ATI LPN Exit Actual Exam (2026 Updated
Version) – Complete Test Bank with Correct
Answers and Detailed Rationales
Q001:
Type: NGN - Extended Multiple Response
Scenario: An LPN is assigned to care for four clients on a medical-surgical unit. Client A
has a new colostomy and is receiving morning care. Client B has a blood glucose of 45
mg/dL and is alert. Client C was admitted with chest pain and is awaiting cardiac
catheterization. Client D has a new prescription for a foley catheter insertion. The LPN's
assignment includes morning vitals for all clients, administering PO medications, and
performing wound care for Client A. The RN is available on the unit.
Question: Which of the following actions are within the LPN's scope of practice and
should be prioritized in this assignment? (Select all that apply)
Options:
A. Perform morning vitals for all four clients
B. Insert the foley catheter for Client D
C. Administer sliding scale insulin per protocol to Client B
D. Begin colostomy care and pouch application for Client A
E. Perform initial pain assessment for Client C
F. Notify the RN immediately of Client B's blood glucose
(Correct: A, D, E, F)
Rationale:
● Answer: A, D, E, F are correct
● Why (LPN Scope 2026): LPNs collect routine vital signs (A) as part of data
gathering for RN analysis. Colostomy care (D) is within LPN scope for
established, non-complex ostomies. Initial pain assessment (E) is data collection
for RN evaluation. Reporting critical glucose <70 mg/dL (F) is an immediate RN
notification requirement per LPN delegation principles. The LPN must report
abnormal findings promptly.
● Errors: B is incorrect because foley catheter insertion is an invasive procedure
that requires RN assessment and delegation based on state Nurse Practice Act;
, LPNs typically require additional certification and direct RN supervision. C is
incorrect because while LPNs may administer insulin per established protocol in
some states, a glucose of 45 mg/dL requires immediate RN assessment and
may need IV dextrose, which is outside LPN scope.
Q002:
Type: Traditional
Scenario: An LPN in a long-term care facility notes a resident's indirect bilirubin level
from morning labs is 3.2 mg/dL (normal 0.2-1.2). The resident appears jaundiced and
reports dark urine for the past 2 days. The resident's care plan includes assistance with
ADLs and medication administration.
Question: What is the most appropriate action for the LPN to take?
Options:
A. Document the findings and continue the care plan as ordered
B. Notify the RN immediately and prepare to collect a urine sample
C. Increase the resident's fluid intake and recheck in 4 hours
D. Call the physician directly to report the lab value
(Correct: B)
Rationale:
● Answer: Notify the RN immediately and prepare to collect a urine sample
● Why (LPN Scope 2026): Elevated bilirubin with clinical jaundice and dark urine
indicates potential liver dysfunction or hemolysis requiring RN assessment and
possible physician notification. The LPN's role is to recognize abnormal data,
report to the RN promptly, and assist with further data collection (urine sample)
as delegated. This falls under "Reduction of Risk Potential" and "Data Collection"
within LPN scope.
● Errors: A is incorrect because abnormal findings require RN notification, not just
documentation. C is incorrect because increasing fluids without RN assessment
delays necessary medical evaluation. D is incorrect because LPNs report to the
RN first; the RN then determines physician notification per chain of command.
Q003:
Type: NGN - Drag-and-Drop
Scenario: An LPN is caring for a postoperative client who had abdominal surgery 2 days
ago. The client reports pain at the incision site rated 6/10, has a temperature of 100.8°F,
and the incision appears red with serosanguineous drainage. The client is ordered for
routine VS q4h, PRN pain medication, and wound care BID.
,Question: Place the following actions in priority order from first to last for the LPN to
perform:
[Drag items to reorder]
● Notify the RN of assessment findings
● Administer PRN pain medication
● Perform hand hygiene and assess vital signs
● Document the wound appearance
Reinforce the dressing with sterile gauze
(Correct Order: 3, 1, 2, 5, 4)
● Rationale:
● Answer: Perform hand hygiene and assess vital signs (3rd), Notify RN (1st),
Administer PRN pain medication (2nd), Reinforce dressing (5th), Document (4th)
● Why (LPN Scope 2026): Priority is: 1) Hand hygiene and vitals (infection control
+ data collection), 2) Immediate RN notification of potential wound infection
(redness, fever), 3) Administer prescribed PRN medication within LPN scope, 4)
Basic wound care (reinforcement) as delegated, 5) Documentation of all actions.
The LPN must report abnormal findings before implementing comfort measures
or wound care.
● Errors: Incorrect ordering would prioritize documentation over RN notification
(violates delegation), or wound care before pain management (client comfort is
priority after reporting), or failing to perform hand hygiene first (infection control
breach).
