LVN – Licensed Vocational Nurse (California &
Texas) Comprehensive Licensing Exam Review |
200+ Practice Questions & Verified Answers |
Complete LVN NCLEX-PN Study Guide,
California & Texas Nursing Exam Prep,
Fundamentals of Nursing, Pharmacology,
Medical-Surgical Nursing, Maternal-Newborn
Care, Pediatrics, Mental Health, Patient Safety,
Clinical Skills, Detailed Rationales
Question 1: A patient who is post-operative day one from a total hip
arthroplasty reports sudden onset of shortness of breath and pleuritic chest
pain. The nurse notes the patient is tachycardic and hypoxic. What is the
priority nursing action?
A. Administer prescribed PRN oxygen via nasal cannula.
B. Encourage the patient to perform incentive spirometry.
C. Prepare for an order for a CT pulmonary angiogram.
D. Place the patient in a high-Fowler's position and remain with the patient.
CORRECT ANSWER: D. Place the patient in a high-Fowler's position and
remain with the patient.
Rationale: This patient is exhibiting classic signs and symptoms of a pulmonary
embolism (PE), a life-threatening post-operative complication. The priority action is to
position the patient in high-Fowler's to optimize ventilation and remain with the patient
to continuously assess their status and prepare for emergency interventions. While
oxygen and diagnostic tests will be necessary, ensuring adequate positioning for
breathing and direct monitoring is the immediate, priority nursing action to maintain
airway, breathing, and circulation (ABCs).
Question 2: A patient with dementia is becoming increasingly agitated and is
trying to remove their IV line. Which intervention should the LVN implement
FIRST to maintain patient safety and prevent the use of restraints?
A. Apply soft wrist restraints to prevent the patient from accessing the IV.
B. Administer a PRN dose of an antipsychotic medication as ordered.
C. Offer the patient a high-calorie snack to distract them.
D. Assess for unmet needs such as pain, hunger, or the need to void.
CORRECT ANSWER: D. Assess for unmet needs such as pain, hunger, or the
need to void.
Rationale: The least restrictive and most appropriate first step is to assess and address
any underlying, unmet physical or psychological needs that may be causing the
agitation. Restraints and chemical restraints should only be considered after all other
less restrictive interventions have failed, and are never a first-line intervention.
Distraction can be helpful, but it is not the first action without a preceding assessment of
the root cause.
Question 3: An LVN is reinforcing teaching for a patient prescribed warfarin
(Coumadin). Which statement by the patient indicates a correct understanding
,of the medication's dietary implications?
A. "I will increase my intake of leafy green vegetables to prevent bleeding."
B. "I should avoid eating large amounts of spinach and kale."
C. "I can take over-the-counter vitamin K supplements to help my blood clot."
D. "I will eat a consistent amount of grapefruit each day."
CORRECT ANSWER: B. "I should avoid eating large amounts of spinach and
kale."
Rationale: Warfarin is a Vitamin K antagonist. Vitamin K-rich foods, such as spinach
and kale, can directly counteract the therapeutic effect of warfarin. While patients don't
need to completely eliminate these foods, they should be instructed to maintain a
consistent intake to avoid fluctuating INR levels.
Question 4: While assisting a patient with a bed bath, the LVN notices a stage 2
pressure injury on the patient's coccyx. Which finding is characteristic of a
stage 2 pressure injury?
A. Full-thickness skin loss with visible subcutaneous fat.
B. Intact skin with non-blanchable redness over a bony prominence.
C. Partial-thickness skin loss with a shallow, open ulcer and a red-pink wound bed.
D. Full-thickness tissue loss with exposed bone, tendon, or muscle.
CORRECT ANSWER: C. Partial-thickness skin loss with a shallow, open ulcer
and a red-pink wound bed.
Rationale: A Stage 2 pressure injury is characterized by partial-thickness loss of skin
with exposed dermis. It presents as a shallow open ulcer with a red-pink wound bed,
without slough. It may also present as an intact or ruptured serum-filled blister. Option
A describes a Stage 3, B describes a Stage 1, and D describes a Stage 4 or unstageable
pressure injury.
