NEW YORK CLINICAL SKILLS ASSESSMENT FOR LPNs
PRACTICE EXAM – ACTUAL TESTBANK & STUDY GUIDE
QUESTIONS | 150 QUESTIONS & 100% CORRECT
ANSWERS | LATEST UPDATE 2026/2027
*## TABLE OF CONTENTS
*1. Nursing Safety, Infection Prevention & Standard Precautions
*2. Patient Assessment & Clinical Judgment
*3. Medication Administration & Pharmacology
*4. IV Therapy, Fluid Balance & Electrolytes
*5. Wound Care, Skin Integrity & Pressure Injury Prevention
*6. Respiratory, Cardiovascular & Neurologic Skills
*7. Gastrointestinal & Genitourinary Care
*8. Endocrine, Metabolic & Nutritional Management
*9. Maternal, Pediatric & Older-Adult Clinical Care
*10. Mental Health, Communication & Behavioral Emergencies
*11. Emergency Response & Rapid Clinical Deterioration
*12. Documentation, Delegation, Scope of Practice & Professional Practice
*13. Infection Control, Isolation & Occupational Safety
*14. Complex Clinical Scenarios & Prioritization
15. Integrated Advanced LPN Clinical Skills
INTRODUCTION
This comprehensive New York Clinical Skills Assessment for LPNs practice examination
is designed to evaluate advanced practical-nursing judgment across assessment,
medication administration, infection prevention, wound management, respiratory and
cardiovascular care, IV therapy, nutrition, elimination, emergency response,
documentation, delegation, and professional practice. The questions emphasize
application rather than memorization, requiring interpretation of clinical findings,
prioritization of competing needs, recognition of deterioration, safe intervention
selection, and appropriate escalation. The difficulty is intentionally high and reflects
the clinical reasoning expected in professional licensing and advanced nursing
assessments. Students should expect realistic patient scenarios, safety-sensitive
decisions, regulatory considerations, exceptions to routine procedures, and questions
requiring selection of the safest LPN action.
QUESTIONS 1–150
Question 1
,A postoperative patient suddenly becomes restless and reports increasing shortness
of breath. The respiratory rate is 30/min, oxygen saturation is 88% on room air, and
the patient is using accessory muscles. Which action should the LPN take FIRST?
A. Encourage the patient to cough and deep-breathe
B. Place the patient in high-Fowler position and initiate appropriate oxygen therapy
C. Obtain a complete medication history
D. Reassess the patient in 15 minutes
Correct Answer: B
Explanation: Acute hypoxemia with respiratory distress requires immediate airway
and breathing support. Positioning and oxygen administration take priority while
additional assistance is obtained.
Question 2
While preparing to administer insulin, an LPN notices that the patient's blood glucose
is 48 mg/dL and the patient is awake, diaphoretic, and able to swallow. What is the
most appropriate action?
A. Administer the scheduled insulin and recheck glucose later
B. Give a rapid-acting carbohydrate and reassess glucose
C. Administer glucagon intramuscularly immediately
D. Restrict oral intake until the provider evaluates the patient
Correct Answer: B
Explanation: A conscious patient who can swallow and has symptomatic
hypoglycemia should receive approximately 15 g of rapid-acting carbohydrate,
followed by reassessment.
Question 3
An LPN is caring for a patient with suspected Clostridioides difficile infection. Which
intervention is most important when leaving the patient's room?
A. Remove gloves and perform hand hygiene with soap and water
B. Remove the gown but retain gloves until reaching the nursing station
C. Use alcohol-based hand sanitizer exclusively
D. Remove the mask before removing the gown
, Correct Answer: A
Explanation: C. difficile spores are not reliably eliminated by alcohol-based hand
sanitizer. Soap-and-water hand hygiene is essential after contact with the patient or
contaminated environment.
Question 4
A patient receiving an IV infusion develops swelling, coolness, pallor, and discomfort
at the insertion site. What should the LPN do FIRST?
A. Increase the infusion rate
B. Apply a pressure dressing over the catheter
C. Stop the infusion
D. Flush the catheter vigorously
Correct Answer: C
Explanation: These findings are consistent with infiltration. The infusion must be
stopped promptly to prevent further tissue injury.
