NCLEX-PN: Saunders Comprehensive Review for
the NCLEX-PN Examination – Complete
LPN/LVN Core Exam Review
Course Code: NCLEX-PN
Course Name: Saunders Comprehensive Review for the NCLEX-PN
Examination
Topic: Complete LPN/LVN Comprehensive Nursing Practice
Academic Year: 2026/2027
1. A licensed practical nurse (LPN) is monitoring a client who was recently
prescribed valium (diazepam) for an acute anxiety disorder. Which central
nervous system manifestation should the nurse recognize as a primary
therapeutic or expected side effect of this benzodiazepine medication class?
A) Increased electrical activity in the cerebral cortex causing heightened
mental alertness.
B) Feelings of calmness, muscle relaxation, and drowsiness due to
potentiation of gamma-aminobutyric acid (GABA).
C) Acute respiratory center inhibition causing significant hypercapnia and
systemic respiratory acidosis.
D) Paradoxical extrapyramidal symptoms including acute dystonic reactions
and severe tardive dyskinesia.
CORRECT ANSWER: B
RATIONALE: Valium (diazepam) is a benzodiazepine that acts as a
central nervous system (CNS) depressant by enhancing the inhibitory actions
of GABA. Its primary therapeutic effects and expected side effects include
calmness, relaxation, and drowsiness. Option A describes the action of a
CNS stimulant (like amphetamines). Option C is incorrect because while
severe benzodiazepine overdoses can cause respiratory depression, normal
therapeutic ranges do not routinely cause severe hypercapnia or respiratory
acidosis. Option D is incorrect because extrapyramidal symptoms are
characteristically associated with antipsychotic medications, not
benzodiazepines.
,2. A nurse is assigned to care for a premature human infant in the neonatal
intensive care unit (NICU) who is exhibiting severe intercostal retractions,
nasal flaring, and grunting. The diagnostic workup confirms a
pathophysiological condition known as respiratory distress syndrome
(RDS). The nurse knows that this specific condition in premature infants is
primarily caused by which factor?
A) Failure of the muscular diaphragm to contract effectively during the
inspiratory phase.
B) A traumatic structural puncture of the thoracic cavity during delivery
leading to pneumothorax.
C) Structural immaturity of the mainstem bronchi leading to mucus plugging
and widespread atelectasis.
D) Lack of surfactant in the alveoli preventing adequate reduction of
alveolar surface tension.
CORRECT ANSWER: D
RATIONALE: Respiratory distress syndrome (RDS) in premature
infants is primarily caused by a deficiency or lack of surfactant in the
alveoli. Surfactant is essential to lower surface tension within the
microscopic air sacs, preventing them from collapsing during expiration.
Option A is incorrect because RDS is an alveolar compliance issue, not a
neurological or primary muscular failure of the diaphragm. Option B
describes a pneumothorax, which is a structural trauma. Option C is
incorrect because the primary pathology is located at the microscopic
alveolar level rather than the conducting bronchi.
3. An LPN is reviewing laboratory results for an infant presenting with
cyanosis, lethargy, and a distinct grayish-blue skin discoloration, commonly
referred to as "blue baby" syndrome. The nurse should understand that this
condition is directly caused by an abnormal accumulation of which
substance in the bloodstream?
A) Methemoglobin, which prevents hemoglobin from effectively binding
and releasing oxygen to tissues.
B) Excessive levels of dissolved oxygen causing oxidative damage to
peripheral capillaries.
C) High concentrations of total dissolved solids (TDS) altering plasma
osmolarity.
, D) Marked excess of extracellular chloride ions leading to hyperchloremic
metabolic acidosis.
CORRECT ANSWER: A
RATIONALE: "Blue baby" syndrome, or methemoglobinemia, results
from elevated levels of methemoglobin in the blood. Methemoglobin
contains an oxidized form of iron (\(Fe^{3+}\)) that cannot effectively bind
or transport oxygen, leading to cellular hypoxia and clinical cyanosis.
Option B is incorrect because the condition involves a deficiency in oxygen
transport, not an excess of dissolved oxygen. Options C and D are incorrect
because total dissolved solids and chloride ion concentrations do not directly
cause this specific hemoglobin dysfunction.
4. While preparing an educational seminar on pharmacology and chemical
structures, a nurse notes a question regarding the environmental contaminant
DDT. The nurse must correctly identify that the full expanded scientific
name for this compound is:
A) Dichlorodiphenyltrichloroethane
B) Dichlorodiethyltrichloroethane
C) Dichlorodipyrydyltrichloroethane
D) Dichlorodiphenyltetrachloroacetate
CORRECT ANSWER: A
RATIONALE: The correct scientific nomenclature and expanded form of
the abbreviation DDT is Dichlorodiphenyltrichloroethane. Options B, C,
and D are incorrect because they alter the specific components of the
chemical structure (substituting ethyl or pyrydyl for phenyl, or altering the
acetate/ethane structure), which does not accurately reflect the compound's
real chemical structure.
