NACE 1 FOUNDATIONS OF NURSING LPN-RN NLN EXAM QUESTIONS
AND ANSWERS WITH DETAILED RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED QUESTIONS | EXPERT VERIFIED
FOR GUARANTEED PASS
This comprehensive 250-question practice exam is meticulously designed for LPNs
preparing for the NACE I Foundations of Nursing LPN to RN exam. It covers essential nursing
content including the nursing process, delegation, pharmacology, pathophysiology, patient
safety, ethical principles, cultural competence, and prioritization. Each question features four
distinct multiple-choice options, a single correct answer, and a detailed rationale explaining
the underlying nursing concept and clinical reasoning. The content reflects NLN exam
standards and tests critical thinking, clinical judgment, and the ability to apply foundational
nursing knowledge in diverse patient care scenarios.
SECTION 1: THE NURSING PROCESS (Questions 1-30)
Question 1:
A nursing advisor is meeting with a student who is interested in earning her RN
degree. The advisor knows that LPNs who enter nursing school come with prior
knowledge and experience. Which statement by the advisor best describes the
effect experience may have on learning?
a) Experience is always a positive and motivating factor.
b) Experience is usually a stumbling block for LPNs.
c) Experience may be a source of insight and motivation, or a barrier.
d) Experience has no significant effect on the learning process.
Answer: c) Experience may be a source of insight and motivation, or a barrier.
Rationale: Experience accentuates differences among learners and can serve as a
foundation for defining the self. It can be a source of insight and motivation,
but it can also be a barrier to new learning if previous knowledge is
contradicted. Educators must recognize that past experience can either facilitate
or hinder the acquisition of new knowledge depending on how it aligns with new
concepts.
Question 2:
A student has a test on Friday morning. She has taken a vacation day on Thursday
to study and is considering skipping her exercise class to go to the library.
1
,Which response best identifies the student's outcome priority?
a) Attending the exercise class.
b) Going to the library.
c) Taking a vacation day from work.
d) Taking the test on Friday.
Answer: b) Going to the library.
Rationale: The student's priority is academic success, which requires adequate
preparation for the test. Going to the library directly supports studying for the
exam. While exercise is important for overall well-being, in this scenario, the
immediate academic outcome takes precedence. The vacation day has already
been
scheduled to facilitate study time.
Question 3:
The nurse is admitting a patient to the medical-surgical unit. Which action is
the priority during the initial assessment?
a) Obtaining a complete medication history
b) Assessing the patient's airway, breathing, and circulation
c) Reviewing the patient's advance directives
d) Asking about the patient's dietary preferences
Answer: b) Assessing the patient's airway, breathing, and circulation.
Rationale: The ABCs (Airway, Breathing, Circulation) are always the priority in
any patient assessment. Life-threatening issues must be identified and addressed
immediately. While medication history, advance directives, and dietary
preferences
are important components of a comprehensive assessment, they are secondary
to
ensuring physiologic stability.
Question 4:
The nurse is developing a care plan for a patient with impaired mobility. Which
of the following is an appropriately written nursing diagnosis?
a) Risk for falls related to impaired mobility
b) Patient will not fall during hospitalization
2
,c) Impaired physical mobility related to muscle weakness as evidenced by
decreased
range of motion
d) Provide assistance with ambulation every 2 hours
Answer: c) Impaired physical mobility related to muscle weakness as evidenced by
decreased range of motion.
Rationale: A properly written nursing diagnosis includes the problem (impaired
physical mobility), the etiology (muscle weakness), and the defining
characteristics (decreased range of motion). Option (a) is a risk diagnosis but
lacks the "as evidenced by" component. Option (b) is a goal, not a diagnosis.
Option (d) is an intervention.
Question 5:
During the planning phase of the nursing process, the nurse establishes goals.
Which of the following goals is correctly written and measurable?
a) Patient will ambulate better by discharge.
b) Patient will walk 50 feet with a walker by the end of the shift.
c) Patient will feel less pain.
d) Patient will eat more food.
Answer: b) Patient will walk 50 feet with a walker by the end of the shift.
Rationale: A correctly written goal must be specific, measurable, achievable,
realistic, and time-bound (SMART). Option (b) specifies the action (walk), the
distance (50 feet), the device (walker), and the time frame (end of shift).
