LPN – Licensed Practical Nurse (U.S.) |
Comprehensive Study Guide, Practice Exam, 250+
Questions & Answers, LPN Licensure Exam Prep
Test Bank, NCLEX-PN Review, Nursing
Fundamentals, Medical-Surgical Nursing,
Pharmacology, Maternal & Pediatric Nursing,
Mental Health, Infection Control, Clinical Skills,
Patient Safety, Detailed Rationales, Updated 2026
Question 1: A patient prescribed digoxin presents with nausea, vomiting, and
visual disturbances showing yellow-green halos. Which of the following lab
values is most critical for the nurse to assess before administering the next
dose?
A. Serum sodium level
B. Serum potassium level
C. Serum calcium level
D. Serum magnesium level
CORRECT ANSWER: B. Serum potassium level
Rationale: Digoxin toxicity is potentiated by hypokalemia. Low serum potassium
increases the binding of digoxin to cardiac sodium-potassium ATPase pumps, increasing
the risk of toxicity. Nausea, vomiting, and visual changes (halos) are classic signs of
digoxin toxicity. While magnesium is also important, potassium is the most critical and
immediate value to check due to its direct impact on toxicity.
Question 2: A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen at 2 L/min via nasal cannula. The nurse assesses the client
and notes a respiratory rate of 10 breaths/min and somnolence. Which action
should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Place the client in a high-Fowler's position
C. Maintain the current oxygen flow rate and assess further
D. Prepare for immediate endotracheal intubation
CORRECT ANSWER: C. Maintain the current oxygen flow rate and assess
further
Rationale: Clients with COPD may have a hypoxic drive to breathe. High-flow oxygen
can eliminate this drive and cause respiratory depression. The current rate of 2 L/min is
appropriate. The nurse should first maintain the rate and perform a more
comprehensive assessment, including arterial blood gases (ABGs), before any
intervention.
Question 3: A postoperative patient has an order for morphine sulfate 4 mg IV
push. The available vial contains 10 mg/mL. How many mL will the nurse
administer?
,A. 0.2 mL
B. 0.4 mL
C. 0.8 mL
D. 1 mL
CORRECT ANSWER: B. 0.4 mL
Rationale: Use the formula: Desired Dose / Available Dose. 4 mg / 10 mg/mL = 0.4
mL.
Question 4: Which of the following dietary modifications is most appropriate
for a patient with end-stage renal disease (ESRD) who is not yet on dialysis?
A. High-protein, high-potassium diet
B. Low-protein, low-phosphorus, low-potassium diet
C. High-carbohydrate, high-calcium diet
D. Low-sodium, high-fluid diet
CORRECT ANSWER: B. Low-protein, low-phosphorus, low-potassium diet
Rationale: In ESRD, the kidneys fail to excrete waste products. A low-protein diet
decreases urea buildup. Low-phosphorus and low-potassium diets are necessary to
prevent hyperphosphatemia and hyperkalemia, which can be life-threatening (cardiac
arrhythmias).
Question 5: A patient is admitted with a urinary tract infection (UTI) and is
started on ciprofloxacin. Which adverse effect is most important for the nurse
to teach the patient about?
A. Tendon rupture or inflammation
B. Photosensitivity
C. Diarrhea
D. Dizziness
CORRECT ANSWER: A. Tendon rupture or inflammation
Rationale: Fluoroquinolones (like ciprofloxacin) carry a black box warning for tendinitis
and tendon rupture. While photosensitivity and diarrhea are also side effects, the risk of
tendon damage is the most severe and must be emphasized, especially in older adults or
those on corticosteroids.
Question 6: A nurse is preparing to administer a cleansing enema to a client.
In which position should the nurse place the client?
A. Supine
B. Prone
C. Left lateral (Sims') position
D. Right lateral position
CORRECT ANSWER: C. Left lateral (Sims') position
,Rationale: The left lateral (Sims') position utilizes gravity to facilitate the flow of enema
solution into the sigmoid and descending colon, which is the natural anatomical curve of
the large intestine.
