NCLEX-PN PRACTICE EXAM– QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A licensed practical nurse (LPN) is caring for a client admitted with a diagnosis of
chronic obstructive pulmonary disease (COPD) experiencing acute dyspnea. Which
intervention should the LPN implement first?
A. Administer the prescribed oral bronchodilator
B. Assist the client into a high-Fowler position
C. Draw blood for arterial blood gas analysis
D. Teach pursed-lip breathing techniques
The LPN should immediately assist the client into a high-Fowler position or tripod position to
maximize chest expansion and ease respiratory distress. Airway and positioning take
precedence before administering medications, drawing labs, or providing education during an
acute crisis.
2. A client with type 1 diabetes mellitus is found confused, tremulous, and diaphoretic by
the LPN. The client is awake and able to swallow. What is the immediate nursing action?
A. Administer 1 mg of glucagon subcutaneously
B. Provide 4 ounces of orange juice
C. Administer regular insulin intravenously
D. Obtain a stat glycosylated hemoglobin level
For a conscious client experiencing mild to moderate hypoglycemia, the rule of 15 should be
applied by giving 15 grams of fast-acting carbohydrates, such as 4 ounces of fruit juice.
Glucagon is reserved for unconscious clients, and insulin would worsen hypoglycemia.
3. The LPN is reinforcing discharge instructions to a client prescribed warfarin sodium.
Which statement by the client indicates an understanding of the dietary teaching?
A. "I will eliminate all green vegetables from my diet immediately."
B. "I should maintain a consistent daily intake of foods containing vitamin K."
,C. "I can safely consume large quantities of cranberry juice every day."
D. "I need to increase my consumption of garlic and ginger supplements."
Vitamin K antagonizes the effects of warfarin. Clients do not need to avoid vitamin K entirely,
but they must keep their intake consistent to maintain stable therapeutic international
normalized ratio (INR) levels. Sudden changes can alter medication efficacy.
4. A client in the immediate postoperative period following a thyroidectomy exhibits muscle
twitching and numbness around the mouth. Which laboratory value should the LPN
monitor closely?
A. Serum sodium
B. Serum calcium
C. Serum potassium
D. Serum magnesium
Inadvertent damage to or removal of the parathyroid glands during a thyroidectomy leads to
hypocalcemia. Early signs of hypocalcemia include circumoral numbness, tingling, and
muscle twitching such as Trousseau or Chvostek signs.
5. The LPN is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires the LPN to withhold the medication and notify the registered
nurse (RN)?
A. Blood pressure of 130/80 mmHg
B. Apical pulse rate of 54 beats per minute
C. Serum potassium level of 4.2 mEq/L
D. Respiratory rate of 16 breaths per minute
Digoxin has a negative chronotropic effect, slowing the heart rate. The LPN must apical pulse
for a full minute and withhold the dose if the heart rate is below 60 beats per minute in an
adult client to prevent severe bradycardia and toxicity.
6. An older adult client is admitted with a diagnosis of dehydration and acute confusion.
Which assessment finding is most indicative of successful rehydration therapy?
A. Blood pressure of 140/90 mmHg
B. Urine output of 45 mL/hr
,C. Serum sodium level of 150 mEq/L
D. Skin tenting lasting 4 seconds
An adequate urine output of at least 30 to 50 mL/hr is the most reliable and direct indicator of
adequate renal perfusion and restoration of circulating fluid volume. The other options reflect
ongoing dehydration or hypertension.
7. A client with a newly placed left arm arteriovenous (AV) fistula for hemodialysis
expresses concern about feeling a vibrating sensation over the access site. How should the
LPN respond?
A. "I will notify the physician immediately because this indicates a clot."
B. "This is a normal finding called a thrill and indicates the fistula is patent."
C. "You should apply a warm compress to the area to reduce the vibration."
D. "Keep your arm elevated above the level of your heart to stop the buzzing."
A palpable thrill and an audible bruit are normal findings over a functioning AV fistula,
indicating turbulent blood flow between the artery and vein, which is necessary for
hemodialysis access.
8. The LPN is monitoring a client receiving a blood transfusion who begins to complain of
lower back pain, chills, and facial flushing 15 minutes after initiation. What is the priority
action?
A. Slow the rate of the blood transfusion
B. Stop the transfusion and disconnect the tubing immediately
C. Administer the prescribed antihistamine
D. Cover the client with an extra warm blanket
Back pain, chills, and flushing are classic signs of an acute hemolytic transfusion reaction.
