

A. Checking vital signs

B. Raising the left arm to decrease edema
C. Monitoring urinary flow rate
D. Installing the IV solution

98. A young woman arrives at the emergency room for a puncture wound. She was bitten on the calf by a marmot.
The animal ran towards her while she was on a bike path. A portion of her skin and external gemellus muscle was
removed by the animal’s teeth. The patient is very worried about getting infected. The young woman’s condition
is evaluated by the doctor as well as the nurse. The LPN begins cleaning the wound. In accordance with the
nurse’s instructions and the collective prescription, the LPN administers 500 mg 2 co. PO analgesic
(acetaminophen). The physician prescribes an anti-rabies vaccine prophylaxis. The patient also receives a first
dose of anti-rabies immunoglobulin around and in the wound.
Which intervention should take priority in this situation?

A. Administering the analgesic

B. Administering the vaccine
C. Cleaning the wound
D. Reassuring the patient

99. A young woman of 18 years is brought to the emergency room on a stretcher. She is unconscious and
accompanied by her ex-boyfriend. Earlier this morning, after being laid off by her employer, the young woman
called her ex-boyfriend to ask him for help. A few minutes later, the ex-boyfriend found pill bottles next to the
patient, which the paramedics have handed over to the LPN. On her observation sheet, the LPN makes note of
the bottle given to her: an empty bottle of anxiolutics (Oxazepam 1 mg), an empty bottle of hypnosedatives
(Phenobarbital 30 mg), and an empty bottle of another type of anxiolytic (Alprazolam 2 mg). After checking the
patient’s vital signs, the LPN notifies the emergency physician, who prescribes an NG tube STAT in order to
perform a gastric lavage and administer activated charcoal afterwards, based on other prescriptions, the LPN
installs a cardiorespiratory monitor and venous and urinary catheters. She also performs blood and urine tests.
Which intervention should take priority in this situation?

A. Administering charcoal through the NG tube

B. Taking blood samples
C. Installing a urinary catheter
D. Checking vital signs

100. A 32-year-old patient underwent an abdominal bowel resection he has been back at the surgery unit since late
this morning. At the beginning of the evening shift, the LPN observes that the patient has a pale face and clammy
skin. The patient’s vital signs are as follows: BP: 90/52, pulse at 102 bpm, resp. at 26 bpm, and SpO2 90% despite
an O2 supply of 2L/min by nasal cannula. The patient is complaining of dull abdominal pain rate 8/10 when at
rest, and feeling a pressure sensation despite repeated use of a patient-administered analgesia (PCA) pump. The
 patient’s surgical dressing has extended beyond the delimited area by 3cm on each side. The LPN is worried
about hypovolemic shock.
Which intervention should take priority in this situation?

A. Administering an additional dose of analgesic

B. Increasing the patient’s oxygen supply
C. Notifying the nurse for an assessment
D. Installing a solution to maintain blood volume

101. A patient is transferred from intensive care. She is morbidly obese. According to the patient’s medical records,
her current weight is 162 kg, but the date of her last weighing is unknown. Her hygiene is deficient, and a strong
odor emanates from her abdominal folds. A request is made for a bed designed for an obese person since it is
otherwise impossible the patient in order to perform care, change her position, and proceed to take care of her
hygiene. The change of bed requires six helpers and two transfer slings. The surface to be used for mobilizing the
patient is now acceptable and safe. During the evening, while making the rounds, the LPN discovers the patient in
a semi-conscious state, her bed flipped on its side.
Which of the following interventions would not be appropriate in this situation?

A. Checking vital signs

B. Checking neurological signs
C. Observing level of consciousness
D. Beginning cardiopulmonary resuscitation

102. A 47-year-old woman notices a lump on her left breast. Shortly afterwards, during her annual medical
examination, her physician prescribes a mammogram and a few blood tests that she will need to have done her
local hospital. Two days after her tests, the woman learns that she must undergo surgery as soon as possible.
Since receiving the news, she sleeping very little and often cries. The pre-admission clinic calls the woman to
finalize the preparations for her surgery. During the telephone interview, the LPN fills out a questionnaire about
the woman’s medical history and informs her about the surgery procedures. While collecting information, the
patient, who is very anxious, tells the LPN that she is afraid of dying because her mother died of breast cancer
ten years ago, but she still tries to stay positive.
Which of the following interventions would not be appropriate for the patient’s preoperative care?

A. Informing the physician of the patient’s fear of dying

B. Not giving the patient hope
C. Giving the patient necessary information about the surgery
D. Learning about the patient’s medical and personal history

103. An 83-year-old woman is admitted to the surgical ward after falling out of her bed. The orthopaedist requests
that the patient be prepared for surgery to repair her fractured femur. The LPN notes that the patient has a
history of hypercholesterolemia and experienced a post-operative myocardial infarction (following a heart valve
replacement) two years. Given the patient’s age and heart condition, the postoperative risks are considered high.
Given the patient’s condition, which of following interventions should be done in postoperative care?

A. Recommendations a diet that’s high in protein and fat

B. Having the patient perform lower-body exercises
C. Encouraging the patient to lie down
D. Placing a pillow under the patient’s knees

104. A 58-year-old patient is placed under heparin by her physician to minimize postoperative complications
following a bowel resection. Two days after the surgery, the patient is still feeling confused and agitated, which
causes active bleeding of the wound. Moreover, the patient is experiencing nausea due to the many narcotics
she’s been taking to reduce her pain. She eats very little, and her haemoglobin has dropped to 80 g/L. the LPN
 has changed the patient’s soiled dressing several times during her shift. She immediately notifies the nurse of her
observations, and interventions.
Given the patient’s condition, which of the following interventions should be done in postoperative care?