Question 7: The nurse is caring for a patient in septic shock. Which type of
intravenous (IV) fluid is the initial fluid of choice for resuscitation?
A. 0.45% normal saline (half normal saline)
B. Dextrose 5% in water (D5W)
C. 0.9% normal saline (normal saline) or Lactated Ringer's (LR)
D. 3% normal saline (hypertonic saline)
CORRECT ANSWER: C. 0.9% normal saline (normal saline) or Lactated
Ringer's (LR)
Rationale: Crystalloids, specifically isotonic solutions like 0.9% NS or LR, are the first-
line resuscitation fluids for septic shock to rapidly expand intravascular volume and
restore tissue perfusion.
Question 8: A client with type 1 diabetes reports feeling shaky, sweaty, and
confused. The nurse obtains a blood glucose reading of 50 mg/dL. Which of
the following is the priority nursing action?
A. Administer insulin subcutaneously
B. Call the physician immediately
C. Give 15 grams of fast-acting carbohydrate (e.g., glucose tablets or 4 oz juice)
D. Restrict all fluids until the blood glucose stabilizes
CORRECT ANSWER: C. Give 15 grams of fast-acting carbohydrate (e.g., glucose
tablets or 4 oz juice)
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia. The priority is to treat
the hypoglycemia immediately with 15 grams of simple carbohydrates (the "Rule of 15")
to prevent neurological damage or coma.
Question 9: When administering an intramuscular (IM) injection in the
ventrogluteal site, which landmark is used to locate the injection site?
A. Greater trochanter and iliac crest
B. Acromion process and axilla
C. Anterior superior iliac spine and iliac crest
D. Posterior superior iliac spine and gluteal fold
CORRECT ANSWER: A. Greater trochanter and iliac crest
Rationale: The ventrogluteal site is located by placing the palm on the greater trochanter
and the index finger on the anterior superior iliac spine, forming a "V" with the thumb
toward the iliac crest. It is the preferred IM site because it avoids major nerves and
blood vessels.
, Question 10: Which nursing diagnosis takes the highest priority for a patient
with a new tracheostomy?
A. Impaired verbal communication
B. Risk for infection
C. Ineffective airway clearance
D. Anxiety
CORRECT ANSWER: C. Ineffective airway clearance
Rationale: Airway clearance is always the top priority (Maslow's hierarchy of needs). A
tracheostomy bypasses the upper airway, increasing the risk of mucus plugs obstructing
the airway, which can lead to hypoxia and death. Airway is always "ABC" (Airway,
Breathing, Circulation).
Question 11: A patient receiving furosemide (Lasix) has a potassium level of
3.0 mEq/L. The nurse should assess for which of the following clinical
manifestations?
A. Muscle weakness and cardiac dysrhythmias
B. Hypertension and bradycardia
C. Increased deep tendon reflexes
D. Flushed skin and dry mouth
CORRECT ANSWER: A. Muscle weakness and cardiac dysrhythmias
Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia. Furosemide is a loop
diuretic that causes potassium wasting. Hypokalemia presents with muscle weakness,
fatigue, and cardiac dysrhythmias (e.g., U waves, PVCs).
Question 12: What is the expected therapeutic effect of the anticholinergic
medication atropine sulfate?
A. Decrease in heart rate
B. Increase in respiratory rate
C. Increase in heart rate and drying of secretions
D. Decrease in blood pressure
CORRECT ANSWER: C. Increase in heart rate and drying of secretions
Rationale: Atropine blocks the action of acetylcholine at muscarinic receptors. This
leads to increased heart rate (positive chronotrope) and decreased secretions (salivary,
bronchial) which is why it's used for bradycardia and as a pre-anesthetic medication.
Question 13: A nurse is performing a neurological assessment using the
Glasgow Coma Scale (GCS). A patient opens eyes only to pain, makes
incomprehensible sounds, and withdraws from painful stimuli. What is the
GCS score?