Question 5
An LPN is changing a sterile wound dressing. Which action would contaminate the
sterile field?
A. Keeping sterile supplies above waist level
B. Opening the sterile package away from the body
C. Allowing the sterile glove to touch the patient's intact skin
D. Keeping sterile objects within the nurse's visual field
Correct Answer: C
Explanation: Intact patient skin is not sterile. A sterile item that contacts a nonsterile
surface is considered contaminated.
Question 6
A patient receiving an opioid becomes difficult to arouse and has a respiratory rate of
7/min. Which finding requires the most immediate intervention?
A. Mild nausea
B. Respiratory depression
, C. Constipation for one day
D. Dry mouth
Correct Answer: B
Explanation: Severe opioid-induced respiratory depression is an airway and
breathing emergency and requires immediate intervention and escalation.
Question 7
An LPN obtains a blood pressure of 84/48 mmHg in a patient who is pale and dizzy.
Which action is most appropriate?
A. Document the value as the patient's baseline
B. Have the patient ambulate to determine whether symptoms improve
C. Reassess promptly, keep the patient safe, and notify the appropriate clinician
D. Administer the next antihypertensive dose
Correct Answer: C
Explanation: Symptomatic hypotension creates an immediate safety concern. The
patient should be protected from falls, reassessed, and the abnormal condition
promptly communicated.
Question 8
A patient with a tracheostomy suddenly develops noisy respirations, cyanosis, and
decreased airflow. What should the LPN prioritize?
A. Routine tracheostomy dressing change
B. Airway assessment and emergency intervention
C. Oral fluid administration
D. Documentation before intervention
Correct Answer: B
Explanation: Sudden respiratory compromise in a tracheostomy patient suggests
airway obstruction or displacement and requires immediate airway-focused
intervention.
Question 9
A patient receiving enteral feeding begins coughing forcefully, develops dyspnea, and
has oxygen saturation falling from 96% to 89%. What should the LPN do FIRST?
PRACTICE EXAM – ACTUAL TESTBANK & STUDY GUIDE
QUESTIONS | 150 QUESTIONS & 100% CORRECT
ANSWERS | LATEST UPDATE 2026/2027
*## TABLE OF CONTENTS
*1. Nursing Safety, Infection Prevention & Standard Precautions
*2. Patient Assessment & Clinical Judgment
*3. Medication Administration & Pharmacology
*4. IV Therapy, Fluid Balance & Electrolytes
*5. Wound Care, Skin Integrity & Pressure Injury Prevention
*6. Respiratory, Cardiovascular & Neurologic Skills
*7. Gastrointestinal & Genitourinary Care
*8. Endocrine, Metabolic & Nutritional Management
*9. Maternal, Pediatric & Older-Adult Clinical Care
*10. Mental Health, Communication & Behavioral Emergencies
*11. Emergency Response & Rapid Clinical Deterioration
*12. Documentation, Delegation, Scope of Practice & Professional Practice
*13. Infection Control, Isolation & Occupational Safety
*14. Complex Clinical Scenarios & Prioritization
15. Integrated Advanced LPN Clinical Skills
INTRODUCTION
This comprehensive New York Clinical Skills Assessment for LPNs practice examination
is designed to evaluate advanced practical-nursing judgment across assessment,
medication administration, infection prevention, wound management, respiratory and
cardiovascular care, IV therapy, nutrition, elimination, emergency response,
documentation, delegation, and professional practice. The questions emphasize
application rather than memorization, requiring interpretation of clinical findings,
prioritization of competing needs, recognition of deterioration, safe intervention
selection, and appropriate escalation. The difficulty is intentionally high and reflects
the clinical reasoning expected in professional licensing and advanced nursing
assessments. Students should expect realistic patient scenarios, safety-sensitive
decisions, regulatory considerations, exceptions to routine procedures, and questions
requiring selection of the safest LPN action.
