NCLEX-PN

85 questions/tasks. Use the approved directions below.

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Question 1

Case 1: At 0900 an adult with diabetes becomes sweaty and shaky. The client received prescribed rapid-acting insulin at 0830 but ate no breakfast. Capillary glucose is 52 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The client is awake, answers questions and swallows safely. Blood pressure is 126/76 mmHg; pulse is 108/min. The licensed practical nurse (LPN) works with an RN. Select all findings that require immediate follow-up for the current change. Only the listed phrases are selectable.
  • ☐ A. Sweaty and shaky
  • ☐ B. Insulin received without breakfast
  • ☐ C. Capillary glucose 52 mg/dL
  • ☐ D. Blood pressure 126/76 mmHg
  • ☐ E. Awake and swallowing safely
  • ☐ F. Pulse 108/min
Show answer and explanation

Response: A,B,C,F

Final answer: Sweaty and shaky; Insulin received without breakfast; Capillary glucose 52 mg/dL; Pulse 108/min
Insulin was given without breakfast, and the subsequent sweating, shakiness, faster pulse and glucose of 52 mg/dL form a low-glucose warning pattern requiring prompt follow-up. The blood pressure is preserved. Being awake and able to swallow helps determine the rescue route rather than removing the need for rescue.

Question 2

Case 1: At 0900 an adult with diabetes becomes sweaty and shaky. The client received prescribed rapid-acting insulin at 0830 but ate no breakfast. Capillary glucose is 52 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The client is awake, answers questions and swallows safely. Blood pressure is 126/76 mmHg; pulse is 108/min. The licensed practical nurse (LPN) works with an RN. For each finding, select its most relevant interpretation. Choose one answer in each row. Insulin followed by no meal
  • ☐ A. Provides a medication-meal explanation for the low reading
  • ☐ B. Suggests the insulin failed because no carbohydrate was eaten
  • ☐ C. Suggests the sweating is a food-related reaction rather than a glucose effect
Awake with safe swallowing
  • ☐ D. Means the glucose should be confirmed after a full meal before rescue
  • ☐ E. Makes an oral rescue route available under protocol
  • ☐ F. Makes an injected rescue preferable despite the available oral route
Glucose 52 mg/dL with symptoms
  • ☐ G. Makes the pulse the main treatment target before the glucose
  • ☐ H. Supports observing symptoms until the next scheduled glucose check
  • ☐ I. Supports prompt rescue with a timed glucose reassessment
Show answer and explanation

Response: A,E,I

Final answer: Row 1: Provides a medication-meal explanation for the low reading; Row 2: Makes an oral rescue route available under protocol; Row 3: Supports prompt rescue with a timed glucose reassessment
The missed meal helps explain why the insulin was followed by low glucose, while safe swallowing makes oral rescue possible. A reading of 52 mg/dL with these symptoms needs prompt treatment and a timed reassessment, even when the client remains awake, because waiting for a full meal or scheduled check leaves the low value untreated.

Question 3

Case 1: At 0900 an adult with diabetes becomes sweaty and shaky. The client received prescribed rapid-acting insulin at 0830 but ate no breakfast. Capillary glucose is 52 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The client is awake, answers questions and swallows safely. Blood pressure is 126/76 mmHg; pulse is 108/min. The licensed practical nurse (LPN) works with an RN. Complete the reasoning statement by choosing one answer per row: The immediate problem is [Row 1], supported most directly by [Row 2]. Row 1: immediate problem
  • ☐ A. Anxiety-related autonomic symptoms
  • ☐ B. Hypoglycemia
  • ☐ C. Orthostatic intolerance
Row 2: decisive supporting evidence
  • ☐ D. Glucose 52 mg/dL with sweating and tremor
  • ☐ E. Sweating and pulse 108/min without the glucose result
  • ☐ F. The missed breakfast without the glucose result
Show answer and explanation

Response: B,D

Final answer: Row 1: Hypoglycemia; Row 2: Glucose 52 mg/dL with sweating and tremor
The glucose result identifies the problem more specifically than sweating, a fast pulse or a missed meal alone, each of which needs context to interpret. Glucose is 52 mg/dL. That value with tremor and sweating supports hypoglycemia, while safe swallowing determines how treatment can be given.

