NEW YORK GERIATRIC LPN PRACTICE EXAM | STUDY GUIDE | TESTBANK | LATEST
UPDATE 2026/2027 | QUESTIONS & 100% CORRECT ANSWERS
TABLE OF CONTENTS: I. Geriatric Assessment & Physiologic Aging — Functional
Status, Delirium, Dementia, Pain; II. Chronic Disease Management — Cardiovascular,
Respiratory, Endocrine, Renal; III. Pharmacology — Polypharmacy, Adverse Effects,
Medication Safety; IV. Safety & Mobility — Falls, Pressure Injuries, Mobility; V.
Infection Prevention — Standard Precautions, Outbreak Management; VI. Nutrition &
Hydration — Malnutrition, Dysphagia, Dehydration; VII. Psychosocial & Cognitive
Health — Depression, Dementia, Behavioral Symptoms; VIII. Ethical, Legal &
Professional Practice — Scope, Delegation, Documentation, Advance Directives; IX.
Long-Term Care & Rehabilitation — Restorative Care, Palliative Care, Resident-
Centered Practice.
INTRODUCTION
This New York Geriatric LPN Practice Exam is designed around advanced clinical
judgment required when caring for older adults in long-term care, residential,
community, and other geriatric settings. Questions emphasize physiologic changes
of aging, complex chronic illness, polypharmacy, cognitive impairment, fall and
pressure-injury prevention, infection control, nutrition, functional decline, end-of-
life care, documentation, delegation, and New York LPN scope-of-practice
principles. The questions require application rather than simple memorization, with
emphasis on prioritization, recognition of subtle deterioration, safety, ethical
decision-making, and appropriate escalation. Expect realistic clinical scenarios in
which several options appear reasonable, but one represents the safest and most
professionally appropriate nursing action.
QUESTION 1
An 84-year-old resident with hypertension and chronic kidney disease has been
stable for several months. During the evening shift, the LPN notices that the
resident is suddenly inattentive, repeatedly asks where she is, attempts to remove
her IV, and alternates between agitation and drowsiness. Her daughter reports that
this behavior began today. Which action is the LPN's priority?
,A. Document the behavior as progression of dementia and initiate the usual
dementia interventions.
B. Assess for acute physiologic causes and promptly report the acute mental-status
change.
C. Encourage the resident to sleep and reassess cognition during the morning shift.
D. Ask the daughter to remain with the resident until the confusion resolves.
Correct Answer: B
Explanation: Sudden fluctuating inattention and altered consciousness strongly
suggest delirium rather than typical dementia progression. The LPN should assess
for potentially reversible causes and promptly communicate the change to the
directing RN or practitioner.
QUESTION 2
An 89-year-old resident takes warfarin, digoxin, furosemide, lisinopril, and several
other medications. The resident reports poor appetite, nausea, and generalized
weakness. The apical pulse is 54/min and irregular. Which finding should cause the
LPN to take the most immediate action?
A. The resident reports increased thirst.
B. The resident has a blood pressure of 138/72 mm Hg.
C. The resident has bradycardia with nausea and weakness while taking digoxin.
D. The resident reports eating less meat than usual.
Correct Answer: C
Explanation: Bradycardia, nausea, and weakness can indicate digoxin toxicity,
particularly in an older adult with possible renal impairment. The medication
history and clinical findings require prompt assessment and escalation.
QUESTION 3
A 78-year-old resident with heart failure has gained 2.2 kg (4.8 lb) in four days. The
resident reports increasing fatigue and needing two pillows to sleep. Which
interpretation is most appropriate?
A. The weight gain is expected because older adults have reduced metabolic rates.
B. The findings suggest fluid retention and possible worsening heart failure.
,C. The symptoms are most consistent with age-related deconditioning.
D. The weight gain indicates improved nutritional status.
Correct Answer: B
Explanation: Rapid weight gain accompanied by orthopnea and fatigue is more
consistent with fluid accumulation than normal aging. The change should be
assessed and reported promptly.
QUESTION 4
An LPN in a long-term-care facility is caring for a resident with moderate
Alzheimer's disease. The resident becomes increasingly agitated every evening and
repeatedly asks to "go home." Which intervention is most appropriate initially?
A. Correct the resident each time and explain that the resident already lives there.
B. Use physical restraints to prevent wandering during the evening hours.
C. Assess for unmet needs and environmental triggers while providing calm
redirection.
