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LPN/LVN Comprehensive Nursing
Competency Exam — Code: LPN-CNC |
100-Question Advanced Practice Exam
2026 | Questions & Answers with
Detailed Rationales | Complete Exam
Prep & Study Guide
1. A client with heart failure suddenly develops severe dyspnea, bilateral
crackles, pink frothy sputum, and an oxygen saturation of 82%. Which
action should the LPN/LVN take first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position and apply oxygen as prescribed
C. Encourage oral fluids
D. Assist the client to ambulate
Answer: Place the client in high-Fowler's position and apply oxygen as
prescribed.
,Rationale: Acute pulmonary edema is life-threatening. Positioning upright
improves lung expansion and decreases venous return, while oxygen supports
impaired gas exchange.
2. A client receiving digoxin has an apical pulse of 54/min and reports nausea
and seeing yellow-green halos. What should the nurse do?
A. Administer the medication with food
B. Give the medication and reassess in 1 hour
C. Hold the medication and notify the healthcare provider
D. Encourage increased potassium intake
Answer: Hold the medication and notify the healthcare provider.
Rationale: Bradycardia, gastrointestinal symptoms, and visual disturbances are
classic manifestations of digoxin toxicity. The medication should be withheld
and the provider notified.
3. A postoperative client suddenly becomes restless, tachycardic, and short of
breath and reports sharp chest pain that worsens with inspiration. Which
complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Hypoglycemia
D. Pneumonia
Answer: Pulmonary embolism.
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and anxiety are
concerning for pulmonary embolism and require immediate intervention.
4. A client with diabetes is awake, diaphoretic, shaky, and has a blood glucose
level of 52 mg/dL. What is the priority intervention?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
,C. Restrict oral intake
D. Administer long-acting insulin
Answer: Give 15 g of rapid-acting carbohydrate.
Rationale: A conscious client experiencing symptomatic hypoglycemia should
receive approximately 15 g of rapidly absorbed carbohydrate, followed by
reassessment of glucose.
5. A client with chronic kidney disease has a potassium level of 6.8 mEq/L and
peaked T waves on the ECG. Which prescription should the nurse anticipate
as a priority?
A. Oral potassium supplementation
B. IV calcium gluconate
C. Increased dietary potassium
D. Magnesium hydroxide
Answer: IV calcium gluconate.
Rationale: Severe hyperkalemia with ECG changes can cause fatal dysrhythmias.
IV calcium stabilizes the cardiac membrane while definitive potassium-lowering
treatment is initiated.
6. A client receiving a blood transfusion develops fever, chills, flank pain, and
hypotension. What is the nurse's priority action?
A. Slow the transfusion
B. Stop the transfusion immediately
C. Administer another unit of blood
D. Obtain a routine urine specimen
Answer: Stop the transfusion immediately.
Rationale: These findings suggest an acute hemolytic transfusion reaction. The
transfusion must be stopped immediately, and the IV line should be maintained
with compatible solution according to protocol.
, 7. A client with COPD is receiving oxygen. Which finding requires the most
immediate attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing somnolence and difficulty awakening
D. Productive cough with clear sputum
Answer: Increasing somnolence and difficulty awakening.
Rationale: Increasing somnolence may indicate worsening hypercapnia and
respiratory failure. Mental-status changes are a significant deterioration in a
client with COPD.
8. A client taking warfarin has an INR of 5.8 without active bleeding. What
should the nurse anticipate?
A. Administration of an additional warfarin dose
B. Holding warfarin and notifying the provider
C. Administering aspirin
D. Encouraging high-dose vitamin K foods immediately
Answer: Holding warfarin and notifying the provider.
Rationale: A markedly elevated INR increases bleeding risk. Warfarin should be
held and the provider notified for further management.
9. A client with suspected sepsis has a temperature of 39.4°C, heart rate
128/min, respiratory rate 30/min, and hypotension. Which intervention has
the highest priority?
A. Delay treatment until culture results return
B. Initiate prescribed sepsis interventions promptly
C. Restrict fluids
D. Encourage ambulation
Answer: Initiate prescribed sepsis interventions promptly.