Question 4

Case 1: At 0900 an adult with diabetes becomes sweaty and shaky. The client received prescribed rapid-acting insulin at 0830 but ate no breakfast. Capillary glucose is 52 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The client is awake, answers questions and swallows safely. Blood pressure is 126/76 mmHg; pulse is 108/min. The licensed practical nurse (LPN) works with an RN. The facility protocol authorizes the LPN to give 15 g of fast-acting carbohydrate to an awake client who can swallow, recheck glucose after 15 minutes, and repeat if it remains below 70 mg/dL. Which actions belong in the immediate care plan? Select all that apply.
  • ☐ A. Give the protocol amount of fast-acting carbohydrate
  • ☐ B. Arrange a glucose recheck in 15 minutes
  • ☐ C. Recheck only if sweating persists after the carbohydrate
  • ☐ D. Alert the RN while initiating the authorized protocol
  • ☐ E. Use a protein-rich snack in place of the rapid carbohydrate
  • ☐ F. Wait for venous confirmation before starting the authorized rescue
Show answer and explanation

Response: A,B,D

Final answer: Give the protocol amount of fast-acting carbohydrate; Arrange a glucose recheck in 15 minutes; Alert the RN while initiating the authorized protocol
The supplied protocol permits fast-acting carbohydrate now, a glucose check in 15 minutes and RN notification alongside rescue. Symptom relief cannot replace the recheck, since a client may feel better before glucose has recovered adequately, and waiting for venous confirmation would postpone the treatment already authorised by this protocol.

Question 5

Case 1: At 0900 an adult with diabetes becomes sweaty and shaky. The client received prescribed rapid-acting insulin at 0830 but ate no breakfast. Capillary glucose is 52 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The client is awake, answers questions and swallows safely. Blood pressure is 126/76 mmHg; pulse is 108/min. The licensed practical nurse (LPN) works with an RN. The authorized protocol calls for 15 g of fast-acting carbohydrate and a 15-minute glucose recheck. Which action should the LPN take first?
  • ☐ A. Provide a protein-and-fat snack first, then recheck after lunch
  • ☐ B. Give 15 g of fast-acting carbohydrate while the client is upright
  • ☐ C. Ask the RN to obtain a rescue injection before giving any oral treatment
  • ☐ D. Assist the client to the cafeteria for a full meal before rechecking
Show answer and explanation

Response: B

Final answer: Give 15 g of fast-acting carbohydrate while the client is upright
Give the oral rescue while the client is upright and able to swallow safely. An injected rescue is not needed before using that available route, and either a slower protein-and-fat snack or a walk to the cafeteria would postpone the rapid carbohydrate specified for the symptomatic low reading.

Question 6

Case 1 follow-up: At 0900 glucose was 52 mg/dL with sweating and tremor. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The LPN gave 15 g of fast-acting carbohydrate under protocol. At 0915 glucose is 84 mg/dL; sweating and tremor have stopped. The client remains awake and can swallow. The protocol calls for ongoing monitoring and a snack if the next meal is more than 1 hour away; lunch is at 1200. Which response best evaluates these findings?
  • ☐ A. Give the scheduled insulin correction solely because glucose rose
  • ☐ B. Repeat the rescue amount now because the previous value was below 70 mg/dL
  • ☐ C. Recognize improvement and omit the snack because symptoms resolved
  • ☐ D. Recognize improvement, provide the protocol snack and continue monitoring
Show answer and explanation

Response: D

Final answer: Recognize improvement, provide the protocol snack and continue monitoring
The reading has risen to 84 mg/dL and the sweating and tremor have stopped, which shows a response to rescue. Lunch is still hours away. The stated protocol therefore calls for a snack and continued monitoring, rather than another rescue amount based on the earlier value or omission of the snack based on symptom relief.

Question 7

Four tasks are available on a rehabilitation unit. Assistive personnel are trained to provide routine personal care and obtain routine measurements, but they must report changes to the nurse. Which task can the LPN assign while retaining the required nursing judgment?
  • ☐ A. Interpret a new pattern of reduced urine output
  • ☐ B. Decide whether a new episode of dizziness needs a care-plan change
  • ☐ C. Give the first explanation of a newly prescribed medicine
  • ☐ D. Provide routine bathing for a stable client and report any new skin finding
Show answer and explanation

Response: D

Final answer: Provide routine bathing for a stable client and report any new skin finding
Bathing a stable client is routine care within the role described here, provided the assistive person reports new findings. Interpreting a change or giving the first explanation of a medicine requires licensed nursing judgment and follow-up, so those tasks cannot be treated as equivalent assignments merely because each involves contact with the client.

