LPN/LVN Adult Health Competency
Exam — Code: LPN-AH-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A client with chronic heart failure suddenly develops severe dyspnea, pink frothy
sputum, and bilateral crackles. Which action should the LPN/LVN take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position
C. Obtain the client's daily weight
D. Assist the client to ambulate
Answer: B. Place the client in high-Fowler's position
,Rationale: Positioning the client upright maximizes lung expansion and
decreases venous return, helping reduce pulmonary congestion. Severe dyspnea
with pink frothy sputum suggests acute pulmonary edema and requires
immediate intervention.
2.
A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The client
becomes increasingly drowsy and difficult to arouse. What is the priority action?
A. Increase oxygen to 6 L/min
B. Remove the oxygen
C. Assess respiratory status and notify the RN/provider
D. Encourage the client to drink water
Answer: C. Assess respiratory status and notify the RN/provider
Rationale: Increasing somnolence may indicate worsening hypercapnia or
respiratory failure. The LPN/LVN should immediately assess respiratory status
and obtain assistance rather than independently increasing oxygen
substantially.
3.
A client with type 1 diabetes is confused, diaphoretic, and trembling. The blood
glucose is 48 mg/dL. The client is awake and able to swallow. What should the
nurse do?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Administer glucagon immediately
D. Give a high-protein meal
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can safely swallow should receive
approximately 15 g of rapid-acting carbohydrate, followed by reassessment of
glucose after about 15 minutes.
,4.
A client with diabetic ketoacidosis has a potassium level of 3.0 mEq/L. Which
prescription should the nurse question?
A. Continuous IV insulin infusion
B. Cardiac monitoring
C. Potassium replacement
D. IV isotonic fluid administration
Answer: A. Continuous IV insulin infusion
Rationale: Insulin drives potassium into cells and can worsen hypokalemia.
When potassium is significantly low, potassium replacement is generally
required before insulin therapy is initiated.
5.
A client with SIADH has a sodium level of 118 mEq/L. Which finding requires
immediate attention?
A. Muscle cramps
B. Mild nausea
C. New-onset seizure activity
D. Decreased urine output
Answer: C. New-onset seizure activity
Rationale: Severe hyponatremia can cause cerebral edema and neurologic
deterioration. Seizure activity is an emergency requiring immediate intervention
and seizure precautions.
6.
A client with chronic kidney disease has a potassium level of 6.4 mEq/L. Which
ECG change should the nurse anticipate?
, A. Prolonged QT interval
B. Peaked T waves
C. ST elevation from myocardial infarction
D. U waves
Answer: B. Peaked T waves
Rationale: Hyperkalemia commonly causes tall, peaked T waves and may
progress to conduction abnormalities, widened QRS complexes, ventricular
dysrhythmias, and cardiac arrest.
7.
A client with acute kidney injury has oliguria and generalized edema. Which
assessment finding is most concerning?
A. Blood pressure of 168/96 mm Hg
B. Weight gain of 1 kg in 24 hours
C. New crackles and oxygen saturation of 88%
D. Mild fatigue
Answer: C. New crackles and oxygen saturation of 88%
Rationale: These findings suggest pulmonary edema from fluid overload and
impaired renal excretion. Respiratory compromise is the immediate priority.
8.
A client receiving digoxin reports nausea and seeing yellow-green halos around
lights. Which action is most appropriate?
A. Administer the next dose early
B. Hold the medication and notify the RN/provider
C. Encourage increased potassium intake without further assessment
D. Document the findings as expected effects
Answer: B. Hold the medication and notify the RN/provider
Exam — Code: LPN-AH-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1.
A client with chronic heart failure suddenly develops severe dyspnea, pink frothy
sputum, and bilateral crackles. Which action should the LPN/LVN take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position
C. Obtain the client's daily weight
D. Assist the client to ambulate
Answer: B. Place the client in high-Fowler's position
,Rationale: Positioning the client upright maximizes lung expansion and
decreases venous return, helping reduce pulmonary congestion. Severe dyspnea
with pink frothy sputum suggests acute pulmonary edema and requires
immediate intervention.
2.
A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The client
becomes increasingly drowsy and difficult to arouse. What is the priority action?
A. Increase oxygen to 6 L/min
B. Remove the oxygen
C. Assess respiratory status and notify the RN/provider
D. Encourage the client to drink water
Answer: C. Assess respiratory status and notify the RN/provider
Rationale: Increasing somnolence may indicate worsening hypercapnia or
respiratory failure. The LPN/LVN should immediately assess respiratory status
and obtain assistance rather than independently increasing oxygen
substantially.
3.
A client with type 1 diabetes is confused, diaphoretic, and trembling. The blood
glucose is 48 mg/dL. The client is awake and able to swallow. What should the
nurse do?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Administer glucagon immediately
D. Give a high-protein meal
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can safely swallow should receive
approximately 15 g of rapid-acting carbohydrate, followed by reassessment of
glucose after about 15 minutes.
,4.
A client with diabetic ketoacidosis has a potassium level of 3.0 mEq/L. Which
prescription should the nurse question?
A. Continuous IV insulin infusion
B. Cardiac monitoring
C. Potassium replacement
D. IV isotonic fluid administration
Answer: A. Continuous IV insulin infusion
Rationale: Insulin drives potassium into cells and can worsen hypokalemia.
When potassium is significantly low, potassium replacement is generally
required before insulin therapy is initiated.
5.
A client with SIADH has a sodium level of 118 mEq/L. Which finding requires
immediate attention?
A. Muscle cramps
B. Mild nausea
C. New-onset seizure activity
D. Decreased urine output
Answer: C. New-onset seizure activity
Rationale: Severe hyponatremia can cause cerebral edema and neurologic
deterioration. Seizure activity is an emergency requiring immediate intervention
and seizure precautions.
6.
A client with chronic kidney disease has a potassium level of 6.4 mEq/L. Which
ECG change should the nurse anticipate?
, A. Prolonged QT interval
B. Peaked T waves
C. ST elevation from myocardial infarction
D. U waves
Answer: B. Peaked T waves
Rationale: Hyperkalemia commonly causes tall, peaked T waves and may
progress to conduction abnormalities, widened QRS complexes, ventricular
dysrhythmias, and cardiac arrest.
7.
A client with acute kidney injury has oliguria and generalized edema. Which
assessment finding is most concerning?
A. Blood pressure of 168/96 mm Hg
B. Weight gain of 1 kg in 24 hours
C. New crackles and oxygen saturation of 88%
D. Mild fatigue
Answer: C. New crackles and oxygen saturation of 88%
Rationale: These findings suggest pulmonary edema from fluid overload and
impaired renal excretion. Respiratory compromise is the immediate priority.
8.
A client receiving digoxin reports nausea and seeing yellow-green halos around
lights. Which action is most appropriate?
A. Administer the next dose early
B. Hold the medication and notify the RN/provider
C. Encourage increased potassium intake without further assessment
D. Document the findings as expected effects
Answer: B. Hold the medication and notify the RN/provider