Options (a), (c), and (d) are vague and not measurable.
Question 6:
The nurse is implementing a care plan for a patient with hypertension. Which
intervention should the nurse perform first?
a) Teach the patient about low-sodium diet.
b) Administer prescribed antihypertensive medication.
c) Encourage the patient to exercise daily.
d) Monitor blood pressure every 4 hours.
Answer: b) Administer prescribed antihypertensive medication.
Rationale: In the implementation phase, interventions that are time-sensitive or
medication-related often take priority. Administering medication directly affects
3
, the patient's blood pressure and is a critical intervention. Monitoring and
teaching are important but follow the administration of medication in the
prioritization sequence.
Question 7:
The nurse evaluates the patient's response to pain medication. The patient rates
pain as 3 out of 10, down from 8 out of 10, 30 minutes after administration.
What is the nurse's best action?
a) Document the effectiveness of the intervention.
b) Administer an additional dose of pain medication.
c) Notify the healthcare provider of inadequate pain control.
d) Reassess the patient in 2 hours.
Answer: a) Document the effectiveness of the intervention.
Rationale: The goal of evaluation is to determine whether the interventions
achieved the desired outcomes. Since the pain score decreased from 8 to 3, the
intervention was effective. The nurse should document the evaluation findings.
There is no need for additional medication or provider notification at this time.
Question 8:
The nurse is using critical thinking when planning care. Which action best
demonstrates critical thinking in nursing?
a) Following the physician's orders without question
b) Implementing the same interventions for all patients with the same diagnosis
c) Analyzing patient data to identify patterns and make informed decisions
d) Relying solely on intuition
Answer: c) Analyzing patient data to identify patterns and make informed
decisions.
Rationale: Critical thinking in nursing involves analyzing information,
identifying patterns, and making evidence-based decisions tailored to the
individual patient. It goes beyond simply following orders or using routine
approaches. While intuition has a role, it must be combined with analysis and
evidence.
Question 9:
The nurse identifies a patient problem of "Anxiety related to upcoming surgery as
4
AND ANSWERS WITH DETAILED RATIONALES EACH | CURRENTLY
TESTING AND FREQUENTLY TESTED QUESTIONS | EXPERT VERIFIED
FOR GUARANTEED PASS
This comprehensive 250-question practice exam is meticulously designed for LPNs
preparing for the NACE I Foundations of Nursing LPN to RN exam. It covers essential nursing
content including the nursing process, delegation, pharmacology, pathophysiology, patient
safety, ethical principles, cultural competence, and prioritization. Each question features four
distinct multiple-choice options, a single correct answer, and a detailed rationale explaining
the underlying nursing concept and clinical reasoning. The content reflects NLN exam
standards and tests critical thinking, clinical judgment, and the ability to apply foundational
nursing knowledge in diverse patient care scenarios.
SECTION 1: THE NURSING PROCESS (Questions 1-30)
Question 1:
A nursing advisor is meeting with a student who is interested in earning her RN
degree. The advisor knows that LPNs who enter nursing school come with prior
knowledge and experience. Which statement by the advisor best describes the
effect experience may have on learning?
a) Experience is always a positive and motivating factor.
b) Experience is usually a stumbling block for LPNs.
c) Experience may be a source of insight and motivation, or a barrier.
d) Experience has no significant effect on the learning process.
Answer: c) Experience may be a source of insight and motivation, or a barrier.
Rationale: Experience accentuates differences among learners and can serve as a
foundation for defining the self. It can be a source of insight and motivation,
but it can also be a barrier to new learning if previous knowledge is
contradicted. Educators must recognize that past experience can either facilitate
or hinder the acquisition of new knowledge depending on how it aligns with new
concepts.
Question 2:
A student has a test on Friday morning. She has taken a vacation day on Thursday
to study and is considering skipping her exercise class to go to the library.
1
,Which response best identifies the student's outcome priority?
a) Attending the exercise class.
b) Going to the library.
c) Taking a vacation day from work.
d) Taking the test on Friday.
Answer: b) Going to the library.
