LPN – Licensed Practical Nurse (U.S.) |
Comprehensive Study Guide, Practice Exam,
Questions & Answers, LPN Licensure Exam Prep
Test Bank, Nursing Fundamentals, Medical-Surgical
Nursing, Pharmacology, Maternal & Pediatric
Nursing, Mental Health, Patient Care, Infection
Control, NCLEX-PN Review, Detailed Rationales,
Complete Review
Question 1: A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen at 2 L/min via nasal cannula. Which assessment finding
indicates an adverse effect of this therapy?
A. Respiratory rate of 22 breaths per minute
B. Oxygen saturation of 91%
C. A decrease in the client's respiratory rate to 8 breaths per minute
D. The client reporting a headache
CORRECT ANSWER: C. A decrease in the client's respiratory rate to 8 breaths
per minute
Rationale: Clients with COPD often have a hypoxic drive to breathe. Administering high-
flow oxygen can decrease this stimulus, leading to respiratory depression and apnea. A
respiratory rate of 8 breaths/min indicates severe depression and is an adverse effect.
Question 2: The LPN is preparing to administer an enteral feeding via a
nasogastric (NG) tube. Which action should the nurse take first?
A. Flush the tube with 30 mL of air
B. Verify tube placement by aspirating gastric contents and checking pH
C. Connect the feeding bag to the tube
D. Position the client in a supine position
CORRECT ANSWER: B. Verify tube placement by aspirating gastric contents
and checking pH
Rationale: Verifying tube placement is the priority action to prevent aspiration and
ensure the feeding is delivered into the stomach. Checking the pH of aspirated gastric
contents (typically ≤ 5.0) is a standard method to confirm placement.
Question 3: A client is prescribed furosemide (Lasix) for heart failure. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
,C. Serum calcium
D. Serum glucose
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium in the
distal tubule. This can lead to hypokalemia, which can cause cardiac arrhythmias,
especially in clients taking digoxin.
Question 4: The LPN is reinforcing teaching for a client with type 1 diabetes
mellitus who is experiencing hypoglycemia. Which symptom is a classic
manifestation of this condition?
A. Polyuria
B. Fruity-smelling breath
C. Tremors and diaphoresis
D. Deep, rapid respirations (Kussmaul's)
CORRECT ANSWER: C. Tremors and diaphoresis
Rationale: Hypoglycemia stimulates the sympathetic nervous system, leading to
symptoms such as tremors, diaphoresis, tachycardia, and palpitations. Polyuria, fruity
breath, and Kussmaul's respirations are signs of hyperglycemia and diabetic
ketoacidosis.
Question 5: The LPN is performing a sterile dressing change for a client with a
surgical wound. Which action is a violation of sterile technique?
A. Opening the sterile pack away from the body
B. Holding sterile objects above the waist
C. Reaching over the sterile field to retrieve a dressing
D. Using sterile forceps to handle the dressing
CORRECT ANSWER: C. Reaching over the sterile field to retrieve a dressing
Rationale: Reaching over the sterile field is a violation because it can cause non-sterile
particles from the nurse's arm or gown to fall onto the sterile field. The 1-inch border of
a sterile field is also considered contaminated.
Question 6: A client with dementia is becoming increasingly agitated and is
attempting to pull out their IV line. What is the least restrictive intervention
the nurse should implement first?
A. Apply wrist restraints
B. Administer a PRN sedative
,C. Offer a security blanket or familiar object for distraction
D. Move the client to a room near the nurses' station
CORRECT ANSWER: C. Offer a security blanket or familiar object for
distraction
Rationale: The least restrictive intervention should always be attempted first. Distraction
and redirection are non-pharmacological, non-restrictive methods. Restraints (chemical
or physical) require a physician's order and are used only when less restrictive measures
have failed.
Question 7: The LPN is caring for a client with a cerebrovascular accident
(CVA) who has left-sided hemiplegia. When positioning the client, the nurse
should place the client in a position that promotes:
A. Adduction of the left arm
B. External rotation of the left hip
C. Plantar flexion of the left foot
D. Abduction of the left shoulder
CORRECT ANSWER: D. Abduction of the left shoulder
Rationale: To prevent contractures and shoulder pain, the affected (left) arm should be
positioned in abduction (away from the body) with a pillow in the axilla. Adduction,
external rotation, and plantar flexion are positions that can lead to contractures.
Question 8: An LPN is reinforcing education to a client prescribed warfarin
(Coumadin). Which statement by the client indicates a need for further
teaching?
A. "I will take my medication at the same time each day."
B. "I will avoid eating large amounts of spinach and kale."
C. "I can take ibuprofen for my headaches."
D. "I need to have my INR checked regularly."
CORRECT ANSWER: C. "I can take ibuprofen for my headaches."