Question 8

During perineal care, the LPN wears gloves that become visibly contaminated. The LPN will next provide oral care for the same client. What should happen before the clean task?
  • ☐ A. Wipe the glove surfaces with a dry towel
  • ☐ B. Remove the gloves, clean the hands and apply fresh gloves for oral care
  • ☐ C. Apply hand rub over the existing gloves
  • ☐ D. Keep the gloves because both tasks involve the same client
Show answer and explanation

Response: B

Final answer: Remove the gloves, clean the hands and apply fresh gloves for oral care
Remove the contaminated gloves, clean the hands and use fresh gloves for oral care. The client has not changed. The body site and task have changed, however, and using the same gloves could carry organisms from stool care into the mouth.

Question 9

A parent describes where a healthy 2-month-old infant sleeps. Which arrangements should the LPN reinforce? Select all that apply.
  • ☐ A. Place the infant on the back for each sleep
  • ☐ B. Use a firm, flat sleep surface in the infant's own sleep space
  • ☐ C. Keep pillows and loose blankets out of the sleep space
  • ☐ D. Use a side position supported by a rolled towel
  • ☐ E. Place the infant in an adult bed beside a sleeping parent
  • ☐ F. Keep the infant's sleep space in the parent's room
Show answer and explanation

Response: A,B,C,F

Final answer: Place the infant on the back for each sleep; Use a firm, flat sleep surface in the infant's own sleep space; Keep pillows and loose blankets out of the sleep space; Keep the infant's sleep space in the parent's room
Put the infant on the back on a firm, flat, separate sleep surface without loose objects. Room sharing permits proximity while preserving that safe setup, whereas an adult bed, side positioning and a rolled towel introduce hazards that cannot be made acceptable by placing an adult nearby.

Question 10

A client says, "My family would be better off without me." The LPN stays with the client in a private area. Which question best collects the immediate safety information?
  • ☐ A. "Would a visit from your family help you feel better?"
  • ☐ B. "Which family problem has been hardest this week?"
  • ☐ C. "How long have you felt discouraged about your recovery?"
  • ☐ D. "Are you thinking about killing yourself right now?"
Show answer and explanation

Response: D

Final answer: "Are you thinking about killing yourself right now?"
Ask directly about thoughts of suicide and possible action, then use the response to guide protection and team assessment. The statement needs clarification. Discussing family stress or offering reassurance without that question would leave the immediate safety concern unresolved.

Question 11

A client with COPD becomes tired halfway through a large dinner and has been eating less overall. The prescribed diet has no fluid restriction. Which suggestion best supports nutrition and energy conservation?
  • ☐ A. Take one large meal after all daily activity is finished
  • ☐ B. Eat several smaller meals and rest before eating
  • ☐ C. Skip the afternoon meal to preserve energy for dinner
  • ☐ D. Finish meals quickly before resting
Show answer and explanation

Response: B

Final answer: Eat several smaller meals and rest before eating
Several smaller meals and rest before eating reduce the effort demanded by one large meal. The problem is fatigue during dinner, so distributing intake through the day helps the client complete food while avoiding the added work of rushing or the lost intake from skipping the tiring meal.

Question 12

A client takes warfarin once daily at 0800. At 1400 the client realizes today's dose was missed. There is no bleeding and no special prescriber instruction about missed doses. Which instruction agrees with the medication guidance?
  • ☐ A. Skip today and add half a dose tomorrow
  • ☐ B. Skip today and resume at 0800 tomorrow despite remembering at 1400
  • ☐ C. Take two usual doses together tomorrow morning
  • ☐ D. Take the missed dose now, on the same day, without doubling
Show answer and explanation

Response: D

Final answer: Take the missed dose now, on the same day, without doubling
Because the client remembers the missed warfarin on the same day, the supplied instruction is to take that dose and resume the usual schedule. Do not double the dose. A catch-up amount on top of the regular dose would add bleeding risk rather than follow the missed-dose direction.

Question 13

An older adult taking digoxin has new nausea and loss of appetite. Which additional findings increase concern about digoxin toxicity? Select all that apply.
  • ☐ A. A recent decline in kidney function
  • ☐ B. A potassium result below the laboratory's reference interval
  • ☐ C. New visual disturbances
  • ☐ D. A stable body weight and usual appetite before this illness
  • ☐ E. A sodium value in the laboratory's reference interval
  • ☐ F. A documented heart rate unchanged from the client's established baseline
Show answer and explanation

Response: A,B,C

Final answer: A recent decline in kidney function; A potassium result below the laboratory's reference interval; New visual disturbances
Renal deterioration can reduce digoxin clearance, and low potassium increases susceptibility to its adverse effects. Nausea, poor appetite and visual disturbance therefore belong in the prompt report together with the renal and electrolyte changes, even when sodium is within range and the documented heart rate remains at baseline.

