LPN – Licensed Practical Nurse (U.S.) |
Comprehensive Study Guide, Practice Exam,
Questions & Answers, LPN Certification &
NCLEX-PN Exam Prep Test Bank, Nursing
Fundamentals, Medical-Surgical Nursing,
Pharmacology, Maternal & Pediatric Care,
Mental Health Nursing, Infection Control,
Clinical Skills, Detailed Rationales, Complete
Review
Question 1: A licensed practical nurse is caring for a client who is
postoperative day one following an open cholecystectomy. The client reports
sudden onset of sharp, right shoulder pain. What is the nurse's priority action?
A. Administer the prescribed PRN opioid analgesic immediately.
B. Elevate the head of the bed and apply a heating pad to the shoulder.
C. Assess the surgical incision site for signs of infection or dehiscence.
D. Auscultate the client's lung sounds and assess for shortness of breath.
CORRECT ANSWER: D. Auscultate the client's lung sounds and assess for
shortness of breath.
Rationale: Sudden sharp shoulder pain in a postoperative abdominal surgery patient can
be a sign of a diaphragmatic irritation or, more critically, a pulmonary embolism. While
referred pain from carbon dioxide insufflation during laparoscopic surgery is common
and benign, the nurse must first rule out life-threatening complications. Assessing lung
sounds and respiratory status is the priority to differentiate between benign referred
pain and a serious condition like a pulmonary embolism or atelectasis.
Question 2: The LPN is reinforcing teaching for a client prescribed a
monoamine oxidase inhibitor (MAOI) for depression. Which dietary item
identified by the client indicates that the teaching has been effective?
A. "I can have a glass of red wine with dinner."
B. "I should avoid aged cheeses like cheddar and blue cheese."
C. "I can eat pepperoni pizza as long as I take my medication with it."
D. "It is safe to eat smoked fish because it is a lean protein."
CORRECT ANSWER: B. "I should avoid aged cheeses like cheddar and blue
cheese."
Rationale: MAOIs inhibit the breakdown of tyramine, which is found in high
concentrations in aged, fermented, or smoked foods. Consuming these foods can lead to
a hypertensive crisis. Aged cheeses are a classic example of a high-tyramine food that
must be strictly avoided.
,Question 3: A client with heart failure is prescribed furosemide (Lasix). The
LPN is reviewing the client’s morning lab results. Which finding is the most
critical to report to the registered nurse?
A. Serum sodium level of 136 mEq/L
B. Serum potassium level of 3.0 mEq/L
C. Serum calcium level of 9.0 mg/dL
D. Serum magnesium level of 2.0 mEq/L
CORRECT ANSWER: B. Serum potassium level of 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in the
urine. Hypokalemia (normal range 3.5-5.0 mEq/L) is a serious and common adverse
effect that can lead to cardiac dysrhythmias, especially in clients with heart failure who
are often also on digoxin. A level of 3.0 mEq/L requires immediate reporting for
potassium replacement.
Question 4: The LPN is providing post-mortem care for a client who has died.
Which action is essential for the nurse to perform to preserve evidence if the
death is considered suspicious or a result of a crime?
A. Bathe the body thoroughly before the family arrives.
B. Remove all tubes and lines from the body.
C. Place the client's personal belongings in a labeled bag.
D. Place paper bags over the client's hands.
CORRECT ANSWER: D. Place paper bags over the client's hands.
Rationale: In the case of a suspicious death, preserving potential forensic evidence is
crucial. Placing paper bags over the hands protects any trace evidence (e.g., skin cells,
fibers, gunshot residue) that might be under the fingernails or on the palms. Plastic bags
should not be used as they can cause condensation and degrade evidence.
Question 5: A client is receiving enteral nutrition via a nasogastric (NG) tube.
The LPN notes that the tube is disconnected from the feeding pump, and the
client is coughing and appears distressed. What is the nurse's immediate
priority?
A. Turn off the feeding pump and restart the feeding at a slower rate.
B. Place the client in a high-Fowler's position and assess respiratory status.
C. Reconnect the tube to the pump and check the residual volume.
D. Document the incident in the client's medical record.
CORRECT ANSWER: B. Place the client in a high-Fowler's position and assess
respiratory status.
