MEDICAL SURGICAL LPN EXAM PREPARATION
PACK 2026 KEY CONCEPTS AND REVISION
NOTES
◉ Maggie Clark, a 42-year-old female, was admitted with newly
diagnosed type 2 diabetes mellitus. Her blood glucose has been
stabilized, and the nurse is preparing her for discharge. Her
discharge orders will include metformin (Glucophage). Mrs. Clark is
also being treated for hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is
important to
1) monitor her glomerular filtration rate.
2) check her serum amylase routinely.
3) obtain her red blood cell count periodically.
4) examine her urine for casts.
Answer: 1) monitor her glomerular filtration rate.
Rationale: The estimated glomerular filtration rate (eGFR) is one
way to measure the adequacy of kidney function. Glucophage is
excreted by the kidney and the risk of lactic acidosis increases in
patients with impaired kidney function. The drug may be used if the
eGFR is between 45 and 60 mL/min/1.73 m2, i.e., in mild chronic
kidney disease. Glucophage is absolutely contraindicated if the eGFR
is below 30 mL/min/1.73 m2.
,◉ Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for
hypertension. Which symptom of hypoglycemia would be masked by
Lopressor?
1) Diaphoresis.
2) Tingling.
3) Diplopia.
4) Tachycardia.
Answer: 4) Tachycardia.
Rationale: A side effect of Lopressor, a beta blocker, is bradycardia.
The Lopressor-induced bradycardia can mask tachycardia, a
symptom of hypoglycemia.
◉ Charles Haverford is diagnosed with prostate cancer and is to
have a radical prostatectomy.
Mr. Haverford has been researching his diagnosis and now asks the
nurse to recommend a reliable web source for accurate prostate
cancer information. The nurse should identify which of these
websites as most reliable?
1) www.wikipedia.org.
2) www.cancer.gov.
3) www.caringbridge.org.
,4) www.google.com.
Answer: 2) www.cancer.gov.
Rationale: When a patient asks about researching information on
the internet, the patient should be instructed to look at reliable sites.
Sites that are most reliable are those sponsored by the government
(.gov).
◉ Mr. Haverford has the planned surgery and immediately
postoperatively he has a urinary catheter inserted. After the urinary
catheter is removed Mr. Haverford is urinating normally, however he
is experiencing occasional incontinence with dribbling. Mr.
Haverford is to be discharged.
Mr. Haverford says to the nurse, "I'm so embarrassed. What will my
wife think about this dribbling?" In addition to acknowledging his
feelings, the nurse should encourage the patient to
1) limit oral intake of fluids before bedtime.
2) palpate his bladder to check for distention three times a day.
3) perform pelvic floor exercises several times daily.
4) avoid interrupting the urinary stream during voiding.
Answer: 3) perform pelvic floor exercises several times daily.
Rationale: It is not unusual for a patient who has had a
prostatectomy, to complain of not having complete bladder control
, after catheter removal. To help the patient regain urinary control,
pelvic floor strengthening exercises are recommended.
◉ A patient's wife is visibly upset and says to the nurse, "I thought
my husband only broke his hip, but the doctor thinks he might have
had a stroke." Which of the following would be an appropriate
response by the nurse?
1) "It's really too early to be concerned about that. Let's wait until
the test results come back."
2) "If it is a stroke, your husband is in the right hospital for
treatment."
3) "Yes, he does have symptoms of a stroke. That's what the tests
will help us find out."
4) "I'm going to get you some information to read about strokes and
their treatment."
Answer: 3) "Yes, he does have symptoms of a stroke. That's what the
tests will help us find out."
Rationale: Symptoms of stroke vary greatly and the initial diagnosis
is made after a non-contrast CT scan is done to determine if the
event was ischemic or hemorrhagic. Then, further tests are done to
confirm the diagnosis and decide on treatment.
PACK 2026 KEY CONCEPTS AND REVISION
NOTES
◉ Maggie Clark, a 42-year-old female, was admitted with newly
diagnosed type 2 diabetes mellitus. Her blood glucose has been
stabilized, and the nurse is preparing her for discharge. Her
discharge orders will include metformin (Glucophage). Mrs. Clark is
also being treated for hypertension.
Because Mrs. Clark is to take Glucophage on a regular basis it is
important to
1) monitor her glomerular filtration rate.
2) check her serum amylase routinely.
3) obtain her red blood cell count periodically.
4) examine her urine for casts.
Answer: 1) monitor her glomerular filtration rate.
Rationale: The estimated glomerular filtration rate (eGFR) is one
way to measure the adequacy of kidney function. Glucophage is
excreted by the kidney and the risk of lactic acidosis increases in
patients with impaired kidney function. The drug may be used if the
eGFR is between 45 and 60 mL/min/1.73 m2, i.e., in mild chronic
kidney disease. Glucophage is absolutely contraindicated if the eGFR
is below 30 mL/min/1.73 m2.
,◉ Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for
hypertension. Which symptom of hypoglycemia would be masked by
Lopressor?
1) Diaphoresis.
2) Tingling.
3) Diplopia.
4) Tachycardia.
Answer: 4) Tachycardia.
Rationale: A side effect of Lopressor, a beta blocker, is bradycardia.
The Lopressor-induced bradycardia can mask tachycardia, a
symptom of hypoglycemia.
◉ Charles Haverford is diagnosed with prostate cancer and is to
have a radical prostatectomy.
Mr. Haverford has been researching his diagnosis and now asks the
nurse to recommend a reliable web source for accurate prostate
cancer information. The nurse should identify which of these
websites as most reliable?
1) www.wikipedia.org.
2) www.cancer.gov.
3) www.caringbridge.org.
,4) www.google.com.
Answer: 2) www.cancer.gov.
Rationale: When a patient asks about researching information on
the internet, the patient should be instructed to look at reliable sites.
Sites that are most reliable are those sponsored by the government
(.gov).
◉ Mr. Haverford has the planned surgery and immediately
postoperatively he has a urinary catheter inserted. After the urinary
catheter is removed Mr. Haverford is urinating normally, however he
is experiencing occasional incontinence with dribbling. Mr.
Haverford is to be discharged.
Mr. Haverford says to the nurse, "I'm so embarrassed. What will my
wife think about this dribbling?" In addition to acknowledging his
feelings, the nurse should encourage the patient to
1) limit oral intake of fluids before bedtime.
2) palpate his bladder to check for distention three times a day.
3) perform pelvic floor exercises several times daily.
4) avoid interrupting the urinary stream during voiding.
Answer: 3) perform pelvic floor exercises several times daily.
Rationale: It is not unusual for a patient who has had a
prostatectomy, to complain of not having complete bladder control
, after catheter removal. To help the patient regain urinary control,
pelvic floor strengthening exercises are recommended.
◉ A patient's wife is visibly upset and says to the nurse, "I thought
my husband only broke his hip, but the doctor thinks he might have
had a stroke." Which of the following would be an appropriate
response by the nurse?
1) "It's really too early to be concerned about that. Let's wait until
the test results come back."
2) "If it is a stroke, your husband is in the right hospital for
treatment."
3) "Yes, he does have symptoms of a stroke. That's what the tests
will help us find out."
4) "I'm going to get you some information to read about strokes and
their treatment."
Answer: 3) "Yes, he does have symptoms of a stroke. That's what the
tests will help us find out."
Rationale: Symptoms of stroke vary greatly and the initial diagnosis
is made after a non-contrast CT scan is done to determine if the
event was ischemic or hemorrhagic. Then, further tests are done to
confirm the diagnosis and decide on treatment.
