LPN – Licensed Practical Nurse (U.S.) |
Comprehensive Study Guide, Practice Exam,
Questions & Answers, LPN/LVN Nursing Exam Prep
Test Bank, Fundamentals of Nursing,
Pharmacology, Medical-Surgical Nursing, Patient
Care, Infection Control, Clinical Skills, NCLEX-PN
Review, Detailed Rationales, Complete Review
Question 1: A client with a history of chronic obstructive pulmonary disease
(COPD) is receiving oxygen at 2 L/min via nasal cannula. Which assessment finding
indicates a potential complication of this therapy?
A. Respiratory rate of 22 breaths per minute
B. Pulse oximetry reading of 88%
C. Client reports a sudden onset of headache and confusion
D. Client reports a decrease in shortness of breath
CORRECT ANSWER: C. Client reports a sudden onset of headache and confusion
Rationale: Clients with COPD may have a hypoxic drive to breathe. Administering high-
flow oxygen can suppress this drive, leading to hypoventilation and carbon dioxide
(CO2) retention. Headache, confusion, and drowsiness are early signs of hypercapnia
(CO2 narcosis). While 2 L/min is generally safe, any change in mental status in a COPD
client receiving oxygen warrants immediate assessment. A respiratory rate of 22 and
decreased dyspnea are expected or positive outcomes, while an SpO2 of 88% indicates
the therapy may be insufficient.
Question 2: A LPN is reinforcing teaching with a client prescribed a monoamine
oxidase inhibitor (MAOI) for depression. Which statement by the client indicates a
need for further teaching?
A. "I will avoid aged cheeses and cured meats."
B. "I can drink a glass of red wine with dinner."
C. "I should report severe headaches or a rapid heartbeat."
D. "I will not take over-the-counter cold medications without asking my provider."
CORRECT ANSWER: B. "I can drink a glass of red wine with dinner."
Rationale: MAOIs interact with tyramine-rich foods, which can precipitate a
hypertensive crisis. Red wine, aged cheeses, cured meats, and fermented products are
high in tyramine and must be avoided. The client's statement about drinking red wine
indicates a misunderstanding. The other options reflect correct understanding: avoiding
tyramine foods, reporting symptoms of hypertensive crisis (headache, palpitations),
and avoiding OTC sympathomimetics.
,Question 3: A client is 2 days post-operative following a total hip arthroplasty.
Which action by the LPN is most appropriate to prevent dislocation of the new
joint?
A. Adduct the affected leg by placing a pillow between the knees.
B. Assist the client to cross their legs at the ankles while sitting.
C. Maintain the client's affected leg in an abducted position.
D. Position the client on the affected side to promote comfort.
CORRECT ANSWER: C. Maintain the client's affected leg in an abducted position.
Rationale: To prevent dislocation of a hip prosthesis, the affected leg must be
maintained in an abducted position. This keeps the femoral head in the acetabulum.
The client should avoid adduction (crossing legs), internal rotation, and acute flexion of
the hip. Placing a pillow between the knees maintains abduction, not adduction.
Positioning on the affected side is generally avoided in the early post-op period.
Question 4: A LPN is preparing to administer an enteral feeding via a nasogastric
tube. What is the priority action before initiating the feeding?
A. Warm the formula to room temperature.
B. Check the residual volume and verify tube placement.
C. Elevate the head of the bed to 30 degrees.
D. Flush the tube with 30 mL of air.
CORRECT ANSWER: B. Check the residual volume and verify tube placement.
Rationale: The priority action before any enteral feeding is to verify proper tube
placement (to prevent pulmonary aspiration) and assess gastric residual volume (to
evaluate gastric emptying and risk of aspiration). While elevating the HOB to 30-45
degrees and warming formula are important, confirming correct placement is the most
critical safety step.
Question 5: A client with diabetes mellitus type 2 is prescribed metformin. The LPN
reinforces teaching about this medication. Which side effect should the client be
instructed to report immediately?