Rationale: A disconnected NG tube in a coughing patient presents a high risk for
aspiration of gastric contents into the lungs. The priority is to position the client upright
(high-Fowler's) to minimize the risk of aspiration and to assess the airway and breathing.
,This is an immediate patient safety issue that precedes reconnecting the tube or
documentation.
Question 6: An LPN is reinforcing instructions to a client who is starting a new
prescription for warfarin (Coumadin). Which statement by the client indicates
a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I should avoid eating a lot of leafy green vegetables."
C. "I can take ibuprofen for my occasional headaches."
D. "I need to have my blood drawn regularly to check my INR."
CORRECT ANSWER: C. "I can take ibuprofen for my occasional headaches."
Rationale: Warfarin is an anticoagulant. Taking ibuprofen, a nonsteroidal anti-
inflammatory drug (NSAID), significantly increases the risk of gastrointestinal bleeding
and potentiates the anticoagulant effect. The client should use acetaminophen (Tylenol)
for pain or headache, as it has minimal effect on INR. The other statements are correct.
Question 7: The LPN is measuring a client's blood pressure using a manual
sphygmomanometer. The nurse inflates the cuff to 180 mmHg and slowly
releases the pressure. The first Korotkoff sound is heard at 142 mmHg, and the
sound disappears at 88 mmHg. How should the nurse document this reading?
A. 142/88
B. 180/88
C. 142/90
D. 180/142
CORRECT ANSWER: A. 142/88
Rationale: The systolic blood pressure is the pressure at which the first Korotkoff sound
is heard (Phase I), which is 142 mmHg. The diastolic pressure is the pressure at which
the sounds disappear (Phase V), which is 88 mmHg. The reading is correctly
documented as 142/88.
Question 8: A client with type 2 diabetes mellitus is admitted with
hyperglycemic hyperosmolar syndrome (HHS). Which assessment finding is
most characteristic of this condition?
A. Kussmaul respirations with a fruity breath odor.
B. Severe dehydration and a serum glucose level of 800 mg/dL.
C. Abdominal pain, nausea, and vomiting.
D. Blood pressure of 90/60 and a heart rate of 120 bpm.
CORRECT ANSWER: B. Severe dehydration and a serum glucose level of 800
mg/dL.
Rationale: HHS is characterized by profound hyperglycemia (often >600 mg/dL), severe
dehydration, and hyperosmolality without significant ketosis. While shock (hypotension
, and tachycardia) can occur, the hallmark is the extremely high glucose level and
dehydration. Kussmaul respirations and fruity breath are typical of diabetic ketoacidosis
(DKA).
Question 9: The LPN is caring for a client who is on fall precautions. Which
intervention is most appropriate to prevent falls?
A. Keep the client's bed in the lowest position with the brakes locked.
B. Place a mattress on the floor beside the bed.
C. Use a vest restraint to keep the client in the chair.
D. Instruct the client to call for help before getting up.
CORRECT ANSWER: A. Keep the client's bed in the lowest position with the
brakes locked.
Rationale: The primary environmental intervention to prevent falls is keeping the bed in
the lowest possible position to minimize injury risk if the client does get out of bed, and
ensuring the brakes are locked so the bed does not move. While instructing the client to
call for help is important, it is not a sufficient physical intervention for a high-risk client.
Question 10: A client is placed in isolation for Clostridioides difficile (C. diff).
Which infection control precaution is most important for the LPN to
implement?
A. Place the client in a negative-pressure room.
B. Wear an N95 respirator when entering the room.
C. Perform hand hygiene with soap and water after removing gloves.
D. Wear a gown and gloves only if splashing is anticipated.
CORRECT ANSWER: C. Perform hand hygiene with soap and water after
removing gloves.
Rationale: C. diff is transmitted via the fecal-oral route and produces spores that are
resistant to alcohol-based hand sanitizers. The most critical infection control measure is
to use soap and water for hand hygiene (friction and rinsing) to physically remove the
spores. Contact precautions (gown and gloves) are required for all entries, not just when
splashing is anticipated.
Question 11: The LPN is calculating an intake and output for a client over an 8-
hour shift. The client received 1000 mL of IV fluids, 400 mL of water, and 240
mL of ice chips. The client's output was 1500 mL of urine and 100 mL of
emesis. What is the client's net fluid balance for this shift?
