LPN NCLEX COMPREHENSIVE EXAM
Questions and Ansẉers with
rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A client with heart failure is prescribed furosemide. Which
electrolyte imbalance should the LPN monitor for most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss
in the urine. Hypokalemia can lead to fatal cardiac dysrhythmias, so
the LPN must monitor for it and ensure the client eats potassium-
rich foods or takes supplements as prescribed.
2. The LPN is delegating tasks to a certified nursing assistant (CNA).
Which task is most appropriate to delegate?
A) Assessing a client's postoperative pain level
B) Administering a prescribed enema
C) Measuring and recording a client's intake and output
D) Evaluating the effectiveness of a new blood pressure medication
Answer: C) Measuring and recording a client's intake and output
Rationale: Measuring and recording intake and output is within the
scope of practice for a CNA. Assessment, evaluation, and
medication administration (including enemas) require the nursing
education and license of an LPN or RN.
3. A client with asthma is prescribed albuterol via inhaler. What is
the primary therapeutic effect of this medication?
A) Reducing airway inflammation
B) Dilating the bronchioles
C) Suppressing the cough reflex
D) Thinng respiratory secretions
,Answer: B) Dilating the bronchioles
Rationale: Albuterol is a short-acting beta-agonist (SABA). Its primary
action is bronchodilation, relaxing the smooth muscles of the
airways to provide quick relief of acute asthma symptoms. Inhaled
corticosteroids reduce inflammation.
4. A postoperative client is experiencing paralytic ileus. Which
assessment finding would the LPN expect?
A) Hypoactive bowel sounds and abdominal distension
B) Hyperactive bowel sounds and diarrhea
C) Sharp, localized right lower quadrant pain
D) Bloody stools and fever
Answer: A) Hypoactive bowel sounds and abdominal distension
Rationale: Paralytic ileus is a temporary cessation of intestinal
peristalsis. This leads to the accumulation of gas and fluids, causing
abdominal distension and hypoactive or absent bowel sounds.
5. A client diagnosed with major depressive disorder is seen pacing
the hallway, muttering to themselves, and stating, "It's just not
worth it anymore." What is the LPN's priority action?
A) Ask the client to return to their room to rest.
B) Redirect the client to a group activity.
C) Report the client's behavior to the RN immediately.
D) Document the behavior in the chart and monitor.
Answer: C) Report the client's behavior to the RN immediately.
Rationale: The statement "It's just not worth it anymore" can be
interpreted as a suicidal ideation. Because the LPN cannot
independently assess or plan for suicide precautions, the priority is
to report this immediately to the RN for a full assessment and
intervention.
6. A client with type 2 diabetes mellitus reports feeling shaky,
diaphoretic, and dizzy. The LPN checks the blood glucose and it is
58 mg/dL. What is the first action the LPN should take?
, A) Administer 1 mg of glucagon intramuscularly.
B) Give the client 4 ounces of orange juice.
C) Check the blood glucose again in 15 minutes.
D) Provide a protein-rich snack.
Answer: B) Give the client 4 ounces of orange juice.
Rationale: The client is experiencing mild to moderate
hypoglycemia. The first line of treatment for a conscious client is
the "Rule of 15": give 15 grams of fast-acting carbohydrates (like 4
oz of juice). Glucagon is for unconscious clients. Protein is given
after the blood sugar stabilizes.
7. The LPN is caring for a client with Clostridioides difficile (C. diff)
infection. Which personal protective equipment (PPE) is required
when entering the room?
A) Gown and gloves only
B) N95 mask, gown, and gloves
C) Gloves and surgical mask
D) Gown, gloves, and face shield
Answer: A) Gown and gloves only
Rationale: C. diff is spread via the fecal-oral route, primarily through
contact with spores on surfaces. Contact precautions (gown and
gloves) are required. N95 masks and face shields are for airborne or
droplet pathogens, which C. diff is not.
8. A pregnant client at 32 weeks gestation is diagnosed with
preeclampsia. Which assessment finding requires immediate
notification of the RN?
