LPN/LVN Comprehensive Reentry
Competency Exam — Code: LPN-
REENTRY-COMP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A nurse returning to practice after several years away is assessing a client with
pneumonia. Which finding requires the most immediate intervention?
A. Temperature of 38.1°C (100.6°F)
B. Productive cough with yellow sputum
C. Respiratory rate of 30/min with oxygen saturation of 86%
D. Fatigue after ambulation
Answer: C. Respiratory rate of 30/min with oxygen saturation of 86%
Rationale: Hypoxemia with tachypnea indicates impaired oxygenation and
requires immediate assessment and intervention. Fever, productive cough, and
,fatigue are common findings with pneumonia but are less immediately life-
threatening.
2.
A client receiving IV potassium chloride reports burning at the IV site. What
should the LPN/LVN do first?
A. Increase the infusion rate
B. Assess the IV site for infiltration or phlebitis
C. Apply a heating pad
D. Flush the IV rapidly
Answer: B. Assess the IV site for infiltration or phlebitis
Rationale: Potassium is irritating to peripheral veins. Pain or burning may
indicate infiltration or phlebitis. The infusion should be stopped if infiltration is
suspected and the site assessed before further administration.
3.
A client with heart failure suddenly develops severe dyspnea, crackles, and pink
frothy sputum. Which action is the priority?
A. Place the client flat
B. Encourage oral fluids
C. Position the client upright and administer oxygen as prescribed
D. Obtain a routine weight
Answer: C. Position the client upright and administer oxygen as prescribed
Rationale: These findings are consistent with acute pulmonary edema. Upright
positioning improves lung expansion and oxygenation while prescribed oxygen
supports gas exchange.
4.
A client taking warfarin has an INR of 5.8. Which finding is most concerning?
,A. Mild fatigue
B. Occasional constipation
C. Bleeding gums and dark stools
D. Increased appetite
Answer: C. Bleeding gums and dark stools
Rationale: A markedly elevated INR increases bleeding risk. Evidence of active
bleeding requires immediate reporting and further evaluation.
5.
A postoperative client becomes restless, confused, and tachycardic. Oxygen
saturation falls from 96% to 89%. What should the nurse do first?
A. Document the behavioral change
B. Assess airway and breathing and apply prescribed oxygen
C. Give the prescribed analgesic
D. Encourage oral fluids
Answer: B. Assess airway and breathing and apply prescribed oxygen
Rationale: Acute restlessness and confusion can be early signs of hypoxemia.
Airway and breathing take priority before less urgent interventions.
6.
A client with diabetes is awake, diaphoretic, shaky, and has a blood glucose of 52
mg/dL. What is the best initial intervention?
A. Administer rapid-acting insulin
B. Give 15 g of a fast-acting carbohydrate
C. Give a high-protein meal only
D. Encourage exercise
Answer: B. Give 15 g of a fast-acting carbohydrate
, Rationale: A conscious client with symptomatic hypoglycemia should receive
approximately 15 g of rapidly absorbed carbohydrate, followed by reassessment
of glucose.
7.
A client taking digoxin reports nausea, anorexia, and seeing yellow halos. Which
action is most appropriate?
A. Administer the next dose
B. Hold the medication and notify the healthcare provider
C. Encourage increased sodium intake
D. Give an antacid and reassess next week
Answer: B. Hold the medication and notify the healthcare provider
Rationale: Gastrointestinal symptoms and visual disturbances can indicate
digoxin toxicity. The medication should be withheld and the provider notified for
further evaluation.
8.
A client with COPD has an oxygen saturation of 88% and increasing dyspnea.
Which intervention is most appropriate?
A. Withhold oxygen because COPD clients should never receive oxygen
B. Administer prescribed oxygen and monitor respiratory status
C. Place the client supine
D. Encourage rapid, deep breathing
Answer: B. Administer prescribed oxygen and monitor respiratory status
Rationale: Clients with COPD may require supplemental oxygen. Oxygen should
be administered according to the prescription and titrated as ordered while
monitoring respiratory status.
