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ATI PN Comprehensive Exit ACTUAL
EXAM 2026/2027 | Version 1 | Verified
Questions and Detailed Correct Answers |
Pass Guaranteed - A+ Graded
1. An LPN is assigned to collect vital signs on a 4-hour-postpartum client who had a vaginal
birth. The client’s BP is 102/60 mmHg (pre-delivery baseline 118/70), pulse 110/min,
respirations 22/min, and fundus boggy 1 cm above umbilicus. What action should the
LPN take first?
A. Document the findings and continue every-15-min checks
B. Massage the fundus until firm and re-evaluate bleeding
C. Offer the client a bedside commode to void
D. Report the blood-pressure change to the RN immediately
Correct Answer: B
Step 1 – Scenario breakdown: Early postpartum, vital signs show tachycardia & relative
hypotension, boggy fundus above umbilicus.
Step 2 – Correct answer explanation: A boggy fundus with excessive bleeding is the most
common cause of early postpartum hemorrhage; LPN scope allows fundal massage to stimulate
contraction and limit bleeding. Massaging first restores tone, reduces bleeding, and can quickly
improve vital signs.
Step 3 – Distractor analysis:
A. Incorrect—documenting without intervening delays essential action and increases hemorrhage
risk.
B. Correct—first-line nursing intervention within LPN scope.
C. Incorrect—voiding helps only if fundus is deviated and firm; boggy fundus indicates atony,
not bladder distention as primary problem.
D. Incorrect—report after immediate intervention; massage may correct problem quickly and is
required before calling RN.
Key Point: Postpartum boggy fundus = atony = massage first, then reassess and report if
unresolved.
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2. A client is prescribed digoxin 0.25 mg PO daily. The LPN notes the apical pulse is 54
beats/min. What is the best action?
A. Give the medication and recheck pulse in 1 hour
B. Hold the dose and recheck the pulse in 15 min
C. Hold the dose and promptly inform the RN
D. Administer half the dose and document
Correct Answer: C
Step 1 – HR 54 bpm (<60) with digoxin order.
Step 2 – Most digoxin holds are for HR <60; holding and notifying RN maintains safety and
keeps RN informed for possible prescriber contact—within LPN role.
Step 3 –
A. Incorrect—giving with low HR risks toxicity.
B. Incorrect—rechecking alone delays needed prescriber evaluation.
C. Correct—hold + notify RN.
D. Incorrect—splitting dose alters pharmacokinetics and is outside LPN independent scope.
Key Point: Hold digoxin for HR <60 bpm and inform RN.
3. The nurse is preparing to insert an indwelling urinary catheter using sterile technique.
Which step occurs first?
A. Clean perineum with soap and water
B. Open sterile tray on bedside table above waist level
C. Don sterile gloves
D. Lubricate catheter tip
Correct Answer: B
Step 1 – Sterile catheter insertion sequence.
Step 2 – Sterile field must be established (opened) before donning sterile gloves; opening first
maintains sterility.
Step 3 –
A. Incorrect—soap/water not used in sterile prep; betadine or chlorhexidine after setup.
B. Correct—first action to create sterile field.
C. Incorrect—gloves donned after field open.
D. Incorrect—lubrication done after gloves on.
Key Point: Create sterile field before personal sterile attire.
4. A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The LPN finds the
flow meter set at 5 L/min. What action is essential?
A. Obtain a prescription for 5 L/min if client tolerates
B. Reduce to 2 L/min and reassess respiratory status
,3
C. Switch to simple mask at 5 L/min
D. Place client in high-Fowler position
Correct Answer: B
Step 1 – COPD client, unintended high O₂ (5 L).
Step 2 – High O₂ can blunt hypoxic drive in COPD; LPN corrects flow to prescribed 2 L and
monitors—within scope.
Step 3 –
A. Incorrect—cannot change order independently.
B. Correct—return to prescribed rate.
C. Incorrect—mask at 5 L still delivers excess O₂.
D. Useful but does not address oxygen toxicity risk.
Key Point: COPD clients risk hypercarbic narcosis with high O₂; deliver exactly as ordered.
5. A 6-year-old with asthma is taught to use a peak-flow meter. Which statement indicates to
the LPN that reinforcement is needed?
A. “I should blow as hard and fast as possible.”
B. “I’ll measure every morning before my medicine.”
C. “I’ll stand up straight when blowing.”
D. “I will record the highest of three readings.”
Correct Answer: A
Step 1 – Evaluating pediatric asthma education.
Step 2 – Peak-flow requires a short sharp expiration, not prolonged “as hard and fast as
possible,” which may yield falsely low; needs reinforcement on technique.
