LPN-TO-ADN HESI TRANSITION PRACTICE
EXAM STUDY GUIDE CRITICAL NCLEX-
STYLE QUESTIONS
This comprehensive practice exam bundle is expertly
engineered for LPNs transitioning into an Associate
Degree in Nursing (ADN) program. It delivers high-yield
multiple-choice questions focusing on critical lab values,
patient mobility, fluid-electrolyte balance, and advanced
clinical prioritization strategies.
1. A nurse is caring for a patient with a history of
deep vein thrombosis (DVT) who is receiving a
continuous intravenous heparin infusion. Which
laboratory value should the nurse monitor to
adjust the medication dosage?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Answer: C) Activated partial thromboplastin time
(aPTT)
Rationale: Activated partial thromboplastin time
(aPTT) is used to monitor the therapeutic
effectiveness of unfractionated heparin
infusions. PT and INR are utilized to monitor oral
warfarin therapy. Platelet counts are monitored
,to screen for heparin-induced thrombocytopenia
(HIT), but not to titrate the active dosage.
2. An LPN-to-ADN transition student is reviewing
lab results for an adult female client presenting
with severe fatigue. The client’s Red Blood Cell
(RBC) count is 3.1 x 10¹²/L. How should the nurse
interpret this finding?
A) Within normal physiological limits for an adult
female
B) Significantly elevated, indicating polycythemia
vera
C) Decreased, suggesting a form of anemia or blood
loss
D) Moderately elevated due to acute dehydration
Answer: C) Decreased, suggesting a form of anemia
or blood loss
Rationale: The normal RBC range for an adult
female is approximately 3.92 to 5.13 x 10¹²/L. A
value of 3.1 x 10¹²/L is low (erythrocytopenia),
which directly corresponds to clinical
manifestations of fatigue, pallor, and weakness
due to decreased oxygen-carrying capacity.
3. A client is admitted to the medical-surgical
unit with chronic liver cirrhosis. The nurse notes
a serum albumin level of 2.1 g/dL. Which clinical
,assessment finding should the nurse anticipate
based on this lab value?
A) Severe generalized fluid volume deficit and
tenting skin turgor
B) Generalized peripheral edema and ascites
C) Deep bone pain and pathological fractures
D) Elevated blood pressure and bounding pulses
Answer: B) Generalized peripheral edema and
ascites
Rationale: Albumin ranges from 3.4 to 5.4 g/dL
normally. It maintains colloid oncotic pressure
within vascular compartments. When it drops
significantly to 2.1 g/dL, fluid shifts out of cells
and vessels into interstitial spaces, manifesting
as third-spacing, peripheral edema, and ascites.
4. The nurse prepares to assist a client who has
left-sided weakness following a cerebrovascular
accident (CVA) from the bed to a wheelchair.
Where should the nurse position the wheelchair?
A) On the client's left side, angled toward the bed
B) On the client's right side, angled toward the bed
C) Directly facing the bed at the foot of the mattress
D) Parallel to the bed on the client's weak side
Answer: B) On the client's right side, angled toward
the bed
, Rationale: During transfers, assistive devices
and seating structures must be placed on the
client's unaffected or strong side (the right side
in this scenario). This allows the client to bear
weight and pivot safely on their functional leg.
5. A client is diagnosed with acute pancreatitis.
Which laboratory values does the nurse expect
to be significantly elevated?
A) Serum amylase and lipase
B) Alanine aminotransferase (ALT) and aspartate
aminotransferase (AST)
C) Blood urea nitrogen (BUN) and creatinine
D) Creatine kinase (CK) and troponin I
Answer: A) Serum amylase and lipase
Rationale: Amylase and lipase are digestive
enzymes produced by the pancreas. In acute
pancreatitis, inflammation causes these
enzymes to leak out into peripheral circulation,
resulting in rapid and diagnostic elevations.
6. A nurse is evaluating a client using a cane for
right-sided hip osteoarthritis. Which
demonstration by the client indicates proper
understanding of the assistive device?