Question 5: A patient who is 2 days post-operative from an abdominal surgery
has a nasogastric (NG) tube connected to low intermittent suction. The LVN
notes that the NG tube is not draining and the patient reports nausea and
abdominal distention. What is the most appropriate action for the LVN to take?
A. Irrigate the NG tube with 30 mL of sterile water as per policy.
B. Reposition the patient to their right side.
C. Notify the registered nurse (RN) or healthcare provider immediately.
D. Check the tube for kinks and ensure the suction is functioning correctly.
CORRECT ANSWER: D. Check the tube for kinks and ensure the suction is
functioning correctly.
Rationale: The initial action when an NG tube is not draining is to perform a basic
troubleshooting assessment. The LVN should first verify that the tube is not kinked, that
the suction device is on and set to the correct pressure, and that all connections are
secure. If these basic checks are unsuccessful, notifying the RN or HCP (C) would be the
next step, but it is not the first action. Irrigation (A) may require a specific order and is
not a first-line intervention.
Question 6: The LVN is preparing to administer an enteral feeding through a
patient's percutaneous endoscopic gastrostomy (PEG) tube. Which action is
,essential to verify correct tube placement before starting the feeding?
A. Aspirate gastric contents and check the pH.
B. Instill 30 mL of air while listening over the stomach with a stethoscope.
C. Measure the length of the tube from the insertion site to the end.
D. Assess the patient for a cough reflex.
CORRECT ANSWER: A. Aspirate gastric contents and check the pH.
Rationale: The most reliable method for an LVN to verify placement of a feeding tube
is to aspirate gastric contents and test the pH. Gastric aspirate typically has a pH of 4.0
or less. The auscultatory method (B) is no longer considered a reliable method to
confirm placement. Measuring tube length (C) is part of the assessment but not a
primary verification method for tube location.
Question 7: A patient with type 2 diabetes mellitus is recovering from a
myocardial infarction. The LVN is reinforcing dietary teaching. Which type of
dietary fat should the patient be advised to limit to reduce the risk of further
cardiovascular events?
A. Monounsaturated fats
B. Polyunsaturated fats
C. Trans fats
D. Omega-3 fatty acids
CORRECT ANSWER: C. Trans fats
Rationale: Trans fats are known to increase "bad" (LDL) cholesterol and decrease
"good" (HDL) cholesterol, significantly increasing the risk of cardiovascular disease.
Patients with a history of MI are advised to strictly limit trans fats. Monounsaturated,
polyunsaturated, and Omega-3 fatty acids are considered beneficial or "healthy" fats that
are encouraged in moderation.
Question 8: An LVN is providing post-mortem care. Which of the following is
the most appropriate action regarding the patient's dentures?
A. Place the dentures in a labeled container with water.
B. Leave the dentures in place and close the patient's mouth.
C. Remove the dentures and place them in the patient's personal belongings.
D. Clean the dentures and place them on the patient's bedside table.
CORRECT ANSWER: B. Leave the dentures in place and close the patient's
mouth.
Rationale: During post-mortem care, dentures should be left in the mouth to maintain
the patient's facial shape for viewing. They should be secured in place and the mouth
gently closed. Removing them (C) or placing them in a container (A) would not serve the
purpose of maintaining facial structure.
Question 9: The LVN is caring for a patient receiving a continuous heparin
infusion for a deep vein thrombosis. Which laboratory value is most critical for
the LVN to monitor to assess the therapeutic effect of the medication?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
, D. Complete Blood Count (CBC)
CORRECT ANSWER: C. Activated Partial Thromboplastin Time (aPTT)
Rationale: Heparin's therapeutic effect is primarily monitored using the aPTT. The goal
is typically to achieve an aPTT level that is 1.5 to 2.5 times the normal control value. PT
and INR (A, B) are used to monitor the effect of oral anticoagulants like warfarin. A CBC
(D) is monitored to assess for bleeding complications (e.g., a drop in
hemoglobin/hematocrit) but not to assess the drug's therapeutic efficacy.
