LPN/LVN Fundamentals Competency
Exam — Code: LPN-FUND-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A newly admitted client with heart failure becomes increasingly dyspneic and
restless. The respiratory rate is 30/min, oxygen saturation is 88%, and the client
is coughing pink, frothy sputum. Which action should the LPN/LVN take first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position
C. Encourage oral fluids
D. Assist the client to ambulate
Answer: B. Place the client in high-Fowler's position
Rationale: High-Fowler's positioning improves lung expansion and decreases
venous return, helping reduce pulmonary congestion and the work of breathing.
,Pink, frothy sputum and hypoxemia suggest acute pulmonary edema, making
immediate respiratory support the priority.
2. A client is receiving oxygen at 4 L/min through a nasal cannula. Which
assessment finding requires the most immediate intervention?
A. Dry nasal mucosa
B. Oxygen saturation of 96%
C. Mild nasal irritation
D. New onset of confusion and lethargy
Answer: D. New onset of confusion and lethargy
Rationale: Acute mental-status changes may indicate worsening hypoxemia or
another serious physiologic problem. Oxygen saturation alone should not
replace clinical assessment. The LPN/LVN should immediately reassess airway,
breathing, oxygen delivery, and other vital signs.
3. Which client should the LPN/LVN assess first?
A. A postoperative client reporting incisional pain of 7/10
B. A client with diabetes requesting a snack
C. A client with COPD who is newly confused and has a respiratory rate of 8/min
D. A client awaiting discharge instructions
Answer: C. A client with COPD who is newly confused and has a respiratory rate
of 8/min
Rationale: A respiratory rate of 8/min with acute confusion indicates potentially
life-threatening respiratory compromise. Airway and breathing take priority
over pain management, nutrition, and discharge planning.
,4. A client has dysphagia following a stroke. Which intervention best reduces
aspiration risk during meals?
A. Position the client supine after eating
B. Provide thin liquids with a straw
C. Keep the client upright during meals and afterward
D. Encourage rapid eating to prevent fatigue
Answer: C. Keep the client upright during meals and afterward
Rationale: Upright positioning promotes safer swallowing and reduces
aspiration risk. The prescribed diet texture and swallowing strategies should be
followed, and the client should remain upright after eating.
5. Which finding most strongly suggests that a client has developed a pressure
injury?
A. Blanchable redness over the sacrum
B. Persistent nonblanchable erythema over a bony prominence
C. Dry skin over the elbows
D. Mild bruising on the forearm
Answer: B. Persistent nonblanchable erythema over a bony prominence
Rationale: Nonblanchable erythema over intact skin is characteristic of a stage 1
pressure injury. Early recognition allows pressure relief and prevention of
progression.
6. A client who has been immobile for several days reports sudden unilateral
calf pain and swelling. Which action is most appropriate?
A. Massage the affected calf
B. Encourage ambulation
, C. Report the finding promptly and avoid massaging the extremity
D. Apply vigorous range-of-motion exercises
Answer: C. Report the finding promptly and avoid massaging the extremity
Rationale: Unilateral swelling and calf pain may indicate deep-vein thrombosis.
Massage or unnecessary manipulation could potentially dislodge a thrombus.
The finding requires prompt clinical evaluation.
7. Which intervention is most effective for preventing postoperative atelectasis?
A. Restricting fluids
B. Encouraging incentive spirometry and deep breathing
C. Maintaining strict bed rest
D. Avoiding coughing
Answer: B. Encouraging incentive spirometry and deep breathing
Rationale: Deep breathing and incentive spirometry promote alveolar expansion
and help prevent atelectasis, especially after surgery when pain and immobility
reduce ventilation.
8. A client becomes dizzy when standing after prolonged bed rest. Which
instruction is most appropriate?
