LPN/LVN Return-to-Practice Exam —
Code: LPN-RTP-EX | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
An LPN/LVN is caring for a client 8 hours after abdominal surgery. The client
reports increasing abdominal pain despite receiving prescribed analgesia. The
abdomen is rigid and distended, and the client has a heart rate of 118/min. Which
action should the nurse take first?
A. Administer another dose of analgesic
B. Encourage oral fluids
C. Notify the healthcare provider immediately
D. Reassess the client in 30 minutes
Answer: C. Notify the healthcare provider immediately
,Rationale: A rigid, distended abdomen with worsening pain and tachycardia
may indicate peritonitis, internal bleeding, or another acute postoperative
complication. Prompt provider notification and further assessment are required.
2.
A client receiving digoxin has an apical pulse of 52/min and reports nausea and
seeing yellow halos around lights. What should the LPN/LVN do?
A. Administer the medication with food
B. Hold the digoxin and notify the provider
C. Give the medication and reassess later
D. Encourage increased potassium intake immediately
Answer: B. Hold the digoxin and notify the provider
Rationale: Bradycardia, nausea, and visual disturbances are classic findings
associated with digoxin toxicity. The medication should be withheld and the
provider notified.
3.
A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The client
becomes increasingly drowsy, and respirations decrease to 8/min. Which
assessment is the priority?
A. Skin temperature
B. Bowel sounds
C. Level of consciousness and respiratory status
D. Peripheral edema
Answer: C. Level of consciousness and respiratory status
,Rationale: Acute drowsiness and respiratory depression may indicate worsening
carbon dioxide retention or respiratory failure. Airway and breathing take
priority.
4.
A client with diabetes is confused, diaphoretic, and trembling. The blood glucose
level is 48 mg/dL, and the client is awake and able to swallow. Which intervention
is most appropriate?
A. Administer regular insulin
B. Give approximately 15 g of rapid-acting carbohydrate
C. Give a high-protein meal only
D. Administer glucagon immediately
Answer: B. Give approximately 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive rapid-acting
carbohydrate for symptomatic hypoglycemia. Glucose should be rechecked after
approximately 15 minutes and treatment repeated if necessary.
5.
A client with heart failure suddenly develops severe dyspnea, crackles throughout
both lungs, and pink, frothy sputum. Which action should the LPN/LVN take first?
A. Place the client flat
B. Encourage oral fluids
C. Position the client upright and provide oxygen as prescribed
D. Obtain a routine weight
Answer: C. Position the client upright and provide oxygen as prescribed
, Rationale: These findings are consistent with acute pulmonary edema. Upright
positioning and oxygen support improve ventilation and oxygenation while
emergency treatment is initiated.
6.
A client receiving warfarin has a markedly elevated INR and reports black, tarry
stools. Which action is most appropriate?
A. Administer the next warfarin dose
B. Encourage foods high in vitamin K without notifying anyone
C. Hold the medication and notify the healthcare provider
D. Encourage ambulation
Answer: C. Hold the medication and notify the healthcare provider
Rationale: Melena with excessive anticoagulation suggests gastrointestinal
bleeding. Warfarin should be withheld and the provider notified promptly.
7.
A client with a newly inserted tracheostomy becomes restless and cyanotic. The
nurse cannot hear airflow through the tracheostomy. What is the priority action?
A. Offer oral fluids
B. Assess for obstruction and suction as indicated
C. Place the client in Trendelenburg position
D. Remove the tracheostomy tube immediately
Answer: B. Assess for obstruction and suction as indicated
Rationale: Sudden cyanosis and absent airflow suggest airway obstruction. The
airway must be assessed and cleared immediately according to facility protocol.
Code: LPN-RTP-EX | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
An LPN/LVN is caring for a client 8 hours after abdominal surgery. The client
reports increasing abdominal pain despite receiving prescribed analgesia. The
abdomen is rigid and distended, and the client has a heart rate of 118/min. Which
action should the nurse take first?
A. Administer another dose of analgesic
B. Encourage oral fluids
C. Notify the healthcare provider immediately
D. Reassess the client in 30 minutes
Answer: C. Notify the healthcare provider immediately
,Rationale: A rigid, distended abdomen with worsening pain and tachycardia
may indicate peritonitis, internal bleeding, or another acute postoperative
complication. Prompt provider notification and further assessment are required.
2.
A client receiving digoxin has an apical pulse of 52/min and reports nausea and
seeing yellow halos around lights. What should the LPN/LVN do?
A. Administer the medication with food
B. Hold the digoxin and notify the provider
C. Give the medication and reassess later
D. Encourage increased potassium intake immediately
Answer: B. Hold the digoxin and notify the provider
Rationale: Bradycardia, nausea, and visual disturbances are classic findings
associated with digoxin toxicity. The medication should be withheld and the
provider notified.
3.
A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The client
becomes increasingly drowsy, and respirations decrease to 8/min. Which
assessment is the priority?
A. Skin temperature
B. Bowel sounds
C. Level of consciousness and respiratory status
D. Peripheral edema
Answer: C. Level of consciousness and respiratory status
,Rationale: Acute drowsiness and respiratory depression may indicate worsening
carbon dioxide retention or respiratory failure. Airway and breathing take
priority.
4.
A client with diabetes is confused, diaphoretic, and trembling. The blood glucose
level is 48 mg/dL, and the client is awake and able to swallow. Which intervention
is most appropriate?
A. Administer regular insulin
B. Give approximately 15 g of rapid-acting carbohydrate
C. Give a high-protein meal only
D. Administer glucagon immediately
Answer: B. Give approximately 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive rapid-acting
carbohydrate for symptomatic hypoglycemia. Glucose should be rechecked after
approximately 15 minutes and treatment repeated if necessary.
5.
A client with heart failure suddenly develops severe dyspnea, crackles throughout
both lungs, and pink, frothy sputum. Which action should the LPN/LVN take first?
A. Place the client flat
B. Encourage oral fluids
C. Position the client upright and provide oxygen as prescribed
D. Obtain a routine weight
Answer: C. Position the client upright and provide oxygen as prescribed
, Rationale: These findings are consistent with acute pulmonary edema. Upright
positioning and oxygen support improve ventilation and oxygenation while
emergency treatment is initiated.
6.
A client receiving warfarin has a markedly elevated INR and reports black, tarry
stools. Which action is most appropriate?
A. Administer the next warfarin dose
B. Encourage foods high in vitamin K without notifying anyone
C. Hold the medication and notify the healthcare provider
D. Encourage ambulation
Answer: C. Hold the medication and notify the healthcare provider
Rationale: Melena with excessive anticoagulation suggests gastrointestinal
bleeding. Warfarin should be withheld and the provider notified promptly.
7.
A client with a newly inserted tracheostomy becomes restless and cyanotic. The
nurse cannot hear airflow through the tracheostomy. What is the priority action?
A. Offer oral fluids
B. Assess for obstruction and suction as indicated
C. Place the client in Trendelenburg position
D. Remove the tracheostomy tube immediately
Answer: B. Assess for obstruction and suction as indicated
Rationale: Sudden cyanosis and absent airflow suggest airway obstruction. The
airway must be assessed and cleared immediately according to facility protocol.