Question 10: A patient is receiving oxygen at 3 L/min via nasal cannula.
Which of the following indicates a potential complication of oxygen therapy
that the LVN should assess for?
A. Decreased level of consciousness
B. Nasal dryness and irritation
C. Increased respiratory rate
D. Peripheral edema
CORRECT ANSWER: B. Nasal dryness and irritation
Rationale: Oxygen is a dry gas that can dry out the mucous membranes, leading to
nasal dryness, irritation, and epistaxis. This is a common complication that can be
mitigated by using humidification, especially at higher flow rates. While oxygen can have
other effects, decreased level of consciousness is more commonly associated with
carbon dioxide narcosis in COPD patients, and increased respiratory rate is not a direct
complication of oxygen therapy itself.
Question 11: The LVN is caring for a patient with a chest tube attached to a
closed-chest drainage system. The tube becomes disconnected from the
patient's chest. What is the priority nursing action?
A. Clamp the chest tube immediately.
B. Place the end of the tube in a container of sterile water.
C. Reconnect the chest tube to the drainage system.
D. Notify the registered nurse (RN) immediately.
CORRECT ANSWER: B. Place the end of the tube in a container of sterile water.
Rationale: If the chest tube becomes disconnected, the priority is to re-establish a
water seal to prevent air from entering the pleural space, which could cause a tension
pneumothorax. Placing the end of the tube in sterile water creates a one-way valve.
Clamping the tube (A) is contraindicated as it can lead to a tension pneumothorax.
Reconnecting (C) should be done with sterile technique after establishing the water seal.
Question 12: A patient is being discharged with a prescription for furosemide
(Lasix). Which instruction should the LVN reinforce with the patient to prevent
a common adverse effect of this medication?
A. "Take the medication with a full glass of milk."
B. "Increase your intake of foods high in potassium, like bananas and oranges."
C. "Limit your fluid intake to 1 liter per day."
D. "Take the medication at bedtime to prevent dizziness."
CORRECT ANSWER: B. "Increase your intake of foods high in potassium, like
bananas and oranges."
Texas) Comprehensive Licensing Exam Review |
200+ Practice Questions & Verified Answers |
Complete LVN NCLEX-PN Study Guide,
California & Texas Nursing Exam Prep,
Fundamentals of Nursing, Pharmacology,
Medical-Surgical Nursing, Maternal-Newborn
Care, Pediatrics, Mental Health, Patient Safety,
Clinical Skills, Detailed Rationales
Question 1: A patient who is post-operative day one from a total hip
arthroplasty reports sudden onset of shortness of breath and pleuritic chest
pain. The nurse notes the patient is tachycardic and hypoxic. What is the
priority nursing action?
A. Administer prescribed PRN oxygen via nasal cannula.
B. Encourage the patient to perform incentive spirometry.
C. Prepare for an order for a CT pulmonary angiogram.
D. Place the patient in a high-Fowler's position and remain with the patient.
CORRECT ANSWER: D. Place the patient in a high-Fowler's position and
remain with the patient.
Rationale: This patient is exhibiting classic signs and symptoms of a pulmonary
embolism (PE), a life-threatening post-operative complication. The priority action is to
position the patient in high-Fowler's to optimize ventilation and remain with the patient
to continuously assess their status and prepare for emergency interventions. While
oxygen and diagnostic tests will be necessary, ensuring adequate positioning for
breathing and direct monitoring is the immediate, priority nursing action to maintain
airway, breathing, and circulation (ABCs).
Question 2: A patient with dementia is becoming increasingly agitated and is
trying to remove their IV line. Which intervention should the LVN implement
FIRST to maintain patient safety and prevent the use of restraints?
A. Apply soft wrist restraints to prevent the patient from accessing the IV.
B. Administer a PRN dose of an antipsychotic medication as ordered.
C. Offer the patient a high-calorie snack to distract them.
D. Assess for unmet needs such as pain, hunger, or the need to void.
CORRECT ANSWER: D. Assess for unmet needs such as pain, hunger, or the
need to void.