A. Administering an antiemetic
B. Applying a pressure dressing
C. Regularly changing the dressing
D. Disinfecting the wound with Dakin’s solution

105. A patient is hospitalized in the surgical ward after having undergone a bowel resection for colon cancer. The
patient has a stoma, and an intravenous infusion is in place. The patient has just returned from the recovery
room, and the LPN must take care of him.
Identify the appropriate intervention for immediate postoperative care.

A. Irrigate the colostomy q2h

B. Noting the characteristics of the patient’s first stools
C. Checking vital signs q15min x1hr
D. Monitoring the return of peristalsis

106. A 54-year-old patient has undergone TURP due to benign prostatic hyperplasia (BPH). During the postoperative
period, the patient wears a urinary catheter. His bladder is continuously irrigated. The LPN ensures that the
patient fully understands how the PCA pump works and that he’s able to use it.
Identify the appropriate intervention for this postoperative care situation.

A. Having the patient drink 500 ml of liquid

B. Limiting the patient’s activity
C. Providing pain relief QID
D. Monitoring the catheter drainage

107. For the past three days, a LPN has been taking care of a 33-year-old woman who underwent a total
thyroidectomy. Every morning, the LPN performs a blood test as prescribe, as well as calcemia monitoring. While
speaking to the LPN, the patient reports having difficulty swallowing and feeling a tingling sensation in her upper
limbs since her surgery. The nurse is informed of this and suspects hypocalcemia.
Given the patient’s condition, which of the following interventions would not be appropriate?

A. Verifying the morning blood test

B. Providing a high-calcium diet
C. Monitoring the patient’s neurological signs
D. Informing the patient of the symptoms of hypocalcemia

108. A 23-year-old patient is admitted to the psychiatric unit after attempting to tend his life by taking medication.
The patient was bullied during his youth, spent time in a drug treatment centre, and now lives in a rooming
house. The patient shows signs of depression, does not want to talk, and refuses to help he is offered.
Given the patient’s condition, which of the following interventions is appropriate?

A. Applying abdominal restraints

B. Checking on the patient q30min
C. Avoiding talking about suicidal thoughts in front of the patient
D. Collaborating with the patient to ensure his safety

109. In day medicine, a patient is receiving instructions for the home care of the tracheostomy he underwent for
laryngeal neoplasia. The instructions session is going well, but the patient says that, since the previous night, he’s
been feeling a pain rated 5/10 at the site of the tracheostomy and has noticed increased secretions. The LPN
 notices a yellowish discharge around the periphery of the tracheostomy. While taking the patient’s vital signs,
she notes an onset of hyperthermia at a buccal temperature of 37.9. The patient is scheduled to return home
today. The LPN immediately informs the informs the physician of the observed changes in the patient’s condition.
Given the patient’s condition, which of the following interventions should be done?

A. Decreasing the patient’s oral fluid intake

B. Changing the cannula using a clean technique
C. Urine a sterile technique to aspirate secretions
D. Changing the cannula every four to eight hours

110. A patient has a kidney stone for the first time, measuring 2 mm according to the renal ultrasound. The physician
immediately prescribes narcotic analgesic STAT to reduce the pain and help the patient expel the stone naturally.
Given the patient’s condition, which of the following interventions should be done?

A. Keeping the patient bedridden to help him rest

B. Performing a urinalysis using test strips
C. Collecting and filtering the patient’s urine to detect the stone
D. Encouraging the patient to drink cranberry juice

111. A beneficiary suffering from Alzheimer’s disease for the past five years is admitted to a CHSLD. Following a
discussion with the beneficiary’s family, the nurse decides to place her in a room with a half-door to keep her
from wandering off. During her afternoon visit, the LPN sees the beneficiary standing on her chair trying to climb
over the door. While bringing her back to bed, the LPN gives the beneficiary back the glasses she found in her
blankets and notices a sign of urinary incontinence.
Which of the following fall prevention measures is not appropriate in this situation?

A. Ensuring that the beneficiary wears well-fitting shoes

B. Ensuring that the beneficiary wears her glasses while walking
C. Removing the chair from the beneficiary’s room
D. Put a picture of a toilet on the commode chair

112. An 82-year old woman has been hospitalized in the department of medicine for decreased general condition
(DGC). Ever since her husband died six months ago, she no longer leaves her home and spends most of her time
lying down. Muscle weakness and atrophy caused by lack of exercise has impaired her mobility. Moreover, the
patient’s vision is diminished by the presence of cataracts. To help her move without falling, the LPN shows the
patient how to use a walker.
Which of the following fall prevention measures is not appropriate in this situation?

A. Ensuring that the patient’s walking aid is within reach

B. Placing the patient near the nursing station
C. Cleaning the patient’s glasses frequently while she waits for her cataract surgery
D. Dimming the lighting to prevent a glare

113. An LPN visits the home of a 38-year-old woman to check her ADL (activities of daily living) and DA (domestic
activities) needs. She observes that the interior of the client’s home is very cluttered. For the past few months,
the client has had severe labyrinthitis, and her physician suspects Meniere’s disease. The client experiences
dizziness and light-headedness whenever she makes twisting motions. She walks very slowly and becomes
discouraged when she has to move too far because her symptoms come on very quickly, causing her to stop her
activities without being able to finish them.
Which of the following fall prevention methods is appropriate in this situation?