The LPN must stop the transfusion immediately, maintain intravenous access with normal
saline using new tubing, and notify the RN and physician.
9. A client diagnosed with major depressive disorder is started on sertraline. Which piece
of education is essential for the LPN to provide regarding this medication?
A. "You will experience immediate relief of depressive symptoms within 24 hours."
, B. "Therapeutic effects may take 2 to 4 weeks or longer to become fully apparent."
C. "You must completely avoid all dietary sources of tyramine."
D. "Stop taking the medication immediately if you feel tired during the day."
Selective serotonin reuptake inhibitors (SSRIs) like sertraline typically require 2 to 4 weeks,
and sometimes up to 6 weeks, to achieve full therapeutic efficacy. Clients must be informed of
this delay to prevent premature discontinuation.
10. An LPN is caring for a client with a nasogastric (NG) tube connected to low
intermittent suction. Which finding indicates a potential complication of tube
management?
A. The pH of the aspirate is 3.5
B. The client reports dry mouth and thirst
C. The client develops metabolic alkalosis
D. The gastric output is pale yellow and clear
Continuous suctioning removes gastric secretions rich in hydrochloric acid and potassium,
which can lead to metabolic alkalosis and hypokalemia. The other findings are normal or
expected side effects of having an NG tube.
11. The LPN is assisting in the care of a client with a diagnosis of iron-deficiency anemia
who has been prescribed liquid ferrous sulfate elixir. What instruction should be included
to maximize absorption and minimize side effects?
A. "Take the medication with a glass of whole milk."
B. "Dilute the liquid iron in juice and drink it through a straw."
C. "Brush your teeth immediately after swallowing the dose."
D. "Expect your stools to appear pale or clay-colored."
Liquid iron preparations can stain the teeth permanently; using a straw minimizes contact
with tooth enamel. Diluting it and taking it with vitamin C enhances absorption, whereas milk
inhibits iron absorption, and stools normally turn dark green or black.
12. A client with Parkinson disease is prescribed levodopa-carbidopa. Which clinical
manifestation indicates that the medication is achieving its therapeutic goal?
A. Increased muscle rigidity and resting tremors
VERIFIED AND WELL DETAILED ANSWERS PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A licensed practical nurse (LPN) is caring for a client admitted with a diagnosis of
chronic obstructive pulmonary disease (COPD) experiencing acute dyspnea. Which
intervention should the LPN implement first?
A. Administer the prescribed oral bronchodilator
B. Assist the client into a high-Fowler position
C. Draw blood for arterial blood gas analysis
D. Teach pursed-lip breathing techniques
The LPN should immediately assist the client into a high-Fowler position or tripod position to
maximize chest expansion and ease respiratory distress. Airway and positioning take
precedence before administering medications, drawing labs, or providing education during an
acute crisis.
2. A client with type 1 diabetes mellitus is found confused, tremulous, and diaphoretic by
the LPN. The client is awake and able to swallow. What is the immediate nursing action?
A. Administer 1 mg of glucagon subcutaneously
B. Provide 4 ounces of orange juice
C. Administer regular insulin intravenously
D. Obtain a stat glycosylated hemoglobin level
For a conscious client experiencing mild to moderate hypoglycemia, the rule of 15 should be
applied by giving 15 grams of fast-acting carbohydrates, such as 4 ounces of fruit juice.
Glucagon is reserved for unconscious clients, and insulin would worsen hypoglycemia.
3. The LPN is reinforcing discharge instructions to a client prescribed warfarin sodium.
Which statement by the client indicates an understanding of the dietary teaching?
A. "I will eliminate all green vegetables from my diet immediately."
B. "I should maintain a consistent daily intake of foods containing vitamin K."
,C. "I can safely consume large quantities of cranberry juice every day."
D. "I need to increase my consumption of garlic and ginger supplements."
Vitamin K antagonizes the effects of warfarin. Clients do not need to avoid vitamin K entirely,
but they must keep their intake consistent to maintain stable therapeutic international
normalized ratio (INR) levels. Sudden changes can alter medication efficacy.
4. A client in the immediate postoperative period following a thyroidectomy exhibits muscle
twitching and numbness around the mouth. Which laboratory value should the LPN
monitor closely?