A. Nausea and diarrhea
B. Metallic taste in the mouth
C. Muscle pain and unusual fatigue
D. Weight loss
CORRECT ANSWER: C. Muscle pain and unusual fatigue
Rationale: Metformin can cause lactic acidosis, a rare but serious complication. Early
signs include muscle pain, weakness, fatigue, and malaise. Clients should be
,instructed to report these symptoms immediately. Nausea and diarrhea are common GI
side effects that often subside, a metallic taste is a less serious side effect, and weight
loss may be a desired effect of the medication.
Question 6: A LPN is caring for a client with a new diagnosis of heart failure. Which
dietary restriction is most important for the LPN to reinforce?
A. Restrict fluids to 1,000 mL per day.
B. Avoid foods high in potassium.
C. Restrict sodium intake.
D. Increase intake of complex carbohydrates.
CORRECT ANSWER: C. Restrict sodium intake.
Rationale: Sodium restriction is a cornerstone of dietary management for heart failure.
Sodium causes fluid retention, which increases preload and worsens heart failure
symptoms. Fluid restriction may be indicated, but it is secondary to sodium restriction
and is based on individual client status. Potassium restriction is not typically indicated;
many diuretics cause potassium loss.
Question 7: A client is receiving heparin subcutaneously for a deep vein
thrombosis. Which assessment finding requires immediate intervention by the
LPN?
A. Pain at the injection site
B. A small hematoma at the injection site
C. Dark, tarry stools
D. A platelet count of 250,000/mm³
CORRECT ANSWER: C. Dark, tarry stools
Rationale: Dark, tarry stools (melena) are a sign of upper gastrointestinal bleeding, a
serious adverse effect of heparin therapy. This finding requires immediate intervention
and notification of the RN or provider. Pain and small hematomas at the injection site
are common and expected. A platelet count of 250,000 is within normal limits.
Question 8: A LPN is providing oral care to an unconscious client. What is the
priority action to prevent aspiration during this procedure?
A. Turn the client's head to the side.
B. Use a small amount of toothpaste.
C. Apply petroleum jelly to the lips.
D. Use a soft-bristled toothbrush.
CORRECT ANSWER: A. Turn the client's head to the side.
, Rationale: The priority action when providing oral care to an unconscious client is to
turn the head to the side to allow fluids to drain out of the mouth and prevent aspiration.
While using a soft-bristled toothbrush and applying lubricant are important, preventing
aspiration is the most critical safety concern.
Question 9: A client with a colostomy expresses concern about the odor from the
pouch. Which intervention should the LPN suggest?
A. Place an antacid tablet in the pouch.
B. Change the pouch immediately whenever odor is present.
C. Spray room deodorizer directly into the pouch.
D. Ensure the pouch is securely sealed and use deodorizing drops.
CORRECT ANSWER: D. Ensure the pouch is securely sealed and use deodorizing
drops.
Rationale: Odor from a colostomy is often caused by a poorly sealed pouch allowing
gas to escape or from the breakdown of effluent. The best interventions are to ensure a
secure seal and to use commercially available deodorizing drops or sprays specifically
designed for ostomy pouches. Antacids are not recommended for this purpose, and
changing the pouch too frequently can cause skin breakdown.
Question 10: A LPN is reinforcing teaching about falls prevention for a client with
peripheral neuropathy. Which statement by the client indicates understanding?
A. "I can walk in my stocking feet to improve my sense of balance."
B. "I should use a nightlight in the hallway and bathroom."
C. "I should wear shoes with smooth, leather soles."
D. "I will hold onto furniture while walking to prevent falls."
CORRECT ANSWER: B. "I should use a nightlight in the hallway and bathroom."
Rationale: Clients with peripheral neuropathy have decreased sensation in their feet,
increasing their risk for falls. Using a nightlight improves visibility and reduces the risk of
falls. Clients should wear non-skid footwear (not smooth soles), and should not walk in
stocking feet. Holding onto furniture is unsafe as it can tip or be unstable.
Question 11: When performing a sterile wound dressing change, the LPN drops a
sterile gauze pad onto the sterile field. The pad lands within 1 inch of the edge of
the field. What should the LPN do?