Rationale: Ibuprofen is an NSAID and can increase the risk of gastrointestinal bleeding
when taken with warfarin. The client should use acetaminophen for pain relief.
Consistent intake of vitamin K (spinach/kale) is important to avoid INR fluctuations.
Question 9: A client is 1-day post-operative from a total hip replacement. The
nurse notes that the client's affected leg is externally rotated and shortened.
What is the nurse's priority action?
, A. Apply ice to the hip
B. Notify the healthcare provider immediately
C. Place a wedge pillow between the legs
D. Re-position the client to promote internal rotation
CORRECT ANSWER: B. Notify the healthcare provider immediately
Rationale: External rotation and shortening of the leg are classic signs of hip dislocation
or prosthesis displacement. This is a surgical emergency. The nurse should not attempt
to reposition the leg; the HCP must be notified.
Question 10: The LPN is preparing to administer an intramuscular (IM)
injection in the ventrogluteal site. Which landmark is used to locate this site?
A. The acromion process and the axilla
B. The anterior superior iliac spine and the iliac crest
C. The greater trochanter and the posterior superior iliac spine
D. The midpoint between the knee and the greater trochanter
CORRECT ANSWER: B. The anterior superior iliac spine and the iliac crest
Rationale: The ventrogluteal site is located by placing the heel of the hand on the greater
trochanter, with the thumb pointing toward the anterior superior iliac spine (ASIS) and
the index finger pointing toward the iliac crest. The injection is given in the V formed
between the fingers.
Question 11: A client is receiving a blood transfusion and begins to complain
of chills, flank pain, and nausea. The nurse's first action should be to:
A. Slow the infusion rate
B. Administer diphenhydramine (Benadryl)
C. Stop the transfusion and disconnect the tubing
D. Notify the healthcare provider
CORRECT ANSWER: C. Stop the transfusion and disconnect the tubing
Rationale: Chills, flank pain, and nausea are signs of an acute hemolytic transfusion
reaction. The transfusion must be stopped immediately to prevent further complications.
The IV line should be kept open with normal saline and new tubing.
Question 12: The LPN is reinforcing dietary teaching for a client with heart
failure. Which food choice by the client indicates understanding of the
prescribed sodium restriction?
A. Grilled chicken sandwich with a pickle
B. Canned vegetable soup with crackers
Comprehensive Study Guide, Practice Exam,
Questions & Answers, LPN Licensure Exam Prep
Test Bank, Nursing Fundamentals, Medical-Surgical
Nursing, Pharmacology, Maternal & Pediatric
Nursing, Mental Health, Patient Care, Infection
Control, NCLEX-PN Review, Detailed Rationales,
Complete Review
Question 1: A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen at 2 L/min via nasal cannula. Which assessment finding
indicates an adverse effect of this therapy?
A. Respiratory rate of 22 breaths per minute
B. Oxygen saturation of 91%
C. A decrease in the client's respiratory rate to 8 breaths per minute
D. The client reporting a headache
CORRECT ANSWER: C. A decrease in the client's respiratory rate to 8 breaths
per minute
Rationale: Clients with COPD often have a hypoxic drive to breathe. Administering high-
flow oxygen can decrease this stimulus, leading to respiratory depression and apnea. A
respiratory rate of 8 breaths/min indicates severe depression and is an adverse effect.
Question 2: The LPN is preparing to administer an enteral feeding via a
nasogastric (NG) tube. Which action should the nurse take first?
A. Flush the tube with 30 mL of air
B. Verify tube placement by aspirating gastric contents and checking pH
C. Connect the feeding bag to the tube
D. Position the client in a supine position
CORRECT ANSWER: B. Verify tube placement by aspirating gastric contents
and checking pH
Rationale: Verifying tube placement is the priority action to prevent aspiration and
ensure the feeding is delivered into the stomach. Checking the pH of aspirated gastric
contents (typically ≤ 5.0) is a standard method to confirm placement.
Question 3: A client is prescribed furosemide (Lasix) for heart failure. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
,C. Serum calcium
D. Serum glucose
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium in the
distal tubule. This can lead to hypokalemia, which can cause cardiac arrhythmias,
especially in clients taking digoxin.
Question 4: The LPN is reinforcing teaching for a client with type 1 diabetes
mellitus who is experiencing hypoglycemia. Which symptom is a classic
manifestation of this condition?
A. Polyuria
B. Fruity-smelling breath
C. Tremors and diaphoresis
D. Deep, rapid respirations (Kussmaul's)
CORRECT ANSWER: C. Tremors and diaphoresis
Rationale: Hypoglycemia stimulates the sympathetic nervous system, leading to
symptoms such as tremors, diaphoresis, tachycardia, and palpitations. Polyuria, fruity
breath, and Kussmaul's respirations are signs of hyperglycemia and diabetic
ketoacidosis.