1. Removing any obstacles form the floor

2. Giving the patient open shoes with a slip heel
 3. Setting up rest areas
4. Raising the patient quickly

A. 1 and 2
B. 1 and 3
C. 2 and 4
D. 3 and 4

114. On the first day of his knee prosthesis surgery, a 65-year-old man is found standing in his room at night during
one of the LPN’s usual rounds. He is pacing around his room, completely disoriented. He has removed his urinary
catheter, his IV solution, and his controlled analgesia (PCA). The blood at the IV site has not coagulated, and the
patient refuses to let the LPN touch him to stop the bleeding. He refuses to listen, raises his voice, and tells the
LPN to leave him alone while making fists. The LPN insists on placing a dressing at the site of the bleeding. The
patient takes his chair and throws it at the window.
Which intervention would not be appropriate to attenuate the patient’s disruptive behaviour?

A. Removing dangerous objects

B. Speaking softly to the patient
C. Asking for reinforcements
D. Avoiding physical contact with the patient

115. Among her pediatric patient’s a LPN must care for a hospitalized fifteen-year-old girl by monitoring her weight
gain as well a her food intake during meals. The patient’s weight and height are 48 kg and 1.67 m, respectively.
While cheking vital signs, the LPN, who had already advised the nurse, permanently installs a nasal cannula at
2L/min. The patient never answers questions, but keeps on requesting laxatives for what she says is chronic
constipation. When it’s time to change her nightgown, which is soiled from food, the patient refuses help
because she does not want the LPN to see her naked, saying she is too fat. The LPN discovers small snack bags
under the patient’s pillow, which are filled with food that’s been chewed and spat out.
Which intervention would be appropriate to attenuate the patient’s disruptive behaviour?

A. Maintaining a respectful and empathetic

B. Discussing the patient’s eating habits
C. Ignoring what you find under the patient’s pillow
D. Allowing the patient to prepare her own menus

116. During inter-departmental reporting, an LPN is informed that a 24-year-old woman, with fractures on both
wrists, was discharged from the hospital but refused to leave. The LPN enters the semi-private room to inquire
about the situation with the patient. The patient, looking frightened, begins to cry. She confesses to the LPN that
she threw herself from the balcony on the second floor to save herself from her violent partner. She does not
want to go back home because she feels she is in danger. She threatens to commit suicide if she doesn’t receive
help.
Which intervention would be appropriate for controlling the patient’s disruptive behaviour?

A. Speaking with the patient in private

B. Speaking with the patient in the presence of her family
C. Offering to host the patient
D. Giving advice to the patient
Applying Care Methods

117. An LPN who works in the surgery unit must perform a capillary glycemia on a 62-year-old patient who is allergic
to disinfectants. The steps for performing a capillary glycemia are presented out of order below.
1. Apply a compress to the puncture site
2. Wash the patient’s hands with warm water
3. Record the test results in the patient’s file
4. Massage the puncture site
5. Put on non-sterile gloves

Select the order in which the procedure should be performed.

Answer choices

A. 5, 2, 1, 4, 3
B. 2, 5, 1, 4, 3
C. 5, 2, 4, 1, 3
D. 2, 5, 4, 1, 3

118. A beneficiary living in a CHSLD has developed a left lateral malleolus wound. Since the beneficiary is an MRSA
carrier, the RN asks that additional contact precautions be taken. The physician has prescribed a wound culture.
When the LPN removes the old dressing, she notes the presence of purulent exudate. She performs the wound
culture and applies a new dressing. The steps for collecting a sample for a wound culture are presented out of
order below.
1. Put on non-sterile gloves
2. Put on sterile gloves
3. Put on a long-sleeved gown
4. Clean the wound and collect the sample
5. Place the beneficiary in the right lateral decubitus position

Select the order in which the procedure should be performed.

Answer choices

A. 1, 3, 5, 2, 4
B. 1, 3, 2, 5, 4
C. 3, 1, 5, 2, 4
D. 3, 2, 1, 5, 4

119. An LPN working in a CHSLD must perform tracheostomy care on a 55-year-old beneficiary using a disposable
inner cannula. The steps for providing tracheostomy care are presented out of order below.
1. Remove and dispose of the inner cannula
2. Gently insert the inner cannula into the outer cannula
3. Open the latch and unlock the inner cannula
4. Perform proper hand hygiene and put on sterile gloves
5. Remove the soiled tracheostomy dressing

Select the order in which the procedure should be performed.

A. 5, 3, 1, 4, 2
B. 4, 5, 3, 1, 2
C. 5, 4, 3, 1, 2
D. 4, 5, 1, 3, 2
120. A patient has been hospitalized for diverticulitis. He says he feels a swelling in his stomach accompanied by
cramps. He is anxious because of the paraclinical exams he underwent this morning. Given the patient’s
condition, the physician gives the following prescription:
- Analgesic (acetaminophen) 650 mg PO q4h PRN 325 mg/co if abdominal pain
- Anxiolytic (clonazepam) 0.5 mg PO STAT 0.5mg/co.
- Rectal tube STAT

Upon insertion of the rectal tube, the patient develops diaphoresis, and becomes pale and agitated. The steps
for the inserting a rectal tube are presented out of order below.
1. Stop the insertion
2. Insert the rectal tube 10 cm into the anus
3. Lubricate the proximal end of the rectal tube
4. Place the patient in the left lateral decubitus position
5. Take the vital signs

Select the order in which the procedure should be performed.

