LPN/LVN Study Guide Exam 4 (2026/2027 Update) |SBON
1. A nurse is caring for a client with Type 1 Diabetes Mellitus. The client is
prescribed NPH insulin at 0800. At what time should the nurse monitor most
closely for a hypoglycemic reaction?
A. 0900 to 1000
B. 1000 to 1200
C. 1400 to 2000
D. 2200 to 2400
Answer: C
Rationale: NPH is an intermediate-acting insulin with a peak effect typically occurring 4 to
12 hours after administration.
2. Which clinical manifestation should a nurse expect to find in a client
diagnosed with Right-sided Heart Failure?
A. Peripheral edema
B. Pulmonary crackles
C. Dyspnea on exertion
D. Pink frothy sputum
Answer: A
Rationale: Right-sided heart failure leads to systemic venous congestion, manifesting as
peripheral edema, jugular venous distention, and hepatomegaly.
,3. A client is receiving Warfarin for deep vein thrombosis. Which laboratory
value should the nurse monitor to determine therapeutic effectiveness?
A. Partial Thromboplastin Time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Hemoglobin level
Answer: C
Rationale: INR is the standard lab used to monitor the effectiveness of Warfarin therapy;
PTT is used for Heparin.
4. Regarding informed consent, what is the primary responsibility of the
LPN/LVN?
A. Witnessing the client’s signature on the consent form
B. Describing alternative treatments to the client
C. Explaining the risks and benefits of the procedure
D. Obtaining the actual consent from the client
Answer: A
Rationale: The nurse acts as a witness to the signature, confirming the client is competent
and signed voluntarily. The provider is responsible for explaining the procedure.
5. A nurse is caring for a client with COPD who is receiving oxygen via nasal
cannula. Which oxygen flow rate is generally safest for this client?
A. 1 to 2 L/min
B. 5 to 6 L/min
C. 8 to 10 L/min
D. 12 to 15 L/min
Answer: A
Rationale: High concentrations of oxygen can suppress the hypoxic drive in some COPD
clients, potentially leading to respiratory arrest.
, 6. Which precaution should the nurse implement for a client colonized with
Methicillin-resistant Staphylococcus aureus (MRSA) in a wound?
A. Airborne precautions
B. Droplet precautions
C. Protective isolation
D. Contact precautions
Answer: D
Rationale: MRSA in a wound requires contact precautions, including gloves and a gown
when entering the room.
7. A client presents with shakiness, diaphoresis, and confusion. The blood
glucose is 52 mg/dL. Which action should the nurse take first?
A. Call the healthcare provider immediately
B. Administer 15g of rapid-acting carbohydrates
C. Administer the scheduled dose of insulin
D. Provide a complex carbohydrate snack like crackers
Answer: B
Rationale: The client is hypoglycemic. The ‘Rule of 15’ dictates giving 15g of fast-acting
carbs (e.g., juice) first.
8. When caring for a client with a new fiberglass cast on the leg, which finding
should the nurse report immediately?
A. Capillary refill of 5 seconds on the toes
B. Itching under the cast
C. The cast feels warm to the touch
D. Small amount of localized swelling
Answer: A
Rationale: Capillary refill greater than 3 seconds indicates impaired circulation, a sign of
compartment syndrome or a cast that is too tight.
1. A nurse is caring for a client with Type 1 Diabetes Mellitus. The client is
prescribed NPH insulin at 0800. At what time should the nurse monitor most
closely for a hypoglycemic reaction?
A. 0900 to 1000
B. 1000 to 1200
C. 1400 to 2000
D. 2200 to 2400
Answer: C
Rationale: NPH is an intermediate-acting insulin with a peak effect typically occurring 4 to
12 hours after administration.
2. Which clinical manifestation should a nurse expect to find in a client
diagnosed with Right-sided Heart Failure?
A. Peripheral edema
B. Pulmonary crackles
C. Dyspnea on exertion
D. Pink frothy sputum
Answer: A
Rationale: Right-sided heart failure leads to systemic venous congestion, manifesting as
peripheral edema, jugular venous distention, and hepatomegaly.
,3. A client is receiving Warfarin for deep vein thrombosis. Which laboratory
value should the nurse monitor to determine therapeutic effectiveness?
A. Partial Thromboplastin Time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Hemoglobin level
Answer: C
Rationale: INR is the standard lab used to monitor the effectiveness of Warfarin therapy;
PTT is used for Heparin.
4. Regarding informed consent, what is the primary responsibility of the
LPN/LVN?
A. Witnessing the client’s signature on the consent form
B. Describing alternative treatments to the client
C. Explaining the risks and benefits of the procedure
D. Obtaining the actual consent from the client
Answer: A
Rationale: The nurse acts as a witness to the signature, confirming the client is competent
and signed voluntarily. The provider is responsible for explaining the procedure.
5. A nurse is caring for a client with COPD who is receiving oxygen via nasal
cannula. Which oxygen flow rate is generally safest for this client?
A. 1 to 2 L/min
B. 5 to 6 L/min
C. 8 to 10 L/min
D. 12 to 15 L/min
Answer: A
Rationale: High concentrations of oxygen can suppress the hypoxic drive in some COPD
clients, potentially leading to respiratory arrest.
, 6. Which precaution should the nurse implement for a client colonized with
Methicillin-resistant Staphylococcus aureus (MRSA) in a wound?
A. Airborne precautions
B. Droplet precautions
C. Protective isolation
D. Contact precautions
Answer: D
Rationale: MRSA in a wound requires contact precautions, including gloves and a gown
when entering the room.
7. A client presents with shakiness, diaphoresis, and confusion. The blood
glucose is 52 mg/dL. Which action should the nurse take first?
A. Call the healthcare provider immediately
B. Administer 15g of rapid-acting carbohydrates
C. Administer the scheduled dose of insulin
D. Provide a complex carbohydrate snack like crackers
Answer: B
Rationale: The client is hypoglycemic. The ‘Rule of 15’ dictates giving 15g of fast-acting
carbs (e.g., juice) first.
8. When caring for a client with a new fiberglass cast on the leg, which finding
should the nurse report immediately?
A. Capillary refill of 5 seconds on the toes
B. Itching under the cast
C. The cast feels warm to the touch
D. Small amount of localized swelling
Answer: A
Rationale: Capillary refill greater than 3 seconds indicates impaired circulation, a sign of
compartment syndrome or a cast that is too tight.