QUESTIONS 1–150
Question 1
,A postoperative patient suddenly becomes restless and reports increasing shortness
of breath. The respiratory rate is 30/min, oxygen saturation is 88% on room air, and
the patient is using accessory muscles. Which action should the LPN take FIRST?
A. Encourage the patient to cough and deep-breathe
B. Place the patient in high-Fowler position and initiate appropriate oxygen therapy
C. Obtain a complete medication history
D. Reassess the patient in 15 minutes
Correct Answer: B
Explanation: Acute hypoxemia with respiratory distress requires immediate airway
and breathing support. Positioning and oxygen administration take priority while
additional assistance is obtained.
Question 2
While preparing to administer insulin, an LPN notices that the patient's blood glucose
is 48 mg/dL and the patient is awake, diaphoretic, and able to swallow. What is the
most appropriate action?
A. Administer the scheduled insulin and recheck glucose later
B. Give a rapid-acting carbohydrate and reassess glucose
C. Administer glucagon intramuscularly immediately
D. Restrict oral intake until the provider evaluates the patient
Correct Answer: B
Explanation: A conscious patient who can swallow and has symptomatic
hypoglycemia should receive approximately 15 g of rapid-acting carbohydrate,
followed by reassessment.
Question 3
An LPN is caring for a patient with suspected Clostridioides difficile infection. Which
intervention is most important when leaving the patient's room?
A. Remove gloves and perform hand hygiene with soap and water
B. Remove the gown but retain gloves until reaching the nursing station
C. Use alcohol-based hand sanitizer exclusively
D. Remove the mask before removing the gown
, Correct Answer: A
Explanation: C. difficile spores are not reliably eliminated by alcohol-based hand
sanitizer. Soap-and-water hand hygiene is essential after contact with the patient or
contaminated environment.
Question 4
A patient receiving an IV infusion develops swelling, coolness, pallor, and discomfort
at the insertion site. What should the LPN do FIRST?
A. Increase the infusion rate
B. Apply a pressure dressing over the catheter
C. Stop the infusion
D. Flush the catheter vigorously
Correct Answer: C
Explanation: These findings are consistent with infiltration. The infusion must be
stopped promptly to prevent further tissue injury.
Question 5
An LPN is changing a sterile wound dressing. Which action would contaminate the
sterile field?
A. Keeping sterile supplies above waist level
B. Opening the sterile package away from the body
C. Allowing the sterile glove to touch the patient's intact skin
D. Keeping sterile objects within the nurse's visual field
Correct Answer: C
Explanation: Intact patient skin is not sterile. A sterile item that contacts a nonsterile
surface is considered contaminated.
Question 6
A patient receiving an opioid becomes difficult to arouse and has a respiratory rate of
7/min. Which finding requires the most immediate intervention?
A. Mild nausea
B. Respiratory depression
, C. Constipation for one day
D. Dry mouth
Correct Answer: B
Explanation: Severe opioid-induced respiratory depression is an airway and
breathing emergency and requires immediate intervention and escalation.
Question 7
An LPN obtains a blood pressure of 84/48 mmHg in a patient who is pale and dizzy.
Which action is most appropriate?
A. Document the value as the patient's baseline
B. Have the patient ambulate to determine whether symptoms improve
C. Reassess promptly, keep the patient safe, and notify the appropriate clinician
D. Administer the next antihypertensive dose
Correct Answer: C
Explanation: Symptomatic hypotension creates an immediate safety concern. The
patient should be protected from falls, reassessed, and the abnormal condition
promptly communicated.
Question 8
A patient with a tracheostomy suddenly develops noisy respirations, cyanosis, and
decreased airflow. What should the LPN prioritize?
A. Routine tracheostomy dressing change
B. Airway assessment and emergency intervention
C. Oral fluid administration
D. Documentation before intervention
Correct Answer: B
Explanation: Sudden respiratory compromise in a tracheostomy patient suggests
airway obstruction or displacement and requires immediate airway-focused
intervention.
Question 9
A patient receiving enteral feeding begins coughing forcefully, develops dyspnea, and
has oxygen saturation falling from 96% to 89%. What should the LPN do FIRST?
