Page 1 of 94
LPN EXIT EXAM 250 QUESTIONS WITH RATIONALES LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
LPN EXIT EXAM – 250 QUESTIONS WITH RATIONALES
SECTION 1: PRIORITIZATION, DELEGATION, & CLINICAL JUDGMENT (Questions 1-
40)
1. The LPN/LVN is planning care for a client who has a fourth-degree midline
laceration that occurred during vaginal delivery of an 8-pound 10-ounce infant.
Which intervention has the highest priority?
A. Administer the prescribed stool softener.
B. Administer the prescribed PRN sleep medications.
C. Encourage breastfeeding to promote uterine involution.
D. Encourage use of prescribed analgesic perineal sprays.
Correct Answer: A
Rationale: The highest priority is to administer the prescribed stool softener to prevent
constipation and straining during bowel movements, which could cause the sutured
laceration to separate or become infected. Stool softeners reduce discomfort and
protect the integrity of the perineal repair. While breastfeeding, perineal sprays, and
sleep are important, stool softener administration directly prevents harm to the surgical
site.
2. Because of census overload, the charge nurse of an acute care medical unit
must select a client who can be transferred back to a residential facility. Which
client is the most stable for transfer?
A. A client requiring frequent PRN pain medication for cancer-related pain.
B. A client who needs daily wound care with sterile technique.
C. A client with stable vital signs and routine medication administration.
D. A client requiring IV antibiotic therapy for a new infection.
, Page 2 of 94
Correct Answer: C
Rationale: The client with stable vital signs and only routine medication administration
is the most appropriate for transfer because they have the lowest acuity and predictable
care needs. The other clients require more complex interventions (PRN titration, sterile
wound care, IV therapy) that are better managed in the acute care setting. Delegation
and transfer decisions should be based on client stability and care complexity.
3. The LPN/LVN is caring for a client with endocarditis who is receiving antibiotic
therapy. Which priority should the PN consider in planning this client's care and
activities of daily living?
A. Constipation and dietary modification.
B. Sequencing activities with rest periods.
C. Oral antibiotic administration.
D. Personal hygiene and oral care.
Correct Answer: B
Rationale: Clients with endocarditis experience significant fatigue due to the infection
and increased cardiac workload, making rest essential. Sequencing activities with rest
periods prevents overexertion and conserves energy for recovery. While the other
options are relevant, rest is the priority to support the client's physiological stability
during acute infection.
4. The LPN/LVN is preparing to ambulate a postoperative client after cardiac
surgery. The nurse plans to do which to enable the client to best tolerate the
ambulation?
A. Premedicate the client with an analgesic before ambulating.
B. Encourage the client to ambulate without assistance to build independence.
C. Ambulate the client immediately after a full meal for energy.
D. Restrict fluids before ambulation to prevent urinary urgency.
Correct Answer: A
Rationale: Premedicating the client with an analgesic before ambulation helps control
pain, making the activity more tolerable and effective. Adequate pain control reduces
guarding, promotes better movement, and supports participation in rehabilitation. The
other options would increase fall risk and discomfort.
, Page 3 of 94
5. The LPN/LVN is caring for a middle-aged client who had a myocardial infarction
(MI) 3 days ago. Which finding is most important for the nurse to report to the
healthcare provider?
A. Frothy red-tinged sputum.
B. Irregular heart rate.
C. Complaints of mild chest discomfort.
D. Blood pressure of 140/88 mm Hg.
Correct Answer: A
Rationale: Frothy red-tinged sputum is a classic sign of pulmonary edema, a life-
threatening complication following MI. This finding suggests left-sided heart failure with
fluid accumulation in the lungs requiring immediate intervention. Irregular heart rate,
mild chest discomfort, and elevated blood pressure are also concerning but do not
indicate the same acute, life-threatening emergency.
6. The practical nurse is preparing to apply a topical medication to a client.
According to the rights of medication administration, which action is most
essential before applying the medication?
A. Verify the client's identity using two identifiers.
B. Review the medication's adverse effects.
C. Assess the skin for any open areas or irritation.
D. Position the client for comfort during application.
Correct Answer: A
Rationale: The "right client" is the foundation of medication safety—verifying identity
using two identifiers (e.g., name and date of birth) prevents administration to the wrong
person. While assessing the skin, reviewing effects, and positioning are important,
client identification is non-negotiable and the first step in the Six Rights. Always verify
identity before any medication administration.
