LVN – Licensed Vocational Nurse (California & Texas) |
Comprehensive Study Guide, Practice Exam, Questions
& Answers, Exam Prep Test Bank, NCLEX-PN Review,
Fundamentals of Nursing, Medical-Surgical Nursing,
Pharmacology, Maternal-Newborn, Pediatrics, Mental
Health, Leadership, Patient Safety, Clinical Judgment,
Detailed Rationales, Complete Review
Question 1: A patient with a history of chronic obstructive pulmonary disease
(COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which
action indicates the patient needs further teaching about the correct use of this
device?
A. The patient shakes the inhaler vigorously before each use.
B. The patient exhales fully before placing the mouthpiece in their mouth.
C. The patient activates the inhaler at the beginning of a slow, deep inhalation.
D. The patient holds their breath for 10 seconds after inhaling the medication.
CORRECT ANSWER: C. The patient activates the inhaler at the beginning of a
slow, deep inhalation.
Rationale:For optimal deposition of medication in the lungs, the patient should activate
the inhaler at the start of a slow, deep inhalation. Activating it at the beginning ensures
that the medication is carried deep into the airways by the airflow. The other options are
correct techniques: shaking the inhaler mixes the medication, exhaling fully prepares the
lungs for a deep breath, and holding the breath allows for better absorption.
Question 2: The LVN is caring for a patient with a diagnosis of heart failure
who is receiving digoxin. Which finding is the earliest and most specific
indicator of digoxin toxicity?
A. Nausea and vomiting
B. Blurred yellow-green vision
C. Bradycardia
D. Anorexia
CORRECT ANSWER: B. Blurred yellow-green vision
Rationale:Visual disturbances, such as seeing yellow-green halos or blurred vision, are
among the earliest and most specific signs of digoxin toxicity. While nausea, vomiting,
anorexia, and bradycardia can also occur, they are less specific and can be caused by
other conditions.
Question 3: A patient is 2 hours post-operative from a total hip arthroplasty.
The LVN notes that the patient's surgical leg is externally rotated and shorter
than the other leg. What is the priority nursing action?
,A. Document the finding as expected.
B. Place a pillow between the legs.
C. Notify the registered nurse immediately.
D. Apply a foot board to maintain dorsiflexion.
CORRECT ANSWER: C. Notify the registered nurse immediately.
Rationale:External rotation and shortening of the operative leg are signs of a possible
hip dislocation or prosthesis failure. This is a medical emergency and requires
immediate notification of the RN or healthcare provider. This is not an expected finding
and requires urgent intervention.
Question 4: The LVN is reinforcing teaching for a patient with a new
colostomy. Which statement by the patient indicates a correct understanding
of stoma care?
A. "I will clean the stoma with alcohol wipes to prevent infection."
B. "I will expect the stoma to shrink in size over the next 6-8 weeks."
C. "I will be able to wear a one-piece pouch system only."
D. "I will change the pouch every day to ensure proper hygiene."
CORRECT ANSWER: B. "I will expect the stoma to shrink in size over the next
6-8 weeks."
Rationale:The stoma will shrink and decrease in size over the first 6-8 weeks post-
surgery, which requires re-measuring to ensure a proper fit. The stoma should only be
cleaned with mild soap and water, and pouches can be changed every 3-7 days or as
needed for leaks, not daily.
Question 5: A patient with type 2 diabetes mellitus is prescribed metformin.
The LVN is reinforcing teaching about this medication. Which adverse effect
should the patient be instructed to report immediately?
A. Nausea and vomiting
B. Diarrhea
C. Muscle pain or weakness
D. Metallic taste in the mouth
CORRECT ANSWER: C. Muscle pain or weakness
Rationale:Muscle pain or weakness can be a sign of lactic acidosis, a rare but serious
adverse effect of metformin. This is a medical emergency. Nausea, diarrhea, and a
metallic taste are common side effects but are not immediately life-threatening and may
resolve with time or dose adjustment.
,Question 6: The LVN is assisting with the care of a patient who has a
nasogastric (NG) tube attached to low intermittent suction. Which assessment
finding requires immediate intervention?
A. A small amount of greenish-yellow drainage in the collection canister.
B. The tube is taped securely to the patient's nose.
C. The patient complains of a sore throat.
D. The patient has absent bowel sounds in all four quadrants.
CORRECT ANSWER: D. The patient has absent bowel sounds in all four
quadrants.
Rationale:Absent bowel sounds can indicate an ileus or bowel obstruction, which is a
serious condition that can be exacerbated by NG suction. This finding warrants
immediate notification of the RN. The other options are expected or non-emergent
findings.
Question 7: An elderly patient is receiving a blood transfusion. Fifteen minutes
after the infusion begins, the LVN observes the patient becoming restless, with
chills and flank pain. What is the priority action?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer an antihistamine per order.