A. Use the gauze pad, as it is still within the sterile field.
B. Pick up the gauze pad and place it back in the center of the field.
Comprehensive Study Guide, Practice Exam,
Questions & Answers, LPN/LVN Nursing Exam Prep
Test Bank, Fundamentals of Nursing,
Pharmacology, Medical-Surgical Nursing, Patient
Care, Infection Control, Clinical Skills, NCLEX-PN
Review, Detailed Rationales, Complete Review
Question 1: A client with a history of chronic obstructive pulmonary disease
(COPD) is receiving oxygen at 2 L/min via nasal cannula. Which assessment finding
indicates a potential complication of this therapy?
A. Respiratory rate of 22 breaths per minute
B. Pulse oximetry reading of 88%
C. Client reports a sudden onset of headache and confusion
D. Client reports a decrease in shortness of breath
CORRECT ANSWER: C. Client reports a sudden onset of headache and confusion
Rationale: Clients with COPD may have a hypoxic drive to breathe. Administering high-
flow oxygen can suppress this drive, leading to hypoventilation and carbon dioxide
(CO2) retention. Headache, confusion, and drowsiness are early signs of hypercapnia
(CO2 narcosis). While 2 L/min is generally safe, any change in mental status in a COPD
client receiving oxygen warrants immediate assessment. A respiratory rate of 22 and
decreased dyspnea are expected or positive outcomes, while an SpO2 of 88% indicates
the therapy may be insufficient.
Question 2: A LPN is reinforcing teaching with a client prescribed a monoamine
oxidase inhibitor (MAOI) for depression. Which statement by the client indicates a
need for further teaching?
A. "I will avoid aged cheeses and cured meats."
B. "I can drink a glass of red wine with dinner."
C. "I should report severe headaches or a rapid heartbeat."
D. "I will not take over-the-counter cold medications without asking my provider."
CORRECT ANSWER: B. "I can drink a glass of red wine with dinner."
Rationale: MAOIs interact with tyramine-rich foods, which can precipitate a
hypertensive crisis. Red wine, aged cheeses, cured meats, and fermented products are
high in tyramine and must be avoided. The client's statement about drinking red wine
indicates a misunderstanding. The other options reflect correct understanding: avoiding
tyramine foods, reporting symptoms of hypertensive crisis (headache, palpitations),
and avoiding OTC sympathomimetics.
,Question 3: A client is 2 days post-operative following a total hip arthroplasty.
Which action by the LPN is most appropriate to prevent dislocation of the new
joint?
A. Adduct the affected leg by placing a pillow between the knees.
B. Assist the client to cross their legs at the ankles while sitting.
C. Maintain the client's affected leg in an abducted position.
D. Position the client on the affected side to promote comfort.
CORRECT ANSWER: C. Maintain the client's affected leg in an abducted position.
Rationale: To prevent dislocation of a hip prosthesis, the affected leg must be
maintained in an abducted position. This keeps the femoral head in the acetabulum.
The client should avoid adduction (crossing legs), internal rotation, and acute flexion of
the hip. Placing a pillow between the knees maintains abduction, not adduction.
Positioning on the affected side is generally avoided in the early post-op period.
Question 4: A LPN is preparing to administer an enteral feeding via a nasogastric
tube. What is the priority action before initiating the feeding?
A. Warm the formula to room temperature.
B. Check the residual volume and verify tube placement.
C. Elevate the head of the bed to 30 degrees.
D. Flush the tube with 30 mL of air.
CORRECT ANSWER: B. Check the residual volume and verify tube placement.
Rationale: The priority action before any enteral feeding is to verify proper tube
placement (to prevent pulmonary aspiration) and assess gastric residual volume (to
evaluate gastric emptying and risk of aspiration). While elevating the HOB to 30-45
degrees and warming formula are important, confirming correct placement is the most
critical safety step.
Question 5: A client with diabetes mellitus type 2 is prescribed metformin. The LPN
reinforces teaching about this medication. Which side effect should the client be
instructed to report immediately?