A. 7
B. 9
Comprehensive Study Guide, Practice Exam, 250+
Questions & Answers, LPN Licensure Exam Prep
Test Bank, NCLEX-PN Review, Nursing
Fundamentals, Medical-Surgical Nursing,
Pharmacology, Maternal & Pediatric Nursing,
Mental Health, Infection Control, Clinical Skills,
Patient Safety, Detailed Rationales, Updated 2026
Question 1: A patient prescribed digoxin presents with nausea, vomiting, and
visual disturbances showing yellow-green halos. Which of the following lab
values is most critical for the nurse to assess before administering the next
dose?
A. Serum sodium level
B. Serum potassium level
C. Serum calcium level
D. Serum magnesium level
CORRECT ANSWER: B. Serum potassium level
Rationale: Digoxin toxicity is potentiated by hypokalemia. Low serum potassium
increases the binding of digoxin to cardiac sodium-potassium ATPase pumps, increasing
the risk of toxicity. Nausea, vomiting, and visual changes (halos) are classic signs of
digoxin toxicity. While magnesium is also important, potassium is the most critical and
immediate value to check due to its direct impact on toxicity.
Question 2: A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen at 2 L/min via nasal cannula. The nurse assesses the client
and notes a respiratory rate of 10 breaths/min and somnolence. Which action
should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Place the client in a high-Fowler's position
C. Maintain the current oxygen flow rate and assess further
D. Prepare for immediate endotracheal intubation
CORRECT ANSWER: C. Maintain the current oxygen flow rate and assess
further
Rationale: Clients with COPD may have a hypoxic drive to breathe. High-flow oxygen
can eliminate this drive and cause respiratory depression. The current rate of 2 L/min is
appropriate. The nurse should first maintain the rate and perform a more
comprehensive assessment, including arterial blood gases (ABGs), before any
intervention.
Question 3: A postoperative patient has an order for morphine sulfate 4 mg IV
push. The available vial contains 10 mg/mL. How many mL will the nurse
administer?
,A. 0.2 mL
B. 0.4 mL
C. 0.8 mL
D. 1 mL
CORRECT ANSWER: B. 0.4 mL
Rationale: Use the formula: Desired Dose / Available Dose. 4 mg / 10 mg/mL = 0.4
mL.
Question 4: Which of the following dietary modifications is most appropriate
for a patient with end-stage renal disease (ESRD) who is not yet on dialysis?
A. High-protein, high-potassium diet
B. Low-protein, low-phosphorus, low-potassium diet
C. High-carbohydrate, high-calcium diet
D. Low-sodium, high-fluid diet
CORRECT ANSWER: B. Low-protein, low-phosphorus, low-potassium diet
Rationale: In ESRD, the kidneys fail to excrete waste products. A low-protein diet
decreases urea buildup. Low-phosphorus and low-potassium diets are necessary to
prevent hyperphosphatemia and hyperkalemia, which can be life-threatening (cardiac
arrhythmias).
Question 5: A patient is admitted with a urinary tract infection (UTI) and is
started on ciprofloxacin. Which adverse effect is most important for the nurse
to teach the patient about?
A. Tendon rupture or inflammation
B. Photosensitivity
C. Diarrhea
D. Dizziness
CORRECT ANSWER: A. Tendon rupture or inflammation
Rationale: Fluoroquinolones (like ciprofloxacin) carry a black box warning for tendinitis
and tendon rupture. While photosensitivity and diarrhea are also side effects, the risk of
tendon damage is the most severe and must be emphasized, especially in older adults or
those on corticosteroids.
Question 6: A nurse is preparing to administer a cleansing enema to a client.
In which position should the nurse place the client?
A. Supine
B. Prone
C. Left lateral (Sims') position
D. Right lateral position
CORRECT ANSWER: C. Left lateral (Sims') position
,Rationale: The left lateral (Sims') position utilizes gravity to facilitate the flow of enema
solution into the sigmoid and descending colon, which is the natural anatomical curve of
the large intestine.