Question 14

At a community clinic, a client suddenly develops right-arm weakness and slurred speech. The client was speaking clearly 10 minutes ago. Capillary glucose is 102 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The clinic emergency policy directs staff to call EMS for suspected stroke, document the last-known-well time and monitor airway and responsiveness while help comes. Complete the printed bow-tie: select TWO actions in Row 1, ONE condition in Row 2 and TWO monitoring priorities in Row 3. For rows with two responses, record both letters. Row 1: actions, choose two
  • ☐ A. Call EMS immediately
  • ☐ B. Document the last-known-well time
  • ☐ C. Arrange urgent private-car transport instead of activating EMS
  • ☐ D. Give an oral drink while obtaining the neurologic history
Row 2: most concerning condition, choose one
  • ☐ E. Possible acute stroke
  • ☐ F. Hypoglycemia causing the focal changes
  • ☐ G. A transient positional nerve compression
Row 3: monitoring, choose two
  • ☐ H. Airway and breathing
  • ☐ I. Responsiveness and neurologic change
  • ☐ J. Completion of a detailed dietary-risk history
  • ☐ K. Serial grip strength alone, without airway or responsiveness checks
Show answer and explanation

Response: A,B,E,H,I

Final answer: Row 1: Call EMS immediately; Document the last-known-well time; Row 2: Possible acute stroke; Row 3: Airway and breathing; Responsiveness and neurologic change
Sudden one-sided weakness and slurred speech require the suspected-stroke response specified in the clinic policy: call EMS, record last-known-well time, and monitor breathing and neurologic responsiveness. Glucose is not low here. Private-car transport or an oral drink would replace or delay the emergency plan, while grip testing alone would miss airway and responsiveness changes.

Question 15

A capable adult client tells the LPN, "Do not give my brother any information about my treatment." The brother later telephones and asks for the medication list. What should the LPN do?
  • ☐ A. Give only medicines that do not reveal the diagnosis
  • ☐ B. Decline to disclose the treatment information and follow the client's stated preference
  • ☐ C. Leave the list for the brother to pick up at reception
  • ☐ D. Give the list after confirming the brother's identity
Show answer and explanation

Response: B

Final answer: Decline to disclose the treatment information and follow the client's stated preference
The capable client's refusal of disclosure controls this request, even if the caller is correctly identified as the brother. Verifying who is asking is different from obtaining permission to tell them, and a shortened medicine list would still disclose information the client expressly asked staff to withhold.

Question 16

A procedure is permitted within the LPN's legal scope and facility role, but this LPN has not been trained or assessed as competent to perform it. A colleague asks the LPN to complete it alone. Which response is appropriate?
  • ☐ A. Obtain verbal directions from a colleague while making the first attempt alone
  • ☐ B. Tell the responsible nurse about the training limitation and arrange qualified assistance
  • ☐ C. Proceed because legal permission establishes individual competence
  • ☐ D. Treat routine experience with other procedures as adequate preparation
Show answer and explanation

Response: B

Final answer: Tell the responsible nurse about the training limitation and arrange qualified assistance
The LPN must explain the training gap and arrange qualified assistance before independently undertaking this procedure, because permission in law does not supply the preparation or demonstrated ability needed for this particular task. Competence still has to be established. A colleague's availability or a general licence cannot replace that missing preparation.

Question 17

A hospitalized client has symptomatic C. difficile infection. For each action, select whether it is appropriate for preventing spread. The facility uses CDC-aligned contact precautions. Choose one answer in each row. Use gown and gloves as required by contact precautions
  • ☐ A. Appropriate
  • ☐ B. Not appropriate
Use dedicated equipment or properly disinfect shared equipment
  • ☐ C. Appropriate
  • ☐ D. Not appropriate
Order repeat stool testing solely to prove cure after symptoms resolve
  • ☐ E. Appropriate
  • ☐ F. Not appropriate
Omit hand hygiene after removing gloves
  • ☐ G. Appropriate
  • ☐ H. Not appropriate
Show answer and explanation

Response: A,C,F,H

Final answer: Row 1: Appropriate; Row 2: Appropriate; Row 3: Not appropriate; Row 4: Not appropriate
Contact precautions, dedicated or properly disinfected equipment, and hand hygiene after glove removal address transmission risk. Repeat testing solely to prove cure after symptoms resolve is not recommended, since a positive result may persist without establishing a need for further treatment, and gloves do not guarantee clean hands after they are removed.