Q004:
Type: Traditional
Scenario: An LPN is assisting the RN with discharge teaching for a client with a new
diagnosis of heart failure. The LPN has reinforced information about daily weights and
sodium restriction. The client states, "I don't understand why I can't add salt to my food.
It tastes so bland."
Question: What is the most appropriate response by the LPN?
Options:
A. "You should follow the doctor's orders without question."
B. "Let me get the RN to explain how salt affects your heart."
C. "Salt makes your body hold onto water, which makes your heart work harder. Let's
look at some seasoning alternatives."
, D. "I will ask the dietitian to bring you a salt substitute."
(Correct: C)
Rationale:
● Answer: "Salt makes your body hold onto water, which makes your heart work
harder. Let's look at some seasoning alternatives."
● Why (LPN Scope 2026): LPNs provide basic health teaching within their scope
as delegated by RN. Explaining the pathophysiology in simple terms and offering
practical solutions (seasoning alternatives) is appropriate. This demonstrates
understanding of Health Promotion and Basic Care & Comfort. The LPN should
reinforce, not replace, RN teaching, but can provide additional clarification.
● Errors: A is incorrect because it doesn't address the client's knowledge deficit
and is dismissive. B is incorrect if the LPN can provide basic teaching; RN should
be consulted for complex questions, but this is within LPN scope. D is
inappropriate because salt substitutes contain potassium, which may be
contraindicated in heart failure patients on ACE inhibitors or ARBs.
Q005:
Type: NGN - Bowtie
Scenario: A client in a long-term care facility receiving tube feedings via PEG tube has
developed diarrhea for the past 24 hours. The LPN notes the client has had 6 loose
stools, skin breakdown on the buttocks, and appears lethargic.
Question: In the Bowtie format, identify:
Left side (Cues): [Select 3 cues from the scenario]
Center (Action): [Select the immediate LPN action]
Right side (Parameters): [Select 2 parameters to monitor]
(Cues: 6 loose stools, skin breakdown on buttocks, lethargy)
(Action: Notify RN immediately)
(Parameters: Skin integrity, Fluid intake/output)
Rationale:
● Answer: Cues: 6 loose stools, skin breakdown, lethargy; Action: Notify RN;
Parameters: Skin integrity, I&O
● Why (LPN Scope 2026): The LPN identifies cues of potential complications
(dehydration, skin breakdown). Immediate RN notification is required because
diarrhea in tube-fed clients can indicate infection, formula intolerance, or
Version) – Complete Test Bank with Correct
Answers and Detailed Rationales
Q001:
Type: NGN - Extended Multiple Response
Scenario: An LPN is assigned to care for four clients on a medical-surgical unit. Client A
has a new colostomy and is receiving morning care. Client B has a blood glucose of 45
mg/dL and is alert. Client C was admitted with chest pain and is awaiting cardiac
catheterization. Client D has a new prescription for a foley catheter insertion. The LPN's
assignment includes morning vitals for all clients, administering PO medications, and
performing wound care for Client A. The RN is available on the unit.
Question: Which of the following actions are within the LPN's scope of practice and
should be prioritized in this assignment? (Select all that apply)
Options:
A. Perform morning vitals for all four clients
B. Insert the foley catheter for Client D
C. Administer sliding scale insulin per protocol to Client B
D. Begin colostomy care and pouch application for Client A
E. Perform initial pain assessment for Client C
F. Notify the RN immediately of Client B's blood glucose
(Correct: A, D, E, F)
Rationale:
● Answer: A, D, E, F are correct
● Why (LPN Scope 2026): LPNs collect routine vital signs (A) as part of data
gathering for RN analysis. Colostomy care (D) is within LPN scope for
established, non-complex ostomies. Initial pain assessment (E) is data collection
for RN evaluation. Reporting critical glucose <70 mg/dL (F) is an immediate RN
notification requirement per LPN delegation principles. The LPN must report
abnormal findings promptly.
● Errors: B is incorrect because foley catheter insertion is an invasive procedure
that requires RN assessment and delegation based on state Nurse Practice Act;
, LPNs typically require additional certification and direct RN supervision. C is
incorrect because while LPNs may administer insulin per established protocol in
some states, a glucose of 45 mg/dL requires immediate RN assessment and
may need IV dextrose, which is outside LPN scope.
Q002:
Type: Traditional
Scenario: An LPN in a long-term care facility notes a resident's indirect bilirubin level
from morning labs is 3.2 mg/dL (normal 0.2-1.2). The resident appears jaundiced and
reports dark urine for the past 2 days. The resident's care plan includes assistance with
ADLs and medication administration.
Question: What is the most appropriate action for the LPN to take?
