LPN Comprehensive Final Review - NCLEX-PN Simulation 2026/2027
UPDATE
1. A licensed practical nurse (LPN) is preparing to administer Lispro insulin to a
client. When should the nurse instruct the client to eat?
A. Immediately after the peak action occurs
B. Exactly 1 hour after administration
C. 30 to 45 minutes before administration
D. Within 15 minutes of administration
Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes. To prevent
hypoglycemia, the client must eat within 15 minutes of the injection.
2. A client is diagnosed with right-sided heart failure. Which clinical
manifestation should the nurse expect to find during the assessment?
A. Crackles in the lungs
B. Peripheral edema
C. Dyspnea on exertion
D. Orthopnea
Answer: B
Rationale: Right-sided heart failure leads to systemic venous congestion, resulting in
peripheral edema, jugular venous distention, and hepatomegaly. Crackles and dyspnea are
associated with left-sided heart failure.
,3. The nurse is reinforcing teaching with a client who has a new prescription for
nitroglycerin sublingual tablets. Which statement by the client indicates a need
for further teaching?
A. I will take one tablet every 15 minutes until the pain stops.
B. I should feel a slight tingling sensation under my tongue.
C. I will keep the tablets in their original dark glass bottle.
D. I should sit or lie down before taking the medication.
Answer: A
Rationale: Nitroglycerin should be taken every 5 minutes for up to 3 doses. If pain persists
after the first dose, the client should call emergency services.
4. A nurse is caring for a client with a Stage 3 pressure injury. How should the
nurse describe this wound in the medical record?
A. Intact skin with non-blanchable redness
B. Partial-thickness loss of dermis with a shallow open ulcer
C. Full-thickness tissue loss with visible subcutaneous fat
D. Full-thickness tissue loss with exposed bone or muscle
Answer: C
Rationale: Stage 3 involves full-thickness tissue loss where subcutaneous fat may be
visible, but bone, tendon, or muscle are not exposed. Stage 4 involves exposed
bone/muscle.
5. Which task is most appropriate for the LPN to delegate to an unlicensed
assistive personnel (UAP)?
A. Assisting a stable client with ambulation
B. Checking the gag reflex of a post-operative client
C. Teaching a client how to use an incentive spirometer
D. Evaluating the effectiveness of pain medication
Answer: A
, Rationale: UAPs can perform routine tasks on stable clients, such as ambulation, feeding,
and hygiene. Assessment, teaching, and evaluation must be performed by licensed nursing
staff.
6. A client is receiving warfarin for deep vein thrombosis. Which laboratory
value should the nurse monitor to determine the effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. Prothrombin time (PT) and INR
D. Hemoglobin and Hematocrit
Answer: C
Rationale: PT and INR are used to monitor warfarin therapy. aPTT is used to monitor
heparin therapy.
7. A client is 24 hours post-appendectomy. Which nursing intervention is the
highest priority?
A. Assisting the client with a bed bath
B. Administering a scheduled stool softener
C. Encouraging the use of an incentive spirometer
D. Changing the surgical dressing
Answer: C
Rationale: Post-operatively, airway and gas exchange are priorities. Incentive spirometry
prevents atelectasis and pneumonia, which are common post-op complications.
UPDATE
1. A licensed practical nurse (LPN) is preparing to administer Lispro insulin to a
client. When should the nurse instruct the client to eat?
A. Immediately after the peak action occurs
B. Exactly 1 hour after administration
C. 30 to 45 minutes before administration
D. Within 15 minutes of administration
Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes. To prevent
hypoglycemia, the client must eat within 15 minutes of the injection.
2. A client is diagnosed with right-sided heart failure. Which clinical
manifestation should the nurse expect to find during the assessment?
A. Crackles in the lungs
B. Peripheral edema
C. Dyspnea on exertion
D. Orthopnea
Answer: B
Rationale: Right-sided heart failure leads to systemic venous congestion, resulting in
peripheral edema, jugular venous distention, and hepatomegaly. Crackles and dyspnea are
associated with left-sided heart failure.
,3. The nurse is reinforcing teaching with a client who has a new prescription for
nitroglycerin sublingual tablets. Which statement by the client indicates a need
for further teaching?
A. I will take one tablet every 15 minutes until the pain stops.
B. I should feel a slight tingling sensation under my tongue.
C. I will keep the tablets in their original dark glass bottle.
D. I should sit or lie down before taking the medication.
Answer: A
Rationale: Nitroglycerin should be taken every 5 minutes for up to 3 doses. If pain persists
after the first dose, the client should call emergency services.
4. A nurse is caring for a client with a Stage 3 pressure injury. How should the
nurse describe this wound in the medical record?
A. Intact skin with non-blanchable redness
B. Partial-thickness loss of dermis with a shallow open ulcer
C. Full-thickness tissue loss with visible subcutaneous fat
D. Full-thickness tissue loss with exposed bone or muscle
Answer: C
Rationale: Stage 3 involves full-thickness tissue loss where subcutaneous fat may be
visible, but bone, tendon, or muscle are not exposed. Stage 4 involves exposed
bone/muscle.
5. Which task is most appropriate for the LPN to delegate to an unlicensed
assistive personnel (UAP)?
A. Assisting a stable client with ambulation
B. Checking the gag reflex of a post-operative client
C. Teaching a client how to use an incentive spirometer
D. Evaluating the effectiveness of pain medication
Answer: A
, Rationale: UAPs can perform routine tasks on stable clients, such as ambulation, feeding,
and hygiene. Assessment, teaching, and evaluation must be performed by licensed nursing
staff.
6. A client is receiving warfarin for deep vein thrombosis. Which laboratory
value should the nurse monitor to determine the effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. Prothrombin time (PT) and INR
D. Hemoglobin and Hematocrit
Answer: C
Rationale: PT and INR are used to monitor warfarin therapy. aPTT is used to monitor
heparin therapy.
7. A client is 24 hours post-appendectomy. Which nursing intervention is the
highest priority?
A. Assisting the client with a bed bath
B. Administering a scheduled stool softener
C. Encouraging the use of an incentive spirometer
D. Changing the surgical dressing
Answer: C
Rationale: Post-operatively, airway and gas exchange are priorities. Incentive spirometry
prevents atelectasis and pneumonia, which are common post-op complications.
