LPN Module 4 Exam: Medical-Surgical Nursing I (2026 Update)
1. A nurse is caring for a patient with hypokalemia. Which of the following is a
common clinical manifestation of this electrolyte imbalance?
A. Muscle weakness and leg cramps
B. Hyperactive bowel sounds
C. Peaked T-waves on ECG
D. Positive Trousseau’s sign
Answer: A
Rationale: Hypokalemia commonly causes muscle weakness, fatigue, and leg cramps due
to the effect on neuromuscular excitability. Peaked T-waves are seen in hyperkalemia, and
Trousseau’s sign is associated with hypocalcemia.
2. Which vital sign should the LPN/LVN report immediately for a patient who is
4 hours post-operative following abdominal surgery?
A. Heart rate 118 beats per minute
B. Temperature 99.1°F (37.3°C)
C. Blood pressure 110/70 mmHg
D. Respiratory rate 18 breaths per minute
Answer: A
Rationale: Tachycardia (HR > 100) in a post-operative patient can be an early sign of
hemorrhage, hypovolemia, or pain and should be reported immediately.
,3. A patient is scheduled for a procedure requiring informed consent. What is
the nurse’s primary responsibility regarding the consent form?
A. Explaining the risks and benefits of the surgery
B. Witnessing the patient’s signature
C. Obtaining the consent if the surgeon is busy
D. Deciding if the patient should have the surgery
Answer: B
Rationale: The nurse’s role is to witness the patient’s signature, confirming that the
patient is competent and signed voluntarily. The surgeon is responsible for explaining the
procedure, risks, and benefits.
4. An LPN is monitoring a patient receiving a blood transfusion. Which symptom
most likely indicates a hemolytic transfusion reaction?
A. Dry cough and crackles
B. Urticaria and itching
C. Distended neck veins
D. Low back pain and hypotension
Answer: D
Rationale: Hemolytic reactions are characterized by low back pain, chills, fever, and
hypotension. Urticaria suggests an allergic reaction, while neck vein distension and
crackles suggest fluid overload.
5. A patient with COPD is receiving oxygen via nasal cannula. Why is it
important to maintain the flow rate at 2L/min or less for this patient?
A. To prevent oxygen toxicity to the eyes
B. To avoid drying out the nasal mucosa
C. To prevent the loss of the hypoxic drive to breathe
D. To reduce the risk of spontaneous pneumothorax
Answer: C
, Rationale: In some COPD patients with chronic hypercapnia, the stimulus to breathe is low
oxygen levels (hypoxic drive). High oxygen levels can suppress this drive, leading to
respiratory arrest.
6. A nurse is reinforcing teaching for a patient with Type 1 Diabetes about foot
care. Which statement by the patient indicates a need for further teaching?
A. I will check my feet every day for cuts or redness.
B. I will wear well-fitting shoes at all times.
C. I will soak my feet in hot water to improve circulation.
D. I will apply lotion to my feet but not between the toes.
Answer: C
Rationale: Diabetic patients should never soak their feet in hot water or use heating pads
because peripheral neuropathy prevents them from sensing burns. Keeping feet dry
(especially between toes) prevents fungal infections.
7. Which of the following is a characteristic sign of right-sided heart failure?
A. Pulmonary edema
B. Dyspnea on exertion
C. Crackles in the lungs
D. Peripheral edema and JVD
Answer: D
Rationale: Right-sided heart failure causes systemic congestion, resulting in peripheral
edema, jugular venous distention (JVD), and hepatomegaly. Left-sided failure causes
pulmonary symptoms.
1. A nurse is caring for a patient with hypokalemia. Which of the following is a
common clinical manifestation of this electrolyte imbalance?
A. Muscle weakness and leg cramps
B. Hyperactive bowel sounds
C. Peaked T-waves on ECG
D. Positive Trousseau’s sign
Answer: A
Rationale: Hypokalemia commonly causes muscle weakness, fatigue, and leg cramps due
to the effect on neuromuscular excitability. Peaked T-waves are seen in hyperkalemia, and
Trousseau’s sign is associated with hypocalcemia.
2. Which vital sign should the LPN/LVN report immediately for a patient who is
4 hours post-operative following abdominal surgery?
A. Heart rate 118 beats per minute
B. Temperature 99.1°F (37.3°C)
C. Blood pressure 110/70 mmHg
D. Respiratory rate 18 breaths per minute
Answer: A
Rationale: Tachycardia (HR > 100) in a post-operative patient can be an early sign of
hemorrhage, hypovolemia, or pain and should be reported immediately.
,3. A patient is scheduled for a procedure requiring informed consent. What is
the nurse’s primary responsibility regarding the consent form?
A. Explaining the risks and benefits of the surgery
B. Witnessing the patient’s signature
C. Obtaining the consent if the surgeon is busy
D. Deciding if the patient should have the surgery
Answer: B
Rationale: The nurse’s role is to witness the patient’s signature, confirming that the
patient is competent and signed voluntarily. The surgeon is responsible for explaining the
procedure, risks, and benefits.
4. An LPN is monitoring a patient receiving a blood transfusion. Which symptom
most likely indicates a hemolytic transfusion reaction?
A. Dry cough and crackles
B. Urticaria and itching
C. Distended neck veins
D. Low back pain and hypotension
Answer: D
Rationale: Hemolytic reactions are characterized by low back pain, chills, fever, and
hypotension. Urticaria suggests an allergic reaction, while neck vein distension and
crackles suggest fluid overload.
5. A patient with COPD is receiving oxygen via nasal cannula. Why is it
important to maintain the flow rate at 2L/min or less for this patient?
A. To prevent oxygen toxicity to the eyes
B. To avoid drying out the nasal mucosa
C. To prevent the loss of the hypoxic drive to breathe
D. To reduce the risk of spontaneous pneumothorax
Answer: C
, Rationale: In some COPD patients with chronic hypercapnia, the stimulus to breathe is low
oxygen levels (hypoxic drive). High oxygen levels can suppress this drive, leading to
respiratory arrest.
6. A nurse is reinforcing teaching for a patient with Type 1 Diabetes about foot
care. Which statement by the patient indicates a need for further teaching?
A. I will check my feet every day for cuts or redness.
B. I will wear well-fitting shoes at all times.
C. I will soak my feet in hot water to improve circulation.
D. I will apply lotion to my feet but not between the toes.
Answer: C
Rationale: Diabetic patients should never soak their feet in hot water or use heating pads
because peripheral neuropathy prevents them from sensing burns. Keeping feet dry
(especially between toes) prevents fungal infections.
7. Which of the following is a characteristic sign of right-sided heart failure?
A. Pulmonary edema
B. Dyspnea on exertion
C. Crackles in the lungs
D. Peripheral edema and JVD
Answer: D
Rationale: Right-sided heart failure causes systemic congestion, resulting in peripheral
edema, jugular venous distention (JVD), and hepatomegaly. Left-sided failure causes
pulmonary symptoms.