Options:
A. Document the findings and continue the care plan as ordered
B. Notify the RN immediately and prepare to collect a urine sample
C. Increase the resident's fluid intake and recheck in 4 hours
D. Call the physician directly to report the lab value
(Correct: B)
Rationale:
● Answer: Notify the RN immediately and prepare to collect a urine sample
● Why (LPN Scope 2026): Elevated bilirubin with clinical jaundice and dark urine
indicates potential liver dysfunction or hemolysis requiring RN assessment and
possible physician notification. The LPN's role is to recognize abnormal data,
report to the RN promptly, and assist with further data collection (urine sample)
as delegated. This falls under "Reduction of Risk Potential" and "Data Collection"
within LPN scope.
● Errors: A is incorrect because abnormal findings require RN notification, not just
documentation. C is incorrect because increasing fluids without RN assessment
delays necessary medical evaluation. D is incorrect because LPNs report to the
RN first; the RN then determines physician notification per chain of command.
Q003:
Type: NGN - Drag-and-Drop
Scenario: An LPN is caring for a postoperative client who had abdominal surgery 2 days
ago. The client reports pain at the incision site rated 6/10, has a temperature of 100.8°F,
and the incision appears red with serosanguineous drainage. The client is ordered for
routine VS q4h, PRN pain medication, and wound care BID.
,Question: Place the following actions in priority order from first to last for the LPN to
perform:
[Drag items to reorder]
● Notify the RN of assessment findings
● Administer PRN pain medication
● Perform hand hygiene and assess vital signs
● Document the wound appearance
Reinforce the dressing with sterile gauze
(Correct Order: 3, 1, 2, 5, 4)
● Rationale:
● Answer: Perform hand hygiene and assess vital signs (3rd), Notify RN (1st),
Administer PRN pain medication (2nd), Reinforce dressing (5th), Document (4th)
● Why (LPN Scope 2026): Priority is: 1) Hand hygiene and vitals (infection control
+ data collection), 2) Immediate RN notification of potential wound infection
(redness, fever), 3) Administer prescribed PRN medication within LPN scope, 4)
Basic wound care (reinforcement) as delegated, 5) Documentation of all actions.
The LPN must report abnormal findings before implementing comfort measures
or wound care.
● Errors: Incorrect ordering would prioritize documentation over RN notification
(violates delegation), or wound care before pain management (client comfort is
priority after reporting), or failing to perform hand hygiene first (infection control
breach).
Q004:
Type: Traditional
Scenario: An LPN is assisting the RN with discharge teaching for a client with a new
diagnosis of heart failure. The LPN has reinforced information about daily weights and
sodium restriction. The client states, "I don't understand why I can't add salt to my food.
It tastes so bland."
Question: What is the most appropriate response by the LPN?
Options:
A. "You should follow the doctor's orders without question."
B. "Let me get the RN to explain how salt affects your heart."
C. "Salt makes your body hold onto water, which makes your heart work harder. Let's
look at some seasoning alternatives."
, D. "I will ask the dietitian to bring you a salt substitute."
(Correct: C)
Rationale:
● Answer: "Salt makes your body hold onto water, which makes your heart work
harder. Let's look at some seasoning alternatives."
● Why (LPN Scope 2026): LPNs provide basic health teaching within their scope
as delegated by RN. Explaining the pathophysiology in simple terms and offering
practical solutions (seasoning alternatives) is appropriate. This demonstrates
understanding of Health Promotion and Basic Care & Comfort. The LPN should
reinforce, not replace, RN teaching, but can provide additional clarification.
● Errors: A is incorrect because it doesn't address the client's knowledge deficit
and is dismissive. B is incorrect if the LPN can provide basic teaching; RN should
be consulted for complex questions, but this is within LPN scope. D is
inappropriate because salt substitutes contain potassium, which may be
contraindicated in heart failure patients on ACE inhibitors or ARBs.
Q005:
Type: NGN - Bowtie
Scenario: A client in a long-term care facility receiving tube feedings via PEG tube has
developed diarrhea for the past 24 hours. The LPN notes the client has had 6 loose
stools, skin breakdown on the buttocks, and appears lethargic.
Question: In the Bowtie format, identify:
Left side (Cues): [Select 3 cues from the scenario]
Center (Action): [Select the immediate LPN action]
Right side (Parameters): [Select 2 parameters to monitor]
(Cues: 6 loose stools, skin breakdown on buttocks, lethargy)
(Action: Notify RN immediately)
(Parameters: Skin integrity, Fluid intake/output)
Rationale:
● Answer: Cues: 6 loose stools, skin breakdown, lethargy; Action: Notify RN;
Parameters: Skin integrity, I&O
● Why (LPN Scope 2026): The LPN identifies cues of potential complications
(dehydration, skin breakdown). Immediate RN notification is required because
diarrhea in tube-fed clients can indicate infection, formula intolerance, or