EXAM STUDY GUIDE CRITICAL NCLEX-
STYLE QUESTIONS
This comprehensive practice exam bundle is expertly
engineered for LPNs transitioning into an Associate
Degree in Nursing (ADN) program. It delivers high-yield
multiple-choice questions focusing on critical lab values,
patient mobility, fluid-electrolyte balance, and advanced
clinical prioritization strategies.
1. A nurse is caring for a patient with a history of
deep vein thrombosis (DVT) who is receiving a
continuous intravenous heparin infusion. Which
laboratory value should the nurse monitor to
adjust the medication dosage?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Answer: C) Activated partial thromboplastin time
(aPTT)
Rationale: Activated partial thromboplastin time
(aPTT) is used to monitor the therapeutic
effectiveness of unfractionated heparin
infusions. PT and INR are utilized to monitor oral
warfarin therapy. Platelet counts are monitored
,to screen for heparin-induced thrombocytopenia
(HIT), but not to titrate the active dosage.
2. An LPN-to-ADN transition student is reviewing
lab results for an adult female client presenting
with severe fatigue. The client’s Red Blood Cell
(RBC) count is 3.1 x 10¹²/L. How should the nurse
interpret this finding?
A) Within normal physiological limits for an adult
female
B) Significantly elevated, indicating polycythemia
vera
C) Decreased, suggesting a form of anemia or blood
loss
D) Moderately elevated due to acute dehydration
Answer: C) Decreased, suggesting a form of anemia
or blood loss
Rationale: The normal RBC range for an adult
female is approximately 3.92 to 5.13 x 10¹²/L. A
value of 3.1 x 10¹²/L is low (erythrocytopenia),
which directly corresponds to clinical
manifestations of fatigue, pallor, and weakness
due to decreased oxygen-carrying capacity.
3. A client is admitted to the medical-surgical
unit with chronic liver cirrhosis. The nurse notes
a serum albumin level of 2.1 g/dL. Which clinical
,assessment finding should the nurse anticipate
based on this lab value?
A) Severe generalized fluid volume deficit and
tenting skin turgor
B) Generalized peripheral edema and ascites
C) Deep bone pain and pathological fractures
D) Elevated blood pressure and bounding pulses
Answer: B) Generalized peripheral edema and
ascites
Rationale: Albumin ranges from 3.4 to 5.4 g/dL
normally. It maintains colloid oncotic pressure
within vascular compartments. When it drops
significantly to 2.1 g/dL, fluid shifts out of cells
and vessels into interstitial spaces, manifesting
as third-spacing, peripheral edema, and ascites.
4. The nurse prepares to assist a client who has
left-sided weakness following a cerebrovascular
accident (CVA) from the bed to a wheelchair.
Where should the nurse position the wheelchair?
A) On the client's left side, angled toward the bed
B) On the client's right side, angled toward the bed
C) Directly facing the bed at the foot of the mattress
D) Parallel to the bed on the client's weak side
Answer: B) On the client's right side, angled toward
the bed
, Rationale: During transfers, assistive devices
and seating structures must be placed on the
client's unaffected or strong side (the right side
in this scenario). This allows the client to bear
weight and pivot safely on their functional leg.
5. A client is diagnosed with acute pancreatitis.
Which laboratory values does the nurse expect
to be significantly elevated?
A) Serum amylase and lipase
B) Alanine aminotransferase (ALT) and aspartate
aminotransferase (AST)
C) Blood urea nitrogen (BUN) and creatinine
D) Creatine kinase (CK) and troponin I
Answer: A) Serum amylase and lipase
Rationale: Amylase and lipase are digestive
enzymes produced by the pancreas. In acute
pancreatitis, inflammation causes these
enzymes to leak out into peripheral circulation,
resulting in rapid and diagnostic elevations.
6. A nurse is evaluating a client using a cane for
right-sided hip osteoarthritis. Which
demonstration by the client indicates proper
understanding of the assistive device?