D. Administer a sedative whenever the resident asks to leave.
Correct Answer: C
Explanation: Behavioral changes in dementia should prompt assessment for pain,
hunger, toileting needs, overstimulation, fear, or other triggers. Calm redirection
and individualized environmental strategies are preferred before restrictive
interventions.
QUESTION 5
An 81-year-old resident has osteoporosis and a history of two falls. The resident
frequently gets up at night to toilet. Which intervention most directly reduces the
resident's fall risk?
A. Keep all four bed rails raised throughout the night.
B. Encourage the resident to remain in bed unless staff are present.
C. Establish scheduled toileting and ensure a clear, adequately illuminated path to
the bathroom.
D. Restrict fluids after dinner to prevent nighttime toileting.
, Correct Answer: C
Explanation: Scheduled toileting and environmental modification directly address
a predictable fall circumstance. Routine bed-rail use and unnecessary fluid
restriction can create additional risks.
QUESTION 6
An 86-year-old resident with diabetes has a new stage 2 pressure injury over the
sacral area. Which intervention is most important for preventing further tissue
damage?
A. Massage the reddened tissue every shift.
B. Reposition the resident according to an individualized pressure-relief schedule.
C. Place a donut-shaped ring beneath the sacrum.
D. Keep the resident completely immobile until the wound heals.
Correct Answer: B
Explanation: Pressure redistribution and repositioning are fundamental to
preventing progression of pressure injury. Massage over vulnerable or injured
tissue and donut devices can worsen tissue damage.
QUESTION 7
A 91-year-old resident with Parkinson disease has coughing during meals, a wet-
sounding voice after swallowing, and recurrent lower-respiratory infections. Which
nursing action is most appropriate?
A. Encourage the resident to drink thin liquids rapidly.
B. Place the resident supine immediately after meals.
C. Recognize possible dysphagia and request appropriate swallowing evaluation.
D. Encourage the resident to eat independently without supervision.
Correct Answer: C
Explanation: Coughing, wet voice, and recurrent respiratory infections suggest
impaired swallowing and aspiration risk. Further swallowing assessment is
appropriate before modifying the diet independently.
UPDATE 2026/2027 | QUESTIONS & 100% CORRECT ANSWERS
TABLE OF CONTENTS: I. Geriatric Assessment & Physiologic Aging — Functional
Status, Delirium, Dementia, Pain; II. Chronic Disease Management — Cardiovascular,
Respiratory, Endocrine, Renal; III. Pharmacology — Polypharmacy, Adverse Effects,
Medication Safety; IV. Safety & Mobility — Falls, Pressure Injuries, Mobility; V.
Infection Prevention — Standard Precautions, Outbreak Management; VI. Nutrition &
Hydration — Malnutrition, Dysphagia, Dehydration; VII. Psychosocial & Cognitive
Health — Depression, Dementia, Behavioral Symptoms; VIII. Ethical, Legal &
Professional Practice — Scope, Delegation, Documentation, Advance Directives; IX.
Long-Term Care & Rehabilitation — Restorative Care, Palliative Care, Resident-
Centered Practice.
INTRODUCTION
This New York Geriatric LPN Practice Exam is designed around advanced clinical
judgment required when caring for older adults in long-term care, residential,
community, and other geriatric settings. Questions emphasize physiologic changes
of aging, complex chronic illness, polypharmacy, cognitive impairment, fall and
pressure-injury prevention, infection control, nutrition, functional decline, end-of-
life care, documentation, delegation, and New York LPN scope-of-practice
principles. The questions require application rather than simple memorization, with
emphasis on prioritization, recognition of subtle deterioration, safety, ethical
decision-making, and appropriate escalation. Expect realistic clinical scenarios in
which several options appear reasonable, but one represents the safest and most
professionally appropriate nursing action.
QUESTION 1
An 84-year-old resident with hypertension and chronic kidney disease has been
stable for several months. During the evening shift, the LPN notices that the
resident is suddenly inattentive, repeatedly asks where she is, attempts to remove
her IV, and alternates between agitation and drowsiness. Her daughter reports that
this behavior began today. Which action is the LPN's priority?
,A. Document the behavior as progression of dementia and initiate the usual
dementia interventions.
