LPN Semester 4 Final Exam — Modules 8–9 (Cumulative) 2026/2027
UPDATED
1. A nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which
task is appropriate to delegate?
A. Evaluating a patient’s response to pain medication
B. Assisting a stable patient with ambulation
C. Performing an initial admission assessment
D. Teaching a patient how to use an incentive spirometer
Answer: B
Rationale: UAPs can perform routine tasks on stable patients such as ADLs and
ambulation. Assessment, evaluation, and teaching are responsibilities of the licensed nurse.
2. A patient taking Digoxin reports seeing yellow-green halos around lights.
What is the nurse’s priority action?
A. Document the finding as a common side effect
B. Assess for signs of toxicity and check the potassium level
C. Administer the next scheduled dose
D. Encourage the patient to increase fluid intake
Answer: B
Rationale: Visual disturbances like yellow-green halos are classic signs of digoxin toxicity,
which can be exacerbated by hypokalemia.
,3. Which precaution should the nurse implement for a patient diagnosed with
Pulmonary Tuberculosis?
A. Droplet precautions
B. Contact precautions
C. Protective environment
D. Airborne precautions
Answer: D
Rationale: Pulmonary Tuberculosis requires airborne precautions, including a private
negative-pressure room and the use of an N95 respirator.
4. The nurse is prioritizing care for four patients. Which patient should the nurse
see first?
A. A patient with pneumonia who is newly confused and restless
B. A patient with Type 1 diabetes and a blood glucose of 150 mg/dL
C. A patient with a fractured hip reporting pain 8/10
D. A patient post-op day 2 needing a dressing change
Answer: A
Rationale: New confusion and restlessness are early signs of hypoxia. Using the ABC
(Airway, Breathing, Circulation) framework, this patient is the priority.
5. A patient is receiving Lithium Carbonate for bipolar disorder. Which lab value
should the nurse monitor most closely to prevent toxicity?
A. Serum Calcium
B. Serum Sodium
C. Serum Glucose
D. Serum Hematocrit
Answer: B
Rationale: Lithium is a salt. Low sodium levels can lead to lithium retention and toxicity.
Patients must maintain a consistent sodium intake.
, 6. A nurse is caring for a patient with preeclampsia receiving Magnesium
Sulfate. Which finding requires immediate intervention?
A. Blood pressure of 145/92 mmHg
B. Urinary output of 20 mL/hr
C. Deep tendon reflexes of 2+
D. Respiratory rate of 16/min
Answer: B
Rationale: Magnesium is excreted by the kidneys. Low urinary output (less than 30
mL/hr) can lead to magnesium toxicity, which can cause respiratory arrest.
7. A newborn has a heart rate of 110, a strong cry, some flexion of extremities,
sneezes when stimulated, and a pink body with blue extremities. What is the
APGAR score?
A. 7
B. 10
C. 9
D. 8
Answer: D
Rationale: Heart rate (2), Cry (2), Flexion (1), Reflex (2), Color (1) = 8.
8. What is the primary rationale for administering low-dose oxygen to a patient
with severe COPD?
A. To prevent oxygen toxicity
B. To maintain the patient’s hypoxic drive to breathe
C. To reduce the risk of pulmonary embolism
D. To prevent the drying of mucous membranes
Answer: B
Rationale: In chronic hypercapnia, the stimulus to breathe shifts from high CO2 levels to
low O2 levels. High oxygen concentrations can suppress this drive.
UPDATED
1. A nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which
task is appropriate to delegate?
A. Evaluating a patient’s response to pain medication
B. Assisting a stable patient with ambulation
C. Performing an initial admission assessment
D. Teaching a patient how to use an incentive spirometer
Answer: B
Rationale: UAPs can perform routine tasks on stable patients such as ADLs and
ambulation. Assessment, evaluation, and teaching are responsibilities of the licensed nurse.
2. A patient taking Digoxin reports seeing yellow-green halos around lights.
What is the nurse’s priority action?
A. Document the finding as a common side effect
B. Assess for signs of toxicity and check the potassium level
C. Administer the next scheduled dose
D. Encourage the patient to increase fluid intake
Answer: B
Rationale: Visual disturbances like yellow-green halos are classic signs of digoxin toxicity,
which can be exacerbated by hypokalemia.
,3. Which precaution should the nurse implement for a patient diagnosed with
Pulmonary Tuberculosis?
A. Droplet precautions
B. Contact precautions
C. Protective environment
D. Airborne precautions
Answer: D
Rationale: Pulmonary Tuberculosis requires airborne precautions, including a private
negative-pressure room and the use of an N95 respirator.
4. The nurse is prioritizing care for four patients. Which patient should the nurse
see first?
A. A patient with pneumonia who is newly confused and restless
B. A patient with Type 1 diabetes and a blood glucose of 150 mg/dL
C. A patient with a fractured hip reporting pain 8/10
D. A patient post-op day 2 needing a dressing change
Answer: A
Rationale: New confusion and restlessness are early signs of hypoxia. Using the ABC
(Airway, Breathing, Circulation) framework, this patient is the priority.
5. A patient is receiving Lithium Carbonate for bipolar disorder. Which lab value
should the nurse monitor most closely to prevent toxicity?
A. Serum Calcium
B. Serum Sodium
C. Serum Glucose
D. Serum Hematocrit
Answer: B
Rationale: Lithium is a salt. Low sodium levels can lead to lithium retention and toxicity.
Patients must maintain a consistent sodium intake.
, 6. A nurse is caring for a patient with preeclampsia receiving Magnesium
Sulfate. Which finding requires immediate intervention?
A. Blood pressure of 145/92 mmHg
B. Urinary output of 20 mL/hr
C. Deep tendon reflexes of 2+
D. Respiratory rate of 16/min
Answer: B
Rationale: Magnesium is excreted by the kidneys. Low urinary output (less than 30
mL/hr) can lead to magnesium toxicity, which can cause respiratory arrest.
7. A newborn has a heart rate of 110, a strong cry, some flexion of extremities,
sneezes when stimulated, and a pink body with blue extremities. What is the
APGAR score?
A. 7
B. 10
C. 9
D. 8
Answer: D
Rationale: Heart rate (2), Cry (2), Flexion (1), Reflex (2), Color (1) = 8.
8. What is the primary rationale for administering low-dose oxygen to a patient
with severe COPD?
A. To prevent oxygen toxicity
B. To maintain the patient’s hypoxic drive to breathe
C. To reduce the risk of pulmonary embolism
D. To prevent the drying of mucous membranes
Answer: B
Rationale: In chronic hypercapnia, the stimulus to breathe shifts from high CO2 levels to
low O2 levels. High oxygen concentrations can suppress this drive.
