ILLINOIS PRACTICAL
NURSE LICENSING
EXAMINATION
Section 1: Safe and Effective Care Environment –
Coordinated Care
1. A charge nurse on a medical-surgical unit is making assignments for a licensed
practical nurse (LPN). Which task is appropriate to delegate to the LPN?
A. Perform the initial admission assessment on a patient with pneumonia
B. Administer a PRN enema to a constipated patient
C. Develop the nursing care plan for a patient with heart failure
D. Teach a patient how to self-administer insulin
Correct Answer: B
Rationale: LPNs can administer medications (including PRN enemas) and perform
stable, routine treatments. Initial assessment (A) and care plan development (C) require
RN-level assessment and critical thinking. Patient teaching (D) can be reinforced by
LPNs, but initial teaching is typically done by the RN .
2. A nurse is caring for a patient who has a do-not-resuscitate (DNR) order. The
family asks the nurse to explain what DNR means. The nurse should respond:
A. "It means we will not provide any treatment to keep the patient alive."
B. "It means that if the patient stops breathing or the heart stops, we will not
perform CPR or advanced cardiac life support."
,C. "I cannot discuss that; you need to talk to the doctor."
D. "It means the patient will be allowed to die naturally without any medical care."
Correct Answer: B
Rationale: DNR means that if the patient experiences cardiac or respiratory arrest, CPR
and ACLS will not be initiated. It does NOT mean withholding other treatments such as
pain relief, antibiotics, or hydration. The nurse can explain this clearly and offer to
contact the provider for further discussion .
3. A charge nurse is observing a new graduate nurse insert a urinary catheter. The
new nurse touches the inner surface of the sterile drape without sterile gloves. The
charge nurse should:
A. Praise the new nurse for completing the procedure quickly
B. Stop the procedure immediately and remind the new nurse about sterile
technique
C. Ignore the error because the patient is not at risk
D. Report the new nurse to the state board of nursing
Correct Answer: B
Rationale: Breaking sterile technique increases the risk of infection. The charge nurse
must intervene immediately to correct the error and prevent contamination. Reporting
to the state board (D) is not appropriate for a single correctable error .
4. A nurse manager is reviewing client rights with the nursing staff. Which
statement indicates an understanding of client rights?
A. "A client can refuse a treatment even if it is life-saving."
B. "A client cannot refuse a treatment once it has been started."
C. "A client's family can override the client's refusal."
D. "Only physicians can determine if a client is competent to refuse."
Correct Answer: A
,Rationale: A competent adult has the right to refuse any treatment, even life-saving
treatment, at any time. This is a fundamental patient right. The provider must ensure the
refusal is informed (patient understands consequences). Family cannot override (C) .
5. A client's family member asks to review the medical record. The client is
intubated and sedated. What is the nurse's best response?
A. Allow the family member to read the chart at the bedside
B. Explain that only the client can access the record, and only with a written request
C. Provide a verbal summary of the client's condition
D. Inform the family that they cannot have any information
Correct Answer: C
Rationale: Under HIPAA, the client has the right to access their medical record. If the
client is incapacitated, the nurse can provide a verbal summary of the client's condition
to family members involved in the client's care, while protecting confidentiality of the
written record .
6. The practical nurse is caring for a client who is 2 days post-op after a total
abdominal hysterectomy. The client suddenly reports a gush of fluid from the
vagina. What should the PN do first?
A. Notify the surgeon immediately
B. Apply a perineal pad and assess the drainage
C. Insert a vaginal pack
D. Reassure the client that this is normal
Correct Answer: B
Rationale: First assess the amount, color, and odor of the drainage. The surgeon should
be notified after the initial assessment. A sudden gush could indicate a fistula, abscess
rupture, or dehiscence .
, 7. The nurse receives a telephone order from a healthcare provider for "Morphine
sulfate 4 mg IV push every 2 hours PRN for severe pain." Which action should the
nurse take FIRST?
A. Administer the medication as ordered
B. Ask the provider to clarify the administration rate
C. Repeat the order back to the provider
D. Document the order in the electronic medical record
Correct Answer: B
Rationale: An IV push order must include the rate of administration (e.g., "over 2–5
minutes") to prevent severe respiratory depression and hypotension. While repeating
back (C) is part of telephone orders, the FIRST action is to recognize the missing
component and obtain clarification before administration .
8. An RN is delegating tasks to an unlicensed assistive personnel (UAP). Which task
is appropriate to delegate?
A. Performing a sterile dressing change on a surgical wound
B. Assessing a client's lung sounds for crackles
C. Feeding a client who requires swallowing precautions
D. Measuring and recording a client's intake and output
Correct Answer: D
Rationale: Measuring and recording intake and output is a basic task that can be
delegated to UAP. Sterile dressing changes (A) and assessments (B) require nursing
judgment and cannot be delegated. Feeding a client with swallowing precautions (C)
requires specialized knowledge of aspiration risks .