D. Notify the healthcare provider.
CORRECT ANSWER: B. Stop the transfusion immediately.
Rationale:The patient is showing signs of an acute hemolytic transfusion reaction
(restlessness, chills, flank pain). The immediate priority is to stop the transfusion to
prevent further complications. The IV line should be kept open with normal saline, and
then the RN and provider must be notified.
Question 8: The LVN is preparing to administer a subcutaneous injection of
heparin to a patient. Which needle length is most appropriate for this route?
A. 5/8 inch
B. 1 inch
C. 1 1/2 inch
D. 2 inch
CORRECT ANSWER: A. 5/8 inch
Rationale:For subcutaneous injections, a needle length of 5/8 inch (or 1/2 inch) is
typically appropriate to ensure the medication is deposited into the subcutaneous tissue,
not into the muscle. A 1-inch needle is often used for intramuscular injections.
, Question 9: A patient on a psychiatric unit is exhibiting signs of escalating
agitation and is pacing in the hallway. Which intervention should the LVN
implement first?
A. Place the patient in seclusion.
B. Administer PRN haloperidol.
C. Use verbal de-escalation techniques.
D. Call for security to assist with physical restraints.
CORRECT ANSWER: C. Use verbal de-escalation techniques.
Rationale:The least restrictive intervention should always be attempted first. Verbal de-
escalation techniques, such as speaking calmly and providing clear choices, are the
initial and most appropriate response to escalating agitation. Seclusion, restraints, and
chemical restraints are used only when less restrictive measures have failed and the
patient is a danger to themselves or others.
Question 10: The LVN is reinforcing discharge teaching for a patient with a
new prescription for warfarin. Which over-the-counter medication should the
patient be warned to avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Calcium carbonate
CORRECT ANSWER: B. Ibuprofen
Rationale:Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that, when
taken with warfarin, significantly increases the risk of bleeding due to additive
antiplatelet effects and interference with the drug's metabolism. Acetaminophen is the
preferred analgesic for patients on warfarin, though in large doses it can also affect INR.
Question 11: A patient with COPD is receiving oxygen at 2 L/min via nasal
cannula. Which assessment finding indicates that the oxygen therapy is
effective?
A. Increased respiratory rate from 20 to 26 breaths per minute.
B. Improved mental status and alertness.
C. Decreased pulse oximetry reading from 92% to 88%.
D. Increased use of accessory muscles.
CORRECT ANSWER: B. Improved mental status and alertness.
Comprehensive Study Guide, Practice Exam, Questions
& Answers, Exam Prep Test Bank, NCLEX-PN Review,
Fundamentals of Nursing, Medical-Surgical Nursing,
Pharmacology, Maternal-Newborn, Pediatrics, Mental
Health, Leadership, Patient Safety, Clinical Judgment,
Detailed Rationales, Complete Review
Question 1: A patient with a history of chronic obstructive pulmonary disease
(COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which
action indicates the patient needs further teaching about the correct use of this
device?
A. The patient shakes the inhaler vigorously before each use.
B. The patient exhales fully before placing the mouthpiece in their mouth.
C. The patient activates the inhaler at the beginning of a slow, deep inhalation.
D. The patient holds their breath for 10 seconds after inhaling the medication.
CORRECT ANSWER: C. The patient activates the inhaler at the beginning of a
slow, deep inhalation.
Rationale:For optimal deposition of medication in the lungs, the patient should activate
the inhaler at the start of a slow, deep inhalation. Activating it at the beginning ensures
that the medication is carried deep into the airways by the airflow. The other options are
correct techniques: shaking the inhaler mixes the medication, exhaling fully prepares the
lungs for a deep breath, and holding the breath allows for better absorption.
Question 2: The LVN is caring for a patient with a diagnosis of heart failure
who is receiving digoxin. Which finding is the earliest and most specific
indicator of digoxin toxicity?
A. Nausea and vomiting
B. Blurred yellow-green vision
C. Bradycardia
D. Anorexia
CORRECT ANSWER: B. Blurred yellow-green vision
Rationale:Visual disturbances, such as seeing yellow-green halos or blurred vision, are
among the earliest and most specific signs of digoxin toxicity. While nausea, vomiting,
anorexia, and bradycardia can also occur, they are less specific and can be caused by
other conditions.
Question 3: A patient is 2 hours post-operative from a total hip arthroplasty.
The LVN notes that the patient's surgical leg is externally rotated and shorter
than the other leg. What is the priority nursing action?
,A. Document the finding as expected.
B. Place a pillow between the legs.
C. Notify the registered nurse immediately.
D. Apply a foot board to maintain dorsiflexion.
CORRECT ANSWER: C. Notify the registered nurse immediately.
Rationale:External rotation and shortening of the operative leg are signs of a possible
hip dislocation or prosthesis failure. This is a medical emergency and requires
immediate notification of the RN or healthcare provider. This is not an expected finding
and requires urgent intervention.
