LPN to ADN Bridge Exam 4 - Advanced RN Practice, Critical Care &
Leadership 2026/2027 UPDATE
1. A nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which of the
following tasks is most appropriate for the RN to delegate to the LPN?
A. Performing the initial admission assessment on a new patient
B. Titrating an intravenous dopamine drip based on hemodynamic parameters
C. Developing a plan of care for a patient with complex wounds
D. Administering a scheduled subcutaneous insulin injection
Answer: D
Rationale: LPNs can perform routine tasks and administer medications like insulin, but the
RN is responsible for initial assessments, care planning, and high-risk titrations.
2. A patient’s arterial blood gas (ABG) results are: pH 7.25, PaCO2 50 mmHg, and
HCO3 24 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale: A low pH (<7.35) indicates acidosis, and a high PaCO2 (>45) indicates the cause
is respiratory.
,3. The nurse is monitoring a patient with a Central Venous Pressure (CVP) of 1
mmHg. Which intervention should the nurse anticipate?
A. Administering a bolus of 0.9% Normal Saline
B. Decreasing the IV fluid rate
C. Administering a diuretic
D. Restricting oral fluid intake
Answer: A
Rationale: A low CVP (normal 2-8 mmHg) indicates hypovolemia, requiring fluid
resuscitation.
4. While monitoring a patient’s EKG, the nurse notes a sudden onset of wide
QRS complexes at a rate of 160 bpm with no visible P waves. The patient is
pulseless. What is the priority action?
A. Administer Amiodarone IV
B. Perform immediate defibrillation
C. Start a dopamine infusion
D. Check a blood pressure
Answer: B
Rationale: Pulseless Ventricular Tachycardia (VT) is a shockable rhythm; immediate
defibrillation is the priority according to ACLS guidelines.
5. A nurse manager encourages staff to participate in decision-making and
values their input in policy changes. Which leadership style is being
demonstrated?
A. Autocratic
B. Democratic
C. Laissez-faire
D. Transactional
Answer: B
, Rationale: Democratic leadership involves collaborative decision-making and values staff
input.
6. During a mass casualty incident, which patient should the triage nurse assign
a ‘Red’ tag?
A. A patient with a minor arm laceration
B. A patient who is unresponsive with no respirations
C. A patient with a compound fracture and stable vitals
D. A patient with a sucking chest wound and respiratory distress
Answer: D
Rationale: Red tags are for immediate life-threatening injuries that are treatable, such as
airway or breathing emergencies.
7. A patient in septic shock has failed to respond to fluid resuscitation. Which
medication should the nurse expect the healthcare provider to order next?
A. Norepinephrine
B. Furosemide
C. Nitroglycerin
D. Atropine
Answer: A
Rationale: Norepinephrine is the first-line vasopressor for septic shock when fluids are
insufficient.
8. The high-pressure alarm on a patient’s mechanical ventilator is sounding.
Which of the following is a potential cause?
A. The patient is biting the endotracheal tube
B. A leak in the cuff of the endotracheal tube
C. The ventilator tubing has become disconnected
D. The patient has self-extubated
Answer: A
Leadership 2026/2027 UPDATE
1. A nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which of the
following tasks is most appropriate for the RN to delegate to the LPN?
A. Performing the initial admission assessment on a new patient
B. Titrating an intravenous dopamine drip based on hemodynamic parameters
C. Developing a plan of care for a patient with complex wounds
D. Administering a scheduled subcutaneous insulin injection
Answer: D
Rationale: LPNs can perform routine tasks and administer medications like insulin, but the
RN is responsible for initial assessments, care planning, and high-risk titrations.
2. A patient’s arterial blood gas (ABG) results are: pH 7.25, PaCO2 50 mmHg, and
HCO3 24 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale: A low pH (<7.35) indicates acidosis, and a high PaCO2 (>45) indicates the cause
is respiratory.
,3. The nurse is monitoring a patient with a Central Venous Pressure (CVP) of 1
mmHg. Which intervention should the nurse anticipate?
A. Administering a bolus of 0.9% Normal Saline
B. Decreasing the IV fluid rate
C. Administering a diuretic
D. Restricting oral fluid intake
Answer: A
Rationale: A low CVP (normal 2-8 mmHg) indicates hypovolemia, requiring fluid
resuscitation.
4. While monitoring a patient’s EKG, the nurse notes a sudden onset of wide
QRS complexes at a rate of 160 bpm with no visible P waves. The patient is
pulseless. What is the priority action?
A. Administer Amiodarone IV
B. Perform immediate defibrillation
C. Start a dopamine infusion
D. Check a blood pressure
Answer: B
Rationale: Pulseless Ventricular Tachycardia (VT) is a shockable rhythm; immediate
defibrillation is the priority according to ACLS guidelines.
5. A nurse manager encourages staff to participate in decision-making and
values their input in policy changes. Which leadership style is being
demonstrated?
A. Autocratic
B. Democratic
C. Laissez-faire
D. Transactional
Answer: B
, Rationale: Democratic leadership involves collaborative decision-making and values staff
input.
6. During a mass casualty incident, which patient should the triage nurse assign
a ‘Red’ tag?
A. A patient with a minor arm laceration
B. A patient who is unresponsive with no respirations
C. A patient with a compound fracture and stable vitals
D. A patient with a sucking chest wound and respiratory distress
Answer: D
Rationale: Red tags are for immediate life-threatening injuries that are treatable, such as
airway or breathing emergencies.
7. A patient in septic shock has failed to respond to fluid resuscitation. Which
medication should the nurse expect the healthcare provider to order next?
A. Norepinephrine
B. Furosemide
C. Nitroglycerin
D. Atropine
Answer: A
Rationale: Norepinephrine is the first-line vasopressor for septic shock when fluids are
insufficient.
8. The high-pressure alarm on a patient’s mechanical ventilator is sounding.
Which of the following is a potential cause?
A. The patient is biting the endotracheal tube
B. A leak in the cuff of the endotracheal tube
C. The ventilator tubing has become disconnected
D. The patient has self-extubated
Answer: A
