LPN Semester 3 Final Exam Comprehensive Study Guide 2026/2027
UPDATE
1. A nurse is caring for a client with a history of depression. The client states, ‘I
finally have everything figured out and don’t need to worry about the future
anymore.’ What is the nurse’s priority action?
A. Document the client’s improved mood and outlook.
B. Ask the client directly if they have a plan for self-harm.
C. Encourage the client to join a group therapy session.
D. Notify the family that the client is feeling better.
Answer: B
Rationale: A sudden improvement in mood or a sense of ‘relief’ in a depressed client often
indicates they have decided on a suicide plan. Direct questioning about suicidal ideation is
the priority for safety.
2. A pregnant client at 34 weeks gestation reports a sudden onset of bright red,
painless vaginal bleeding. Which condition should the nurse suspect?
A. Abruptio Placentae
B. Ectopic Pregnancy
C. Uterine Rupture
D. Placenta Previa
Answer: D
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
third trimester. Abruptio placentae usually involves painful, dark red bleeding.
,3. The nurse is monitoring a pediatric client with suspected epiglottitis. Which
action is contraindicated?
A. Administering humidified oxygen.
B. Keeping the child in an upright position.
C. Monitoring pulse oximetry.
D. Visualizing the throat with a tongue blade.
Answer: D
Rationale: Visualizing the throat of a child with suspected epiglottitis can cause a
laryngospasm and total airway obstruction. This should only be done where emergency
intubation is available.
4. Which of the following tasks is most appropriate for the LPN to delegate to an
Unlicensed Assistive Personnel (UAP)?
A. Assessing a client’s surgical incision.
B. Assisting a stable client with ambulation.
C. Providing discharge instructions for a new medication.
D. Adjusting the flow rate of an IV infusion.
Answer: B
Rationale: UAPs can perform routine tasks like ADLs and ambulation for stable clients.
Assessment, teaching, and medication administration are responsibilities of licensed
nurses.
5. A client is prescribed Lithium for bipolar disorder. Which lab value is most
critical to monitor to prevent toxicity?
A. Serum Potassium
B. Serum Calcium
C. Serum Sodium
D. Serum Magnesium
Answer: C
, Rationale: Lithium is a salt. Low sodium levels (hyponatremia) can lead to lithium
retention and toxicity. Maintaining adequate sodium intake is vital.
6. A newborn has an APGAR score of 9 at 1 minute. What does this score
indicate?
A. The infant is in severe distress.
B. The infant needs immediate resuscitation.
C. The infant is adjusting well to extrauterine life.
D. The infant has moderate difficulty breathing.
Answer: C
Rationale: APGAR scores between 7 and 10 are considered normal and indicate that the
newborn is in good condition and adjusting well.
7. The nurse is caring for a client with Chronic Obstructive Pulmonary Disease
(COPD). What is the recommended oxygen delivery rate for this client?
A. 1-2 L/min via Nasal Cannula.
B. 10-15 L/min via Non-rebreather mask.
C. 5-8 L/min via Simple Face Mask.
D. Oxygen is contraindicated for COPD clients.
Answer: A
Rationale: Clients with COPD often rely on a hypoxic drive to breathe. High concentrations
of oxygen can suppress this drive, leading to respiratory arrest. Low-flow oxygen is
typically preferred.
8. Which developmental milestone is expected for a 12-month-old infant?
A. Sitting without support and beginning to stand.
B. Using a spoon without spilling.
C. Building a tower of six blocks.
D. Running and climbing stairs.
Answer: A
UPDATE
1. A nurse is caring for a client with a history of depression. The client states, ‘I
finally have everything figured out and don’t need to worry about the future
anymore.’ What is the nurse’s priority action?
A. Document the client’s improved mood and outlook.
B. Ask the client directly if they have a plan for self-harm.
C. Encourage the client to join a group therapy session.
D. Notify the family that the client is feeling better.
Answer: B
Rationale: A sudden improvement in mood or a sense of ‘relief’ in a depressed client often
indicates they have decided on a suicide plan. Direct questioning about suicidal ideation is
the priority for safety.
2. A pregnant client at 34 weeks gestation reports a sudden onset of bright red,
painless vaginal bleeding. Which condition should the nurse suspect?
A. Abruptio Placentae
B. Ectopic Pregnancy
C. Uterine Rupture
D. Placenta Previa
Answer: D
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
third trimester. Abruptio placentae usually involves painful, dark red bleeding.
,3. The nurse is monitoring a pediatric client with suspected epiglottitis. Which
action is contraindicated?
A. Administering humidified oxygen.
B. Keeping the child in an upright position.
C. Monitoring pulse oximetry.
D. Visualizing the throat with a tongue blade.
Answer: D
Rationale: Visualizing the throat of a child with suspected epiglottitis can cause a
laryngospasm and total airway obstruction. This should only be done where emergency
intubation is available.
4. Which of the following tasks is most appropriate for the LPN to delegate to an
Unlicensed Assistive Personnel (UAP)?
A. Assessing a client’s surgical incision.
B. Assisting a stable client with ambulation.
C. Providing discharge instructions for a new medication.
D. Adjusting the flow rate of an IV infusion.
Answer: B
Rationale: UAPs can perform routine tasks like ADLs and ambulation for stable clients.
Assessment, teaching, and medication administration are responsibilities of licensed
nurses.
5. A client is prescribed Lithium for bipolar disorder. Which lab value is most
critical to monitor to prevent toxicity?
A. Serum Potassium
B. Serum Calcium
C. Serum Sodium
D. Serum Magnesium
Answer: C
, Rationale: Lithium is a salt. Low sodium levels (hyponatremia) can lead to lithium
retention and toxicity. Maintaining adequate sodium intake is vital.
6. A newborn has an APGAR score of 9 at 1 minute. What does this score
indicate?
A. The infant is in severe distress.
B. The infant needs immediate resuscitation.
C. The infant is adjusting well to extrauterine life.
D. The infant has moderate difficulty breathing.
Answer: C
Rationale: APGAR scores between 7 and 10 are considered normal and indicate that the
newborn is in good condition and adjusting well.
7. The nurse is caring for a client with Chronic Obstructive Pulmonary Disease
(COPD). What is the recommended oxygen delivery rate for this client?
A. 1-2 L/min via Nasal Cannula.
B. 10-15 L/min via Non-rebreather mask.
C. 5-8 L/min via Simple Face Mask.
D. Oxygen is contraindicated for COPD clients.
Answer: A
Rationale: Clients with COPD often rely on a hypoxic drive to breathe. High concentrations
of oxygen can suppress this drive, leading to respiratory arrest. Low-flow oxygen is
typically preferred.
8. Which developmental milestone is expected for a 12-month-old infant?
A. Sitting without support and beginning to stand.
B. Using a spoon without spilling.
C. Building a tower of six blocks.
D. Running and climbing stairs.
Answer: A
