Quiz 4

1. Marie-Claire Tremblay, a 54-year-old woman, arrives in the Emergency Department after fainting in a department store. She mentions that she's been fasting for the past 24 hours as part of a detox program. Her initial assessment shows she is pale and has ketones in her urine. The doctor suspects metabolic acidosis due to starvation and orders an arterial blood gas (ABG) test to assess her acid-base balance. As the assigned Licensed Practical Nurse (LPN), you review the order. As an LPN, what is the most appropriate action in response to the ABG order? *
2. The LPN can obtain Venous Blood Gases (VBG) as prescribed. *
3. Mélissa, a Licensed Practical Nurse (LPN), is working in the neonatal unit caring for Alexandre, a premature newborn admitted for respiratory support. Alexandre's physician orders a capillary blood gas (CBG) sample to monitor his oxygenation and acid-base status. As an LPN, Mélissa reviews the order and prepares to carry out the sampling.
As the assigned LPN, what is the most appropriate action for Mélissa in response to the capillary blood gas order? *
4. Sophie, a Licensed Practical Nurse (LPN), is working the evening shift in a rural clinic when a 68-year-old patient, Mr. Claude Bergeron, arrives complaining of severe shortness of breath. Mr. Bergeron has a known history of chronic obstructive pulmonary disease (COPD) and frequently requires supplemental oxygen. His respiratory rate is 30 breaths per minute, and he appears to be in respiratory distress. The RN and physician are both currently attending to an emergency case in another area and are unavailable. Sophie considers installing a nasopharyngeal cannula to help Mr. Bergeron breathe more comfortably. As the LPN, what is the most appropriate action for Sophie in this situation? *
5. Jean-Pierre, a 68-year-old man with a history of chronic obstructive pulmonary disease (COPD) and sleep apnea, is recovering from a recent tracheostomy. During your assessment as the LPN, you notice Jean-Pierre has difficulty breathing and his voice sounds muffled when he tries to speak. You suspect that the pressure in the tracheostomy cuff balloon may need adjusting. As an LPN, what is your best course of action? *
6. The LPN can install and remove a tracheostomy speaking valve. *
7. The LPN can install a tracheostomy cannula using an obturator. *
8. Sophie Tremblay, an LPN, is caring for a patient, Jacques Martin, who recently underwent surgery for an ileal conduit due to bladder cancer. During her assessment, Sophie notes that Jacques’s stoma appears smaller than usual, and he has reported difficulty in passing urine through the stoma. The RN suggests that Sophie dilate the stoma as a preventive measure against stenosis. Sophie recalls from her training that certain procedures are within her scope of practice but wants to verify her understanding. Can the LPN dilate an intestinal stoma or an ileal conduit for the purpose of preventing stenosis? *
9. Maïna, a 45-year-old patient, was admitted to the emergency department after ingesting a large number of aspirin in a suicide attempt. She is alert but visibly distressed and has been prescribed gastric lavage. The physician orders a nasogastric (NG) tube placement and gastric lavage to remove the ingested toxins. The nurse assigned to Maïna is an LPN (Licensed Practical Nurse) named Jeanette. Jeanette is preparing to carry out the procedure but is uncertain whether performing an NG tube insertion and gastric lavage is within her scope of practice as an LPN. Is it within the scope of practice for Jeanette, an LPN, to perform nasogastric tube insertion and gastric lavage? *
10. LPN Sophie is caring for Monsieur Tremblay, an elderly patient who is experiencing severe constipation and abdominal discomfort. Upon assessment, Sophie suspects fecal impaction, or fecaloma, and notes that she can feel hardened stool during a gentle examination. Sophie wonders if she is within her scope of practice to manually remove the stool. She reviews the guidelines from the Ordre des infirmières et infirmiers auxiliaires du Québec (OIIAQ) regarding LPN interventions in cases of fecal impaction. What is the best course of action for Sophie? *
11. M. Philippe Lavoie, 52 years old, arrives at the ambulatory orthopedic clinic for follow-up of a forearm fracture. His cast has become slightly loose, and the physician asks the LPN to adjust the cast to improve stability. The LPN has experience in general orthopedic care but has not completed additional training required for cast installation, adjustment, removal, and repair. What should the LPN do? *
12. The LPN can remove the cast of pediatric patients. *
13. LPN Amélie is caring for Étienne, a 6-year-old boy who is due to have his cast removed following the healing of a broken arm. Étienne is nervous about the cast removal, and his mother expresses concern, asking if Amélie is allowed to perform this procedure. What should Amélie do regarding the removal of Étienne's cast? *
14. LPN Marie is caring for Monsieur Lefebvre, a patient with severe constipation. The physician has ordered a rectal enema to relieve his discomfort. As Marie begins to gather the supplies needed, the patient's family member asks if it is within Marie’s scope of practice to prepare the enema solution for administration. What is the appropriate response regarding the LPN’s scope of practice in this situation? *
15. Marie Dubois, a 40-year-old woman, was recently discharged following a left wrist fracture sustained during a fall. She is visiting the clinic for follow-up care and is seen by an LPN, Jeanette. Marie reports discomfort with her current splint and asks if a custom-fitted splint could be made to better support her wrist. Jeanette reviews the patient’s history and proceeds to assess the current splint, ensuring it is adjusted appropriately. Marie asks if Jeanette can make a custom-fitted splint for her. Can an LPN fabricate a custom-fitted splint for the patient? *
16. Pierre Lefebvre, a 55-year-old man, was recently discharged after surgery to treat a lumbar spine fracture. He was prescribed a molded thoraco-lumbo-sacral-corset (TLSO) to provide support during his recovery. The LPN, Claire, is performing a routine check-up at the orthopedic clinic. Pierre reports feeling discomfort in his back and is unsure whether the TLSO is positioned properly. Claire carefully examines the appliance and considers adjusting it to relieve his discomfort, as per the physician's instructions. Can the LPN adjust Pierre’s molded thoraco-lumbo-sacral-corset? *