NEW YORK SURGICAL NURSING LPN PRACTICE EXAM | STUDY GUIDE |
TESTBANK | LATEST UPDATE 2026/2027 | 30 ADVANCED QUESTIONS & 100%
CORRECT ANSWERS
TABLE OF CONTENTS
i. Preoperative Assessment and Surgical Risk
ii. Intraoperative Safety and Aseptic Practice
iii. Postoperative Assessment and Complications
iv. Wound, Drain, and Incision Management
v. Fluid, Electrolyte, and Hemodynamic Management
vi. Pain, Medication, and Transfusion Safety
vii. Gastrointestinal, Genitourinary, and Respiratory Surgery
viii. Infection Prevention and Sepsis Recognition
ix. New York LPN Scope of Practice and Professional Accountability
x. Clinical Judgment, Documentation, and Ethical Decision-Making
INTRODUCTION
This advanced New York Surgical Nursing LPN practice examination evaluates the
clinical judgment, technical knowledge, safety awareness, and professional
decision-making expected in contemporary perioperative and postoperative
nursing practice. Questions integrate surgical assessment, airway and hemodynamic
complications, wound management, infection prevention, pain control, fluid and
electrolyte balance, drains, transfusion safety, and recognition of clinical
deterioration. New York-specific questions emphasize the LPN's scope of practice,
required direction, competency, delegation, documentation, and professional
accountability. The examination uses realistic clinical scenarios requiring
prioritization, interpretation of findings, identification of complications, and
selection of the safest nursing action. Expect challenging questions that distinguish
routine postoperative findings from potentially life-threatening abnormalities.
Question 1
A patient is 6 hours postoperative following an open abdominal colectomy. The
LPN notes that the patient's heart rate has increased from 88/min to 118/min,
blood pressure has decreased from 128/76 mmHg to 96/58 mmHg, and urine
output has fallen to 15 mL during the last hour. The patient reports increasing
,abdominal pressure but has no visible external bleeding. Which action is the
priority?
A. Encourage the patient to use the incentive spirometer
B. Document the findings and reassess in 30 minutes
C. Immediately notify the RN/directing practitioner of possible internal hemorrhage
D. Administer the prescribed opioid analgesic for abdominal discomfort
Correct Answer: C
Explanation: The combination of tachycardia, hypotension, oliguria, and
increasing abdominal pressure suggests possible internal bleeding and evolving
hypovolemia. This requires immediate escalation rather than routine
reassessment or analgesia.
Question 2
During preoperative preparation, an LPN is caring for a patient scheduled for
surgery. The patient states, "I signed the consent because my family told me to, but
I don't really understand what the surgeon plans to do." Which action is most
appropriate?
A. Explain the surgical procedure in detail and obtain a new signature
B. Ask the patient's family to explain the procedure
C. Notify the RN and surgeon that the patient has unresolved questions about
informed consent
D. Proceed because the signed consent establishes that the patient understands the
procedure
Correct Answer: C
Explanation: The LPN should not independently provide the surgeon's informed-
consent discussion or determine whether consent is valid. The patient's expressed
lack of understanding requires immediate notification of the appropriate
responsible clinician before surgery proceeds.
Question 3
,A patient 2 days after total hip arthroplasty suddenly develops dyspnea, pleuritic
chest pain, tachycardia, and oxygen saturation of 86% on room air. Which action
should the LPN take first?
A. Assist the patient to ambulate to improve circulation
B. Apply oxygen as prescribed/protocol allows and immediately escalate the acute
change
C. Administer the scheduled oral analgesic
D. Encourage oral fluids and reassess after 15 minutes
Correct Answer: B
Explanation: Acute dyspnea, hypoxemia, tachycardia, and pleuritic pain are
concerning for pulmonary embolism. Immediate oxygen support within the LPN's
authorized practice and rapid escalation are priorities.
Question 4
A postoperative patient has a Jackson-Pratt drain. During the previous shift, the
drain contained 40 mL of serosanguineous fluid. During the current shift, 180 mL of
bright-red drainage accumulates over 45 minutes, accompanied by increasing heart
rate. What is the most appropriate response?
A. Compress the tubing to prevent further drainage
B. Empty the drain and document the finding as expected postoperative drainage
C. Promptly report the change and assess for additional signs of hemorrhage
D. Remove the drain because the drainage indicates that it is no longer functioning
properly
Correct Answer: C
Explanation: A sudden increase in bright-red drainage with tachycardia is
concerning for active bleeding. The change requires prompt assessment and
escalation rather than treating it as routine drainage.
Question 5
, A patient receiving a packed red blood cell transfusion develops chills, fever, flank
discomfort, and anxiety approximately 15 minutes after initiation. Which action has
the highest priority?
A. Slow the transfusion rate and reassess the temperature
B. Stop the transfusion immediately and maintain IV access with appropriate
compatible fluid
C. Administer the prescribed antipyretic and continue the transfusion
D. Flush the blood tubing rapidly with normal saline
Correct Answer: B
Explanation: Fever, chills, and flank pain shortly after transfusion may indicate an
acute hemolytic reaction. The transfusion must be stopped immediately while
maintaining IV access according to transfusion-reaction procedures.
Question 6
A patient is postoperative following thyroidectomy. Several hours later, the patient
develops perioral tingling, muscle twitching, and carpopedal spasm. Which
complication should the LPN recognize as most likely?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
Correct Answer: B
Explanation: Thyroid surgery can inadvertently affect the parathyroid glands,
resulting in decreased calcium levels. Perioral paresthesia, muscle twitching, and
tetany are classic manifestations of acute hypocalcemia.
