LPN/LVN Nursing Skills Competency
Exam — Code: LPN-SKILLS | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. An LPN/LVN is preparing to administer a subcutaneous injection of insulin.
Which action is most important before drawing up the medication?
A. Massage the injection site
B. Verify the insulin type and concentration against the medication order
C. Apply an alcohol pad after injecting the insulin
D. Shake the insulin vigorously
Answer: Verify the insulin type and concentration against the medication order
Rationale: Insulin errors can cause serious hypoglycemia or hyperglycemia. The
nurse should verify the insulin type, concentration, dose, and order before
preparation. Insulin suspensions should generally be gently rolled rather than
shaken.
, 2. A client receiving oxygen through a nasal cannula has an oxygen saturation
of 86% and increasing respiratory distress. What should the LPN/LVN do
first?
A. Document the finding
B. Remove the oxygen
C. Assess the client's airway and breathing and immediately intervene according
to the oxygen order/protocol
D. Offer oral fluids
Answer: Assess the client's airway and breathing and immediately intervene
according to the oxygen order/protocol
Rationale: Severe hypoxemia with respiratory distress requires immediate
assessment and intervention. Airway and breathing take priority over
documentation or nonurgent interventions.
3. While inserting an indwelling urinary catheter, the LPN/LVN encounters
resistance in a male client. What is the best action?
A. Apply force to advance the catheter
B. Inflate the balloon immediately
C. Stop advancing and reassess the technique and client
D. Remove the catheter rapidly
Answer: Stop advancing and reassess the technique and client
Rationale: Resistance can indicate urethral obstruction, improper positioning, or
trauma. Forcing the catheter can cause injury. The nurse should stop and seek
assistance or further evaluation as appropriate.
4. A client has a nasogastric tube connected to intermittent suction. Which
finding requires the most immediate attention?
A. Mild throat discomfort
B. Abdominal distention with absent bowel sounds
,C. Dry lips
D. Small amount of nasal drainage
Answer: Abdominal distention with absent bowel sounds
Rationale: Significant abdominal distention with absent bowel sounds may
indicate an ileus or worsening gastrointestinal obstruction and requires prompt
assessment.
5. Before administering medication through a feeding tube, which action is
essential?
A. Mix all medications together
B. Verify tube placement and medication compatibility
C. Crush enteric-coated tablets
D. Add medications directly to the formula
Answer: Verify tube placement and medication compatibility
Rationale: Tube placement must be confirmed according to facility policy, and
medications should be individually prepared and evaluated for crushing and
enteral compatibility. Enteric-coated and extended-release products generally
should not be crushed.
6. A client receiving IV fluids develops swelling, coolness, and pallor at the
insertion site. What complication should the nurse suspect?
A. Phlebitis
B. Infiltration
C. Infection
D. Hematoma
Answer: Infiltration
Rationale: Infiltration occurs when a nonvesicant IV solution enters surrounding
tissue, commonly causing swelling, coolness, pallor, and slowed infusion.
, 7. A client receiving a vesicant medication through a peripheral IV reports
burning at the site. What should the LPN/LVN do first?
A. Increase the infusion rate
B. Stop the infusion and follow the facility's extravasation protocol
C. Flush the catheter forcefully
D. Apply pressure over the site
Answer: Stop the infusion and follow the facility's extravasation protocol
Rationale: Vesicant extravasation can cause severe tissue injury. The infusion
should be stopped promptly, and the nurse should follow the specific medication
and facility protocol, including whether aspiration through the catheter is
indicated.
8. Which technique is appropriate when changing a sterile dressing?
A. Touch the sterile side of the dressing with bare hands
B. Keep sterile supplies below waist level
C. Maintain the sterile field above waist level and in constant view
D. Turn away from the sterile field when obtaining supplies
Answer: Maintain the sterile field above waist level and in constant view
Rationale: Sterile fields must remain visible and protected from contamination.
Items below waist level or outside the nurse's view are considered
contaminated.
9. A postoperative client suddenly becomes restless and confused. The
oxygen saturation is 88%. Which action has priority?
A. Reorient the client
B. Assess respiratory status and provide oxygen as ordered/protocolized
C. Administer a sedative
D. Encourage ambulation
Answer: Assess respiratory status and provide oxygen as ordered/protocolized
Exam — Code: LPN-SKILLS | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. An LPN/LVN is preparing to administer a subcutaneous injection of insulin.