A. +40 mL
B. +240 mL
C. -40 mL
D. -240 mL
CORRECT ANSWER: A. +40 mL
Comprehensive Study Guide, Practice Exam,
Questions & Answers, LPN Certification &
NCLEX-PN Exam Prep Test Bank, Nursing
Fundamentals, Medical-Surgical Nursing,
Pharmacology, Maternal & Pediatric Care,
Mental Health Nursing, Infection Control,
Clinical Skills, Detailed Rationales, Complete
Review
Question 1: A licensed practical nurse is caring for a client who is
postoperative day one following an open cholecystectomy. The client reports
sudden onset of sharp, right shoulder pain. What is the nurse's priority action?
A. Administer the prescribed PRN opioid analgesic immediately.
B. Elevate the head of the bed and apply a heating pad to the shoulder.
C. Assess the surgical incision site for signs of infection or dehiscence.
D. Auscultate the client's lung sounds and assess for shortness of breath.
CORRECT ANSWER: D. Auscultate the client's lung sounds and assess for
shortness of breath.
Rationale: Sudden sharp shoulder pain in a postoperative abdominal surgery patient can
be a sign of a diaphragmatic irritation or, more critically, a pulmonary embolism. While
referred pain from carbon dioxide insufflation during laparoscopic surgery is common
and benign, the nurse must first rule out life-threatening complications. Assessing lung
sounds and respiratory status is the priority to differentiate between benign referred
pain and a serious condition like a pulmonary embolism or atelectasis.
Question 2: The LPN is reinforcing teaching for a client prescribed a
monoamine oxidase inhibitor (MAOI) for depression. Which dietary item
identified by the client indicates that the teaching has been effective?
A. "I can have a glass of red wine with dinner."
B. "I should avoid aged cheeses like cheddar and blue cheese."
C. "I can eat pepperoni pizza as long as I take my medication with it."
D. "It is safe to eat smoked fish because it is a lean protein."
CORRECT ANSWER: B. "I should avoid aged cheeses like cheddar and blue
cheese."
Rationale: MAOIs inhibit the breakdown of tyramine, which is found in high
concentrations in aged, fermented, or smoked foods. Consuming these foods can lead to
a hypertensive crisis. Aged cheeses are a classic example of a high-tyramine food that
must be strictly avoided.
,Question 3: A client with heart failure is prescribed furosemide (Lasix). The
LPN is reviewing the client’s morning lab results. Which finding is the most
critical to report to the registered nurse?
A. Serum sodium level of 136 mEq/L
B. Serum potassium level of 3.0 mEq/L
C. Serum calcium level of 9.0 mg/dL
D. Serum magnesium level of 2.0 mEq/L
CORRECT ANSWER: B. Serum potassium level of 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in the
urine. Hypokalemia (normal range 3.5-5.0 mEq/L) is a serious and common adverse
effect that can lead to cardiac dysrhythmias, especially in clients with heart failure who
are often also on digoxin. A level of 3.0 mEq/L requires immediate reporting for
potassium replacement.
Question 4: The LPN is providing post-mortem care for a client who has died.
Which action is essential for the nurse to perform to preserve evidence if the
death is considered suspicious or a result of a crime?
A. Bathe the body thoroughly before the family arrives.
B. Remove all tubes and lines from the body.
C. Place the client's personal belongings in a labeled bag.
D. Place paper bags over the client's hands.
CORRECT ANSWER: D. Place paper bags over the client's hands.
Rationale: In the case of a suspicious death, preserving potential forensic evidence is
crucial. Placing paper bags over the hands protects any trace evidence (e.g., skin cells,
fibers, gunshot residue) that might be under the fingernails or on the palms. Plastic bags
should not be used as they can cause condensation and degrade evidence.
Question 5: A client is receiving enteral nutrition via a nasogastric (NG) tube.
The LPN notes that the tube is disconnected from the feeding pump, and the
client is coughing and appears distressed. What is the nurse's immediate
priority?
A. Turn off the feeding pump and restart the feeding at a slower rate.
B. Place the client in a high-Fowler's position and assess respiratory status.
C. Reconnect the tube to the pump and check the residual volume.
D. Document the incident in the client's medical record.
CORRECT ANSWER: B. Place the client in a high-Fowler's position and assess
respiratory status.
Rationale: A disconnected NG tube in a coughing patient presents a high risk for
aspiration of gastric contents into the lungs. The priority is to position the client upright
(high-Fowler's) to minimize the risk of aspiration and to assess the airway and breathing.