Rationale: The least restrictive and most appropriate first step is to assess and address
any underlying, unmet physical or psychological needs that may be causing the
agitation. Restraints and chemical restraints should only be considered after all other
less restrictive interventions have failed, and are never a first-line intervention.
Distraction can be helpful, but it is not the first action without a preceding assessment of
the root cause.
Question 3: An LVN is reinforcing teaching for a patient prescribed warfarin
(Coumadin). Which statement by the patient indicates a correct understanding
,of the medication's dietary implications?
A. "I will increase my intake of leafy green vegetables to prevent bleeding."
B. "I should avoid eating large amounts of spinach and kale."
C. "I can take over-the-counter vitamin K supplements to help my blood clot."
D. "I will eat a consistent amount of grapefruit each day."
CORRECT ANSWER: B. "I should avoid eating large amounts of spinach and
kale."
Rationale: Warfarin is a Vitamin K antagonist. Vitamin K-rich foods, such as spinach
and kale, can directly counteract the therapeutic effect of warfarin. While patients don't
need to completely eliminate these foods, they should be instructed to maintain a
consistent intake to avoid fluctuating INR levels.
Question 4: While assisting a patient with a bed bath, the LVN notices a stage 2
pressure injury on the patient's coccyx. Which finding is characteristic of a
stage 2 pressure injury?
A. Full-thickness skin loss with visible subcutaneous fat.
B. Intact skin with non-blanchable redness over a bony prominence.
C. Partial-thickness skin loss with a shallow, open ulcer and a red-pink wound bed.
D. Full-thickness tissue loss with exposed bone, tendon, or muscle.
CORRECT ANSWER: C. Partial-thickness skin loss with a shallow, open ulcer
and a red-pink wound bed.
Rationale: A Stage 2 pressure injury is characterized by partial-thickness loss of skin
with exposed dermis. It presents as a shallow open ulcer with a red-pink wound bed,
without slough. It may also present as an intact or ruptured serum-filled blister. Option
A describes a Stage 3, B describes a Stage 1, and D describes a Stage 4 or unstageable
pressure injury.
Question 5: A patient who is 2 days post-operative from an abdominal surgery
has a nasogastric (NG) tube connected to low intermittent suction. The LVN
notes that the NG tube is not draining and the patient reports nausea and
abdominal distention. What is the most appropriate action for the LVN to take?
A. Irrigate the NG tube with 30 mL of sterile water as per policy.
B. Reposition the patient to their right side.
C. Notify the registered nurse (RN) or healthcare provider immediately.
D. Check the tube for kinks and ensure the suction is functioning correctly.
CORRECT ANSWER: D. Check the tube for kinks and ensure the suction is
functioning correctly.
Rationale: The initial action when an NG tube is not draining is to perform a basic
troubleshooting assessment. The LVN should first verify that the tube is not kinked, that
the suction device is on and set to the correct pressure, and that all connections are
secure. If these basic checks are unsuccessful, notifying the RN or HCP (C) would be the
next step, but it is not the first action. Irrigation (A) may require a specific order and is
not a first-line intervention.
Question 6: The LVN is preparing to administer an enteral feeding through a
patient's percutaneous endoscopic gastrostomy (PEG) tube. Which action is
,essential to verify correct tube placement before starting the feeding?
A. Aspirate gastric contents and check the pH.
B. Instill 30 mL of air while listening over the stomach with a stethoscope.
C. Measure the length of the tube from the insertion site to the end.
D. Assess the patient for a cough reflex.
CORRECT ANSWER: A. Aspirate gastric contents and check the pH.
Rationale: The most reliable method for an LVN to verify placement of a feeding tube
is to aspirate gastric contents and test the pH. Gastric aspirate typically has a pH of 4.0
or less. The auscultatory method (B) is no longer considered a reliable method to
confirm placement. Measuring tube length (C) is part of the assessment but not a
primary verification method for tube location.
Question 7: A patient with type 2 diabetes mellitus is recovering from a
myocardial infarction. The LVN is reinforcing dietary teaching. Which type of
dietary fat should the patient be advised to limit to reduce the risk of further
cardiovascular events?