Question 5: The LPN is performing a sterile dressing change for a client with a
surgical wound. Which action is a violation of sterile technique?
A. Opening the sterile pack away from the body
B. Holding sterile objects above the waist
C. Reaching over the sterile field to retrieve a dressing
D. Using sterile forceps to handle the dressing
CORRECT ANSWER: C. Reaching over the sterile field to retrieve a dressing
Rationale: Reaching over the sterile field is a violation because it can cause non-sterile
particles from the nurse's arm or gown to fall onto the sterile field. The 1-inch border of
a sterile field is also considered contaminated.
Question 6: A client with dementia is becoming increasingly agitated and is
attempting to pull out their IV line. What is the least restrictive intervention
the nurse should implement first?
A. Apply wrist restraints
B. Administer a PRN sedative
,C. Offer a security blanket or familiar object for distraction
D. Move the client to a room near the nurses' station
CORRECT ANSWER: C. Offer a security blanket or familiar object for
distraction
Rationale: The least restrictive intervention should always be attempted first. Distraction
and redirection are non-pharmacological, non-restrictive methods. Restraints (chemical
or physical) require a physician's order and are used only when less restrictive measures
have failed.
Question 7: The LPN is caring for a client with a cerebrovascular accident
(CVA) who has left-sided hemiplegia. When positioning the client, the nurse
should place the client in a position that promotes:
A. Adduction of the left arm
B. External rotation of the left hip
C. Plantar flexion of the left foot
D. Abduction of the left shoulder
CORRECT ANSWER: D. Abduction of the left shoulder
Rationale: To prevent contractures and shoulder pain, the affected (left) arm should be
positioned in abduction (away from the body) with a pillow in the axilla. Adduction,
external rotation, and plantar flexion are positions that can lead to contractures.
Question 8: An LPN is reinforcing education to a client prescribed warfarin
(Coumadin). Which statement by the client indicates a need for further
teaching?
A. "I will take my medication at the same time each day."
B. "I will avoid eating large amounts of spinach and kale."
C. "I can take ibuprofen for my headaches."
D. "I need to have my INR checked regularly."
CORRECT ANSWER: C. "I can take ibuprofen for my headaches."
Rationale: Ibuprofen is an NSAID and can increase the risk of gastrointestinal bleeding
when taken with warfarin. The client should use acetaminophen for pain relief.
Consistent intake of vitamin K (spinach/kale) is important to avoid INR fluctuations.
Question 9: A client is 1-day post-operative from a total hip replacement. The
nurse notes that the client's affected leg is externally rotated and shortened.
What is the nurse's priority action?
, A. Apply ice to the hip
B. Notify the healthcare provider immediately
C. Place a wedge pillow between the legs
D. Re-position the client to promote internal rotation
CORRECT ANSWER: B. Notify the healthcare provider immediately
Rationale: External rotation and shortening of the leg are classic signs of hip dislocation
or prosthesis displacement. This is a surgical emergency. The nurse should not attempt
to reposition the leg; the HCP must be notified.
Question 10: The LPN is preparing to administer an intramuscular (IM)
injection in the ventrogluteal site. Which landmark is used to locate this site?
A. The acromion process and the axilla
B. The anterior superior iliac spine and the iliac crest
C. The greater trochanter and the posterior superior iliac spine
D. The midpoint between the knee and the greater trochanter
CORRECT ANSWER: B. The anterior superior iliac spine and the iliac crest
Rationale: The ventrogluteal site is located by placing the heel of the hand on the greater
trochanter, with the thumb pointing toward the anterior superior iliac spine (ASIS) and
the index finger pointing toward the iliac crest. The injection is given in the V formed
between the fingers.
Question 11: A client is receiving a blood transfusion and begins to complain
of chills, flank pain, and nausea. The nurse's first action should be to:
A. Slow the infusion rate
B. Administer diphenhydramine (Benadryl)
C. Stop the transfusion and disconnect the tubing
D. Notify the healthcare provider
CORRECT ANSWER: C. Stop the transfusion and disconnect the tubing
Rationale: Chills, flank pain, and nausea are signs of an acute hemolytic transfusion
reaction. The transfusion must be stopped immediately to prevent further complications.
The IV line should be kept open with normal saline and new tubing.
Question 12: The LPN is reinforcing dietary teaching for a client with heart
failure. Which food choice by the client indicates understanding of the
prescribed sodium restriction?
A. Grilled chicken sandwich with a pickle
B. Canned vegetable soup with crackers