Question 4: The LVN is reinforcing teaching for a patient with a new
colostomy. Which statement by the patient indicates a correct understanding
of stoma care?
A. "I will clean the stoma with alcohol wipes to prevent infection."
B. "I will expect the stoma to shrink in size over the next 6-8 weeks."
C. "I will be able to wear a one-piece pouch system only."
D. "I will change the pouch every day to ensure proper hygiene."
CORRECT ANSWER: B. "I will expect the stoma to shrink in size over the next
6-8 weeks."
Rationale:The stoma will shrink and decrease in size over the first 6-8 weeks post-
surgery, which requires re-measuring to ensure a proper fit. The stoma should only be
cleaned with mild soap and water, and pouches can be changed every 3-7 days or as
needed for leaks, not daily.
Question 5: A patient with type 2 diabetes mellitus is prescribed metformin.
The LVN is reinforcing teaching about this medication. Which adverse effect
should the patient be instructed to report immediately?
A. Nausea and vomiting
B. Diarrhea
C. Muscle pain or weakness
D. Metallic taste in the mouth
CORRECT ANSWER: C. Muscle pain or weakness
Rationale:Muscle pain or weakness can be a sign of lactic acidosis, a rare but serious
adverse effect of metformin. This is a medical emergency. Nausea, diarrhea, and a
metallic taste are common side effects but are not immediately life-threatening and may
resolve with time or dose adjustment.
,Question 6: The LVN is assisting with the care of a patient who has a
nasogastric (NG) tube attached to low intermittent suction. Which assessment
finding requires immediate intervention?
A. A small amount of greenish-yellow drainage in the collection canister.
B. The tube is taped securely to the patient's nose.
C. The patient complains of a sore throat.
D. The patient has absent bowel sounds in all four quadrants.
CORRECT ANSWER: D. The patient has absent bowel sounds in all four
quadrants.
Rationale:Absent bowel sounds can indicate an ileus or bowel obstruction, which is a
serious condition that can be exacerbated by NG suction. This finding warrants
immediate notification of the RN. The other options are expected or non-emergent
findings.
Question 7: An elderly patient is receiving a blood transfusion. Fifteen minutes
after the infusion begins, the LVN observes the patient becoming restless, with
chills and flank pain. What is the priority action?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer an antihistamine per order.
D. Notify the healthcare provider.
CORRECT ANSWER: B. Stop the transfusion immediately.
Rationale:The patient is showing signs of an acute hemolytic transfusion reaction
(restlessness, chills, flank pain). The immediate priority is to stop the transfusion to
prevent further complications. The IV line should be kept open with normal saline, and
then the RN and provider must be notified.
Question 8: The LVN is preparing to administer a subcutaneous injection of
heparin to a patient. Which needle length is most appropriate for this route?
A. 5/8 inch
B. 1 inch
C. 1 1/2 inch
D. 2 inch
CORRECT ANSWER: A. 5/8 inch
Rationale:For subcutaneous injections, a needle length of 5/8 inch (or 1/2 inch) is
typically appropriate to ensure the medication is deposited into the subcutaneous tissue,
not into the muscle. A 1-inch needle is often used for intramuscular injections.
, Question 9: A patient on a psychiatric unit is exhibiting signs of escalating
agitation and is pacing in the hallway. Which intervention should the LVN
implement first?
A. Place the patient in seclusion.
B. Administer PRN haloperidol.
C. Use verbal de-escalation techniques.
D. Call for security to assist with physical restraints.
CORRECT ANSWER: C. Use verbal de-escalation techniques.
Rationale:The least restrictive intervention should always be attempted first. Verbal de-
escalation techniques, such as speaking calmly and providing clear choices, are the
initial and most appropriate response to escalating agitation. Seclusion, restraints, and
chemical restraints are used only when less restrictive measures have failed and the
patient is a danger to themselves or others.
Question 10: The LVN is reinforcing discharge teaching for a patient with a
new prescription for warfarin. Which over-the-counter medication should the
patient be warned to avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Calcium carbonate
CORRECT ANSWER: B. Ibuprofen
Rationale:Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that, when
taken with warfarin, significantly increases the risk of bleeding due to additive
antiplatelet effects and interference with the drug's metabolism. Acetaminophen is the
preferred analgesic for patients on warfarin, though in large doses it can also affect INR.
Question 11: A patient with COPD is receiving oxygen at 2 L/min via nasal
cannula. Which assessment finding indicates that the oxygen therapy is
effective?
A. Increased respiratory rate from 20 to 26 breaths per minute.
B. Improved mental status and alertness.
C. Decreased pulse oximetry reading from 92% to 88%.
D. Increased use of accessory muscles.
CORRECT ANSWER: B. Improved mental status and alertness.