Question 18

The parent of a 2-year-old says, "Last month she used two-word phrases. Now she no longer uses the words she had." Which response should the LPN make?
  • ☐ A. Explain that loss of previously used skills needs prompt discussion with the child's provider and appropriate screening or referral
  • ☐ B. Repeat the same checklist in six months before raising the concern
  • ☐ C. Use the milestone checklist alone to identify a specific diagnosis
  • ☐ D. Recheck at the next annual visit because development varies
Show answer and explanation

Response: A

Final answer: Explain that loss of previously used skills needs prompt discussion with the child's provider and appropriate screening or referral
A loss of words the child previously used should be discussed promptly with the provider for developmental follow-up. This is a reported loss. The checklist can organise that observation but cannot diagnose its cause, and waiting for the next age milestone would postpone attention to a change already present.

Question 19

A client says, "I want quiet time with my own spiritual adviser before the procedure." The procedure can safely wait 15 minutes, and the adviser is available by telephone. Which response best supports the client's expressed need?
  • ☐ A. Proceed now and arrange the requested adviser after recovery
  • ☐ B. Ask whether the client wants a private telephone call and coordinate the safe delay
  • ☐ C. Arrange a staff-selected adviser who can arrive immediately instead of contacting the requested adviser
  • ☐ D. Offer the unit's usual group spiritual service instead
Show answer and explanation

Response: B

Final answer: Ask whether the client wants a private telephone call and coordinate the safe delay
The client has requested a private adviser conversation, and the stem says the team can safely accommodate a 15-minute delay. Arrange that contact and coordinate the timing with the team rather than select an adviser for the client or proceed before the expressed spiritual need has been addressed.

Question 20

A client reports hearing a voice that says, "Hurt yourself tonight." The LPN remains nearby and calls for appropriate team support. Which response best gathers immediate safety information without affirming the voice as real?
  • ☐ A. "I do not hear that voice. Are you feeling that you might act on what it says?"
  • ☐ B. "Would music help you pay less attention to the voice tonight?"
  • ☐ C. "Tell me the voice's full story before we discuss what it asks."
  • ☐ D. "Which relaxation technique would you like to try before bedtime?"
Show answer and explanation

Response: A

Final answer: "I do not hear that voice. Are you feeling that you might act on what it says?"
Asking whether the client might act on the harmful command establishes information needed for immediate protection and further assessment. The nurse does not hear it. Acknowledge that difference without arguing, and leave relaxation or a longer account of the experience until the risk of acting on the command has been clarified.

Question 21

A bedbound client has frequent moisture from incontinence and cannot reposition independently. The care team is updating the skin-protection plan. Which proposal best responds to the actual risks?
  • ☐ A. Schedule repositioning only when the client asks to move
  • ☐ B. Address moisture care and arrange an individualized repositioning plan with reassessment
  • ☐ C. Update the total score and keep the previous care schedule
  • ☐ D. Address moisture only because it is the most visible current problem
Show answer and explanation

Response: B

Final answer: Address moisture care and arrange an individualized repositioning plan with reassessment
Moisture and limited movement create two care needs, so use an individualised moisture-care and repositioning plan and reassess its effect. A score documents risk but does not supply prevention by itself, and a plan addressing only one of the two findings leaves the other source of vulnerability unchanged.

Question 22

The verified prescription is for 250 mg of an oral medicine. The pharmacy supplies 125 mg per 5 mL. The LPN has confirmed the medicine and route. How many milliliters should be administered? Write the numeric answer in mL. Response:
Show answer and explanation

Response: 10

Final answer: 10 mL
The label supplies 125 mg in 5 mL, so the ordered 250 mg is twice that amount and requires 10 mL. Two labelled volumes are needed. Checking that the final unit is millilitres prevents a dose in milligrams from being entered as though it were a volume.

Question 23

The care plan calls for a mechanical lift when a client cannot bear weight. Today the client cannot stand even with assistance. The lift instructions require two trained staff members; one is currently available. What should the LPN arrange?
  • ☐ A. A second trained staff member before using the mechanical lift
  • ☐ B. A two-person manual lift instead of the prescribed device
  • ☐ C. A one-person manual lift because the task is brief
  • ☐ D. Use of the lift by the one available person
Show answer and explanation

Response: A

Final answer: A second trained staff member before using the mechanical lift
The care plan calls for a mechanical lift when this client cannot bear weight, and its operation requires a second trained person. Arrange that help and use the equipment as instructed rather than improvise a manual transfer, since having two people does not turn a different transfer method into the planned one.