7. The LPN/LVN notes that a client is wearing a continuous cardiac monitor, which
begins to alarm at the nurse's station. The nurse sees no electrocardiographic
complexes on the screen. The nurse should do which first?
A. Check the client's status and lead placement.
B. Call a code blue immediately.
C. Document the event in the client's chart.
D. Notify the healthcare provider of the monitor alarm.
, Page 4 of 94
Correct Answer: A
Rationale: The first action is to check the client and lead placement. The alarm could
be due to lead dislodgement, loose connections, or client movement rather than
cardiac arrest. Direct assessment of the client prevents unnecessary emergency
interventions. Patient assessment always precedes activating emergency protocols.
8. The LPN/LVN is caring for a client who has a new prescription for sildenafil.
Which instruction should the nurse reinforce with the client?
A. "Do not take this medication with nitrates."
B. "Take this medication with a high-fat meal."
C. "This medication can be taken with any other medications."
D. "You can expect results within 5 minutes."
Correct Answer: A
Rationale: Sildenafil (Viagra) is contraindicated with nitrates because the combination
can cause severe, life-threatening hypotension. This is a critical safety teaching point.
The medication should be taken on an empty stomach for best absorption, and results
typically occur within 30-60 minutes.
9. The LPN/LVN is caring for a client with small cell carcinoma of the lung who has
developed syndrome of inappropriate antidiuretic hormone (SIADH). Which
outcome finding is the priority for this client?
A. Reduced peripheral edema.
B. Urinary output of at least 70 mL/hr.
C. Decrease in urine osmolarity.
D. Serum sodium level of 137 mEq/L.
Correct Answer: D
Rationale: SIADH causes fluid retention and dilutional hyponatremia, leading to central
nervous system fluid shifts that can be life-threatening. Normalization of the serum
sodium level (135-145 mEq/L) is the most important outcome because severe
hyponatremia can result in seizures, coma, and death. While urine output and edema
are related, serum sodium is the priority.
10. The LPN/LVN is assigned to a client who has a prescription for an antipsychotic
medication. Which assessment finding would indicate a potential adverse effect
that should be reported immediately?
LPN EXIT EXAM 250 QUESTIONS WITH RATIONALES LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
LPN EXIT EXAM – 250 QUESTIONS WITH RATIONALES
SECTION 1: PRIORITIZATION, DELEGATION, & CLINICAL JUDGMENT (Questions 1-
40)
1. The LPN/LVN is planning care for a client who has a fourth-degree midline
laceration that occurred during vaginal delivery of an 8-pound 10-ounce infant.
Which intervention has the highest priority?
A. Administer the prescribed stool softener.
B. Administer the prescribed PRN sleep medications.
C. Encourage breastfeeding to promote uterine involution.
D. Encourage use of prescribed analgesic perineal sprays.
Correct Answer: A
Rationale: The highest priority is to administer the prescribed stool softener to prevent
constipation and straining during bowel movements, which could cause the sutured
laceration to separate or become infected. Stool softeners reduce discomfort and
protect the integrity of the perineal repair. While breastfeeding, perineal sprays, and
sleep are important, stool softener administration directly prevents harm to the surgical
site.
2. Because of census overload, the charge nurse of an acute care medical unit
must select a client who can be transferred back to a residential facility. Which
client is the most stable for transfer?
A. A client requiring frequent PRN pain medication for cancer-related pain.
B. A client who needs daily wound care with sterile technique.
C. A client with stable vital signs and routine medication administration.
D. A client requiring IV antibiotic therapy for a new infection.
, Page 2 of 94
Correct Answer: C
Rationale: The client with stable vital signs and only routine medication administration
is the most appropriate for transfer because they have the lowest acuity and predictable
care needs. The other clients require more complex interventions (PRN titration, sterile
wound care, IV therapy) that are better managed in the acute care setting. Delegation
and transfer decisions should be based on client stability and care complexity.
3. The LPN/LVN is caring for a client with endocarditis who is receiving antibiotic
therapy. Which priority should the PN consider in planning this client's care and
activities of daily living?