Question 7: The nurse is caring for a patient in septic shock. Which type of
intravenous (IV) fluid is the initial fluid of choice for resuscitation?
A. 0.45% normal saline (half normal saline)
B. Dextrose 5% in water (D5W)
C. 0.9% normal saline (normal saline) or Lactated Ringer's (LR)
D. 3% normal saline (hypertonic saline)
CORRECT ANSWER: C. 0.9% normal saline (normal saline) or Lactated
Ringer's (LR)
Rationale: Crystalloids, specifically isotonic solutions like 0.9% NS or LR, are the first-
line resuscitation fluids for septic shock to rapidly expand intravascular volume and
restore tissue perfusion.
Question 8: A client with type 1 diabetes reports feeling shaky, sweaty, and
confused. The nurse obtains a blood glucose reading of 50 mg/dL. Which of
the following is the priority nursing action?
A. Administer insulin subcutaneously
B. Call the physician immediately
C. Give 15 grams of fast-acting carbohydrate (e.g., glucose tablets or 4 oz juice)
D. Restrict all fluids until the blood glucose stabilizes
CORRECT ANSWER: C. Give 15 grams of fast-acting carbohydrate (e.g., glucose
tablets or 4 oz juice)
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia. The priority is to treat
the hypoglycemia immediately with 15 grams of simple carbohydrates (the "Rule of 15")
to prevent neurological damage or coma.
Question 9: When administering an intramuscular (IM) injection in the
ventrogluteal site, which landmark is used to locate the injection site?
A. Greater trochanter and iliac crest
B. Acromion process and axilla
C. Anterior superior iliac spine and iliac crest
D. Posterior superior iliac spine and gluteal fold
CORRECT ANSWER: A. Greater trochanter and iliac crest
Rationale: The ventrogluteal site is located by placing the palm on the greater trochanter
and the index finger on the anterior superior iliac spine, forming a "V" with the thumb
toward the iliac crest. It is the preferred IM site because it avoids major nerves and
blood vessels.
, Question 10: Which nursing diagnosis takes the highest priority for a patient
with a new tracheostomy?
A. Impaired verbal communication
B. Risk for infection
C. Ineffective airway clearance
D. Anxiety
CORRECT ANSWER: C. Ineffective airway clearance
Rationale: Airway clearance is always the top priority (Maslow's hierarchy of needs). A
tracheostomy bypasses the upper airway, increasing the risk of mucus plugs obstructing
the airway, which can lead to hypoxia and death. Airway is always "ABC" (Airway,
Breathing, Circulation).
Question 11: A patient receiving furosemide (Lasix) has a potassium level of
3.0 mEq/L. The nurse should assess for which of the following clinical
manifestations?
A. Muscle weakness and cardiac dysrhythmias
B. Hypertension and bradycardia
C. Increased deep tendon reflexes
D. Flushed skin and dry mouth
CORRECT ANSWER: A. Muscle weakness and cardiac dysrhythmias
Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia. Furosemide is a loop
diuretic that causes potassium wasting. Hypokalemia presents with muscle weakness,
fatigue, and cardiac dysrhythmias (e.g., U waves, PVCs).
Question 12: What is the expected therapeutic effect of the anticholinergic
medication atropine sulfate?
A. Decrease in heart rate
B. Increase in respiratory rate
C. Increase in heart rate and drying of secretions
D. Decrease in blood pressure
CORRECT ANSWER: C. Increase in heart rate and drying of secretions
Rationale: Atropine blocks the action of acetylcholine at muscarinic receptors. This
leads to increased heart rate (positive chronotrope) and decreased secretions (salivary,
bronchial) which is why it's used for bradycardia and as a pre-anesthetic medication.
Question 13: A nurse is performing a neurological assessment using the
Glasgow Coma Scale (GCS). A patient opens eyes only to pain, makes
incomprehensible sounds, and withdraws from painful stimuli. What is the
GCS score?
A. 7
B. 9
