LPN/LVN Care Management
Competency Exam — Code: LPN-CM-
COMP | 100-Question Advanced
Practice Exam 2026 | Questions &
Answers with Detailed Rationales |
Complete Exam Prep & Study Guide
1. An LPN/LVN is caring for four clients. Which client should the nurse
prioritize for immediate reassessment?
A. A client with chronic osteoarthritis reporting pain of 6/10
B. A client with heart failure who gained 2 lb overnight
C. A client with pneumonia whose oxygen saturation decreased from 95% to 87%
D. A client with diabetes whose premeal glucose is 168 mg/dL
Answer: A client with pneumonia whose oxygen saturation decreased from 95%
to 87%
,Rationale: A significant decline in oxygen saturation in a client with pneumonia
may indicate worsening respiratory compromise and requires immediate
assessment and intervention.
2. During discharge planning, which action by the LPN/LVN best demonstrates
effective care management?
A. Providing the client with a list of medications
B. Asking the client to sign the discharge form
C. Identifying barriers that could interfere with the client's ability to follow the
care plan
D. Telling the family to call the provider if complications occur
Answer: Identifying barriers that could interfere with the client's ability to
follow the care plan
Rationale: Effective care management requires identifying barriers such as
transportation, finances, health literacy, medication access, and caregiver
availability before discharge.
3. A client with chronic obstructive pulmonary disease is being discharged
with home oxygen. Which finding requires the greatest attention during
care coordination?
A. The client prefers morning appointments
B. The client lives alone and has no reliable method of obtaining oxygen supplies
C. The client reports mild fatigue after walking
D. The client prefers a particular pharmacy
Answer: The client lives alone and has no reliable method of obtaining oxygen
supplies
Rationale: Reliable access to oxygen is essential for safety and continuity of
treatment. The care team should address equipment delivery, backup supplies,
and emergency planning before discharge.
, 4. A client has multiple chronic conditions and receives medications from
three different providers. Which intervention is most important to reduce
medication-related harm?
A. Encourage the client to keep medications in separate rooms
B. Perform medication reconciliation across all prescribing providers
C. Ask the client to stop medications that appear unnecessary
D. Recommend taking all medications at bedtime
Answer: Perform medication reconciliation across all prescribing providers
Rationale: Medication reconciliation identifies duplications, omissions,
interactions, and discrepancies across care settings and providers.
5. An LPN/LVN identifies that a client repeatedly misses appointments
because of transportation problems. Which intervention demonstrates the
best care-management approach?
A. Documenting the missed appointments
B. Advising the client to arrange transportation independently
C. Collaborating with the appropriate team members to identify transportation
resources
D. Requesting that the provider discharge the client from the practice
Answer: Collaborating with the appropriate team members to identify
transportation resources
Rationale: Care management addresses social and logistical barriers that affect
access to care rather than simply documenting nonadherence.
6. Which client is most appropriate for referral to a social worker?
A. A client requesting a different meal preference
B. A client who needs assistance obtaining stable housing after discharge
C. A client requesting an extra blanket
D. A client who wants to change television channels
Answer: A client who needs assistance obtaining stable housing after discharge
, Rationale: Housing instability is a significant social determinant of health and
may require social-work intervention and community-resource coordination.
7. An LPN/LVN notices that a client does not understand how to administer a
newly prescribed injectable medication. What should the nurse do first?
A. Document that the client is noncompliant
B. Ask the client to demonstrate the procedure
C. Tell the family to administer the medication
D. Provide the medication and leave instructions at the bedside
Answer: Ask the client to demonstrate the procedure
Rationale: Teach-back and return demonstration assess actual understanding
and skill rather than assuming comprehension from verbal agreement.
8. A client with diabetes reports difficulty affording insulin. Which care-
management intervention is most appropriate?
A. Instruct the client to use less insulin
B. Tell the client to skip doses when money is limited
C. Notify the appropriate care team members and explore medication-assistance
resources
D. Substitute another medication without consulting the provider
Answer: Notify the appropriate care team members and explore medication-
assistance resources
Rationale: Cost-related nonadherence should be addressed through
interdisciplinary coordination and available assistance programs rather than
unsafe dose reduction.
