ATI LPN Exit Exam (2026 Updated Version) –
Complete Test Bank with Correct Answers and
Detailed Rationales
Q001:
Type: NGN - Extended Multiple Response
Scenario: 78-year-old resident in long-term care has a Stage II pressure injury on the
sacrum. Orders read: clean with NS, apply hydrocolloid dressing BID, turn q2h. During
morning care the LPN notes serous drainage, warmth, and foul odor.
Question: Which actions should the LPN take? (Select all that apply.)
Options:
A. Document findings
B. Obtain a wound culture per protocol
C. Apply a heating pad to increase circulation
D. Report findings to the charge RN
E. Reinforce the same hydrocolloid dressing
(Correct: A, B, D)
Rationale:
● Answer: Document, obtain culture per protocol, report to RN
, ● **Why (LPN Scope 2026):) LPNs may collect specimens when protocol exists
and must report signs of infection; documentation is required.
● Errors: Heating pad contraindicated (burn risk); re-using dressing violates
infection-control standards.
Q002:
Type: Traditional
Scenario: A 4-year-old child in a clinic is scheduled for MMR and varicella vaccines. The
parent asks if the vaccines can be given today.
Question: What is the priority action for the LPN?
Options:
A. Administer both vaccines after obtaining consent
B. Verify immunization history and screen for contraindications
C. Tell the parent to return after 24 h fasting
D. Ask the RN to reconstitute the vaccines
(Correct: B)
Rationale:
● Answer: Verify history and screen for contraindications
● **Why (LPN Scope 2026):) LPNs collect data and screen; ensuring no
contraindications is required before any vaccine.
● Errors: Administering without screening risks error; fasting unnecessary; LPN can
reconstitute if competency validated.
Q003:
Type: NGN - Drag-and-Drop (Prioritization)
,Scenario: Four clients are in an assisted-living dining room. The LPN must decide the
order of assessment after a call for help.
Client 1: 81-year-old, coughing continuously after drinking water
Client 2: 77-year-old, BP 180/98, denies dizziness
Client 3: 70-year-old, new colostomy, asking for bag change teaching
Client 4: 75-year-old, blood glucose 60 mg/dL, shaky
Question: Place the clients in the order the LPN should assess/intervene. (1 = first)
Options:
Client 1 → 1
Client 4 → 2
Client 2 → 3
Client 3 → 4
(Correct: Client 1, Client 4, Client 2, Client 3)
Rationale:
● Answer: Airway/breathing (choking) first, then hypoglycemia, then hypertensive
urgency, then teaching
● **Why (LPN Scope 2026):) LPNs follow ABC; hypoglycemia is life-threatening;
teaching is non-urgent.
● Errors: Delaying airway assessment or hypoglycemia risks harm.
Q004:
Type: Traditional
, Scenario: The LPN is preparing to give 0900 medications. A new blister pack contains
digoxin 0.25 mg. The resident’s HR is 56 bpm.
Question: What should the LPN do?
Options:
A. Give the medication and recheck HR in 1 hour
B. Hold the medication and notify the RN immediately
C. Cut the tablet in half and administer 0.125 mg
D. Recheck HR in 15 min and give if >60
(Correct: B)
Rationale:
● Answer: Hold and notify RN
● **Why (LPN Scope 2026):) HR <60 is a hold parameter for digoxin; LPN cannot
alter dose without provider order.
● Errors: Administering risks bradycardia; partial dose outside scope.
Q005:
Type: NGN - Bowtie
Scenario: A 66-year-old post-stroke client has right-sided weakness and a new PCA
fentanyl patch 25 μg/h. At 0800 the LPN finds the client drowsy, respirations 10/min, O₂
sat 93% RA.
Question: Identify the cue, the immediate action, and the parameter to report. (Bowtie
response)
Cue: Respiratory depression (10/min)
Complete Test Bank with Correct Answers and
Detailed Rationales
Q001:
Type: NGN - Extended Multiple Response
Scenario: 78-year-old resident in long-term care has a Stage II pressure injury on the
sacrum. Orders read: clean with NS, apply hydrocolloid dressing BID, turn q2h. During
morning care the LPN notes serous drainage, warmth, and foul odor.
Question: Which actions should the LPN take? (Select all that apply.)
Options:
A. Document findings
B. Obtain a wound culture per protocol
C. Apply a heating pad to increase circulation
D. Report findings to the charge RN
E. Reinforce the same hydrocolloid dressing
(Correct: A, B, D)
Rationale:
● Answer: Document, obtain culture per protocol, report to RN
, ● **Why (LPN Scope 2026):) LPNs may collect specimens when protocol exists
and must report signs of infection; documentation is required.
● Errors: Heating pad contraindicated (burn risk); re-using dressing violates
infection-control standards.
Q002:
Type: Traditional
Scenario: A 4-year-old child in a clinic is scheduled for MMR and varicella vaccines. The
parent asks if the vaccines can be given today.
Question: What is the priority action for the LPN?
Options:
A. Administer both vaccines after obtaining consent
B. Verify immunization history and screen for contraindications
C. Tell the parent to return after 24 h fasting
D. Ask the RN to reconstitute the vaccines
(Correct: B)
Rationale:
● Answer: Verify history and screen for contraindications
● **Why (LPN Scope 2026):) LPNs collect data and screen; ensuring no
contraindications is required before any vaccine.
● Errors: Administering without screening risks error; fasting unnecessary; LPN can
reconstitute if competency validated.
Q003:
Type: NGN - Drag-and-Drop (Prioritization)
,Scenario: Four clients are in an assisted-living dining room. The LPN must decide the
order of assessment after a call for help.
Client 1: 81-year-old, coughing continuously after drinking water
Client 2: 77-year-old, BP 180/98, denies dizziness
Client 3: 70-year-old, new colostomy, asking for bag change teaching
Client 4: 75-year-old, blood glucose 60 mg/dL, shaky
Question: Place the clients in the order the LPN should assess/intervene. (1 = first)
Options:
Client 1 → 1
Client 4 → 2
Client 2 → 3
Client 3 → 4
(Correct: Client 1, Client 4, Client 2, Client 3)
Rationale:
● Answer: Airway/breathing (choking) first, then hypoglycemia, then hypertensive
urgency, then teaching
● **Why (LPN Scope 2026):) LPNs follow ABC; hypoglycemia is life-threatening;
teaching is non-urgent.
● Errors: Delaying airway assessment or hypoglycemia risks harm.
Q004:
Type: Traditional
, Scenario: The LPN is preparing to give 0900 medications. A new blister pack contains
digoxin 0.25 mg. The resident’s HR is 56 bpm.
Question: What should the LPN do?
Options:
A. Give the medication and recheck HR in 1 hour
B. Hold the medication and notify the RN immediately
C. Cut the tablet in half and administer 0.125 mg
D. Recheck HR in 15 min and give if >60
(Correct: B)
Rationale:
● Answer: Hold and notify RN
● **Why (LPN Scope 2026):) HR <60 is a hold parameter for digoxin; LPN cannot
alter dose without provider order.
● Errors: Administering risks bradycardia; partial dose outside scope.
Q005:
Type: NGN - Bowtie
Scenario: A 66-year-old post-stroke client has right-sided weakness and a new PCA
fentanyl patch 25 μg/h. At 0800 the LPN finds the client drowsy, respirations 10/min, O₂
sat 93% RA.
Question: Identify the cue, the immediate action, and the parameter to report. (Bowtie
response)
Cue: Respiratory depression (10/min)
