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SECTION 1: MANAGEMENT OF CARE (Questions 1-25)
Question 1
A charge nurse is planning client assignments for the shift. Which client should be
assigned to the LPN?
A. A client newly admitted with acute GI bleeding requiring fluid resuscitation
B. A client who is 2 days post-op from a hip replacement needing routine wound care
and ambulation assistance
C. A client receiving their first dose of IV chemotherapy for lymphoma
D. A client with new-onset chest pain requiring STAT cardiac enzymes and telemetry
Correct Answer: B
Rationale: The LPN scope of practice includes caring for stable clients with predictable
outcomes, performing routine wound care, and reinforcing teaching. A 2-day post-op
hip replacement client with routine needs fits this scope. Clients with acute GI bleeding
(unstable, fluid resuscitation), first-dose IV chemotherapy (requires RN assessment), and
new-onset chest pain (requires immediate RN assessment) are beyond LPN scope.
Question 2
The PN is assigned to care for a client who has a new cast on the right arm. Which task
should the PN delegate to the UAP?
,A. Assessing the client's capillary refill in the affected hand
B. Teaching the client how to keep the cast dry while showering
C. Assisting the client with ambulation to the bathroom
D. Evaluating the client's pain level using the 0-10 scale
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task within the UAP scope.
The PN cannot delegate assessment (A), evaluation (D), or teaching (B) as these require
professional nursing judgment.
Question 3
A client with dementia has an order for bilateral soft wrist restraints. Which action is
required?
A. Secure the restraint ties to the side rails
B. Apply the restraint snugly against the skin
C. Obtain a written prescription for the restraint application
D. Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a physician's written order specifying duration and reason.
Ties must never be secured to side rails. The restraint should allow two fingers of width.
Observations must be made every 15-30 minutes, not hourly.
Question 4
,A client post-op day 1 following a total knee replacement reports pain of 7/10. The
client has hydromorphone 2 mg IV q4h PRN, last dose 6 hours ago. What is the PN's
priority action?
A. Administer the prescribed hydromorphone immediately
B. Apply ice to the surgical site and elevate the leg
C. Encourage the client to use relaxation techniques
D. Notify the RN regarding the medication request
Correct Answer: A
Rationale: The client has a valid PRN prescription, is due for the dose (over 4 hours),
and reports significant pain. Administering the medication is the priority intervention.
Question 5
A nurse is caring for a client with chronic heart failure who reports increased shortness
of breath and swelling in the ankles. Which intervention should the nurse prioritize?
A. Encourage increased fluid intake
B. Administer prescribed diuretic
C. Provide a high-sodium snack
D. Increase the room temperature
Correct Answer: B
Rationale: The symptoms indicate fluid overload. Administering a diuretic (e.g.,
furosemide) directly addresses the cause by reducing preload and pulmonary
congestion.
, Question 6
A client is admitted with suspected stroke. Which action should the nurse perform first?
A. Obtain a detailed neurological history
B. Check blood glucose level
C. Prepare for CT scan
D. Administer aspirin
Correct Answer: B
Rationale: Hypoglycemia can mimic stroke symptoms (slurred speech, weakness,
confusion). The nurse must quickly rule out low blood sugar before proceeding with a
stroke workup.
Question 7
A nurse is discussing legal issues with newly hired assistive personnel. Which of the
following should the nurse include as an example of assault?
A. Informing a client the nurse is going to administer an injection even though the client
refuses
B. Applying restraints without an order
C. Threatening to withhold food from a client
D. Performing a procedure without consent
Correct Answer: A
Rationale: Assault is the threat of touching a person without consent. Informing a client
that the nurse is going to administer an injection despite the client's refusal is an
example of assault.