LPN Leadership, IV Therapy, and Transition to Practice (Week 37-44)
2026/2027 UPDATE
1. Which task is most appropriate for a Licensed Practical Nurse (LPN) to
delegate to an Unlicensed Assistive Personnel (UAP)?
A. Measuring and recording intake and output for a stable client.
B. Performing a sterile dressing change on a post-operative wound.
C. Assessing a client’s pain level after medication administration.
D. Teaching a client how to use an incentive spirometer.
Answer: A
Rationale: UAPs can perform routine, non-invasive tasks such as measuring intake and
output. Assessment, teaching, and sterile procedures are generally outside the UAP’s scope
of practice.
2. A client is receiving an IV infusion of 0.9% Normal Saline. The LPN notes
coolness, swelling, and pallor at the insertion site. Which complication is most
likely occurring?
A. Phlebitis
B. Extravasation
C. Infiltration
D. Air Embolism
Answer: C
Rationale: Infiltration is characterized by coolness, swelling, and pallor. Phlebitis would
present with warmth and redness. Extravasation involves vesicant drugs, and air embolism
involves systemic respiratory distress.
,3. Which leadership style is characterized by a leader who makes all decisions
and gives orders without seeking input from the team?
A. Autocratic
B. Laissez-faire
C. Democratic
D. Transformational
Answer: A
Rationale: Autocratic (or authoritarian) leadership involves centralized decision-making
and control, where the leader dictates tasks and methods.
4. The LPN is caring for a client with an IV line. To prevent an air embolism when
changing IV tubing, which action should the nurse take?
A. Ask the client to cough vigorously.
B. Position the client on their right side.
C. Instruct the client to perform the Valsalva maneuver.
D. Lower the IV pole below the level of the heart.
Answer: C
Rationale: The Valsalva maneuver increases intrathoracic pressure, which helps prevent
air from entering the venous system during tubing changes or central line removal.
5. According to the ‘Five Rights of Delegation,’ which of the following is an
essential factor for the LPN to consider?
A. Right Cost
B. Right Supervision/Evaluation
C. Right Shift-Change Timing
D. Right Medication Dose
Answer: B
Rationale: The five rights are Right Task, Right Circumstance, Right Person, Right
Direction/Communication, and Right Supervision/Evaluation.
, 6. Which IV solution is considered isotonic?
A. Lactated Ringer’s
B. 5% Dextrose in 0.9% Sodium Chloride
C. 0.45% Sodium Chloride
D. 3% Sodium Chloride
Answer: A
Rationale: Lactated Ringer’s and 0.9% Sodium Chloride are common isotonic solutions.
0.45% NaCl is hypotonic, while 3% NaCl is hypertonic.
7. An LPN is preparing to graduate and transition to practice. What is the most
important legal document governing their nursing practice?
A. The Hospital’s Policy Manual
B. The NCLEX-PN Examination Blueprint
C. The American Nurses Association (ANA) Code of Ethics
D. The Nurse Practice Act of the state
Answer: D
Rationale: The Nurse Practice Act (NPA) in each state defines the scope of practice and
legal boundaries for LPNs/LVNs.
8. A client’s IV site is red, warm to the touch, and has a visible red streak
spreading up the arm. What is the priority nursing action?
A. Discontinue the IV and remove the catheter.
B. Apply a cold compress immediately.
C. Slow the infusion rate to a KVO (Keep Vein Open) rate.
D. Elevate the extremity above the heart.
Answer: A
Rationale: These are signs of phlebitis. The IV must be discontinued immediately to
prevent further vessel damage.
2026/2027 UPDATE
1. Which task is most appropriate for a Licensed Practical Nurse (LPN) to
delegate to an Unlicensed Assistive Personnel (UAP)?
A. Measuring and recording intake and output for a stable client.
B. Performing a sterile dressing change on a post-operative wound.
C. Assessing a client’s pain level after medication administration.
D. Teaching a client how to use an incentive spirometer.
Answer: A
Rationale: UAPs can perform routine, non-invasive tasks such as measuring intake and
output. Assessment, teaching, and sterile procedures are generally outside the UAP’s scope
of practice.
2. A client is receiving an IV infusion of 0.9% Normal Saline. The LPN notes
coolness, swelling, and pallor at the insertion site. Which complication is most
likely occurring?
A. Phlebitis
B. Extravasation
C. Infiltration
D. Air Embolism
Answer: C
Rationale: Infiltration is characterized by coolness, swelling, and pallor. Phlebitis would
present with warmth and redness. Extravasation involves vesicant drugs, and air embolism
involves systemic respiratory distress.
,3. Which leadership style is characterized by a leader who makes all decisions
and gives orders without seeking input from the team?
A. Autocratic
B. Laissez-faire
C. Democratic
D. Transformational
Answer: A
Rationale: Autocratic (or authoritarian) leadership involves centralized decision-making
and control, where the leader dictates tasks and methods.
4. The LPN is caring for a client with an IV line. To prevent an air embolism when
changing IV tubing, which action should the nurse take?
A. Ask the client to cough vigorously.
B. Position the client on their right side.
C. Instruct the client to perform the Valsalva maneuver.
D. Lower the IV pole below the level of the heart.
Answer: C
Rationale: The Valsalva maneuver increases intrathoracic pressure, which helps prevent
air from entering the venous system during tubing changes or central line removal.
5. According to the ‘Five Rights of Delegation,’ which of the following is an
essential factor for the LPN to consider?
A. Right Cost
B. Right Supervision/Evaluation
C. Right Shift-Change Timing
D. Right Medication Dose
Answer: B
Rationale: The five rights are Right Task, Right Circumstance, Right Person, Right
Direction/Communication, and Right Supervision/Evaluation.
, 6. Which IV solution is considered isotonic?
A. Lactated Ringer’s
B. 5% Dextrose in 0.9% Sodium Chloride
C. 0.45% Sodium Chloride
D. 3% Sodium Chloride
Answer: A
Rationale: Lactated Ringer’s and 0.9% Sodium Chloride are common isotonic solutions.
0.45% NaCl is hypotonic, while 3% NaCl is hypertonic.
7. An LPN is preparing to graduate and transition to practice. What is the most
important legal document governing their nursing practice?
A. The Hospital’s Policy Manual
B. The NCLEX-PN Examination Blueprint
C. The American Nurses Association (ANA) Code of Ethics
D. The Nurse Practice Act of the state
Answer: D
Rationale: The Nurse Practice Act (NPA) in each state defines the scope of practice and
legal boundaries for LPNs/LVNs.
8. A client’s IV site is red, warm to the touch, and has a visible red streak
spreading up the arm. What is the priority nursing action?
A. Discontinue the IV and remove the catheter.
B. Apply a cold compress immediately.
C. Slow the infusion rate to a KVO (Keep Vein Open) rate.
D. Elevate the extremity above the heart.
Answer: A
Rationale: These are signs of phlebitis. The IV must be discontinued immediately to
prevent further vessel damage.