A. Serum sodium
B. Serum calcium
C. Serum potassium
D. Serum magnesium
Inadvertent damage to or removal of the parathyroid glands during a thyroidectomy leads to
hypocalcemia. Early signs of hypocalcemia include circumoral numbness, tingling, and
muscle twitching such as Trousseau or Chvostek signs.
5. The LPN is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires the LPN to withhold the medication and notify the registered
nurse (RN)?
A. Blood pressure of 130/80 mmHg
B. Apical pulse rate of 54 beats per minute
C. Serum potassium level of 4.2 mEq/L
D. Respiratory rate of 16 breaths per minute
Digoxin has a negative chronotropic effect, slowing the heart rate. The LPN must apical pulse
for a full minute and withhold the dose if the heart rate is below 60 beats per minute in an
adult client to prevent severe bradycardia and toxicity.
6. An older adult client is admitted with a diagnosis of dehydration and acute confusion.
Which assessment finding is most indicative of successful rehydration therapy?
A. Blood pressure of 140/90 mmHg
B. Urine output of 45 mL/hr
,C. Serum sodium level of 150 mEq/L
D. Skin tenting lasting 4 seconds
An adequate urine output of at least 30 to 50 mL/hr is the most reliable and direct indicator of
adequate renal perfusion and restoration of circulating fluid volume. The other options reflect
ongoing dehydration or hypertension.
7. A client with a newly placed left arm arteriovenous (AV) fistula for hemodialysis
expresses concern about feeling a vibrating sensation over the access site. How should the
LPN respond?
A. "I will notify the physician immediately because this indicates a clot."
B. "This is a normal finding called a thrill and indicates the fistula is patent."
C. "You should apply a warm compress to the area to reduce the vibration."
D. "Keep your arm elevated above the level of your heart to stop the buzzing."
A palpable thrill and an audible bruit are normal findings over a functioning AV fistula,
indicating turbulent blood flow between the artery and vein, which is necessary for
hemodialysis access.
8. The LPN is monitoring a client receiving a blood transfusion who begins to complain of
lower back pain, chills, and facial flushing 15 minutes after initiation. What is the priority
action?
A. Slow the rate of the blood transfusion
B. Stop the transfusion and disconnect the tubing immediately
C. Administer the prescribed antihistamine
D. Cover the client with an extra warm blanket
Back pain, chills, and flushing are classic signs of an acute hemolytic transfusion reaction.
The LPN must stop the transfusion immediately, maintain intravenous access with normal
saline using new tubing, and notify the RN and physician.
9. A client diagnosed with major depressive disorder is started on sertraline. Which piece
of education is essential for the LPN to provide regarding this medication?
A. "You will experience immediate relief of depressive symptoms within 24 hours."
, B. "Therapeutic effects may take 2 to 4 weeks or longer to become fully apparent."
C. "You must completely avoid all dietary sources of tyramine."
D. "Stop taking the medication immediately if you feel tired during the day."
Selective serotonin reuptake inhibitors (SSRIs) like sertraline typically require 2 to 4 weeks,
and sometimes up to 6 weeks, to achieve full therapeutic efficacy. Clients must be informed of
this delay to prevent premature discontinuation.
10. An LPN is caring for a client with a nasogastric (NG) tube connected to low
intermittent suction. Which finding indicates a potential complication of tube
management?
A. The pH of the aspirate is 3.5
B. The client reports dry mouth and thirst
C. The client develops metabolic alkalosis
D. The gastric output is pale yellow and clear
Continuous suctioning removes gastric secretions rich in hydrochloric acid and potassium,
which can lead to metabolic alkalosis and hypokalemia. The other findings are normal or
expected side effects of having an NG tube.
11. The LPN is assisting in the care of a client with a diagnosis of iron-deficiency anemia
who has been prescribed liquid ferrous sulfate elixir. What instruction should be included
to maximize absorption and minimize side effects?
A. "Take the medication with a glass of whole milk."
B. "Dilute the liquid iron in juice and drink it through a straw."
C. "Brush your teeth immediately after swallowing the dose."
D. "Expect your stools to appear pale or clay-colored."
Liquid iron preparations can stain the teeth permanently; using a straw minimizes contact
with tooth enamel. Diluting it and taking it with vitamin C enhances absorption, whereas milk
inhibits iron absorption, and stools normally turn dark green or black.
12. A client with Parkinson disease is prescribed levodopa-carbidopa. Which clinical
manifestation indicates that the medication is achieving its therapeutic goal?
A. Increased muscle rigidity and resting tremors