Question 24

A urine culture requires a small fresh sample from a client with an indwelling catheter. Which collection method should the LPN use?
  • ☐ A. Disconnect the catheter from the drainage tubing
  • ☐ B. Use the sampling port without cleansing because the system is closed
  • ☐ C. Collect urine from the drainage bag after it has accumulated
  • ☐ D. Clean the needleless sampling port and obtain urine using the appropriate sterile collection equipment
Show answer and explanation

Response: D

Final answer: Clean the needleless sampling port and obtain urine using the appropriate sterile collection equipment
A small fresh culture specimen comes from the disinfected sampling port using the appropriate sterile equipment. Leave the tubing connected. Bag urine has accumulated, and opening the drainage connection unnecessarily would add an avoidable contamination opportunity while failing to follow the specimen method requested.

Question 25

A client with heart failure is comfortable sitting but now needs three pillows to sleep, compared with one last week. Weight has risen 2 kg in 3 days, and ankle swelling has increased. Which finding pattern should the LPN promptly report?
  • ☐ A. An isolated sleep-position preference requiring routine follow-up
  • ☐ B. Expected dependent edema without evidence of change
  • ☐ C. A new pattern of worsening fluid-related symptoms
  • ☐ D. A dietary issue requiring weight reassessment next month
Show answer and explanation

Response: C

Final answer: A new pattern of worsening fluid-related symptoms
New orthopnea, weight gain and increasing ankle swelling make a combined change from last week's status. Sitting up may ease the breathlessness without correcting its cause, so the improved position does not justify delaying a report of the worsening congestion pattern or describing it solely as a sleep preference.

Question 26

The transfer medication list shows a medicine twice daily, but the current signed order specifies once daily. The LPN is processing the orders and has not administered it. What should happen next?
  • ☐ A. Hold all medicines on the list until the next routine visit
  • ☐ B. Clarify and reconcile the discrepancy with the authorized prescriber through the facility process
  • ☐ C. Follow the transfer frequency and document the difference
  • ☐ D. Use the signed frequency and leave the older list unreconciled
Show answer and explanation

Response: B

Final answer: Clarify and reconcile the discrepancy with the authorized prescriber through the facility process
The two medicine lists specify different frequencies, and clarification through the authorised order process is needed before selecting one. The conflict remains unresolved. Choosing whichever list arrived last would carry that uncertainty into treatment, while holding every medicine would extend the interruption beyond the specific discrepancy.

Question 27

After a medicine-measuring lesson, a client says, "Yes, I understand," but fills an oral syringe to the wrong mark during the return demonstration. Which observation best identifies the teaching need?
  • ☐ A. The return demonstration can be deferred because the verbal check was positive
  • ☐ B. The measuring error should be classified as a dexterity problem before the instruction is reassessed
  • ☐ C. The demonstrated measurement shows that the instruction needs to be checked and retaught
  • ☐ D. The verbal agreement shows that only written reinforcement is needed
Show answer and explanation

Response: C

Final answer: The demonstrated measurement shows that the instruction needs to be checked and retaught
The client has demonstrated an incorrect syringe measurement despite saying that the lesson was understood. This directly observed error establishes a need to check and reteach the skill before relying on it, but supplies no evidence that the error is solely a dexterity problem or that written reinforcement alone will correct the measurement.

Question 28

Facility policy requires verifying a client's full name and date of birth against the medication record before giving medicine. Two clients have similar surnames. Which action follows that policy?
  • ☐ A. Ask the client to state the full name and date of birth and compare them with the record
  • ☐ B. Ask the client to confirm that the medicine is usually taken
  • ☐ C. Compare the room number with the medication cart list
  • ☐ D. Ask whether the displayed surname sounds familiar
Show answer and explanation

Response: A

Final answer: Ask the client to state the full name and date of birth and compare them with the record
Ask for the full name and date of birth and compare them with the record. Two identifiers are required here. A room number, familiar face or similar surname cannot supply both checks in the policy, even when staff have met the client before.