A. Constipation and dietary modification.
B. Sequencing activities with rest periods.
C. Oral antibiotic administration.
D. Personal hygiene and oral care.
Correct Answer: B
Rationale: Clients with endocarditis experience significant fatigue due to the infection
and increased cardiac workload, making rest essential. Sequencing activities with rest
periods prevents overexertion and conserves energy for recovery. While the other
options are relevant, rest is the priority to support the client's physiological stability
during acute infection.
4. The LPN/LVN is preparing to ambulate a postoperative client after cardiac
surgery. The nurse plans to do which to enable the client to best tolerate the
ambulation?
A. Premedicate the client with an analgesic before ambulating.
B. Encourage the client to ambulate without assistance to build independence.
C. Ambulate the client immediately after a full meal for energy.
D. Restrict fluids before ambulation to prevent urinary urgency.
Correct Answer: A
Rationale: Premedicating the client with an analgesic before ambulation helps control
pain, making the activity more tolerable and effective. Adequate pain control reduces
guarding, promotes better movement, and supports participation in rehabilitation. The
other options would increase fall risk and discomfort.
, Page 3 of 94
5. The LPN/LVN is caring for a middle-aged client who had a myocardial infarction
(MI) 3 days ago. Which finding is most important for the nurse to report to the
healthcare provider?
A. Frothy red-tinged sputum.
B. Irregular heart rate.
C. Complaints of mild chest discomfort.
D. Blood pressure of 140/88 mm Hg.
Correct Answer: A
Rationale: Frothy red-tinged sputum is a classic sign of pulmonary edema, a life-
threatening complication following MI. This finding suggests left-sided heart failure with
fluid accumulation in the lungs requiring immediate intervention. Irregular heart rate,
mild chest discomfort, and elevated blood pressure are also concerning but do not
indicate the same acute, life-threatening emergency.
6. The practical nurse is preparing to apply a topical medication to a client.
According to the rights of medication administration, which action is most
essential before applying the medication?
A. Verify the client's identity using two identifiers.
B. Review the medication's adverse effects.
C. Assess the skin for any open areas or irritation.
D. Position the client for comfort during application.
Correct Answer: A
Rationale: The "right client" is the foundation of medication safety—verifying identity
using two identifiers (e.g., name and date of birth) prevents administration to the wrong
person. While assessing the skin, reviewing effects, and positioning are important,
client identification is non-negotiable and the first step in the Six Rights. Always verify
identity before any medication administration.
7. The LPN/LVN notes that a client is wearing a continuous cardiac monitor, which
begins to alarm at the nurse's station. The nurse sees no electrocardiographic
complexes on the screen. The nurse should do which first?
A. Check the client's status and lead placement.
B. Call a code blue immediately.
C. Document the event in the client's chart.
D. Notify the healthcare provider of the monitor alarm.
, Page 4 of 94
Correct Answer: A
Rationale: The first action is to check the client and lead placement. The alarm could
be due to lead dislodgement, loose connections, or client movement rather than
cardiac arrest. Direct assessment of the client prevents unnecessary emergency
interventions. Patient assessment always precedes activating emergency protocols.
8. The LPN/LVN is caring for a client who has a new prescription for sildenafil.
Which instruction should the nurse reinforce with the client?
A. "Do not take this medication with nitrates."
B. "Take this medication with a high-fat meal."
C. "This medication can be taken with any other medications."
D. "You can expect results within 5 minutes."
Correct Answer: A
Rationale: Sildenafil (Viagra) is contraindicated with nitrates because the combination
can cause severe, life-threatening hypotension. This is a critical safety teaching point.
The medication should be taken on an empty stomach for best absorption, and results
typically occur within 30-60 minutes.
9. The LPN/LVN is caring for a client with small cell carcinoma of the lung who has
developed syndrome of inappropriate antidiuretic hormone (SIADH). Which
outcome finding is the priority for this client?
A. Reduced peripheral edema.
B. Urinary output of at least 70 mL/hr.
C. Decrease in urine osmolarity.
D. Serum sodium level of 137 mEq/L.
Correct Answer: D
Rationale: SIADH causes fluid retention and dilutional hyponatremia, leading to central
nervous system fluid shifts that can be life-threatening. Normalization of the serum
sodium level (135-145 mEq/L) is the most important outcome because severe
hyponatremia can result in seizures, coma, and death. While urine output and edema
are related, serum sodium is the priority.
10. The LPN/LVN is assigned to a client who has a prescription for an antipsychotic
medication. Which assessment finding would indicate a potential adverse effect
that should be reported immediately?
