LPN Clinical Rotation & NCLEX-PN 2026 Review 2026/2027 UPDATE
1. A patient with schizophrenia is hearing voices. Which is the most appropriate
initial response by the LPN?
A. I don’t hear the voices, but I understand they are real to you.
B. There are no voices; it is just your imagination.
C. What are the voices telling you to do right now?
D. Would you like to listen to music to drown out the noise?
Answer: C
Rationale: Safety is the priority. The nurse must first determine if the hallucinations are
‘command’ in nature to assess the risk of harm to self or others.
2. A client is 2 hours post-operative after an abdominal hysterectomy. Which
finding should the LPN report immediately?
A. Pain level of 6 on a scale of 0 to 10.
B. A saturated perineal pad within 15 minutes.
C. Urine output of 40 mL over the last hour.
D. Absent bowel sounds in all four quadrants.
Answer: B
Rationale: Saturating a pad in 15 minutes or less indicates excessive bleeding/hemorrhage
and requires immediate intervention.
,3. Which developmental milestone should a 6-month-old infant typically
demonstrate?
A. Walking while holding onto furniture.
B. Sitting steadily without support.
C. Speaking three to five words.
D. Rolling from back to abdomen.
Answer: D
Rationale: By 6 months, infants should be rolling from back to abdomen; sitting
unsupported usually occurs around 7-8 months.
4. A pregnant client at 34 weeks gestation reports a sudden gush of fluid from
the vagina. What is the priority action?
A. Perform a sterile vaginal exam.
B. Monitor the fetal heart rate.
C. Notify the healthcare provider.
D. Test the fluid with Nitrazine paper.
Answer: B
Rationale: After a rupture of membranes, the priority is assessing fetal well-being to
ensure there is no cord prolapse or fetal distress.
5. A patient on Lithium Carbonate for Bipolar Disorder reports diarrhea and
tremors. What does the LPN suspect?
A. Common side effects that will subside.
B. Extrapyramidal symptoms.
C. Serotonin syndrome.
D. Lithium toxicity.
Answer: D
Rationale: Diarrhea, vomiting, and fine tremors are early signs of lithium toxicity. The
therapeutic range is narrow (0.6-1.2 mEq/L).
, 6. Which intervention is most important for a patient in the immediate post-
operative period to prevent DVT?
A. Applying sequential compression devices (SCDs).
B. Administering prescribed analgesics.
C. Maintaining a high-protein diet.
D. Performing deep breathing exercises.
Answer: A
Rationale: SCDs and early ambulation are the primary mechanical interventions to prevent
deep vein thrombosis post-surgery.
7. A toddler is admitted with Laryngotracheobronchitis (Croup). Which sign
indicates worsening respiratory distress?
A. Barking cough.
B. Capillary refill of 2 seconds.
C. Inspiratory stridor at rest.
D. Pulse oximetry of 95%.
Answer: C
Rationale: Stridor at rest indicates significant airway narrowing and is a sign of worsening
respiratory status in croup.
8. What is the primary purpose of Magnesium Sulfate in a client with
Preeclampsia?
A. To lower the blood pressure.
B. To prevent seizures.
C. To increase urinary output.
D. To induce labor.
Answer: B
Rationale: Magnesium Sulfate is an anticonvulsant used to prevent eclamptic seizures,
though it may also cause a mild decrease in BP.
1. A patient with schizophrenia is hearing voices. Which is the most appropriate
initial response by the LPN?
A. I don’t hear the voices, but I understand they are real to you.
B. There are no voices; it is just your imagination.
C. What are the voices telling you to do right now?
D. Would you like to listen to music to drown out the noise?
Answer: C
Rationale: Safety is the priority. The nurse must first determine if the hallucinations are
‘command’ in nature to assess the risk of harm to self or others.
2. A client is 2 hours post-operative after an abdominal hysterectomy. Which
finding should the LPN report immediately?
A. Pain level of 6 on a scale of 0 to 10.
B. A saturated perineal pad within 15 minutes.
C. Urine output of 40 mL over the last hour.
D. Absent bowel sounds in all four quadrants.
Answer: B
Rationale: Saturating a pad in 15 minutes or less indicates excessive bleeding/hemorrhage
and requires immediate intervention.
,3. Which developmental milestone should a 6-month-old infant typically
demonstrate?
A. Walking while holding onto furniture.
B. Sitting steadily without support.
C. Speaking three to five words.
D. Rolling from back to abdomen.
Answer: D
Rationale: By 6 months, infants should be rolling from back to abdomen; sitting
unsupported usually occurs around 7-8 months.
4. A pregnant client at 34 weeks gestation reports a sudden gush of fluid from
the vagina. What is the priority action?
A. Perform a sterile vaginal exam.
B. Monitor the fetal heart rate.
C. Notify the healthcare provider.
D. Test the fluid with Nitrazine paper.
Answer: B
Rationale: After a rupture of membranes, the priority is assessing fetal well-being to
ensure there is no cord prolapse or fetal distress.
5. A patient on Lithium Carbonate for Bipolar Disorder reports diarrhea and
tremors. What does the LPN suspect?
A. Common side effects that will subside.
B. Extrapyramidal symptoms.
C. Serotonin syndrome.
D. Lithium toxicity.
Answer: D
Rationale: Diarrhea, vomiting, and fine tremors are early signs of lithium toxicity. The
therapeutic range is narrow (0.6-1.2 mEq/L).
, 6. Which intervention is most important for a patient in the immediate post-
operative period to prevent DVT?
A. Applying sequential compression devices (SCDs).
B. Administering prescribed analgesics.
C. Maintaining a high-protein diet.
D. Performing deep breathing exercises.
Answer: A
Rationale: SCDs and early ambulation are the primary mechanical interventions to prevent
deep vein thrombosis post-surgery.
7. A toddler is admitted with Laryngotracheobronchitis (Croup). Which sign
indicates worsening respiratory distress?
A. Barking cough.
B. Capillary refill of 2 seconds.
C. Inspiratory stridor at rest.
D. Pulse oximetry of 95%.
Answer: C
Rationale: Stridor at rest indicates significant airway narrowing and is a sign of worsening
respiratory status in croup.
8. What is the primary purpose of Magnesium Sulfate in a client with
Preeclampsia?
A. To lower the blood pressure.
B. To prevent seizures.
C. To increase urinary output.
D. To induce labor.
Answer: B
Rationale: Magnesium Sulfate is an anticonvulsant used to prevent eclamptic seizures,
though it may also cause a mild decrease in BP.
