Licensed Practical Nurse (LPN) - Safe & Effective Care Environment
(2026 Update)
1. A Licensed Practical Nurse (LPN) is assigned to care for four clients. Which
client should the nurse assess first?
A. A client with a history of heart failure reporting a 1 lb weight gain overnight.
B. A client with chronic obstructive pulmonary disease (COPD) having a respiratory rate of 22 breaths/min.
C. A client with diabetes mellitus whose morning blood glucose level is 130 mg/dL.
D. A client 2 hours postoperative following a thyroidectomy reporting tingling in the fingers.
Answer: D
Rationale: Tingling in the fingers after a thyroidectomy may indicate hypocalcemia due to
accidental parathyroid damage, which can lead to life-threatening laryngospasm and
requires immediate intervention.
2. Which task is most appropriate for the LPN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Assisting a stable client with a total hip replacement to ambulate for the second time.
B. Feeding a client with a high risk for aspiration during their first meal post-stroke.
C. Performing a sterile dressing change on a client’s surgical wound.
D. Explaining the side effects of a new medication to a client being discharged.
Answer: A
Rationale: UAPs can assist stable clients with activities of daily living, including
ambulation. Task A (aspiration risk), C (sterile procedure), and D (education) require
nursing judgment or specialized skills.
,3. A client who is confused is constantly trying to get out of bed. Which action
should the nurse take first to ensure client safety?
A. Place the client in a room near the nurse’s station.
B. Request a prescription for a sedative medication.
C. Apply soft wrist restraints to the client’s arms.
D. Raise all four side rails of the client’s bed.
Answer: A
Rationale: Placing a confused client near the nurse’s station allows for closer observation
without using restrictive measures. Restraints and four side rails (a form of restraint)
should be used only as a last resort.
4. An LPN is caring for a client with active pulmonary tuberculosis (TB). Which
personal protective equipment (PPE) is required when entering the room?
A. Surgical mask and gloves.
B. Gown and face shield.
C. N95 respirator and gloves.
D. Goggles and a surgical mask.
Answer: C
Rationale: Pulmonary TB requires airborne precautions, which include a private room
with negative pressure and the use of an N95 respirator mask.
5. In the event of a fire in a client’s room, which action should the nurse
perform first?
A. Move the client out of the room to a safe area.
B. Attempt to extinguish the fire with a fire extinguisher.
C. Pull the fire alarm pull station.
D. Close the doors and windows to contain the fire.
Answer: A
, Rationale: The RACE acronym (Rescue, Alarm, Contain, Extinguish) dictates that the first
priority is to rescue/remove the client from immediate danger.
6. A client is scheduled for surgery and the LPN is witnessing the signature on
the informed consent form. What is the nurse’s primary responsibility?
A. Ensuring the client understands the risks and benefits of the procedure.
B. Defining the surgical procedure in detail for the client.
C. Explaining alternative treatments available to the client.
D. Verifying that the client’s signature is authentic and voluntary.
Answer: D
Rationale: When witnessing a signature, the nurse is verifying that the client is competent,
the signature is authentic, and it was given voluntarily. The surgeon is responsible for
explaining the procedure and risks.
7. Which client should be placed in a private room with negative airflow
pressure?
A. A client with Methicillin-resistant Staphylococcus aureus (MRSA).
B. A client with Varicella (chickenpox).
C. A client with Influenza A.
D. A client with Clostridium difficile (C. diff).
Answer: B
Rationale: Varicella and Disseminated Herpes Zoster require airborne precautions,
including a negative pressure room. MRSA (Contact), Influenza (Droplet), and C. diff
(Contact) do not require negative pressure.
(2026 Update)
1. A Licensed Practical Nurse (LPN) is assigned to care for four clients. Which
client should the nurse assess first?
A. A client with a history of heart failure reporting a 1 lb weight gain overnight.
B. A client with chronic obstructive pulmonary disease (COPD) having a respiratory rate of 22 breaths/min.
C. A client with diabetes mellitus whose morning blood glucose level is 130 mg/dL.
D. A client 2 hours postoperative following a thyroidectomy reporting tingling in the fingers.
Answer: D
Rationale: Tingling in the fingers after a thyroidectomy may indicate hypocalcemia due to
accidental parathyroid damage, which can lead to life-threatening laryngospasm and
requires immediate intervention.
2. Which task is most appropriate for the LPN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Assisting a stable client with a total hip replacement to ambulate for the second time.
B. Feeding a client with a high risk for aspiration during their first meal post-stroke.
C. Performing a sterile dressing change on a client’s surgical wound.
D. Explaining the side effects of a new medication to a client being discharged.
Answer: A
Rationale: UAPs can assist stable clients with activities of daily living, including
ambulation. Task A (aspiration risk), C (sterile procedure), and D (education) require
nursing judgment or specialized skills.
,3. A client who is confused is constantly trying to get out of bed. Which action
should the nurse take first to ensure client safety?
A. Place the client in a room near the nurse’s station.
B. Request a prescription for a sedative medication.
C. Apply soft wrist restraints to the client’s arms.
D. Raise all four side rails of the client’s bed.
Answer: A
Rationale: Placing a confused client near the nurse’s station allows for closer observation
without using restrictive measures. Restraints and four side rails (a form of restraint)
should be used only as a last resort.
4. An LPN is caring for a client with active pulmonary tuberculosis (TB). Which
personal protective equipment (PPE) is required when entering the room?
A. Surgical mask and gloves.
B. Gown and face shield.
C. N95 respirator and gloves.
D. Goggles and a surgical mask.
Answer: C
Rationale: Pulmonary TB requires airborne precautions, which include a private room
with negative pressure and the use of an N95 respirator mask.
5. In the event of a fire in a client’s room, which action should the nurse
perform first?
A. Move the client out of the room to a safe area.
B. Attempt to extinguish the fire with a fire extinguisher.
C. Pull the fire alarm pull station.
D. Close the doors and windows to contain the fire.
Answer: A
, Rationale: The RACE acronym (Rescue, Alarm, Contain, Extinguish) dictates that the first
priority is to rescue/remove the client from immediate danger.
6. A client is scheduled for surgery and the LPN is witnessing the signature on
the informed consent form. What is the nurse’s primary responsibility?
A. Ensuring the client understands the risks and benefits of the procedure.
B. Defining the surgical procedure in detail for the client.
C. Explaining alternative treatments available to the client.
D. Verifying that the client’s signature is authentic and voluntary.
Answer: D
Rationale: When witnessing a signature, the nurse is verifying that the client is competent,
the signature is authentic, and it was given voluntarily. The surgeon is responsible for
explaining the procedure and risks.
7. Which client should be placed in a private room with negative airflow
pressure?
A. A client with Methicillin-resistant Staphylococcus aureus (MRSA).
B. A client with Varicella (chickenpox).
C. A client with Influenza A.
D. A client with Clostridium difficile (C. diff).
Answer: B
Rationale: Varicella and Disseminated Herpes Zoster require airborne precautions,
including a negative pressure room. MRSA (Contact), Influenza (Droplet), and C. diff
(Contact) do not require negative pressure.