9.
Competency Exam — Code: LPN-
REENTRY-COMP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A nurse returning to practice after several years away is assessing a client with
pneumonia. Which finding requires the most immediate intervention?
A. Temperature of 38.1°C (100.6°F)
B. Productive cough with yellow sputum
C. Respiratory rate of 30/min with oxygen saturation of 86%
D. Fatigue after ambulation
Answer: C. Respiratory rate of 30/min with oxygen saturation of 86%
Rationale: Hypoxemia with tachypnea indicates impaired oxygenation and
requires immediate assessment and intervention. Fever, productive cough, and
,fatigue are common findings with pneumonia but are less immediately life-
threatening.
2.
A client receiving IV potassium chloride reports burning at the IV site. What
should the LPN/LVN do first?
A. Increase the infusion rate
B. Assess the IV site for infiltration or phlebitis
C. Apply a heating pad
D. Flush the IV rapidly
Answer: B. Assess the IV site for infiltration or phlebitis
Rationale: Potassium is irritating to peripheral veins. Pain or burning may
indicate infiltration or phlebitis. The infusion should be stopped if infiltration is
suspected and the site assessed before further administration.
3.
A client with heart failure suddenly develops severe dyspnea, crackles, and pink
frothy sputum. Which action is the priority?
A. Place the client flat
B. Encourage oral fluids
C. Position the client upright and administer oxygen as prescribed
D. Obtain a routine weight
Answer: C. Position the client upright and administer oxygen as prescribed
Rationale: These findings are consistent with acute pulmonary edema. Upright
positioning improves lung expansion and oxygenation while prescribed oxygen
supports gas exchange.
4.
A client taking warfarin has an INR of 5.8. Which finding is most concerning?
,A. Mild fatigue
B. Occasional constipation
C. Bleeding gums and dark stools
D. Increased appetite
Answer: C. Bleeding gums and dark stools
Rationale: A markedly elevated INR increases bleeding risk. Evidence of active
bleeding requires immediate reporting and further evaluation.
5.
A postoperative client becomes restless, confused, and tachycardic. Oxygen
saturation falls from 96% to 89%. What should the nurse do first?
A. Document the behavioral change
B. Assess airway and breathing and apply prescribed oxygen
C. Give the prescribed analgesic
D. Encourage oral fluids
Answer: B. Assess airway and breathing and apply prescribed oxygen
Rationale: Acute restlessness and confusion can be early signs of hypoxemia.
Airway and breathing take priority before less urgent interventions.
6.
A client with diabetes is awake, diaphoretic, shaky, and has a blood glucose of 52
mg/dL. What is the best initial intervention?
A. Administer rapid-acting insulin
B. Give 15 g of a fast-acting carbohydrate
C. Give a high-protein meal only
D. Encourage exercise
Answer: B. Give 15 g of a fast-acting carbohydrate
, Rationale: A conscious client with symptomatic hypoglycemia should receive
approximately 15 g of rapidly absorbed carbohydrate, followed by reassessment
of glucose.
7.
A client taking digoxin reports nausea, anorexia, and seeing yellow halos. Which
action is most appropriate?
A. Administer the next dose
B. Hold the medication and notify the healthcare provider
C. Encourage increased sodium intake
D. Give an antacid and reassess next week
Answer: B. Hold the medication and notify the healthcare provider
Rationale: Gastrointestinal symptoms and visual disturbances can indicate
digoxin toxicity. The medication should be withheld and the provider notified for
further evaluation.
8.
A client with COPD has an oxygen saturation of 88% and increasing dyspnea.
Which intervention is most appropriate?
A. Withhold oxygen because COPD clients should never receive oxygen
B. Administer prescribed oxygen and monitor respiratory status
C. Place the client supine
D. Encourage rapid, deep breathing
Answer: B. Administer prescribed oxygen and monitor respiratory status
Rationale: Clients with COPD may require supplemental oxygen. Oxygen should
be administered according to the prescription and titrated as ordered while
monitoring respiratory status.
9.
