LPN Capstone Clinical - Full Patient Load Management (2026 Update)
1. When receiving a hand-off report using the SBAR tool, which information
belongs in the ‘Background’ section?
A. The patient’s current vital signs and mental status.
B. The patient’s medical history, admitting diagnosis, and allergies.
C. A specific request for a change in the medication dosage.
D. The nurse’s assessment of the patient’s immediate risk level.
Answer: B
Rationale: The Background section of SBAR includes relevant history, admitting diagnosis,
and historical data that provides context for the current situation.
2. An LPN is managing a 6-patient load. Which patient should the nurse assess
first after the morning report?
A. A post-operative patient reporting sudden onset of shortness of breath.
B. A patient with chronic COPD requesting a PRN bronchodilator.
C. A patient scheduled for physical therapy in 30 minutes.
D. A patient who needs a dressing change for a stage II pressure injury.
Answer: A
Rationale: Sudden onset of shortness of breath indicates a potential life-threatening
respiratory or cardiovascular issue (ABC priority) and requires immediate assessment.
,3. Which task is most appropriate for the LPN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Evaluating the effectiveness of pain medication given 30 minutes ago.
B. Assisting a stable post-operative patient with initial ambulation.
C. Teaching a patient how to use an incentive spirometer.
D. Performing a sterile dressing change on a central venous line.
Answer: B
Rationale: UAPs can assist stable patients with activities of daily living, including
ambulation. Evaluation, teaching, and sterile procedures are generally within the LPN or
RN scope.
4. The LPN is preparing to administer insulin to a patient. What is the most
critical safety step to prevent a medication error?
A. Documenting the administration immediately before giving the injection.
B. Verifying the dose with another licensed nurse.
C. Asking the patient if they are ready for their meal.
D. Checking the patient’s blood pressure prior to administration.
Answer: B
Rationale: Insulin is a high-alert medication. Per safety protocols and many facility
policies, verifying the dose with another licensed nurse is essential to prevent errors.
5. A patient with heart failure has gained 3 pounds (1.36 kg) in 24 hours. What is
the nurse’s priority action?
A. Notify the healthcare provider and assess for peripheral edema and lung sounds.
B. Restrict the patient’s fluid intake to 500 mL per shift.
C. Continue to monitor the weight for another 24 hours.
D. Administer an extra dose of the patient’s prescribed diuretic.
Answer: A
, Rationale: Rapid weight gain is a sign of fluid volume excess in heart failure. The nurse
must assess the patient for worsening symptoms and notify the provider for further orders.
6. While managing a full patient load, the LPN notices a patient’s pulse oximetry
reading is 88% on room air. What is the first intervention?
A. Call the Rapid Response Team immediately.
B. Encourage the patient to cough and take deep breaths.
C. Check the equipment for proper placement on the finger.
D. Document the finding as a baseline for a patient with lung disease.
Answer: B
Rationale: The first nursing action for a drop in oxygen saturation should be to improve
the patient’s ventilation (e.g., repositioning, deep breathing). Checking equipment is
secondary if the patient shows no distress.
7. In the 2026 update for NCLEX-PN standards, which action best demonstrates
‘Clinical Judgment’?
A. Following a procedure manual step-by-step without variation.
B. Asking a more experienced nurse to perform all difficult tasks.
C. Completing all documentation exactly at the end of the shift.
D. Recognizing a pattern of declining vitals and prioritizing that patient for intervention.
Answer: D
Rationale: Clinical judgment involves noticing cues, interpreting them, and prioritizing
actions based on the patient’s changing clinical status.
1. When receiving a hand-off report using the SBAR tool, which information
belongs in the ‘Background’ section?
A. The patient’s current vital signs and mental status.
B. The patient’s medical history, admitting diagnosis, and allergies.
C. A specific request for a change in the medication dosage.
D. The nurse’s assessment of the patient’s immediate risk level.
Answer: B
Rationale: The Background section of SBAR includes relevant history, admitting diagnosis,
and historical data that provides context for the current situation.
2. An LPN is managing a 6-patient load. Which patient should the nurse assess
first after the morning report?
A. A post-operative patient reporting sudden onset of shortness of breath.
B. A patient with chronic COPD requesting a PRN bronchodilator.
C. A patient scheduled for physical therapy in 30 minutes.
D. A patient who needs a dressing change for a stage II pressure injury.
Answer: A
Rationale: Sudden onset of shortness of breath indicates a potential life-threatening
respiratory or cardiovascular issue (ABC priority) and requires immediate assessment.
,3. Which task is most appropriate for the LPN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Evaluating the effectiveness of pain medication given 30 minutes ago.
B. Assisting a stable post-operative patient with initial ambulation.
C. Teaching a patient how to use an incentive spirometer.
D. Performing a sterile dressing change on a central venous line.
Answer: B
Rationale: UAPs can assist stable patients with activities of daily living, including
ambulation. Evaluation, teaching, and sterile procedures are generally within the LPN or
RN scope.
4. The LPN is preparing to administer insulin to a patient. What is the most
critical safety step to prevent a medication error?
A. Documenting the administration immediately before giving the injection.
B. Verifying the dose with another licensed nurse.
C. Asking the patient if they are ready for their meal.
D. Checking the patient’s blood pressure prior to administration.
Answer: B
Rationale: Insulin is a high-alert medication. Per safety protocols and many facility
policies, verifying the dose with another licensed nurse is essential to prevent errors.
5. A patient with heart failure has gained 3 pounds (1.36 kg) in 24 hours. What is
the nurse’s priority action?
A. Notify the healthcare provider and assess for peripheral edema and lung sounds.
B. Restrict the patient’s fluid intake to 500 mL per shift.
C. Continue to monitor the weight for another 24 hours.
D. Administer an extra dose of the patient’s prescribed diuretic.
Answer: A
, Rationale: Rapid weight gain is a sign of fluid volume excess in heart failure. The nurse
must assess the patient for worsening symptoms and notify the provider for further orders.
6. While managing a full patient load, the LPN notices a patient’s pulse oximetry
reading is 88% on room air. What is the first intervention?
A. Call the Rapid Response Team immediately.
B. Encourage the patient to cough and take deep breaths.
C. Check the equipment for proper placement on the finger.
D. Document the finding as a baseline for a patient with lung disease.
Answer: B
Rationale: The first nursing action for a drop in oxygen saturation should be to improve
the patient’s ventilation (e.g., repositioning, deep breathing). Checking equipment is
secondary if the patient shows no distress.
7. In the 2026 update for NCLEX-PN standards, which action best demonstrates
‘Clinical Judgment’?
A. Following a procedure manual step-by-step without variation.
B. Asking a more experienced nurse to perform all difficult tasks.
C. Completing all documentation exactly at the end of the shift.
D. Recognizing a pattern of declining vitals and prioritizing that patient for intervention.
Answer: D
Rationale: Clinical judgment involves noticing cues, interpreting them, and prioritizing
actions based on the patient’s changing clinical status.