A. 3, 4, 2, 5, 1
B. 4, 3, 2, 5, 1
C. 4, 3, 2, 1, 5
D. 3, 4, 2, 1, 5

121. A hospitalized patient in the cardiology unit is receiving anticoagulant therapy. The LPN prepares to take a blood
sample by venipuncture at the crease of the patient’s left elbow. The patient said he doesn’t like needles at all
and that he often gets bruises on his arms.
Which of the following interventions is most appropriate for promoting hemostasis?

A. Applying firm pressure for one minute

B. Bending the elbow for one minute
C. Applying firm pressure for five minutes
D. Bending the elbow for five minutes

122. A patient is hospitalized for hyperthermia. The patient has bladder cancer and uses a urinary catheter. Her urine
is orange and cloudy, and gives off a strong, foul-smelling odor. The patient is calm and cooperative while
receiving care. The LPN must collect a sample for a blood culture. Everything goes well with the first bottle, but
the LPN is unable to obtain the necessary amount of blood for the second one. In fact, she is only able to collect a
few drops at first, but no more afterwards. She repositions the needle, but to no avail.
Which of the following actions must be carried out by the LPN?

A. Taking a complete sample (both bottles) from another site

B. Collecting a sample from another site to fill a second bottle
C. Sending the two bottles to the laboratory in their current state
D. Collecting a sample from another site to finish filling the second bottle

123. A beneficiary with Alzheimer’s dementia is very agitated and confused. She fell out of her bed during the night,
and the physician has therefore prescribed a magnetic abdominal restraint for when she is in bed. The LPN who
works at night installs the beneficiary’s restraint for the first time, as prescribed, and ensures follow-up.
What would be the appropriate follow-up?

A. Checking on the beneficiary every two hours

B. Limiting the interventions performed on the beneficiary
C. Removing the restraint for 15 minutes every two hours
D. Removing the restraint if the beneficiary is no longer agitated
124. A patient is hospitalized in the neurological unit for epileptic seizures. The LPN must change the short
intravenous catheter of less than 7.5 cm that has been in place for three days, as instructed by the care plan.
While removing the transparent film dressing, the LPN notices a significant redness and slight edema on the skin
at the exact location of the dressing. The patient feels no pain and says that the redness and edema are normal,
since her skin always reacts to dressings.
What would be the appropriate follow-up?

A. Waiting until the redness disappears before reinstalling another catheter

B. Notifying the RN, who will then evaluate the possibility of using another type of catheter fixation
C. Applying a warm compress to the red area to help reduce edema
D. Administering an antihistamine according to the collective prescription

125. An LPN providing common services at a CLSC must administer an influenza vaccine. A client arrives and says that
the last time she received a vaccine, she had respiratory problems afterwards. She also tells the LPN that she
often gets allergic reactions.
What would be the appropriate follow-up?

A. Advising the patient to stay on site for 10 minutes

B. Applying emergency measures as needed
C. Ensuring that an RN stays in the building
D. Assessing the patient’s condition until she leaves

126. A 75-year-old patient is hospitalized in the surgery unit for a left hip arthroplasty. He has a history of heart
problems and must comply with a fluid restriction of 1L per day. He is on his third day post-op, and his urinary
catheter was removed this morning at 6:00 am. It is now 2:00 pm, and the patient has not urinated nor felt the
urge to do so.
What would be the appropriate follow-up?

A. Increasing hydration to promote urinary excretion

B. Ensuring the patient can urinate freely within eight hours after removing the catheter
C. Performing a urinary catheterization before leaving your shift
D. Using an ultrasound to check the amount of urine in the bladder after removing the catheter

127. A patient has been hospitalized in the medical unit for the past week. He is suffering from chronic bronchitis and
pneumonia. At 8:00 am, the patient feels pain in his rib cage rated at 6/10. He then receives 1000 mg of non-
narcotic analgesic. His vital signs are the following: BP at 155/90, pulse at 90 bpm, resp. at 18 bpm, SpO2 at 92%,
and buccal temperature at 38.2. at 9:00 am, the LPN observes that the patient has dyspnea, upon strain. She
takes the patient’s vital signs, which are as follows: BP at 140/78, pulse at 74 bpm, resp. 24 bpm, SpO2 at 86%,
buccal temperature at 38.4, and a pain rate 6/10. After verifying the documents and receiving authorization from
the RN, the LPN reinstalls 1.5L of O2 via nasal cannula.
What would be the appropriate follow-up?

A. Increasing the O2 flow rate after 30 minutes

B. Measuring SpO2 30 minutes after oxygen therapy begins
C. Having the patient perform respiratory exercised for 5 min q1h
D. Verifying pulse and blood pressure

128. An 8-year-old patient received an operation this morning for reduction of a double fracture in his right leg. It is
5:30 pm, and the young patient is becoming increasingly agitated. He moves a lot, says he has a sore leg, and asks
that his cast be removed. The LPN collects the patient’s data and notes the following: BP at 124/80, pulse at 104
bpm, resp. at 18 bpm, and SpO2 at 98%. The boy responds well to questions, but has numbness in his right leg.
His pupils are reactive and symmetrical.
Which of the following signs shown by the patient indicated a neurovascular complication?
 a. Increased heart rate
b. Orientation in all three spheres
c. Numbness in the right leg
d. Reactive and symmetrical