A. Stand quickly to restore circulation
B. Dangle the legs and change positions gradually
C. Avoid drinking fluids
D. Remain completely immobile
Answer: B. Dangle the legs and change positions gradually
Exam — Code: LPN-FUND-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A newly admitted client with heart failure becomes increasingly dyspneic and
restless. The respiratory rate is 30/min, oxygen saturation is 88%, and the client
is coughing pink, frothy sputum. Which action should the LPN/LVN take first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position
C. Encourage oral fluids
D. Assist the client to ambulate
Answer: B. Place the client in high-Fowler's position
Rationale: High-Fowler's positioning improves lung expansion and decreases
venous return, helping reduce pulmonary congestion and the work of breathing.
,Pink, frothy sputum and hypoxemia suggest acute pulmonary edema, making
immediate respiratory support the priority.
2. A client is receiving oxygen at 4 L/min through a nasal cannula. Which
assessment finding requires the most immediate intervention?
A. Dry nasal mucosa
B. Oxygen saturation of 96%
C. Mild nasal irritation
D. New onset of confusion and lethargy
Answer: D. New onset of confusion and lethargy
Rationale: Acute mental-status changes may indicate worsening hypoxemia or
another serious physiologic problem. Oxygen saturation alone should not
replace clinical assessment. The LPN/LVN should immediately reassess airway,
breathing, oxygen delivery, and other vital signs.
3. Which client should the LPN/LVN assess first?
A. A postoperative client reporting incisional pain of 7/10
B. A client with diabetes requesting a snack
C. A client with COPD who is newly confused and has a respiratory rate of 8/min
D. A client awaiting discharge instructions
Answer: C. A client with COPD who is newly confused and has a respiratory rate
of 8/min
Rationale: A respiratory rate of 8/min with acute confusion indicates potentially
life-threatening respiratory compromise. Airway and breathing take priority
over pain management, nutrition, and discharge planning.
,4. A client has dysphagia following a stroke. Which intervention best reduces
aspiration risk during meals?
A. Position the client supine after eating
B. Provide thin liquids with a straw
C. Keep the client upright during meals and afterward
D. Encourage rapid eating to prevent fatigue
Answer: C. Keep the client upright during meals and afterward
Rationale: Upright positioning promotes safer swallowing and reduces
aspiration risk. The prescribed diet texture and swallowing strategies should be
followed, and the client should remain upright after eating.
5. Which finding most strongly suggests that a client has developed a pressure
injury?
A. Blanchable redness over the sacrum
B. Persistent nonblanchable erythema over a bony prominence
C. Dry skin over the elbows
D. Mild bruising on the forearm
Answer: B. Persistent nonblanchable erythema over a bony prominence
Rationale: Nonblanchable erythema over intact skin is characteristic of a stage 1
pressure injury. Early recognition allows pressure relief and prevention of
progression.
6. A client who has been immobile for several days reports sudden unilateral
calf pain and swelling. Which action is most appropriate?
A. Massage the affected calf
B. Encourage ambulation
, C. Report the finding promptly and avoid massaging the extremity
D. Apply vigorous range-of-motion exercises
Answer: C. Report the finding promptly and avoid massaging the extremity
Rationale: Unilateral swelling and calf pain may indicate deep-vein thrombosis.
Massage or unnecessary manipulation could potentially dislodge a thrombus.
The finding requires prompt clinical evaluation.
7. Which intervention is most effective for preventing postoperative atelectasis?
A. Restricting fluids
B. Encouraging incentive spirometry and deep breathing
C. Maintaining strict bed rest
D. Avoiding coughing
Answer: B. Encouraging incentive spirometry and deep breathing
Rationale: Deep breathing and incentive spirometry promote alveolar expansion
and help prevent atelectasis, especially after surgery when pain and immobility
reduce ventilation.
8. A client becomes dizzy when standing after prolonged bed rest. Which
instruction is most appropriate?
A. Stand quickly to restore circulation
B. Dangle the legs and change positions gradually
C. Avoid drinking fluids
D. Remain completely immobile
Answer: B. Dangle the legs and change positions gradually