Which action is most important before drawing up the medication?
A. Massage the injection site
B. Verify the insulin type and concentration against the medication order
C. Apply an alcohol pad after injecting the insulin
D. Shake the insulin vigorously
Answer: Verify the insulin type and concentration against the medication order
Rationale: Insulin errors can cause serious hypoglycemia or hyperglycemia. The
nurse should verify the insulin type, concentration, dose, and order before
preparation. Insulin suspensions should generally be gently rolled rather than
shaken.
, 2. A client receiving oxygen through a nasal cannula has an oxygen saturation
of 86% and increasing respiratory distress. What should the LPN/LVN do
first?
A. Document the finding
B. Remove the oxygen
C. Assess the client's airway and breathing and immediately intervene according
to the oxygen order/protocol
D. Offer oral fluids
Answer: Assess the client's airway and breathing and immediately intervene
according to the oxygen order/protocol
Rationale: Severe hypoxemia with respiratory distress requires immediate
assessment and intervention. Airway and breathing take priority over
documentation or nonurgent interventions.
3. While inserting an indwelling urinary catheter, the LPN/LVN encounters
resistance in a male client. What is the best action?
A. Apply force to advance the catheter
B. Inflate the balloon immediately
C. Stop advancing and reassess the technique and client
D. Remove the catheter rapidly
Answer: Stop advancing and reassess the technique and client
Rationale: Resistance can indicate urethral obstruction, improper positioning, or
trauma. Forcing the catheter can cause injury. The nurse should stop and seek
assistance or further evaluation as appropriate.
4. A client has a nasogastric tube connected to intermittent suction. Which
finding requires the most immediate attention?
A. Mild throat discomfort
B. Abdominal distention with absent bowel sounds
,C. Dry lips
D. Small amount of nasal drainage
Answer: Abdominal distention with absent bowel sounds
Rationale: Significant abdominal distention with absent bowel sounds may
indicate an ileus or worsening gastrointestinal obstruction and requires prompt
assessment.
5. Before administering medication through a feeding tube, which action is
essential?
A. Mix all medications together
B. Verify tube placement and medication compatibility
C. Crush enteric-coated tablets
D. Add medications directly to the formula
Answer: Verify tube placement and medication compatibility
Rationale: Tube placement must be confirmed according to facility policy, and
medications should be individually prepared and evaluated for crushing and
enteral compatibility. Enteric-coated and extended-release products generally
should not be crushed.
6. A client receiving IV fluids develops swelling, coolness, and pallor at the
insertion site. What complication should the nurse suspect?
A. Phlebitis
B. Infiltration
C. Infection
D. Hematoma
Answer: Infiltration
Rationale: Infiltration occurs when a nonvesicant IV solution enters surrounding
tissue, commonly causing swelling, coolness, pallor, and slowed infusion.
, 7. A client receiving a vesicant medication through a peripheral IV reports
burning at the site. What should the LPN/LVN do first?
A. Increase the infusion rate
B. Stop the infusion and follow the facility's extravasation protocol
C. Flush the catheter forcefully
D. Apply pressure over the site
Answer: Stop the infusion and follow the facility's extravasation protocol
Rationale: Vesicant extravasation can cause severe tissue injury. The infusion
should be stopped promptly, and the nurse should follow the specific medication
and facility protocol, including whether aspiration through the catheter is
indicated.
8. Which technique is appropriate when changing a sterile dressing?
A. Touch the sterile side of the dressing with bare hands
B. Keep sterile supplies below waist level
C. Maintain the sterile field above waist level and in constant view
D. Turn away from the sterile field when obtaining supplies
Answer: Maintain the sterile field above waist level and in constant view
Rationale: Sterile fields must remain visible and protected from contamination.
Items below waist level or outside the nurse's view are considered
contaminated.
9. A postoperative client suddenly becomes restless and confused. The
oxygen saturation is 88%. Which action has priority?
A. Reorient the client
B. Assess respiratory status and provide oxygen as ordered/protocolized
C. Administer a sedative
D. Encourage ambulation
Answer: Assess respiratory status and provide oxygen as ordered/protocolized