9. A charge nurse is making assignments on a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A. A client with pneumonia requiring IV antibiotics every 6 hours
B. A client with a fractured hip who is 1 day post-operative
NURSE LICENSING
EXAMINATION
Section 1: Safe and Effective Care Environment –
Coordinated Care
1. A charge nurse on a medical-surgical unit is making assignments for a licensed
practical nurse (LPN). Which task is appropriate to delegate to the LPN?
A. Perform the initial admission assessment on a patient with pneumonia
B. Administer a PRN enema to a constipated patient
C. Develop the nursing care plan for a patient with heart failure
D. Teach a patient how to self-administer insulin
Correct Answer: B
Rationale: LPNs can administer medications (including PRN enemas) and perform
stable, routine treatments. Initial assessment (A) and care plan development (C) require
RN-level assessment and critical thinking. Patient teaching (D) can be reinforced by
LPNs, but initial teaching is typically done by the RN .
2. A nurse is caring for a patient who has a do-not-resuscitate (DNR) order. The
family asks the nurse to explain what DNR means. The nurse should respond:
A. "It means we will not provide any treatment to keep the patient alive."
B. "It means that if the patient stops breathing or the heart stops, we will not
perform CPR or advanced cardiac life support."
,C. "I cannot discuss that; you need to talk to the doctor."
D. "It means the patient will be allowed to die naturally without any medical care."
Correct Answer: B
Rationale: DNR means that if the patient experiences cardiac or respiratory arrest, CPR
and ACLS will not be initiated. It does NOT mean withholding other treatments such as
pain relief, antibiotics, or hydration. The nurse can explain this clearly and offer to
contact the provider for further discussion .
3. A charge nurse is observing a new graduate nurse insert a urinary catheter. The
new nurse touches the inner surface of the sterile drape without sterile gloves. The
charge nurse should:
A. Praise the new nurse for completing the procedure quickly
B. Stop the procedure immediately and remind the new nurse about sterile
technique
C. Ignore the error because the patient is not at risk
D. Report the new nurse to the state board of nursing
Correct Answer: B
Rationale: Breaking sterile technique increases the risk of infection. The charge nurse
must intervene immediately to correct the error and prevent contamination. Reporting
to the state board (D) is not appropriate for a single correctable error .
4. A nurse manager is reviewing client rights with the nursing staff. Which
statement indicates an understanding of client rights?
A. "A client can refuse a treatment even if it is life-saving."
B. "A client cannot refuse a treatment once it has been started."
C. "A client's family can override the client's refusal."
D. "Only physicians can determine if a client is competent to refuse."
Correct Answer: A
,Rationale: A competent adult has the right to refuse any treatment, even life-saving
treatment, at any time. This is a fundamental patient right. The provider must ensure the
refusal is informed (patient understands consequences). Family cannot override (C) .
5. A client's family member asks to review the medical record. The client is
intubated and sedated. What is the nurse's best response?
A. Allow the family member to read the chart at the bedside
B. Explain that only the client can access the record, and only with a written request
C. Provide a verbal summary of the client's condition
D. Inform the family that they cannot have any information
Correct Answer: C
Rationale: Under HIPAA, the client has the right to access their medical record. If the
client is incapacitated, the nurse can provide a verbal summary of the client's condition
to family members involved in the client's care, while protecting confidentiality of the
written record .
6. The practical nurse is caring for a client who is 2 days post-op after a total
abdominal hysterectomy. The client suddenly reports a gush of fluid from the
vagina. What should the PN do first?
A. Notify the surgeon immediately
B. Apply a perineal pad and assess the drainage
C. Insert a vaginal pack
D. Reassure the client that this is normal
Correct Answer: B
Rationale: First assess the amount, color, and odor of the drainage. The surgeon should
be notified after the initial assessment. A sudden gush could indicate a fistula, abscess
rupture, or dehiscence .
, 7. The nurse receives a telephone order from a healthcare provider for "Morphine
sulfate 4 mg IV push every 2 hours PRN for severe pain." Which action should the
nurse take FIRST?
A. Administer the medication as ordered
B. Ask the provider to clarify the administration rate
C. Repeat the order back to the provider
D. Document the order in the electronic medical record
Correct Answer: B
Rationale: An IV push order must include the rate of administration (e.g., "over 2–5
minutes") to prevent severe respiratory depression and hypotension. While repeating
back (C) is part of telephone orders, the FIRST action is to recognize the missing
component and obtain clarification before administration .
8. An RN is delegating tasks to an unlicensed assistive personnel (UAP). Which task
is appropriate to delegate?
A. Performing a sterile dressing change on a surgical wound
B. Assessing a client's lung sounds for crackles
C. Feeding a client who requires swallowing precautions
D. Measuring and recording a client's intake and output
Correct Answer: D
Rationale: Measuring and recording intake and output is a basic task that can be
delegated to UAP. Sterile dressing changes (A) and assessments (B) require nursing
judgment and cannot be delegated. Feeding a client with swallowing precautions (C)
requires specialized knowledge of aspiration risks .
9. A charge nurse is making assignments on a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A. A client with pneumonia requiring IV antibiotics every 6 hours
B. A client with a fractured hip who is 1 day post-operative