B. Assess for acute physiologic causes and promptly report the acute mental-status
change.
C. Encourage the resident to sleep and reassess cognition during the morning shift.
D. Ask the daughter to remain with the resident until the confusion resolves.
Correct Answer: B
Explanation: Sudden fluctuating inattention and altered consciousness strongly
suggest delirium rather than typical dementia progression. The LPN should assess
for potentially reversible causes and promptly communicate the change to the
directing RN or practitioner.
QUESTION 2
An 89-year-old resident takes warfarin, digoxin, furosemide, lisinopril, and several
other medications. The resident reports poor appetite, nausea, and generalized
weakness. The apical pulse is 54/min and irregular. Which finding should cause the
LPN to take the most immediate action?
A. The resident reports increased thirst.
B. The resident has a blood pressure of 138/72 mm Hg.
C. The resident has bradycardia with nausea and weakness while taking digoxin.
D. The resident reports eating less meat than usual.
Correct Answer: C
Explanation: Bradycardia, nausea, and weakness can indicate digoxin toxicity,
particularly in an older adult with possible renal impairment. The medication
history and clinical findings require prompt assessment and escalation.
QUESTION 3
A 78-year-old resident with heart failure has gained 2.2 kg (4.8 lb) in four days. The
resident reports increasing fatigue and needing two pillows to sleep. Which
interpretation is most appropriate?
A. The weight gain is expected because older adults have reduced metabolic rates.
B. The findings suggest fluid retention and possible worsening heart failure.
,C. The symptoms are most consistent with age-related deconditioning.
D. The weight gain indicates improved nutritional status.
Correct Answer: B
Explanation: Rapid weight gain accompanied by orthopnea and fatigue is more
consistent with fluid accumulation than normal aging. The change should be
assessed and reported promptly.
QUESTION 4
An LPN in a long-term-care facility is caring for a resident with moderate
Alzheimer's disease. The resident becomes increasingly agitated every evening and
repeatedly asks to "go home." Which intervention is most appropriate initially?
A. Correct the resident each time and explain that the resident already lives there.
B. Use physical restraints to prevent wandering during the evening hours.
C. Assess for unmet needs and environmental triggers while providing calm
redirection.
D. Administer a sedative whenever the resident asks to leave.
Correct Answer: C
Explanation: Behavioral changes in dementia should prompt assessment for pain,
hunger, toileting needs, overstimulation, fear, or other triggers. Calm redirection
and individualized environmental strategies are preferred before restrictive
interventions.
QUESTION 5
An 81-year-old resident has osteoporosis and a history of two falls. The resident
frequently gets up at night to toilet. Which intervention most directly reduces the
resident's fall risk?
A. Keep all four bed rails raised throughout the night.
B. Encourage the resident to remain in bed unless staff are present.
C. Establish scheduled toileting and ensure a clear, adequately illuminated path to
the bathroom.
D. Restrict fluids after dinner to prevent nighttime toileting.
, Correct Answer: C
Explanation: Scheduled toileting and environmental modification directly address
a predictable fall circumstance. Routine bed-rail use and unnecessary fluid
restriction can create additional risks.
QUESTION 6
An 86-year-old resident with diabetes has a new stage 2 pressure injury over the
sacral area. Which intervention is most important for preventing further tissue
damage?
A. Massage the reddened tissue every shift.
B. Reposition the resident according to an individualized pressure-relief schedule.
C. Place a donut-shaped ring beneath the sacrum.
D. Keep the resident completely immobile until the wound heals.
Correct Answer: B
Explanation: Pressure redistribution and repositioning are fundamental to
preventing progression of pressure injury. Massage over vulnerable or injured
tissue and donut devices can worsen tissue damage.
QUESTION 7
A 91-year-old resident with Parkinson disease has coughing during meals, a wet-
sounding voice after swallowing, and recurrent lower-respiratory infections. Which
nursing action is most appropriate?
A. Encourage the resident to drink thin liquids rapidly.
B. Place the resident supine immediately after meals.
C. Recognize possible dysphagia and request appropriate swallowing evaluation.
D. Encourage the resident to eat independently without supervision.
Correct Answer: C
Explanation: Coughing, wet voice, and recurrent respiratory infections suggest
impaired swallowing and aspiration risk. Further swallowing assessment is
appropriate before modifying the diet independently.