129. A 68-year-old snowmobiler has been hospitalized for two days following a collision with another snowmobiler.
He had ended up in a ditch, stuck under his snowmobile for several minutes. He fractured his right femur and his
pelvis, and is now on bed rest. At 10:00 am, while monitoring the patient’s NVS, the LPN collects the following
data:
RLE LLE
- Temperature: lukewarm - Temperature: lukewarm
- Colour: pale - Colour: pale
- Mobility: can move toes - Mobility: can move toes
- Sensitivity: good - Sensitivity: good
- Pedal pulse: detected by doppler - Pedal pulse: present

At 2:00 pm, the LPN monitors the patient’s NVS once again, and collects the following data:

RLE LLE
- Temperature: cold - Temperature: cold
- Colour: pale - Colour: pale
- Mobility: none - Mobility: can move toes
- Sensitivity: none - Sensitivity: numbness
- Pedal and tibial pulse: absent - Pedal pulse: weak

Which of the following signs indicates a neurovascular complication?

A. Lukewarm lower extremities

B. Mobile LLEs
C. Good sensitivity in the LEs
D. Absent pedal and tibial in the RLE

130. A 28-year-old patient in the neurological unit following an accident at a construction site. He took a heavy fall on
his back, and fractured his L2 and L3 vertebrae. He has to wear a corset at all times and must be mobilized by log-
roll techniques at all times. His lower extremities are numb and cold, and he is unable to move his toes. He is
responsive to pain, and his pedal pulses are weak. Before completing her night shift, the LPN verifies the patient’s
NVS and notes the following:

RLE
- Temperature: cold
- Colour: pale
- Mobility: none
- Sensitivity: numbness
- Pedal pulse: weak
LLE
- Temperature: warm
- Colour: red
- Mobility: none
- Sensitivity: sharp pain
- Pedal pulse: weak

Which of the following signs shown by the patient indicates a neurovascular complication?
 A. Sharp pain in the LLE
B. Cold lower extremities
C. Numbness in the RLE
D. Weak pedal pulse in the RLE

131. In the rehabilitation unit, a patient is recovering from a stroke on the left side of the brain. She has expressive
aphasia, right hemiparesis, and unilateral spatial neglect. Her pupils are reactive and normal, and she possesses
good muscular strength in both and lower left extremities. It is 6:00 am, and the LPN collects the patient’s blood
samples. She notices that the patient’s mouth is deviated to the left and that the patient feels drowsier than she
did yesterday. The patient opens her eyes as a reaction to verbal stimuli, but closes them within seconds. The
LPN verifies the patient’s neurological signs and collects the following data:
- Left pupil fixed in mydriasis, right pupil reactive and normal
- RUE no reaction
- LUE average muscular strength
- RLE no reaction
- LLE average muscular strength
The LPN immediately notifies the RN.
Which of the following signs shown by the patient indicates a neurological complication?

A. Diminished muscular strength in the LLE and LUE

B. Left pupil fixed in mydriasis
C. Reactive right pupil
D. Difficulty answering questions

132. A 7-month-old infant is hospitalized after off his changing table. The LPN observes significant bruising on the
baby’s front and around his eye sockets. The baby cries when the LPN performs a venipuncture. His pupils are
uneven, and slow to react. The physician asks that the infant’s neurological signs be monitored for the next 24
hours.
Which of the following signs shown by the patient indicates a neurological complication?

A. Responsiveness to pain
B. Bruising on the front
C. Asymmetrical pupils
D. Slow-reacting pupils

133. A 65-year-old client with a history of diabetes and high blood pressure receives treatment at home for an ulcer
on her right foot and cellulitis at the bottom of her right leg. During the last few visits, her vital signs were
normal. The client is currently taking the following medications: a hypoglycemic, an antihypertensive beta-
blocker, and angiotensin-converting enzyme (ACE) inhibitor, a thiazide diuretic, and an antibiotic. The LPN visits
the client every day to take her vital signs. Today, the results are the following: BP at 90/56, pulse at 94 bpm,
resp. at 20 bpm, SpO2 at 96%, and buccal temperature at 37.2. While the LPN is reapplying the dressing, the
client says that she feel pain in her right leg.
Which of the following possible complications are indicated by the client’s vital signs?

A. Hypertension
B. Hypotension
C. Hyperthermia
D. Bradycardia

134. A patient with lung cancer is hospitalized for an infection. For the past few weeks, she has been taking
anticoagulants and corticosteroids. She also gets headaches, and has gained five pounds in a way that gives her a
swollen appearance. The physician has prescribed IM antibiotics. At 9:00 am, the LPN takes the patient’s vital
 signs, which are as follows: BP at 170/90, pulse at 80 bpm, resp. at 18 bpm, SpO2 at 96%, and buccal temperature
at 37.5.
What is the main reason for the patient’s unbalanced vital signs?

A. The patient’s blood is too viscous

B. The takes antibiotics
C. The patient has gained weight
D. The patient has to drain excess fluid

135. An LPN visits a 75-year-old who recently moved into a private seniors’ residence. The man used to live alone, but
ever since his wife died a year ago, his independence has diminished considerably. He says he does not know
how to cook, so he’s been buying prepared meals and canned food. He has put on 25 kg over the past few
months, and now weighs a total of 95 kg at a height of 1.7 metres. He used to smoke four to five cigarettes a day,
but now he smokes almost one pack a day. The patient becomes dyspneic at the slightest effort and the LPN
observes significant edema at the ankles. The physician asked the LPN to visit the client weekly to take his vital
signs and monitor his breathing. This morning, the LPN collects the following data: BP at 130/88, pulse at 88 bpm,
wheezing at 24 bpm, SpO2 at 95%, and buccal temperature at 36.4.
Which of the following possible complications are indicated by the client’s vital signs?

