ATI LPN Exit Exam (2026 Updated Version) –
Complete Test Bank with Correct Answers and
Detailed Rationales
Q001:
Type: NGN - Extended Multiple Response
Scenario: An 82-year-old resident in a long-term care facility has a stage 3 pressure
injury on the coccyx. The wound measures 4 cm × 3 cm × 0.5 cm with yellow slough and
mild odor. Vital signs at 08:00 are BP 142/88, HR 92, RR 20, O₂ sat 95% RA, T 37.6 °C.
The LPN is reviewing the morning wound-treatment orders and the last 24-h
intake/output record (I 1850 mL, O 1600 mL).
Question: Which findings must the LPN immediately report to the RN? (Select all that
apply.)
Options:
A. Temperature 37.6 °C
B. Foul odor from wound
C. Intake 250 mL > output
D. Yellow slough in wound bed
E. Blood pressure 142/88 mmHg
F. Patient reports new-onset sharp pain in coccyx area
,(Correct: B, F)
Rationale:
● Answer: B, F
● Why (LPN Scope 2026): Foul odor and new sharp pain suggest possible infection
or deterioration—both are changes in condition that the LPN must report so the
RN can assess and contact the provider.
● Errors: Low-grade fever and mild slough are chronic findings; I/O imbalance is
not acute; BP is elevated but stable.
Q002:
Type: Traditional
Scenario: A 6-year-old child in a pediatric clinic is receiving a DTaP vaccination. The
LPN prepares the injection after verifying the order.
Question: Prior to administering the vaccine, which action is essential for the LPN to
take?
Options:
A. Ask the child to state his birth date
B. Check the vial against the 6 rights of medication administration
C. Have the parent sign a consent form if not already on file
D. Obtain a set of vital signs
(Correct: B)
Rationale:
, ● Answer: Check the vial against the 6 rights of medication administration
● Why (LPN Scope 2026): Vaccines are medications; the LPN is responsible for the
6 rights to prevent errors.
● Errors: Consent is clerical and should be completed; birth date is not a right;
routine vitals are not required unless clinical indication.
Q003:
Type: NGN - Drag-and-Drop
Scenario: The LPN is assigned four clients on a medical floor at 07:30. The RN will
make rounds at 08:00. Place the clients in the order the LPN should see them.
Client A: 54-year-old post-op laparoscopic cholecystectomy, first day post-op, asking for
pain medication, rating pain 8/10.
Client B: 78-year-old on continuous cardiac monitoring, new onset irregular heart rhythm
noted on monitor at 07:25.
Client C: 60-year-old scheduled for a barium swallow at 09:00, NPO since midnight.
Client D: 45-year-old with pneumonia, IV antibiotics due at 08:00, no complaints.
Question: What is the correct first-to-last priority order?
Options:
A. B → A → D → C
B. A → B → C → D
C. D → B → A → C
D. C → D → B → A
, (Correct: A)
Rationale:
● Answer: B → A → D → C
● Why (LPN Scope 2026): LPN must report acute rhythm change immediately; then
treat pain; then administer time-critical meds; finally prepare NPO client.
● Errors: Pain is urgent but not life-threatening before dysrhythmia; NPO is least
acute.
Q004:
Type: Traditional
Scenario: A newly admitted client has sliding-scale insulin ac orders. The blood glucose
before lunch is 218 mg/dL.
Question: What should the LPN do first?
Options:
A. Give 4 units regular insulin as ordered
B. Recheck the finger-stick in 15 minutes
C. Ask the client if he ate any snacks
D. Call the RN to verify the dose
(Correct: A)
Rationale:
● Answer: Give 4 units regular insulin as ordered
● Why (LPN Scope 2026): Administering insulin per sliding scale is within LPN
scope once the order is verified; no need to recheck or delay.
Complete Test Bank with Correct Answers and
Detailed Rationales
Q001:
Type: NGN - Extended Multiple Response
Scenario: An 82-year-old resident in a long-term care facility has a stage 3 pressure
injury on the coccyx. The wound measures 4 cm × 3 cm × 0.5 cm with yellow slough and
mild odor. Vital signs at 08:00 are BP 142/88, HR 92, RR 20, O₂ sat 95% RA, T 37.6 °C.
The LPN is reviewing the morning wound-treatment orders and the last 24-h
intake/output record (I 1850 mL, O 1600 mL).
Question: Which findings must the LPN immediately report to the RN? (Select all that
apply.)
Options:
A. Temperature 37.6 °C
B. Foul odor from wound
C. Intake 250 mL > output
D. Yellow slough in wound bed
E. Blood pressure 142/88 mmHg
F. Patient reports new-onset sharp pain in coccyx area
,(Correct: B, F)
Rationale:
● Answer: B, F
● Why (LPN Scope 2026): Foul odor and new sharp pain suggest possible infection
or deterioration—both are changes in condition that the LPN must report so the
RN can assess and contact the provider.
● Errors: Low-grade fever and mild slough are chronic findings; I/O imbalance is
not acute; BP is elevated but stable.
Q002:
Type: Traditional
Scenario: A 6-year-old child in a pediatric clinic is receiving a DTaP vaccination. The
LPN prepares the injection after verifying the order.
Question: Prior to administering the vaccine, which action is essential for the LPN to
take?
Options:
A. Ask the child to state his birth date
B. Check the vial against the 6 rights of medication administration
C. Have the parent sign a consent form if not already on file
D. Obtain a set of vital signs
(Correct: B)
Rationale:
, ● Answer: Check the vial against the 6 rights of medication administration
● Why (LPN Scope 2026): Vaccines are medications; the LPN is responsible for the
6 rights to prevent errors.
● Errors: Consent is clerical and should be completed; birth date is not a right;
routine vitals are not required unless clinical indication.
Q003:
Type: NGN - Drag-and-Drop
Scenario: The LPN is assigned four clients on a medical floor at 07:30. The RN will
make rounds at 08:00. Place the clients in the order the LPN should see them.
Client A: 54-year-old post-op laparoscopic cholecystectomy, first day post-op, asking for
pain medication, rating pain 8/10.
Client B: 78-year-old on continuous cardiac monitoring, new onset irregular heart rhythm
noted on monitor at 07:25.
Client C: 60-year-old scheduled for a barium swallow at 09:00, NPO since midnight.
Client D: 45-year-old with pneumonia, IV antibiotics due at 08:00, no complaints.
Question: What is the correct first-to-last priority order?
Options:
A. B → A → D → C
B. A → B → C → D
C. D → B → A → C
D. C → D → B → A
, (Correct: A)
Rationale:
● Answer: B → A → D → C
● Why (LPN Scope 2026): LPN must report acute rhythm change immediately; then
treat pain; then administer time-critical meds; finally prepare NPO client.
● Errors: Pain is urgent but not life-threatening before dysrhythmia; NPO is least
acute.
Q004:
Type: Traditional
Scenario: A newly admitted client has sliding-scale insulin ac orders. The blood glucose
before lunch is 218 mg/dL.
Question: What should the LPN do first?
Options:
A. Give 4 units regular insulin as ordered
B. Recheck the finger-stick in 15 minutes
C. Ask the client if he ate any snacks
D. Call the RN to verify the dose
(Correct: A)
Rationale:
● Answer: Give 4 units regular insulin as ordered
● Why (LPN Scope 2026): Administering insulin per sliding scale is within LPN
scope once the order is verified; no need to recheck or delay.
