LPN/LVN Module Exam 4 (Week 12) NCLEX-PN Practice 2026 UPDATE
|SBON
1. A nurse is caring for a client with heart failure who is taking digoxin. Which
laboratory value should the nurse monitor most closely to prevent digoxin
toxicity?
A. Serum potassium
B. Serum calcium
C. Serum sodium
D. Serum glucose
Answer: A
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
2. A client is prescribed warfarin for atrial fibrillation. The nurse should instruct
the client to maintain a consistent intake of which food?
A. Red meat
B. Citrus fruits
C. Dairy products
D. Spinach
Answer: D
Rationale: Spinach is high in Vitamin K, which is the antidote for warfarin. Large
fluctuations in Vitamin K intake can interfere with the medication’s anticoagulant effects.
,3. The nurse is assessing a client 4 hours after a vaginal delivery. The fundus is
firm, 2 cm above the umbilicus, and displaced to the right. What is the priority
nursing action?
A. Massage the fundus
B. Assist the client to the bathroom to void
C. Notify the healthcare provider immediately
D. Administer oxytocin as ordered
Answer: B
Rationale: A fundus displaced to the right and above the umbilicus usually indicates a full
bladder, which can prevent the uterus from contracting and lead to hemorrhage.
4. Which of the following is a positive symptom of schizophrenia?
A. Flat affect
B. Social withdrawal
C. Lack of motivation
D. Auditory hallucinations
Answer: D
Rationale: Positive symptoms of schizophrenia are ‘add-ons’ to normal behavior, such as
hallucinations, delusions, and disorganized speech. Negative symptoms involve a loss of
normal function (e.g., flat affect).
5. A nurse is preparing to administer 0.5 mL of a medication intramuscularly to a
6-month-old infant. Which site is most appropriate?
A. Dorsogluteal
B. Ventrogluteal
C. Deltoid
D. Vastus lateralis
Answer: D
, Rationale: The vastus lateralis is the preferred site for IM injections in infants under 1 year
of age because it is the most developed muscle group.
6. A client with bipolar disorder is in the manic phase. Which meal choice is
most appropriate for the nurse to provide?
A. A cheeseburger and an apple
B. Chicken noodle soup and crackers
C. Steak, baked potato, and salad
D. Spaghetti and meatballs
Answer: A
Rationale: Clients in a manic phase often cannot sit still to eat. Providing high-calorie
‘finger foods’ like a cheeseburger allows them to eat while moving.
7. What is the therapeutic serum lithium level range for a client with bipolar
disorder?
A. 0.1 to 0.5 mEq/L
B. 2.5 to 3.0 mEq/L
C. 1.5 to 2.0 mEq/L
D. 0.6 to 1.2 mEq/L
Answer: D
Rationale: The therapeutic range for lithium is narrow, typically 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L are considered toxic.
8. A nurse is caring for a client with a new diagnosis of Type 1 Diabetes. Which
symptom is a classic sign of hyperglycemia?
A. Diaphoresis
B. Tremors
C. Polydipsia
D. Irritability
Answer: C
|SBON
1. A nurse is caring for a client with heart failure who is taking digoxin. Which
laboratory value should the nurse monitor most closely to prevent digoxin
toxicity?
A. Serum potassium
B. Serum calcium
C. Serum sodium
D. Serum glucose
Answer: A
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
2. A client is prescribed warfarin for atrial fibrillation. The nurse should instruct
the client to maintain a consistent intake of which food?
A. Red meat
B. Citrus fruits
C. Dairy products
D. Spinach
Answer: D
Rationale: Spinach is high in Vitamin K, which is the antidote for warfarin. Large
fluctuations in Vitamin K intake can interfere with the medication’s anticoagulant effects.
,3. The nurse is assessing a client 4 hours after a vaginal delivery. The fundus is
firm, 2 cm above the umbilicus, and displaced to the right. What is the priority
nursing action?
A. Massage the fundus
B. Assist the client to the bathroom to void
C. Notify the healthcare provider immediately
D. Administer oxytocin as ordered
Answer: B
Rationale: A fundus displaced to the right and above the umbilicus usually indicates a full
bladder, which can prevent the uterus from contracting and lead to hemorrhage.
4. Which of the following is a positive symptom of schizophrenia?
A. Flat affect
B. Social withdrawal
C. Lack of motivation
D. Auditory hallucinations
Answer: D
Rationale: Positive symptoms of schizophrenia are ‘add-ons’ to normal behavior, such as
hallucinations, delusions, and disorganized speech. Negative symptoms involve a loss of
normal function (e.g., flat affect).
5. A nurse is preparing to administer 0.5 mL of a medication intramuscularly to a
6-month-old infant. Which site is most appropriate?
A. Dorsogluteal
B. Ventrogluteal
C. Deltoid
D. Vastus lateralis
Answer: D
, Rationale: The vastus lateralis is the preferred site for IM injections in infants under 1 year
of age because it is the most developed muscle group.
6. A client with bipolar disorder is in the manic phase. Which meal choice is
most appropriate for the nurse to provide?
A. A cheeseburger and an apple
B. Chicken noodle soup and crackers
C. Steak, baked potato, and salad
D. Spaghetti and meatballs
Answer: A
Rationale: Clients in a manic phase often cannot sit still to eat. Providing high-calorie
‘finger foods’ like a cheeseburger allows them to eat while moving.
7. What is the therapeutic serum lithium level range for a client with bipolar
disorder?
A. 0.1 to 0.5 mEq/L
B. 2.5 to 3.0 mEq/L
C. 1.5 to 2.0 mEq/L
D. 0.6 to 1.2 mEq/L
Answer: D
Rationale: The therapeutic range for lithium is narrow, typically 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L are considered toxic.
8. A nurse is caring for a client with a new diagnosis of Type 1 Diabetes. Which
symptom is a classic sign of hyperglycemia?
A. Diaphoresis
B. Tremors
C. Polydipsia
D. Irritability
Answer: C