A. Tachypnea
B. Hypertension
C. Saturation
D. Tachycardia
Code of Ethics

136. A patient suffered a stroke that left her hemiplegic on the left side. She grows signs of dysphagia, dysphagia and
hemianopsia. The physician tells her she will be transferred to physical rehabilitation. This news causes her some
stress, and since then she has had trouble sleeping. The quality care provided by the LPN, and the relationship of
trust she’s established with the patient over the past few weeks, is making it even more difficult for the patient
to leave for another department. The day before her transfer, the patient asks the LPN to make a prognosis
about her possibilities for functional rehabilitation.
What should the LPN do in this situation?

A. Reassess the patient’s physical limitations

B. Guarantee a remission of at least 50%
C. Reassure the patient that everything will be fine
D. Refer the patient to her physician

137. A 55-year-old woman at the emergency room following a sudden onset of fever associated with respiratory
problems. The physician diagnoses SARS, and the patient is placed in isolation in the medical unit. Since her
admission, the patient is confused and has difficulty expressing herself. When family members come to the room,
they are greeted by the LPN.
What should the LPN do in this situation?

A. Explain to the family the measures to be taken

B. Allow the family members to visit the patient for a few minutes
C. Ensure compliance with proper hand hygiene only
D. Prohibiting the family members from visiting

138. This morning, in the dining room of a CHSLD, a 72-year-old beneficiary with Alzheimer’s dementia is agitated,
shouting, and wants to hit everyone. The LPN, who has worked for more than thirteen years in this environment,
intervenes by speaking louder than the beneficiary and roughly seating louder than the beneficiary and roughly
seating him back in his chair. She asks her new colleague to go get a sedative. After, the LPN tells her colleague
that when dealing with disruptive behaviour, it’s necessary to act the way she did regardless of the patient’s
illness. The LPN tells her colleague that when dealing with disruptive behaviour, it’s necessary to act the way she
did regardless f the patient’s illness. The LPN’s colleague, however, is unsettled by what she witnessed.
What should the LPN have done in this situation?

A. Use an abdominal restraint on the patient’s seat

B. Administer a neuroleptic tablet
C. Negotiate with the beneficiary
D. Provide a quiet environment for the beneficiary

139. A 32-year-old single mother is admitted for a second time to the psychiatric unit for drug and alcohol abuse. A
few days later, the patient’s condition has greatly improved with the adequate medication. The psychiatrist signs
the patient’s discharge and refers her to the CLSC. Before the patient leaves, the LPN ask her to sign a consent
form allowing the CLSC to do a follow-up. The patient adamantly refuses to sign the consent form. The LPN tell
the patient that she has a responsibility to her child and that failure to accept follow-up may have consequences.
She suggests to the patient to reconsider her decision.
What should the LPN do in this situation?

A. Persuade the patient of the benefits of psychosocial monitoring

B. Notify the CLSC of the referral
C. Refer the patient to an intervention centre specializing in drug addiction
D. Respect the patient’s decision
140. A 38-year-old LPN, who works in long-term care, is often on duty for more than sixteen consecutive hours
because of mandatory overtime. She is currently experiencing person and financial difficulties following a
divorce. For the past few weeks, she’s had trouble concentrating while performing her duties due to exhaustion
and frequent memory loss. Mistakes related to patient care are accumulating. Just today, a colleague told her
that she failed to administer a patient’s morning insulin dose. The LPN is well aware her frequent errors are
affecting the quality of her patient care. She finds that her professional situation is deteriorating and that she is
becoming less and less empathetic with patients and colleagues. She is also afraid of receiving a disciplinary
notice if she refuses to work overtime.
Which of the following interventions would not be appropriate?

A. Respecting one’s physical and psychological limits

B. Filling out an incident or accident report
C. Speaking with the nurse
D. Requesting more staff for the unit

141. A two-year-old boy is hospitalized in the pediatric ward for bronchitis. Around 3:45 pm, the chid wants to get
out of bed ends falling. While the LPN tries to reassure the crying child, she takes his vital signs and carefully
examines his skin. She notices redness and edema on his right arm. Before leaving her shift at 4:00 pm, the LPN
writes the patient’s progress notes without mentioning that the child fell. When she returned to work at 8:00 the
next morning, the LPN consults the progress notes made since she left, and notices that her young patient has a
humerus fracture.
What should the LPN have done in this situation?

A. Accurately report the incident

B. Modify her notes in the patient’s file
C. Further assess the child’s physical condition
D. Apologize to the nurse

142. An LPN has been working in the medical unit for five years. She is appreciated by her colleagues for her
dedication, sense of humor and availability to team members. This morning, she prepares a 4 mg tablet of
narcotic analgesic (Dilaudid) to be administered to a patient recovering from orthopaedic surgery. She has it
checked by the nurse in charge and signs the register. The LPN goes to the patient’s room to administer the
tablet. Another LPN walking in the same direction sees her swallow the patient’s tablet and replace it with two
acetaminophen tablets she removes form her uniform.
Which of the following actions should be a priority for the LPN witnessing this incident?

