LPN Semester 2 Comprehensive Review (NCLEX-PN) 2026/2027
UPDATE
1. A nurse is caring for a client with heart failure. Which clinical finding should
the nurse report immediately as a sign of worsening condition?
A. Trace edema in the ankles
B. Pulse rate of 82 beats per minute
C. Increased appetite
D. Weight gain of 3 lbs (1.4 kg) in 24 hours
Answer: D
Rationale: Sudden weight gain (over 2-3 lbs in a day) indicates fluid retention, a hallmark
of worsening heart failure and potential pulmonary edema.
2. Which task is most appropriate for the Licensed Practical Nurse (LPN) to
delegate to an Unlicensed Assistive Personnel (UAP)?
A. Assessing a client’s lung sounds
B. Administering a nebulizer treatment
C. Assisting a stable client with a bed bath
D. Evaluating the effectiveness of pain medication
Answer: C
Rationale: UAPs can perform ADLs like bathing for stable clients. Assessment, medication
administration, and evaluation require licensed nursing judgment.
,3. A client is prescribed furosemide (Lasix). Which lab value should the nurse
monitor most closely?
A. Serum calcium
B. Hemoglobin
C. White blood cell count
D. Serum potassium
Answer: D
Rationale: Furosemide is a loop diuretic that causes potassium excretion; hypokalemia is a
significant risk.
4. What is the priority nursing intervention for a client experiencing a tonic-
clonic seizure?
A. Inserting a padded tongue blade
B. Restraining the client’s limbs
C. Turning the client to a side-lying position
D. Administering oral glucose
Answer: C
Rationale: The side-lying position helps maintain a patent airway and prevents aspiration
of secretions or vomitus during or after a seizure.
5. A client with type 1 diabetes mellitus presents with diaphoresis, tremors, and
confusion. Which action should the nurse take first?
A. Administer the scheduled insulin dose
B. Call the healthcare provider
C. Check the client’s blood glucose level
D. Document the findings
Answer: C
Rationale: Symptoms suggest hypoglycemia. The nurse must verify the blood glucose level
before intervening (e.g., providing oral glucose).
, 6. Which dietary instruction should be included for a client diagnosed with
chronic renal failure?
A. Restrict dietary potassium and phosphorus
B. Increase protein intake
C. Increase sodium intake
D. Drink at least 3 liters of water daily
Answer: A
Rationale: Damaged kidneys cannot effectively filter potassium or phosphorus. Protein,
sodium, and fluids are also typically restricted based on the stage of failure.
7. A client is taking warfarin (Coumadin). Which vitamin should the nurse
instruct the client to maintain at a consistent intake level?
A. Vitamin K
B. Vitamin B12
C. Vitamin C
D. Vitamin D
Answer: A
Rationale: Vitamin K is the antagonist to warfarin. Fluctuations in intake can alter the
drug’s effectiveness and the client’s INR levels.
8. The nurse is preparing to administer digoxin. Which assessment finding would
require withholding the medication?
A. Blood pressure of 140/90 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Temperature of 99.1°F
Answer: B
Rationale: Digoxin should be withheld if the apical pulse is below 60 bpm in adults to
prevent further bradycardia.
UPDATE
1. A nurse is caring for a client with heart failure. Which clinical finding should
the nurse report immediately as a sign of worsening condition?
A. Trace edema in the ankles
B. Pulse rate of 82 beats per minute
C. Increased appetite
D. Weight gain of 3 lbs (1.4 kg) in 24 hours
Answer: D
Rationale: Sudden weight gain (over 2-3 lbs in a day) indicates fluid retention, a hallmark
of worsening heart failure and potential pulmonary edema.
2. Which task is most appropriate for the Licensed Practical Nurse (LPN) to
delegate to an Unlicensed Assistive Personnel (UAP)?
A. Assessing a client’s lung sounds
B. Administering a nebulizer treatment
C. Assisting a stable client with a bed bath
D. Evaluating the effectiveness of pain medication
Answer: C
Rationale: UAPs can perform ADLs like bathing for stable clients. Assessment, medication
administration, and evaluation require licensed nursing judgment.
,3. A client is prescribed furosemide (Lasix). Which lab value should the nurse
monitor most closely?
A. Serum calcium
B. Hemoglobin
C. White blood cell count
D. Serum potassium
Answer: D
Rationale: Furosemide is a loop diuretic that causes potassium excretion; hypokalemia is a
significant risk.
4. What is the priority nursing intervention for a client experiencing a tonic-
clonic seizure?
A. Inserting a padded tongue blade
B. Restraining the client’s limbs
C. Turning the client to a side-lying position
D. Administering oral glucose
Answer: C
Rationale: The side-lying position helps maintain a patent airway and prevents aspiration
of secretions or vomitus during or after a seizure.
5. A client with type 1 diabetes mellitus presents with diaphoresis, tremors, and
confusion. Which action should the nurse take first?
A. Administer the scheduled insulin dose
B. Call the healthcare provider
C. Check the client’s blood glucose level
D. Document the findings
Answer: C
Rationale: Symptoms suggest hypoglycemia. The nurse must verify the blood glucose level
before intervening (e.g., providing oral glucose).
, 6. Which dietary instruction should be included for a client diagnosed with
chronic renal failure?
A. Restrict dietary potassium and phosphorus
B. Increase protein intake
C. Increase sodium intake
D. Drink at least 3 liters of water daily
Answer: A
Rationale: Damaged kidneys cannot effectively filter potassium or phosphorus. Protein,
sodium, and fluids are also typically restricted based on the stage of failure.
7. A client is taking warfarin (Coumadin). Which vitamin should the nurse
instruct the client to maintain at a consistent intake level?
A. Vitamin K
B. Vitamin B12
C. Vitamin C
D. Vitamin D
Answer: A
Rationale: Vitamin K is the antagonist to warfarin. Fluctuations in intake can alter the
drug’s effectiveness and the client’s INR levels.
8. The nurse is preparing to administer digoxin. Which assessment finding would
require withholding the medication?
A. Blood pressure of 140/90 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Temperature of 99.1°F
Answer: B
Rationale: Digoxin should be withheld if the apical pulse is below 60 bpm in adults to
prevent further bradycardia.