Question 29

Before signing procedural consent, a client says, "I do not understand what could go wrong, and I need an interpreter." The LPN is asked to witness the signature. What should the LPN do?
  • ☐ A. Have a bilingual visitor summarize the form before the signature
  • ☐ B. Witness the signature and flag the questions for postoperative teaching
  • ☐ C. Give the client a translated form and proceed without addressing the risk questions
  • ☐ D. Pause the signature process and arrange qualified communication and an explanation by the responsible clinician
Show answer and explanation

Response: D

Final answer: Pause the signature process and arrange qualified communication and an explanation by the responsible clinician
Pause witnessing until qualified communication and the responsible clinician's explanation address the risk questions. Consent is not established by completing a signature while those questions remain unanswered, and a translated form or a visitor's summary does not itself meet this client's explicitly reported need for further explanation.

Question 30

Case 2: After surgery, an adult was alert at 1000 with a respiratory rate of 16/min and received prescribed hydromorphone at 1005. At 1020 the client is difficult to awaken, breathes 6 times/min with shallow breaths, and has a pulse of 82/min and blood pressure of 118/70 mmHg. Oxygen saturation is 96 percent while receiving supplemental oxygen. The airway is patent without snoring or stridor. The RN and emergency response team are available. Which listed phrases are immediate warning cues? Select all that apply; only these phrases are selectable.
  • ☐ A. Difficult to awaken
  • ☐ B. Shallow breathing at 6/min
  • ☐ C. Pulse 82/min
  • ☐ D. Oxygen saturation 96 percent on supplemental oxygen
  • ☐ E. Recent opioid administration before the deterioration
  • ☐ F. Blood pressure 118/70 mmHg
Show answer and explanation

Response: A,B,E

Final answer: Difficult to awaken; Shallow breathing at 6/min; Recent opioid administration before the deterioration
Difficult arousal, shallow breathing at 6/min and the recent opioid are the cues demanding immediate follow-up. Oxygen saturation remains supported. That number does not demonstrate adequate ventilation, and preserved pulse and blood pressure cannot cancel the danger indicated by respiratory depth, rate and responsiveness.

Question 31

Case 2: After surgery, an adult was alert at 1000 with a respiratory rate of 16/min and received prescribed hydromorphone at 1005. At 1020 the client is difficult to awaken, breathes 6 times/min with shallow breaths, and has a pulse of 82/min and blood pressure of 118/70 mmHg. Oxygen saturation is 96 percent while receiving supplemental oxygen. The airway is patent without snoring or stridor. The RN and emergency response team are available. Choose the most relevant interpretation for each finding. Breathing 6 times/min with shallow breaths
  • ☐ A. Fits sleep-related slowing that can be reassessed at the next round
  • ☐ B. Shows serious ventilatory depression
  • ☐ C. Suggests pain-limited breathing that should be treated with the next opioid dose
Saturation 96 percent while receiving oxygen
  • ☐ D. Makes a higher oxygen setting the complete response to the slow breaths
  • ☐ E. Suggests pulse oximetry should decide whether assisted ventilation is needed
  • ☐ F. Does not exclude inadequate ventilation
New difficult arousal after opioid administration
  • ☐ G. Adds concern about opioid-related depression
  • ☐ H. Supports giving the next analgesic dose before evaluating arousal
  • ☐ I. Suggests the earlier alert assessment is sufficient to classify recovery as stable
Show answer and explanation

Response: B,F,G

Final answer: Row 1: Shows serious ventilatory depression; Row 2: Does not exclude inadequate ventilation; Row 3: Adds concern about opioid-related depression
Slow, shallow breathing and poor arousal after hydromorphone support concern about opioid-related ventilatory depression. Supplemental oxygen can maintain a reassuring saturation while ventilation is inadequate, so the full respiratory and arousal findings govern follow-up rather than a higher oxygen setting, a previous alert assessment or the pulse-oximeter number alone.

Question 32

Case 2: After surgery, an adult was alert at 1000 with a respiratory rate of 16/min and received prescribed hydromorphone at 1005. At 1020 the client is difficult to awaken, breathes 6 times/min with shallow breaths, and has a pulse of 82/min and blood pressure of 118/70 mmHg. Oxygen saturation is 96 percent while receiving supplemental oxygen. The airway is patent without snoring or stridor. The RN and emergency response team are available. Complete the priority statement: The immediate concern is [Row 1], and the most urgent threat is [Row 2]. Choose one answer in each row. Row 1: immediate concern
  • ☐ A. Opioid-associated respiratory depression
  • ☐ B. Upper-airway obstruction as the primary explanation
  • ☐ C. Uncontrolled postoperative pain as the primary explanation
Row 2: urgent threat
  • ☐ D. Aspiration when the next meal is served
  • ☐ E. Inadequate ventilation now
  • ☐ F. Pain-related delay in starting mobilization
Show answer and explanation