A. Monitoring the care given to the patient

B. Informing his colleague that her conduct is unacceptable
C. Notifying the head of the department
D. Seeking advice from a colleague

143. This afternoon, ambulance services inform emergency staff that a chairlift has just collapsed at a ski resort,
leaving two teenagers seriously injured. The first teenage is sent to surgery for cerebral hemmorrhage. The LPN
has just begun her shift in the surgical ward. As she enter the operating room, she realizes that it’s her son who
has just been placed on the operating table. Terrified, she tried to regain her composure.
What should the LPN do in this situation?

A. Continue her shift

B. See if someone can replace her
C. Control her panic
D. Leave the premises
144. A 53-year-old woman has just been admitted to the department of oncology for breast cancer. The oncologist is
considering an ablation because the prescribed treatments have not produced the desired results. The patient’s
husband, who owns a performance hall gives the LPN caring for his wife an envelope containing a pair of tickets
to a concert put on by an international group. He wants to ensure that his wife receives the best care and insists
at length with the LPN. He tells her he will get upset if she refuses.
What should the LPN do in this situation?

A. Refuse the tickets

B. Thank the patient’s husband for the gift
C. Keep one ticket and invite a colleague
D. Draw the tickets among the other workers in the unit

145. It is 8:15 am and a physician prescribes blood test “stat” to a diabetic patient with renal failure in order to
determine treatment. Overwhelmed with work, the LPN collects the blood sample after taking her lunch break,
but does not send it to the laboratory until the end of her shift.
What would have been the best intervention in this situation?

A. Carefully taking the blood sample

B. Prioritization the physician’s request
C. Asking a colleague to take the blood sample
D. Immediately forwarding the blood sample

146. An LPN has been working at a CHSLD for two years. She is recognized for the quality of her interventions and the
adherence to her schedules. This morning, she has to leave her house in a rush so she would not be late. It is
10:00 am, and she is about to take her scheduled break so she can finally eat something to help the nausea and
dizziness caused by her morning rush. Before leaving for her break, a beneficiary stops her to say he has severe
arthritic pain in his hands and that he needs a painkiller. The LPN reassures him that she will be back in 20
minutes.
What would have been the best intervention in this situation?

A. Taking her break a scheduled

B. Telling the beneficiary about her current condition
C. Immediately attending to the patient’s request
D. Authorizing the beneficiary attendant to administer the painkiller

147. An LPN working in the working in the medical unit receives a 42-year-old man who is in remission from lung
cancer. He has been hospitalized for a virus affecting his lungs. The LPN confides in a colleague that she feels
upset and very emotional every time she cares for the patient because his condition makes her relive the struggle
she went through with her husband, who died the same cancer. Consequently she is starting to doubt her clinical
judgement.
What should the LPN do in this situation?

A. Ask her colleague to replace her in caring for the patient

B. Continue to care for the patient
C. Speak with the nurse in charge
D. Confide in the patient

148. For two weeks, a 36-year-old LPN working in a psychiatric centre has been caring for a 32-year-old patient
suffering from major depression. The patient especially appreciates the listening and safety provided by the LPN.
While caring for the patient, the LPN learns that the patient is currently going through a divorce. When she gets
home one night, the LPN notices a friend request from the patient on one of her social networks.
Which of the following behviours is compliant with the LPN’s duties and responsibilities?
 A. Accepting the friend request to maintain a relationship of trust
B. Asking the patient to be discreet
C. Refusing the patient’s friend request and explaining this to the patient in person
D. Refusing the patient’s friend request and explaining this to the patient in a private message

149. An LPN has been working at the postoperative unit for five years. She is currently providing care to a patient
who has sustained various gunshot wounds, one of which a splenectomy. While the LPN is changing his dressings,
the patient confides in her that he knows the identity of his attacker. After giving a name, he tells the LPN that he
vows to get revenge once he gets out of the hospital. He also tells the LPN to keep this information confidential.
What should the LPN do in this situation?

A. Report the patient the public authorities

B. Respect the patient’s request
C. Enter this information in the patient’s record
D. Speak with the nurse in charge
Scope of Practice

150. Under the Professional Code, LPN’s may apply invasive measures for the maintenance of therapeutic
equipment.
Which of the following care methods does not relate to this activity?

A. Draining a peritoneal catheter used in dialysis

B. Cleaning the inner cannula of a tracheostomy tube
C. Performing a closed intermittent bladder irrigation using a three-way catheter
D. Providing skin care around percutaneous drain

151. LPN’s work in medicine and must take several types of specimens during their work day.
Which type of specimen would not be taken by an LPN in their field of practice?

A. Heel capillary punctures

B. Lumbar punctures
C. Gastric secretion specimens
D. Ear secretion specimens

152. A beneficiary is admitted to the medical unit. She has a sacral pressure wound covered with necrotic tissue. It is
a stage 4 with dimensions of 5 cm by 2.5 cm.
Which of the following wound care activities are reserved for LPN’s?

1. Applying a sterile dressing

2. Debriding the wound with a scalpel
3. Assessing the wound’s evolution
4. Irrigating the wound with a saline solution

A. 1 and 2
B. 1 and 4
C. 2 and 3
D. 3 and 4

153. In their field of practice, LPN’s may provide care and treatment for wounds.
Which of the following activities does not relate to those reserved for LPN’s in wound care and treatment?

A. Changing the initial post-operative dressing

B. Disinfecting the wound with a saline solution
C. Applying a sterile bandage with a drain
D. Treating cuts with stitches

154. A patient is admitted to the medical unit after suffering a stroke following his hockey training. The RN notes in
her TNP to monitor the patient’s state of consciousness.
Which of the following activities does not relate to those reserved for LPN’s in observing a patient’s sate of
consciousness?