A. Nausea and diarrhea
B. Metallic taste in the mouth
C. Muscle pain and unusual fatigue
D. Weight loss
CORRECT ANSWER: C. Muscle pain and unusual fatigue
Rationale: Metformin can cause lactic acidosis, a rare but serious complication. Early
signs include muscle pain, weakness, fatigue, and malaise. Clients should be
,instructed to report these symptoms immediately. Nausea and diarrhea are common GI
side effects that often subside, a metallic taste is a less serious side effect, and weight
loss may be a desired effect of the medication.
Question 6: A LPN is caring for a client with a new diagnosis of heart failure. Which
dietary restriction is most important for the LPN to reinforce?
A. Restrict fluids to 1,000 mL per day.
B. Avoid foods high in potassium.
C. Restrict sodium intake.
D. Increase intake of complex carbohydrates.
CORRECT ANSWER: C. Restrict sodium intake.
Rationale: Sodium restriction is a cornerstone of dietary management for heart failure.
Sodium causes fluid retention, which increases preload and worsens heart failure
symptoms. Fluid restriction may be indicated, but it is secondary to sodium restriction
and is based on individual client status. Potassium restriction is not typically indicated;
many diuretics cause potassium loss.
Question 7: A client is receiving heparin subcutaneously for a deep vein
thrombosis. Which assessment finding requires immediate intervention by the
LPN?
A. Pain at the injection site
B. A small hematoma at the injection site
C. Dark, tarry stools
D. A platelet count of 250,000/mm³
CORRECT ANSWER: C. Dark, tarry stools
Rationale: Dark, tarry stools (melena) are a sign of upper gastrointestinal bleeding, a
serious adverse effect of heparin therapy. This finding requires immediate intervention
and notification of the RN or provider. Pain and small hematomas at the injection site
are common and expected. A platelet count of 250,000 is within normal limits.
Question 8: A LPN is providing oral care to an unconscious client. What is the
priority action to prevent aspiration during this procedure?
A. Turn the client's head to the side.
B. Use a small amount of toothpaste.
C. Apply petroleum jelly to the lips.
D. Use a soft-bristled toothbrush.
CORRECT ANSWER: A. Turn the client's head to the side.
, Rationale: The priority action when providing oral care to an unconscious client is to
turn the head to the side to allow fluids to drain out of the mouth and prevent aspiration.
While using a soft-bristled toothbrush and applying lubricant are important, preventing
aspiration is the most critical safety concern.
Question 9: A client with a colostomy expresses concern about the odor from the
pouch. Which intervention should the LPN suggest?
A. Place an antacid tablet in the pouch.
B. Change the pouch immediately whenever odor is present.
C. Spray room deodorizer directly into the pouch.
D. Ensure the pouch is securely sealed and use deodorizing drops.
CORRECT ANSWER: D. Ensure the pouch is securely sealed and use deodorizing
drops.
Rationale: Odor from a colostomy is often caused by a poorly sealed pouch allowing
gas to escape or from the breakdown of effluent. The best interventions are to ensure a
secure seal and to use commercially available deodorizing drops or sprays specifically
designed for ostomy pouches. Antacids are not recommended for this purpose, and
changing the pouch too frequently can cause skin breakdown.
Question 10: A LPN is reinforcing teaching about falls prevention for a client with
peripheral neuropathy. Which statement by the client indicates understanding?
A. "I can walk in my stocking feet to improve my sense of balance."
B. "I should use a nightlight in the hallway and bathroom."
C. "I should wear shoes with smooth, leather soles."
D. "I will hold onto furniture while walking to prevent falls."
CORRECT ANSWER: B. "I should use a nightlight in the hallway and bathroom."
Rationale: Clients with peripheral neuropathy have decreased sensation in their feet,
increasing their risk for falls. Using a nightlight improves visibility and reduces the risk of
falls. Clients should wear non-skid footwear (not smooth soles), and should not walk in
stocking feet. Holding onto furniture is unsafe as it can tip or be unstable.
Question 11: When performing a sterile wound dressing change, the LPN drops a
sterile gauze pad onto the sterile field. The pad lands within 1 inch of the edge of
the field. What should the LPN do?
A. Use the gauze pad, as it is still within the sterile field.
B. Pick up the gauze pad and place it back in the center of the field.