Step 3 –
A. Needs reinforcement—technique incorrect.
B. Correct timing.
C. Correct position.
D. Correct documentation.
Key Point: Peak-flow = short maximal blast, not sustained force.
6. The HbA1c of a client with diabetes is 9.8%. What is the LPN’s priority reinforcement
topic?
A. Importance of daily foot inspection
B. Consistency in meal timing
C. Need to rotate injection sites
D. Proper storage of insulin vials
Correct Answer: B
, 4
Step 1 – HbA1c 9.8% indicates poor glycemic control.
Step 2 – Meal timing most directly affects daily glucose excursions and HbA1c; reinforcing this
helps stabilize levels.
Step 3 –
A. Important but long-term complication prevention.
B. Highest impact on glucose control.
C. Prevents lipodystrophy but less effect on HbA1c.
D. Safety issue, not metabolic control.
Key Point: Glycemic control hinges on meal–insulin coordination.
7. A postoperative client has a new prescription for morphine 10 mg IM q4h prn. Prior to
administration, what assessment is essential for the LPN?
A. Pain rating on 0–10 scale
B. Blood pressure
C. Respiratory rate
D. Urine output
Correct Answer: C
Step 1 – First dose of morphine post-op.
Step 2 – Opioids depress respiration; baseline RR must be ≥12 for safe administration—LPN
responsibility.
Step 3 –
A. Needed but not safety-critical compared to RR.
B. Good practice but hypotension less immediate.
C. Essential.
D. Not a pre-requisite for first dose.
Key Point: Always assess RR before giving opioid; hold if <12.
8. A newborn’s heel-stick blood glucose is 38 mg/dL. The LPN should:
A. Encourage breastfeeding and recheck in 30 min
B. Obtain an order for IV dextrose 10% bolus
C. Notify the pediatrician stat
D. Document as normal for 2-hour-old infant
Correct Answer: A
Step 1 – Term newborn glucose 38 mg/dL (low normal to mildly low).
Step 2 – Early feeding is first-line; LPN can assist with breastfeeding and re-check per
protocol—supports glucose without over-treating.
Step 3 –
A. Correct first action.
B. IV bolus requires RN/Provider order; not first.
ATI PN Comprehensive Exit ACTUAL
EXAM 2026/2027 | Version 1 | Verified
Questions and Detailed Correct Answers |
Pass Guaranteed - A+ Graded
1. An LPN is assigned to collect vital signs on a 4-hour-postpartum client who had a vaginal
birth. The client’s BP is 102/60 mmHg (pre-delivery baseline 118/70), pulse 110/min,
respirations 22/min, and fundus boggy 1 cm above umbilicus. What action should the
LPN take first?
A. Document the findings and continue every-15-min checks
B. Massage the fundus until firm and re-evaluate bleeding
C. Offer the client a bedside commode to void
D. Report the blood-pressure change to the RN immediately
Correct Answer: B
Step 1 – Scenario breakdown: Early postpartum, vital signs show tachycardia & relative
hypotension, boggy fundus above umbilicus.
Step 2 – Correct answer explanation: A boggy fundus with excessive bleeding is the most
common cause of early postpartum hemorrhage; LPN scope allows fundal massage to stimulate
contraction and limit bleeding. Massaging first restores tone, reduces bleeding, and can quickly
improve vital signs.
Step 3 – Distractor analysis:
A. Incorrect—documenting without intervening delays essential action and increases hemorrhage
risk.
B. Correct—first-line nursing intervention within LPN scope.
C. Incorrect—voiding helps only if fundus is deviated and firm; boggy fundus indicates atony,
not bladder distention as primary problem.
D. Incorrect—report after immediate intervention; massage may correct problem quickly and is
required before calling RN.
Key Point: Postpartum boggy fundus = atony = massage first, then reassess and report if
unresolved.
,2
2. A client is prescribed digoxin 0.25 mg PO daily. The LPN notes the apical pulse is 54
beats/min. What is the best action?
A. Give the medication and recheck pulse in 1 hour
B. Hold the dose and recheck the pulse in 15 min
C. Hold the dose and promptly inform the RN
D. Administer half the dose and document
Correct Answer: C
Step 1 – HR 54 bpm (<60) with digoxin order.
Step 2 – Most digoxin holds are for HR <60; holding and notifying RN maintains safety and
keeps RN informed for possible prescriber contact—within LPN role.