A) Dependent edema in the lower extremities
B) Blood pressure of 150/96 mmHg
C) Severe headache and visual disturbances
D) Weight gain of 2 lbs in one week
Answer: C) Severe headache and visual disturbances
Rationale: Severe headache and visual disturbances (blurred vision,
spots, flashing lights) are signs of central nervous system
Questions and Ansẉers with
rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A client with heart failure is prescribed furosemide. Which
electrolyte imbalance should the LPN monitor for most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss
in the urine. Hypokalemia can lead to fatal cardiac dysrhythmias, so
the LPN must monitor for it and ensure the client eats potassium-
rich foods or takes supplements as prescribed.
2. The LPN is delegating tasks to a certified nursing assistant (CNA).
Which task is most appropriate to delegate?
A) Assessing a client's postoperative pain level
B) Administering a prescribed enema
C) Measuring and recording a client's intake and output
D) Evaluating the effectiveness of a new blood pressure medication
Answer: C) Measuring and recording a client's intake and output
Rationale: Measuring and recording intake and output is within the
scope of practice for a CNA. Assessment, evaluation, and
medication administration (including enemas) require the nursing
education and license of an LPN or RN.
3. A client with asthma is prescribed albuterol via inhaler. What is
the primary therapeutic effect of this medication?
A) Reducing airway inflammation
B) Dilating the bronchioles
C) Suppressing the cough reflex
D) Thinng respiratory secretions
,Answer: B) Dilating the bronchioles
Rationale: Albuterol is a short-acting beta-agonist (SABA). Its primary
action is bronchodilation, relaxing the smooth muscles of the
airways to provide quick relief of acute asthma symptoms. Inhaled
corticosteroids reduce inflammation.
4. A postoperative client is experiencing paralytic ileus. Which
assessment finding would the LPN expect?
A) Hypoactive bowel sounds and abdominal distension
B) Hyperactive bowel sounds and diarrhea
C) Sharp, localized right lower quadrant pain
D) Bloody stools and fever
Answer: A) Hypoactive bowel sounds and abdominal distension
Rationale: Paralytic ileus is a temporary cessation of intestinal
peristalsis. This leads to the accumulation of gas and fluids, causing
abdominal distension and hypoactive or absent bowel sounds.
5. A client diagnosed with major depressive disorder is seen pacing
the hallway, muttering to themselves, and stating, "It's just not
worth it anymore." What is the LPN's priority action?
A) Ask the client to return to their room to rest.
B) Redirect the client to a group activity.
C) Report the client's behavior to the RN immediately.
D) Document the behavior in the chart and monitor.
Answer: C) Report the client's behavior to the RN immediately.
Rationale: The statement "It's just not worth it anymore" can be
interpreted as a suicidal ideation. Because the LPN cannot
independently assess or plan for suicide precautions, the priority is
to report this immediately to the RN for a full assessment and
intervention.
6. A client with type 2 diabetes mellitus reports feeling shaky,
diaphoretic, and dizzy. The LPN checks the blood glucose and it is
58 mg/dL. What is the first action the LPN should take?
, A) Administer 1 mg of glucagon intramuscularly.
B) Give the client 4 ounces of orange juice.
C) Check the blood glucose again in 15 minutes.
D) Provide a protein-rich snack.
Answer: B) Give the client 4 ounces of orange juice.
Rationale: The client is experiencing mild to moderate
hypoglycemia. The first line of treatment for a conscious client is
the "Rule of 15": give 15 grams of fast-acting carbohydrates (like 4
oz of juice). Glucagon is for unconscious clients. Protein is given
after the blood sugar stabilizes.
7. The LPN is caring for a client with Clostridioides difficile (C. diff)
infection. Which personal protective equipment (PPE) is required
when entering the room?
A) Gown and gloves only
B) N95 mask, gown, and gloves
C) Gloves and surgical mask
D) Gown, gloves, and face shield
Answer: A) Gown and gloves only
Rationale: C. diff is spread via the fecal-oral route, primarily through
contact with spores on surfaces. Contact precautions (gown and
gloves) are required. N95 masks and face shields are for airborne or
droplet pathogens, which C. diff is not.
8. A pregnant client at 32 weeks gestation is diagnosed with
preeclampsia. Which assessment finding requires immediate
notification of the RN?
A) Dependent edema in the lower extremities
B) Blood pressure of 150/96 mmHg
C) Severe headache and visual disturbances
D) Weight gain of 2 lbs in one week
Answer: C) Severe headache and visual disturbances
Rationale: Severe headache and visual disturbances (blurred vision,
spots, flashing lights) are signs of central nervous system