A. Monitoring muscle function

B. Checking he capillary filling time
C. Checking pupil reflex
D. Checking spoken word stimuli

155. Pharmacotherapy care practices are shared between RNs & LPNs. The latter may, when required, mix
substances to prepare medication.
 Which of the following care methods is in the scope of LPN’s field of practice?

A. Adding medication to dialysis fluid

B. Adding adjuvants to intramuscular vaccines
C. Mixing medication for intravenous administration
D. Preparing NaCl and an anticoagulant for maintenance of an intravenous catheter

156. This morning, a CHSLD beneficiary says she has pain in the joints of her right hand. According to the beneficiary’s
MAR, nothing is prescribed. However, a collective prescription is available for pain relief.
What is the main action the LPN must perform before she can administer the available collective prescription?

A. Explain the medication’s side effects to the beneficiary

B. Have the beneficiary assessed and obtain authorization from the physician or RN
C. Verify that the beneficiary is not allergic to the prescribed medication
D. Verify that the beneficiary meets the requirements for the prescription

157. A diabetic patient has just given birth to her first child. Her blood glucose level is 12 mmol/L. The physician
prescribes both a fast-acting SC insulin.
Which of the following activities is not in the scope of those reserved for LPN’s when administering
medication?

A. Mixing both types of insulin in the same syringe

B. Preparing the insulin pen
C. Administering insulin in a 100ml bolus
D. Installing a SC insulin pump

158. An LPN who has been working in palliative care for a few years has gained considerable experience in
administering medications. She is responsible for training new LPN’s in the department. Since the LPN plays an
important role in drug therapy activities, she can administer medications or substances, in accordance with a
prescription.
Which of the following interventions is the LPN not permitted to perform?

A. Administering a narcotic analgesic via gastrostomy

B. Administering an enema via colostomy
C. Applying a local anesthetic via pharynx
D. Giving an analgesic via peripheral nerve block

159. An LPN working at CLSC has just received training on administering Engerix B10 vaccine. She is asked to
participate in a Hepatitis B vaccination campaign for fourth grade students at a primary school.
Which of the following activities are in the scope of those reserved for LPN’s in administering vaccines?

1. Administering the vaccine in the presence of the RN

2. Administering the vaccine without a prescription
3. Informing the Director of Public Health of unusual manifestations
4. Filling out the vaccination booklet

A. 1 and 2
B. 1 and 4
C. 2 and 3
D. 3 and 4

160. LPN may introduce an instrument or a finger, according to a prescription, beyond the nasal vertibule, labia
majora, urinary meatus or anal margin or into artificial opening in the human body.
 Which of the following intervention are LPN’s not permitted to perform?

A. Aspirating nasal secretions with a bulb syringe

B. Inserting an endotracheal intubation probe
C. Installing a nasogastric feeding tube
D. Using a vaginal speculum to take a specimen

161. The Professional Code, which determine LPN’s field of practice, reserves nine activities for them, which include
introducing an instrument into a peripheral vein in order to take a specimen, according to a prescription.
Which of the following activities are in the scope of those reserved for LPN’s when taking a blood specimen?

1. Taking specimens on behalf on Hema-Quebec

2. Taking specimens via arterial route to measure arterial gasometry
3. Taking specimens for liver function tests
4. Taking specimens via central venous catheter

A. 1 and 2
B. 1 and 3
C. 2 and 4
D. 3 and 4

162. A physician prescribes an intravenous infusion to a fifteen-year-old patient who suffers from peritonitis as a
result of a ruptured appendix.
Which of the following activities is not in the scope of practice of those authorized for LPN’s during intravenous
therapy?

A. Setting up IV fluid with a butterfly needle

B. Setting up physiological saline using a short peripheral intravenous catheter
C. Setting up KCl solution using a short peripheral intravenous catheter
D. Installing a short peripheral catheter connected to an infusion pump

163. Under the Regulation respecting certain profession activities which may be engaged in by nursing assistants, and
in accordance with certain conditions described in that regulation, LPN’s may contribute to IV therapy.
Which of the following care methods related tot his activity is not permitted for LPN’s?

A. Installing a short peripheral catheter measuring less than 7.5 cm for a fifteen-year-old child
B. Installing a short peripheral catheter measuring less than 7.5 cm for a twelve-year-old child
C. Removing a short peripheral catheter measuring less than 7.5 cm for a two-year-old child
D. Checking an eight-year-old child’s intravenous and maintaining the flow rate

164. A 75-year-old patient is admitted to the emergency room for pulmonary emphysema. His morning cough causes
him to coughing up whitish secretions, and his dyspnea prevents him from caring for his hygiene. He continuously
receives oxygen at 2L/min via nasal cannula.
Which of the following activities concerning the TNP is in the line with those reserved for LPN’s?

A. Assessing the patient and drawing up a clinical profile

B. Recording new data regarding follow-up into the TNP
C. Entering their initials once an intervention is over
D. Providing patient care and treatment, as directed

165. The Reglement sur la formation continue obligatoire des infirmieres et infirmiers auxilliaires du Quebec
(obligation of continuing training) came in effect on March 29th, 2007.
Which of the following obligations apply to LPN’s?
A. Completing five continuing education hours per one-year reference period
B. Completing at least one continuing education activity per two-year reference period
C. Completing ten continuing education hours per two-year reference period
D. Completing twenty continuing education hours per three-year reference