Step 3 –
A. Incorrect—giving with low HR risks toxicity.
B. Incorrect—rechecking alone delays needed prescriber evaluation.
C. Correct—hold + notify RN.
D. Incorrect—splitting dose alters pharmacokinetics and is outside LPN independent scope.
Key Point: Hold digoxin for HR <60 bpm and inform RN.
3. The nurse is preparing to insert an indwelling urinary catheter using sterile technique.
Which step occurs first?
A. Clean perineum with soap and water
B. Open sterile tray on bedside table above waist level
C. Don sterile gloves
D. Lubricate catheter tip
Correct Answer: B
Step 1 – Sterile catheter insertion sequence.
Step 2 – Sterile field must be established (opened) before donning sterile gloves; opening first
maintains sterility.
Step 3 –
A. Incorrect—soap/water not used in sterile prep; betadine or chlorhexidine after setup.
B. Correct—first action to create sterile field.
C. Incorrect—gloves donned after field open.
D. Incorrect—lubrication done after gloves on.
Key Point: Create sterile field before personal sterile attire.
4. A client with COPD is receiving oxygen at 2 L/min via nasal cannula. The LPN finds the
flow meter set at 5 L/min. What action is essential?
A. Obtain a prescription for 5 L/min if client tolerates
B. Reduce to 2 L/min and reassess respiratory status
,3
C. Switch to simple mask at 5 L/min
D. Place client in high-Fowler position
Correct Answer: B
Step 1 – COPD client, unintended high O₂ (5 L).
Step 2 – High O₂ can blunt hypoxic drive in COPD; LPN corrects flow to prescribed 2 L and
monitors—within scope.
Step 3 –
A. Incorrect—cannot change order independently.
B. Correct—return to prescribed rate.
C. Incorrect—mask at 5 L still delivers excess O₂.
D. Useful but does not address oxygen toxicity risk.
Key Point: COPD clients risk hypercarbic narcosis with high O₂; deliver exactly as ordered.
5. A 6-year-old with asthma is taught to use a peak-flow meter. Which statement indicates to
the LPN that reinforcement is needed?
A. “I should blow as hard and fast as possible.”
B. “I’ll measure every morning before my medicine.”
C. “I’ll stand up straight when blowing.”
D. “I will record the highest of three readings.”
Correct Answer: A
Step 1 – Evaluating pediatric asthma education.
Step 2 – Peak-flow requires a short sharp expiration, not prolonged “as hard and fast as
possible,” which may yield falsely low; needs reinforcement on technique.
Step 3 –
A. Needs reinforcement—technique incorrect.
B. Correct timing.
C. Correct position.
D. Correct documentation.
Key Point: Peak-flow = short maximal blast, not sustained force.
6. The HbA1c of a client with diabetes is 9.8%. What is the LPN’s priority reinforcement
topic?
A. Importance of daily foot inspection
B. Consistency in meal timing
C. Need to rotate injection sites
D. Proper storage of insulin vials
Correct Answer: B
, 4
Step 1 – HbA1c 9.8% indicates poor glycemic control.
Step 2 – Meal timing most directly affects daily glucose excursions and HbA1c; reinforcing this
helps stabilize levels.
Step 3 –
A. Important but long-term complication prevention.
B. Highest impact on glucose control.
C. Prevents lipodystrophy but less effect on HbA1c.
D. Safety issue, not metabolic control.
Key Point: Glycemic control hinges on meal–insulin coordination.
7. A postoperative client has a new prescription for morphine 10 mg IM q4h prn. Prior to
administration, what assessment is essential for the LPN?
A. Pain rating on 0–10 scale
B. Blood pressure
C. Respiratory rate
D. Urine output
Correct Answer: C
Step 1 – First dose of morphine post-op.
Step 2 – Opioids depress respiration; baseline RR must be ≥12 for safe administration—LPN
responsibility.
Step 3 –
A. Needed but not safety-critical compared to RR.
B. Good practice but hypotension less immediate.
C. Essential.
D. Not a pre-requisite for first dose.
Key Point: Always assess RR before giving opioid; hold if <12.
8. A newborn’s heel-stick blood glucose is 38 mg/dL. The LPN should:
A. Encourage breastfeeding and recheck in 30 min
B. Obtain an order for IV dextrose 10% bolus
C. Notify the pediatrician stat
D. Document as normal for 2-hour-old infant
Correct Answer: A
Step 1 – Term newborn glucose 38 mg/dL (low normal to mildly low).
Step 2 – Early feeding is first-line; LPN can assist with breastfeeding and re-check per
protocol—supports glucose without over-treating.
Step 3 –
A. Correct first action.
B. IV bolus requires RN/Provider order; not first.