Question 7
A patient recovering from abdominal surgery has shallow respirations and refuses
to cough because of incisional pain. Oxygen saturation has decreased from 97% to
TESTBANK | LATEST UPDATE 2026/2027 | 30 ADVANCED QUESTIONS & 100%
CORRECT ANSWERS
TABLE OF CONTENTS
i. Preoperative Assessment and Surgical Risk
ii. Intraoperative Safety and Aseptic Practice
iii. Postoperative Assessment and Complications
iv. Wound, Drain, and Incision Management
v. Fluid, Electrolyte, and Hemodynamic Management
vi. Pain, Medication, and Transfusion Safety
vii. Gastrointestinal, Genitourinary, and Respiratory Surgery
viii. Infection Prevention and Sepsis Recognition
ix. New York LPN Scope of Practice and Professional Accountability
x. Clinical Judgment, Documentation, and Ethical Decision-Making
INTRODUCTION
This advanced New York Surgical Nursing LPN practice examination evaluates the
clinical judgment, technical knowledge, safety awareness, and professional
decision-making expected in contemporary perioperative and postoperative
nursing practice. Questions integrate surgical assessment, airway and hemodynamic
complications, wound management, infection prevention, pain control, fluid and
electrolyte balance, drains, transfusion safety, and recognition of clinical
deterioration. New York-specific questions emphasize the LPN's scope of practice,
required direction, competency, delegation, documentation, and professional
accountability. The examination uses realistic clinical scenarios requiring
prioritization, interpretation of findings, identification of complications, and
selection of the safest nursing action. Expect challenging questions that distinguish
routine postoperative findings from potentially life-threatening abnormalities.
Question 1
A patient is 6 hours postoperative following an open abdominal colectomy. The
LPN notes that the patient's heart rate has increased from 88/min to 118/min,
blood pressure has decreased from 128/76 mmHg to 96/58 mmHg, and urine
output has fallen to 15 mL during the last hour. The patient reports increasing
,abdominal pressure but has no visible external bleeding. Which action is the
priority?
A. Encourage the patient to use the incentive spirometer
B. Document the findings and reassess in 30 minutes
C. Immediately notify the RN/directing practitioner of possible internal hemorrhage
D. Administer the prescribed opioid analgesic for abdominal discomfort
Correct Answer: C
Explanation: The combination of tachycardia, hypotension, oliguria, and
increasing abdominal pressure suggests possible internal bleeding and evolving
hypovolemia. This requires immediate escalation rather than routine
reassessment or analgesia.
Question 2
During preoperative preparation, an LPN is caring for a patient scheduled for
surgery. The patient states, "I signed the consent because my family told me to, but
I don't really understand what the surgeon plans to do." Which action is most
appropriate?
A. Explain the surgical procedure in detail and obtain a new signature
B. Ask the patient's family to explain the procedure
C. Notify the RN and surgeon that the patient has unresolved questions about
informed consent
D. Proceed because the signed consent establishes that the patient understands the
procedure
Correct Answer: C
Explanation: The LPN should not independently provide the surgeon's informed-
consent discussion or determine whether consent is valid. The patient's expressed
lack of understanding requires immediate notification of the appropriate
responsible clinician before surgery proceeds.
Question 3
,A patient 2 days after total hip arthroplasty suddenly develops dyspnea, pleuritic
chest pain, tachycardia, and oxygen saturation of 86% on room air. Which action
should the LPN take first?
A. Assist the patient to ambulate to improve circulation
B. Apply oxygen as prescribed/protocol allows and immediately escalate the acute
change
C. Administer the scheduled oral analgesic
D. Encourage oral fluids and reassess after 15 minutes
Correct Answer: B
Explanation: Acute dyspnea, hypoxemia, tachycardia, and pleuritic pain are
concerning for pulmonary embolism. Immediate oxygen support within the LPN's
authorized practice and rapid escalation are priorities.
Question 4
A postoperative patient has a Jackson-Pratt drain. During the previous shift, the
drain contained 40 mL of serosanguineous fluid. During the current shift, 180 mL of
bright-red drainage accumulates over 45 minutes, accompanied by increasing heart
rate. What is the most appropriate response?
A. Compress the tubing to prevent further drainage
B. Empty the drain and document the finding as expected postoperative drainage
C. Promptly report the change and assess for additional signs of hemorrhage
D. Remove the drain because the drainage indicates that it is no longer functioning
properly
Correct Answer: C
Explanation: A sudden increase in bright-red drainage with tachycardia is
concerning for active bleeding. The change requires prompt assessment and
escalation rather than treating it as routine drainage.
Question 5
, A patient receiving a packed red blood cell transfusion develops chills, fever, flank
discomfort, and anxiety approximately 15 minutes after initiation. Which action has
the highest priority?
A. Slow the transfusion rate and reassess the temperature
B. Stop the transfusion immediately and maintain IV access with appropriate
compatible fluid
C. Administer the prescribed antipyretic and continue the transfusion
D. Flush the blood tubing rapidly with normal saline
Correct Answer: B
Explanation: Fever, chills, and flank pain shortly after transfusion may indicate an
acute hemolytic reaction. The transfusion must be stopped immediately while
maintaining IV access according to transfusion-reaction procedures.
Question 6
A patient is postoperative following thyroidectomy. Several hours later, the patient
develops perioral tingling, muscle twitching, and carpopedal spasm. Which
complication should the LPN recognize as most likely?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
Correct Answer: B
Explanation: Thyroid surgery can inadvertently affect the parathyroid glands,
resulting in decreased calcium levels. Perioral paresthesia, muscle twitching, and
tetany are classic manifestations of acute hypocalcemia.
Question 7
A patient recovering from abdominal surgery has shallow respirations and refuses
to cough because of incisional pain. Oxygen saturation has decreased from 97% to