LPN/LVN Comprehensive Nursing
Competency Exam — Code: LPN-CNC |
100-Question Advanced Practice Exam
2026 | Questions & Answers with
Detailed Rationales | Complete Exam
Prep & Study Guide
1. A client with heart failure suddenly develops severe dyspnea, bilateral
crackles, pink frothy sputum, and an oxygen saturation of 82%. Which
action should the LPN/LVN take first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position and apply oxygen as prescribed
C. Encourage oral fluids
D. Assist the client to ambulate
Answer: Place the client in high-Fowler's position and apply oxygen as
prescribed.
,Rationale: Acute pulmonary edema is life-threatening. Positioning upright
improves lung expansion and decreases venous return, while oxygen supports
impaired gas exchange.
2. A client receiving digoxin has an apical pulse of 54/min and reports nausea
and seeing yellow-green halos. What should the nurse do?
A. Administer the medication with food
B. Give the medication and reassess in 1 hour
C. Hold the medication and notify the healthcare provider
D. Encourage increased potassium intake
Answer: Hold the medication and notify the healthcare provider.
Rationale: Bradycardia, gastrointestinal symptoms, and visual disturbances are
classic manifestations of digoxin toxicity. The medication should be withheld
and the provider notified.
3. A postoperative client suddenly becomes restless, tachycardic, and short of
breath and reports sharp chest pain that worsens with inspiration. Which
complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Hypoglycemia
D. Pneumonia
Answer: Pulmonary embolism.
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and anxiety are
concerning for pulmonary embolism and require immediate intervention.
4. A client with diabetes is awake, diaphoretic, shaky, and has a blood glucose
level of 52 mg/dL. What is the priority intervention?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
,C. Restrict oral intake
D. Administer long-acting insulin
Answer: Give 15 g of rapid-acting carbohydrate.
Rationale: A conscious client experiencing symptomatic hypoglycemia should
receive approximately 15 g of rapidly absorbed carbohydrate, followed by
reassessment of glucose.
5. A client with chronic kidney disease has a potassium level of 6.8 mEq/L and
peaked T waves on the ECG. Which prescription should the nurse anticipate
as a priority?
A. Oral potassium supplementation
B. IV calcium gluconate
C. Increased dietary potassium
D. Magnesium hydroxide
Answer: IV calcium gluconate.
Rationale: Severe hyperkalemia with ECG changes can cause fatal dysrhythmias.
IV calcium stabilizes the cardiac membrane while definitive potassium-lowering
treatment is initiated.
6. A client receiving a blood transfusion develops fever, chills, flank pain, and
hypotension. What is the nurse's priority action?
A. Slow the transfusion
B. Stop the transfusion immediately
C. Administer another unit of blood
D. Obtain a routine urine specimen
Answer: Stop the transfusion immediately.
Rationale: These findings suggest an acute hemolytic transfusion reaction. The
transfusion must be stopped immediately, and the IV line should be maintained
with compatible solution according to protocol.
, 7. A client with COPD is receiving oxygen. Which finding requires the most
immediate attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing somnolence and difficulty awakening
D. Productive cough with clear sputum
Answer: Increasing somnolence and difficulty awakening.
Rationale: Increasing somnolence may indicate worsening hypercapnia and
respiratory failure. Mental-status changes are a significant deterioration in a
client with COPD.
8. A client taking warfarin has an INR of 5.8 without active bleeding. What
should the nurse anticipate?
A. Administration of an additional warfarin dose
B. Holding warfarin and notifying the provider
C. Administering aspirin
D. Encouraging high-dose vitamin K foods immediately
Answer: Holding warfarin and notifying the provider.
Rationale: A markedly elevated INR increases bleeding risk. Warfarin should be
held and the provider notified for further management.
9. A client with suspected sepsis has a temperature of 39.4°C, heart rate
128/min, respiratory rate 30/min, and hypotension. Which intervention has
the highest priority?
A. Delay treatment until culture results return
B. Initiate prescribed sepsis interventions promptly
C. Restrict fluids
D. Encourage ambulation
Answer: Initiate prescribed sepsis interventions promptly.