,This is an immediate patient safety issue that precedes reconnecting the tube or
documentation.
Question 6: An LPN is reinforcing instructions to a client who is starting a new
prescription for warfarin (Coumadin). Which statement by the client indicates
a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I should avoid eating a lot of leafy green vegetables."
C. "I can take ibuprofen for my occasional headaches."
D. "I need to have my blood drawn regularly to check my INR."
CORRECT ANSWER: C. "I can take ibuprofen for my occasional headaches."
Rationale: Warfarin is an anticoagulant. Taking ibuprofen, a nonsteroidal anti-
inflammatory drug (NSAID), significantly increases the risk of gastrointestinal bleeding
and potentiates the anticoagulant effect. The client should use acetaminophen (Tylenol)
for pain or headache, as it has minimal effect on INR. The other statements are correct.
Question 7: The LPN is measuring a client's blood pressure using a manual
sphygmomanometer. The nurse inflates the cuff to 180 mmHg and slowly
releases the pressure. The first Korotkoff sound is heard at 142 mmHg, and the
sound disappears at 88 mmHg. How should the nurse document this reading?
A. 142/88
B. 180/88
C. 142/90
D. 180/142
CORRECT ANSWER: A. 142/88
Rationale: The systolic blood pressure is the pressure at which the first Korotkoff sound
is heard (Phase I), which is 142 mmHg. The diastolic pressure is the pressure at which
the sounds disappear (Phase V), which is 88 mmHg. The reading is correctly
documented as 142/88.
Question 8: A client with type 2 diabetes mellitus is admitted with
hyperglycemic hyperosmolar syndrome (HHS). Which assessment finding is
most characteristic of this condition?
A. Kussmaul respirations with a fruity breath odor.
B. Severe dehydration and a serum glucose level of 800 mg/dL.
C. Abdominal pain, nausea, and vomiting.
D. Blood pressure of 90/60 and a heart rate of 120 bpm.
CORRECT ANSWER: B. Severe dehydration and a serum glucose level of 800
mg/dL.
Rationale: HHS is characterized by profound hyperglycemia (often >600 mg/dL), severe
dehydration, and hyperosmolality without significant ketosis. While shock (hypotension
, and tachycardia) can occur, the hallmark is the extremely high glucose level and
dehydration. Kussmaul respirations and fruity breath are typical of diabetic ketoacidosis
(DKA).
Question 9: The LPN is caring for a client who is on fall precautions. Which
intervention is most appropriate to prevent falls?
A. Keep the client's bed in the lowest position with the brakes locked.
B. Place a mattress on the floor beside the bed.
C. Use a vest restraint to keep the client in the chair.
D. Instruct the client to call for help before getting up.
CORRECT ANSWER: A. Keep the client's bed in the lowest position with the
brakes locked.
Rationale: The primary environmental intervention to prevent falls is keeping the bed in
the lowest possible position to minimize injury risk if the client does get out of bed, and
ensuring the brakes are locked so the bed does not move. While instructing the client to
call for help is important, it is not a sufficient physical intervention for a high-risk client.
Question 10: A client is placed in isolation for Clostridioides difficile (C. diff).
Which infection control precaution is most important for the LPN to
implement?
A. Place the client in a negative-pressure room.
B. Wear an N95 respirator when entering the room.
C. Perform hand hygiene with soap and water after removing gloves.
D. Wear a gown and gloves only if splashing is anticipated.
CORRECT ANSWER: C. Perform hand hygiene with soap and water after
removing gloves.
Rationale: C. diff is transmitted via the fecal-oral route and produces spores that are
resistant to alcohol-based hand sanitizers. The most critical infection control measure is
to use soap and water for hand hygiene (friction and rinsing) to physically remove the
spores. Contact precautions (gown and gloves) are required for all entries, not just when
splashing is anticipated.
Question 11: The LPN is calculating an intake and output for a client over an 8-
hour shift. The client received 1000 mL of IV fluids, 400 mL of water, and 240
mL of ice chips. The client's output was 1500 mL of urine and 100 mL of
emesis. What is the client's net fluid balance for this shift?
A. +40 mL
B. +240 mL
C. -40 mL
D. -240 mL
CORRECT ANSWER: A. +40 mL