9. Which documentation entry best supports continuity of care?
A. “Client doing okay.”
B. “Client remains stable.”
C. “Client ambulated 100 feet with a walker, required one rest period, and
Competency Exam — Code: LPN-CM-
COMP | 100-Question Advanced
Practice Exam 2026 | Questions &
Answers with Detailed Rationales |
Complete Exam Prep & Study Guide
1. An LPN/LVN is caring for four clients. Which client should the nurse
prioritize for immediate reassessment?
A. A client with chronic osteoarthritis reporting pain of 6/10
B. A client with heart failure who gained 2 lb overnight
C. A client with pneumonia whose oxygen saturation decreased from 95% to 87%
D. A client with diabetes whose premeal glucose is 168 mg/dL
Answer: A client with pneumonia whose oxygen saturation decreased from 95%
to 87%
,Rationale: A significant decline in oxygen saturation in a client with pneumonia
may indicate worsening respiratory compromise and requires immediate
assessment and intervention.
2. During discharge planning, which action by the LPN/LVN best demonstrates
effective care management?
A. Providing the client with a list of medications
B. Asking the client to sign the discharge form
C. Identifying barriers that could interfere with the client's ability to follow the
care plan
D. Telling the family to call the provider if complications occur
Answer: Identifying barriers that could interfere with the client's ability to
follow the care plan
Rationale: Effective care management requires identifying barriers such as
transportation, finances, health literacy, medication access, and caregiver
availability before discharge.
3. A client with chronic obstructive pulmonary disease is being discharged
with home oxygen. Which finding requires the greatest attention during
care coordination?
A. The client prefers morning appointments
B. The client lives alone and has no reliable method of obtaining oxygen supplies
C. The client reports mild fatigue after walking
D. The client prefers a particular pharmacy
Answer: The client lives alone and has no reliable method of obtaining oxygen
supplies
Rationale: Reliable access to oxygen is essential for safety and continuity of
treatment. The care team should address equipment delivery, backup supplies,
and emergency planning before discharge.
, 4. A client has multiple chronic conditions and receives medications from
three different providers. Which intervention is most important to reduce
medication-related harm?
A. Encourage the client to keep medications in separate rooms
B. Perform medication reconciliation across all prescribing providers
C. Ask the client to stop medications that appear unnecessary
D. Recommend taking all medications at bedtime
Answer: Perform medication reconciliation across all prescribing providers
Rationale: Medication reconciliation identifies duplications, omissions,
interactions, and discrepancies across care settings and providers.
5. An LPN/LVN identifies that a client repeatedly misses appointments
because of transportation problems. Which intervention demonstrates the
best care-management approach?
A. Documenting the missed appointments
B. Advising the client to arrange transportation independently
C. Collaborating with the appropriate team members to identify transportation
resources
D. Requesting that the provider discharge the client from the practice
Answer: Collaborating with the appropriate team members to identify
transportation resources
Rationale: Care management addresses social and logistical barriers that affect
access to care rather than simply documenting nonadherence.
6. Which client is most appropriate for referral to a social worker?
A. A client requesting a different meal preference
B. A client who needs assistance obtaining stable housing after discharge
C. A client requesting an extra blanket
D. A client who wants to change television channels
Answer: A client who needs assistance obtaining stable housing after discharge
, Rationale: Housing instability is a significant social determinant of health and
may require social-work intervention and community-resource coordination.
7. An LPN/LVN notices that a client does not understand how to administer a
newly prescribed injectable medication. What should the nurse do first?
A. Document that the client is noncompliant
B. Ask the client to demonstrate the procedure
C. Tell the family to administer the medication
D. Provide the medication and leave instructions at the bedside
Answer: Ask the client to demonstrate the procedure
Rationale: Teach-back and return demonstration assess actual understanding
and skill rather than assuming comprehension from verbal agreement.
8. A client with diabetes reports difficulty affording insulin. Which care-
management intervention is most appropriate?
A. Instruct the client to use less insulin
B. Tell the client to skip doses when money is limited
C. Notify the appropriate care team members and explore medication-assistance
resources
D. Substitute another medication without consulting the provider
Answer: Notify the appropriate care team members and explore medication-
assistance resources
Rationale: Cost-related nonadherence should be addressed through
interdisciplinary coordination and available assistance programs rather than
unsafe dose reduction.
9. Which documentation entry best supports continuity of care?
A. “Client doing okay.”
B. “Client remains stable.”
C. “Client ambulated 100 feet with a walker, required one rest period, and