5. An LPN is caring for a client with an endocrine disorder and reviews the
mechanism of hormone action. The nurse understands that protein
hormones (such as insulin or growth hormone) exhibit different binding
behaviors than steroid hormones. Where are the specific receptors for
protein hormones located?
A) Embedded within the dense chromatin inside the nucleus.
B) Floating freely as soluble proteins inside the cytoplasm.
C) Positioned specifically on the inner membrane surface of the rough
, endoplasmic reticulum.
D) On the cell surface bound to the extracellular domain of the plasma
membrane.
CORRECT ANSWER: D
RATIONALE: Because protein hormones are typically large,
hydrophilic, and water-soluble molecules, they cannot freely diffuse through
the lipid bilayer of the plasma membrane. Therefore, their receptors are
located on the cell surface. In contrast, steroid hormones are lipid-soluble
and can cross the cell membrane to bind to intracellular or intranuclear
receptors. Options A, B, and C are incorrect because protein hormones do
not cross the plasma membrane to interact with internal organelles or the
nucleus.
6. During a physical assessment course, an LPN learns how fundamental
measurements form the baseline of clinical monitoring. The nurse should
recognize that which of the following is considered a derived quantity
rather than a fundamental physical quantity in standard systems of
measurement?
A) Time, used to measure heart rate or respiratory frequency.
B) Mass, used to calculate appropriate medication dosages.
C) Length, used to track infant growth charts or height.
D) Force, which is calculated as the product of mass and acceleration.
CORRECT ANSWER: D
RATIONALE: In standard physics and measurement systems, time,
mass, and length are fundamental quantities that cannot be broken down
further. Force is a derived quantity because it is calculated from
fundamental parameters using the formula \(F=ma\) (mass multiplied by
length divided by time squared). Options A, B, and C are incorrect because
they represent base, independent fundamental quantities.
7. A nurse is conducting a community health education workshop focusing on
preventative medicine and lifestyle modifications. To achieve the best
outcomes for maintaining good health, the nurse should emphasize that the
client must prioritize:
A) A strict, nutritionally balanced diet high in essential macronutrients.
B) Meticulous personal hygiene routines to minimize pathogen transmission.
the NCLEX-PN Examination – Complete
LPN/LVN Core Exam Review
Course Code: NCLEX-PN
Course Name: Saunders Comprehensive Review for the NCLEX-PN
Examination
Topic: Complete LPN/LVN Comprehensive Nursing Practice
Academic Year: 2026/2027
1. A licensed practical nurse (LPN) is monitoring a client who was recently
prescribed valium (diazepam) for an acute anxiety disorder. Which central
nervous system manifestation should the nurse recognize as a primary
therapeutic or expected side effect of this benzodiazepine medication class?
A) Increased electrical activity in the cerebral cortex causing heightened
mental alertness.
B) Feelings of calmness, muscle relaxation, and drowsiness due to
potentiation of gamma-aminobutyric acid (GABA).
C) Acute respiratory center inhibition causing significant hypercapnia and
systemic respiratory acidosis.
D) Paradoxical extrapyramidal symptoms including acute dystonic reactions
and severe tardive dyskinesia.
CORRECT ANSWER: B
RATIONALE: Valium (diazepam) is a benzodiazepine that acts as a
central nervous system (CNS) depressant by enhancing the inhibitory actions
of GABA. Its primary therapeutic effects and expected side effects include
calmness, relaxation, and drowsiness. Option A describes the action of a
CNS stimulant (like amphetamines). Option C is incorrect because while
severe benzodiazepine overdoses can cause respiratory depression, normal
therapeutic ranges do not routinely cause severe hypercapnia or respiratory
acidosis. Option D is incorrect because extrapyramidal symptoms are
characteristically associated with antipsychotic medications, not
benzodiazepines.
,2. A nurse is assigned to care for a premature human infant in the neonatal
intensive care unit (NICU) who is exhibiting severe intercostal retractions,
nasal flaring, and grunting. The diagnostic workup confirms a
pathophysiological condition known as respiratory distress syndrome
(RDS). The nurse knows that this specific condition in premature infants is
primarily caused by which factor?
A) Failure of the muscular diaphragm to contract effectively during the
inspiratory phase.
B) A traumatic structural puncture of the thoracic cavity during delivery
leading to pneumothorax.
C) Structural immaturity of the mainstem bronchi leading to mucus plugging
and widespread atelectasis.
D) Lack of surfactant in the alveoli preventing adequate reduction of
alveolar surface tension.