A. Monounsaturated fats
B. Polyunsaturated fats
C. Trans fats
D. Omega-3 fatty acids
CORRECT ANSWER: C. Trans fats
Rationale: Trans fats are known to increase "bad" (LDL) cholesterol and decrease
"good" (HDL) cholesterol, significantly increasing the risk of cardiovascular disease.
Patients with a history of MI are advised to strictly limit trans fats. Monounsaturated,
polyunsaturated, and Omega-3 fatty acids are considered beneficial or "healthy" fats that
are encouraged in moderation.
Question 8: An LVN is providing post-mortem care. Which of the following is
the most appropriate action regarding the patient's dentures?
A. Place the dentures in a labeled container with water.
B. Leave the dentures in place and close the patient's mouth.
C. Remove the dentures and place them in the patient's personal belongings.
D. Clean the dentures and place them on the patient's bedside table.
CORRECT ANSWER: B. Leave the dentures in place and close the patient's
mouth.
Rationale: During post-mortem care, dentures should be left in the mouth to maintain
the patient's facial shape for viewing. They should be secured in place and the mouth
gently closed. Removing them (C) or placing them in a container (A) would not serve the
purpose of maintaining facial structure.
Question 9: The LVN is caring for a patient receiving a continuous heparin
infusion for a deep vein thrombosis. Which laboratory value is most critical for
the LVN to monitor to assess the therapeutic effect of the medication?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
, D. Complete Blood Count (CBC)
CORRECT ANSWER: C. Activated Partial Thromboplastin Time (aPTT)
Rationale: Heparin's therapeutic effect is primarily monitored using the aPTT. The goal
is typically to achieve an aPTT level that is 1.5 to 2.5 times the normal control value. PT
and INR (A, B) are used to monitor the effect of oral anticoagulants like warfarin. A CBC
(D) is monitored to assess for bleeding complications (e.g., a drop in
hemoglobin/hematocrit) but not to assess the drug's therapeutic efficacy.
Question 10: A patient is receiving oxygen at 3 L/min via nasal cannula.
Which of the following indicates a potential complication of oxygen therapy
that the LVN should assess for?
A. Decreased level of consciousness
B. Nasal dryness and irritation
C. Increased respiratory rate
D. Peripheral edema
CORRECT ANSWER: B. Nasal dryness and irritation
Rationale: Oxygen is a dry gas that can dry out the mucous membranes, leading to
nasal dryness, irritation, and epistaxis. This is a common complication that can be
mitigated by using humidification, especially at higher flow rates. While oxygen can have
other effects, decreased level of consciousness is more commonly associated with
carbon dioxide narcosis in COPD patients, and increased respiratory rate is not a direct
complication of oxygen therapy itself.
Question 11: The LVN is caring for a patient with a chest tube attached to a
closed-chest drainage system. The tube becomes disconnected from the
patient's chest. What is the priority nursing action?
A. Clamp the chest tube immediately.
B. Place the end of the tube in a container of sterile water.
C. Reconnect the chest tube to the drainage system.
D. Notify the registered nurse (RN) immediately.
CORRECT ANSWER: B. Place the end of the tube in a container of sterile water.
Rationale: If the chest tube becomes disconnected, the priority is to re-establish a
water seal to prevent air from entering the pleural space, which could cause a tension
pneumothorax. Placing the end of the tube in sterile water creates a one-way valve.
Clamping the tube (A) is contraindicated as it can lead to a tension pneumothorax.
Reconnecting (C) should be done with sterile technique after establishing the water seal.
Question 12: A patient is being discharged with a prescription for furosemide
(Lasix). Which instruction should the LVN reinforce with the patient to prevent
a common adverse effect of this medication?
A. "Take the medication with a full glass of milk."
B. "Increase your intake of foods high in potassium, like bananas and oranges."
C. "Limit your fluid intake to 1 liter per day."
D. "Take the medication at bedtime to prevent dizziness."
CORRECT ANSWER: B. "Increase your intake of foods high in potassium, like
bananas and oranges."