Rationale: The student's priority is academic success, which requires adequate
preparation for the test. Going to the library directly supports studying for the
exam. While exercise is important for overall well-being, in this scenario, the
immediate academic outcome takes precedence. The vacation day has already
been
scheduled to facilitate study time.
Question 3:
The nurse is admitting a patient to the medical-surgical unit. Which action is
the priority during the initial assessment?
a) Obtaining a complete medication history
b) Assessing the patient's airway, breathing, and circulation
c) Reviewing the patient's advance directives
d) Asking about the patient's dietary preferences
Answer: b) Assessing the patient's airway, breathing, and circulation.
Rationale: The ABCs (Airway, Breathing, Circulation) are always the priority in
any patient assessment. Life-threatening issues must be identified and addressed
immediately. While medication history, advance directives, and dietary
preferences
are important components of a comprehensive assessment, they are secondary
to
ensuring physiologic stability.
Question 4:
The nurse is developing a care plan for a patient with impaired mobility. Which
of the following is an appropriately written nursing diagnosis?
a) Risk for falls related to impaired mobility
b) Patient will not fall during hospitalization
2
,c) Impaired physical mobility related to muscle weakness as evidenced by
decreased
range of motion
d) Provide assistance with ambulation every 2 hours
Answer: c) Impaired physical mobility related to muscle weakness as evidenced by
decreased range of motion.
Rationale: A properly written nursing diagnosis includes the problem (impaired
physical mobility), the etiology (muscle weakness), and the defining
characteristics (decreased range of motion). Option (a) is a risk diagnosis but
lacks the "as evidenced by" component. Option (b) is a goal, not a diagnosis.
Option (d) is an intervention.
Question 5:
During the planning phase of the nursing process, the nurse establishes goals.
Which of the following goals is correctly written and measurable?
a) Patient will ambulate better by discharge.
b) Patient will walk 50 feet with a walker by the end of the shift.
c) Patient will feel less pain.
d) Patient will eat more food.
Answer: b) Patient will walk 50 feet with a walker by the end of the shift.
Rationale: A correctly written goal must be specific, measurable, achievable,
realistic, and time-bound (SMART). Option (b) specifies the action (walk), the
distance (50 feet), the device (walker), and the time frame (end of shift).
Options (a), (c), and (d) are vague and not measurable.
Question 6:
The nurse is implementing a care plan for a patient with hypertension. Which
intervention should the nurse perform first?
a) Teach the patient about low-sodium diet.
b) Administer prescribed antihypertensive medication.
c) Encourage the patient to exercise daily.
d) Monitor blood pressure every 4 hours.
Answer: b) Administer prescribed antihypertensive medication.
Rationale: In the implementation phase, interventions that are time-sensitive or
medication-related often take priority. Administering medication directly affects
3
, the patient's blood pressure and is a critical intervention. Monitoring and
teaching are important but follow the administration of medication in the
prioritization sequence.
Question 7:
The nurse evaluates the patient's response to pain medication. The patient rates
pain as 3 out of 10, down from 8 out of 10, 30 minutes after administration.
What is the nurse's best action?
a) Document the effectiveness of the intervention.
b) Administer an additional dose of pain medication.
c) Notify the healthcare provider of inadequate pain control.
d) Reassess the patient in 2 hours.
Answer: a) Document the effectiveness of the intervention.
Rationale: The goal of evaluation is to determine whether the interventions
achieved the desired outcomes. Since the pain score decreased from 8 to 3, the
intervention was effective. The nurse should document the evaluation findings.
There is no need for additional medication or provider notification at this time.
Question 8:
The nurse is using critical thinking when planning care. Which action best
demonstrates critical thinking in nursing?
a) Following the physician's orders without question
b) Implementing the same interventions for all patients with the same diagnosis
c) Analyzing patient data to identify patterns and make informed decisions
d) Relying solely on intuition
Answer: c) Analyzing patient data to identify patterns and make informed
decisions.
Rationale: Critical thinking in nursing involves analyzing information,
identifying patterns, and making evidence-based decisions tailored to the
individual patient. It goes beyond simply following orders or using routine
approaches. While intuition has a role, it must be combined with analysis and
evidence.
Question 9:
The nurse identifies a patient problem of "Anxiety related to upcoming surgery as
4