CORRECT ANSWER: D
RATIONALE: Respiratory distress syndrome (RDS) in premature
infants is primarily caused by a deficiency or lack of surfactant in the
alveoli. Surfactant is essential to lower surface tension within the
microscopic air sacs, preventing them from collapsing during expiration.
Option A is incorrect because RDS is an alveolar compliance issue, not a
neurological or primary muscular failure of the diaphragm. Option B
describes a pneumothorax, which is a structural trauma. Option C is
incorrect because the primary pathology is located at the microscopic
alveolar level rather than the conducting bronchi.
3. An LPN is reviewing laboratory results for an infant presenting with
cyanosis, lethargy, and a distinct grayish-blue skin discoloration, commonly
referred to as "blue baby" syndrome. The nurse should understand that this
condition is directly caused by an abnormal accumulation of which
substance in the bloodstream?
A) Methemoglobin, which prevents hemoglobin from effectively binding
and releasing oxygen to tissues.
B) Excessive levels of dissolved oxygen causing oxidative damage to
peripheral capillaries.
C) High concentrations of total dissolved solids (TDS) altering plasma
osmolarity.
, D) Marked excess of extracellular chloride ions leading to hyperchloremic
metabolic acidosis.
CORRECT ANSWER: A
RATIONALE: "Blue baby" syndrome, or methemoglobinemia, results
from elevated levels of methemoglobin in the blood. Methemoglobin
contains an oxidized form of iron (\(Fe^{3+}\)) that cannot effectively bind
or transport oxygen, leading to cellular hypoxia and clinical cyanosis.
Option B is incorrect because the condition involves a deficiency in oxygen
transport, not an excess of dissolved oxygen. Options C and D are incorrect
because total dissolved solids and chloride ion concentrations do not directly
cause this specific hemoglobin dysfunction.
4. While preparing an educational seminar on pharmacology and chemical
structures, a nurse notes a question regarding the environmental contaminant
DDT. The nurse must correctly identify that the full expanded scientific
name for this compound is:
A) Dichlorodiphenyltrichloroethane
B) Dichlorodiethyltrichloroethane
C) Dichlorodipyrydyltrichloroethane
D) Dichlorodiphenyltetrachloroacetate
CORRECT ANSWER: A
RATIONALE: The correct scientific nomenclature and expanded form of
the abbreviation DDT is Dichlorodiphenyltrichloroethane. Options B, C,
and D are incorrect because they alter the specific components of the
chemical structure (substituting ethyl or pyrydyl for phenyl, or altering the
acetate/ethane structure), which does not accurately reflect the compound's
real chemical structure.
5. An LPN is caring for a client with an endocrine disorder and reviews the
mechanism of hormone action. The nurse understands that protein
hormones (such as insulin or growth hormone) exhibit different binding
behaviors than steroid hormones. Where are the specific receptors for
protein hormones located?
A) Embedded within the dense chromatin inside the nucleus.
B) Floating freely as soluble proteins inside the cytoplasm.
C) Positioned specifically on the inner membrane surface of the rough
, endoplasmic reticulum.
D) On the cell surface bound to the extracellular domain of the plasma
membrane.
CORRECT ANSWER: D
RATIONALE: Because protein hormones are typically large,
hydrophilic, and water-soluble molecules, they cannot freely diffuse through
the lipid bilayer of the plasma membrane. Therefore, their receptors are
located on the cell surface. In contrast, steroid hormones are lipid-soluble
and can cross the cell membrane to bind to intracellular or intranuclear
receptors. Options A, B, and C are incorrect because protein hormones do
not cross the plasma membrane to interact with internal organelles or the
nucleus.
6. During a physical assessment course, an LPN learns how fundamental
measurements form the baseline of clinical monitoring. The nurse should
recognize that which of the following is considered a derived quantity
rather than a fundamental physical quantity in standard systems of
measurement?
A) Time, used to measure heart rate or respiratory frequency.
B) Mass, used to calculate appropriate medication dosages.
C) Length, used to track infant growth charts or height.
D) Force, which is calculated as the product of mass and acceleration.
CORRECT ANSWER: D
RATIONALE: In standard physics and measurement systems, time,
mass, and length are fundamental quantities that cannot be broken down
further. Force is a derived quantity because it is calculated from
fundamental parameters using the formula \(F=ma\) (mass multiplied by
length divided by time squared). Options A, B, and C are incorrect because
they represent base, independent fundamental quantities.
7. A nurse is conducting a community health education workshop focusing on
preventative medicine and lifestyle modifications. To achieve the best
outcomes for maintaining good health, the nurse should emphasize that the
client must prioritize:
A) A strict, nutritionally balanced diet high in essential macronutrients.
B) Meticulous personal hygiene routines to minimize pathogen transmission.
