LPN NCLEX-PN Comprehensive Review: OB, Peds, Psych, and
Advanced Med-Surg (2026 Update)
1. A nurse is caring for a client in the first stage of labor. The fetal heart rate
(FHR) monitor shows late decelerations. What is the nurse’s priority action?
A. Increase the IV oxytocin infusion rate.
B. Prepare the client for an immediate amniotomy.
C. Perform a vaginal examination to check for dilation.
D. Reposition the client to a side-lying position.
Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning the
client to a side-lying position improves blood flow to the placenta and is the first nursing
intervention.
2. Which clinical manifestation should a nurse expect in a newborn with a high
bilirubin level (Jaundice)?
A. Excessive hunger and weight gain
B. Dark green or tarry stools
C. Yellowish tint to the sclera and skin
D. Elevated blood glucose levels
Answer: C
Rationale: Jaundice is characterized by a yellowing of the skin and sclera caused by the
accumulation of bilirubin in the blood.
,3. A nurse is monitoring a client with preeclampsia. Which finding is the most
concerning and should be reported immediately?
A. Epigastric pain or right upper quadrant pain
B. Weight gain of 1 pound in one week
C. Blood pressure of 138/88 mmHg
D. 1+ pitting edema in the lower extremities
Answer: A
Rationale: Epigastric or RUQ pain in a preeclamptic client can indicate liver involvement
(HELLP syndrome) or an impending seizure (eclampsia).
4. An infant’s APGAR score at 1 minute is 8. At 5 minutes, it is 9. How should the
nurse interpret these findings?
A. The infant is in severe respiratory distress.
B. The infant requires immediate neonatal resuscitation.
C. The infant is adjusting well to extrauterine life.
D. The infant has significant neurological impairment.
Answer: C
Rationale: APGAR scores between 7 and 10 are considered normal and indicate that the
newborn is in good condition.
5. A pregnant client at 32 weeks gestation presents with painless, bright red
vaginal bleeding. The nurse should suspect which condition?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Ectopic pregnancy
Answer: A
Rationale: Painless, bright red vaginal bleeding in the third trimester is the classic sign of
placenta previa.
, 6. Which vaccine is typically administered to a newborn within the first 24 hours
of birth?
A. Hepatitis B
B. MMR (Measles, Mumps, Rubella)
C. Influenza
D. Varicella
Answer: A
Rationale: The Hepatitis B vaccine is the first vaccine recommended for newborns, usually
given within 24 hours of birth.
7. A toddler is admitted with suspected epiglottitis. Which action is
contraindicated for the nurse?
A. Placing the child in an upright position
B. Monitoring oxygen saturation
C. Examining the throat with a tongue blade
D. Preparing for emergency intubation
Answer: C
Rationale: Using a tongue blade or swab can cause a laryngospasm, leading to sudden and
complete airway obstruction in a child with epiglottitis.
8. According to Erikson, what is the primary developmental task for a child aged
3 to 6 years (Preschooler)?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: C
Rationale: Preschoolers are in the stage of Initiative vs. Guilt, where they begin to assert
power and control over the world through play and social interaction.
Advanced Med-Surg (2026 Update)
1. A nurse is caring for a client in the first stage of labor. The fetal heart rate
(FHR) monitor shows late decelerations. What is the nurse’s priority action?
A. Increase the IV oxytocin infusion rate.
B. Prepare the client for an immediate amniotomy.
C. Perform a vaginal examination to check for dilation.
D. Reposition the client to a side-lying position.
Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning the
client to a side-lying position improves blood flow to the placenta and is the first nursing
intervention.
2. Which clinical manifestation should a nurse expect in a newborn with a high
bilirubin level (Jaundice)?
A. Excessive hunger and weight gain
B. Dark green or tarry stools
C. Yellowish tint to the sclera and skin
D. Elevated blood glucose levels
Answer: C
Rationale: Jaundice is characterized by a yellowing of the skin and sclera caused by the
accumulation of bilirubin in the blood.
,3. A nurse is monitoring a client with preeclampsia. Which finding is the most
concerning and should be reported immediately?
A. Epigastric pain or right upper quadrant pain
B. Weight gain of 1 pound in one week
C. Blood pressure of 138/88 mmHg
D. 1+ pitting edema in the lower extremities
Answer: A
Rationale: Epigastric or RUQ pain in a preeclamptic client can indicate liver involvement
(HELLP syndrome) or an impending seizure (eclampsia).
4. An infant’s APGAR score at 1 minute is 8. At 5 minutes, it is 9. How should the
nurse interpret these findings?
A. The infant is in severe respiratory distress.
B. The infant requires immediate neonatal resuscitation.
C. The infant is adjusting well to extrauterine life.
D. The infant has significant neurological impairment.
Answer: C
Rationale: APGAR scores between 7 and 10 are considered normal and indicate that the
newborn is in good condition.
5. A pregnant client at 32 weeks gestation presents with painless, bright red
vaginal bleeding. The nurse should suspect which condition?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Ectopic pregnancy
Answer: A
Rationale: Painless, bright red vaginal bleeding in the third trimester is the classic sign of
placenta previa.
, 6. Which vaccine is typically administered to a newborn within the first 24 hours
of birth?
A. Hepatitis B
B. MMR (Measles, Mumps, Rubella)
C. Influenza
D. Varicella
Answer: A
Rationale: The Hepatitis B vaccine is the first vaccine recommended for newborns, usually
given within 24 hours of birth.
7. A toddler is admitted with suspected epiglottitis. Which action is
contraindicated for the nurse?
A. Placing the child in an upright position
B. Monitoring oxygen saturation
C. Examining the throat with a tongue blade
D. Preparing for emergency intubation
Answer: C
Rationale: Using a tongue blade or swab can cause a laryngospasm, leading to sudden and
complete airway obstruction in a child with epiglottitis.
8. According to Erikson, what is the primary developmental task for a child aged
3 to 6 years (Preschooler)?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: C
Rationale: Preschoolers are in the stage of Initiative vs. Guilt, where they begin to assert
power and control over the world through play and social interaction.