Response: A,E

Final answer: Row 1: Opioid-associated respiratory depression; Row 2: Inadequate ventilation now
The client was alert before hydromorphone and then developed profound sedation with shallow breathing at 6/min, making opioid-associated respiratory depression the priority explanation. The airway is patent. The urgent threat is inadequate ventilation now, rather than a problem inferred from pain, a future meal or an obstructed airway that the assessment does not show.

Question 33

Case 2: After surgery, an adult was alert at 1000 with a respiratory rate of 16/min and received prescribed hydromorphone at 1005. At 1020 the client is difficult to awaken, breathes 6 times/min with shallow breaths, and has a pulse of 82/min and blood pressure of 118/70 mmHg. Oxygen saturation is 96 percent while receiving supplemental oxygen. The airway is patent without snoring or stridor. The RN and emergency response team are available. The emergency protocol permits the LPN to activate the response team, support a patent airway, provide assisted ventilation when trained to do so, and withhold further sedating doses while the team assesses the client. Which actions should be included? Select all that apply.
  • ☐ A. Activate the emergency response and alert the RN
  • ☐ B. Support the airway and provide assisted ventilation under the protocol
  • ☐ C. Withhold further sedating doses pending assessment
  • ☐ D. Use supplemental oxygen alone and remeasure saturation before considering assisted ventilation
  • ☐ E. Use repeated stimulation as the sole response until the next respiratory check
  • ☐ F. Obtain the full medication history before activating the response team
Show answer and explanation

Response: A,B,C

Final answer: Activate the emergency response and alert the RN; Support the airway and provide assisted ventilation under the protocol; Withhold further sedating doses pending assessment
Activate help, support the airway and ventilation within the supplied permissions, and withhold another sedating dose while assessment proceeds. Waiting for a saturation drop would postpone the respiratory support needed for the current slow, shallow breaths, and collecting a medication history or stimulating the client does not itself restore adequate ventilation.

Question 34

Case 2: After surgery, an adult was alert at 1000 with a respiratory rate of 16/min and received prescribed hydromorphone at 1005. At 1020 the client is difficult to awaken, breathes 6 times/min with shallow breaths, and has a pulse of 82/min and blood pressure of 118/70 mmHg. Oxygen saturation is 96 percent while receiving supplemental oxygen. The airway is patent without snoring or stridor. The RN and emergency response team are available. Another staff member activates the emergency response team. The LPN is trained and authorized to provide bag-mask ventilation. The airway is opened, but breathing remains shallow at 6/min. Which bedside action takes priority while the team arrives?
  • ☐ A. Increase oxygen delivery while waiting to see if arousal improves
  • ☐ B. Provide assisted ventilation under the emergency protocol
  • ☐ C. Wait for the reversal agent because it targets the suspected cause
  • ☐ D. Complete the medication history before starting ventilatory support
Show answer and explanation

Response: B

Final answer: Provide assisted ventilation under the emergency protocol
Assisted ventilation supplies the immediate respiratory support this trained LPN is authorised to provide while the emergency team prepares further treatment. Oxygen alone is insufficient. With an open airway but shallow breathing at 6/min, drug-history collection or reversal preparation must proceed alongside support rather than replace movement of air.

Question 35

Case 2 follow-up: After the emergency team supported ventilation and gave an authorized opioid reversal agent, the client is awake and breathes 14 times/min at 1040. At 1100 the client again becomes difficult to awaken and breathes 8 times/min with shallow breaths. Which evaluation is appropriate?
  • ☐ A. Document the earlier improvement and repeat routine checks at the scheduled interval
  • ☐ B. Increase oxygen alone because it improved the earlier saturation
  • ☐ C. The current pattern suggests recurrent depression and requires immediate reassessment and renewed support
  • ☐ D. Request pain reassessment before reporting the respiratory trend
Show answer and explanation

Response: C

Final answer: The current pattern suggests recurrent depression and requires immediate reassessment and renewed support
The 1100 findings show renewed respiratory deterioration after an earlier response to reversal. An opioid can outlast its reversal agent, so the earlier response cannot establish stable recovery or justify routine observation of a later deteriorating respiratory pattern.

Question 36

A client with a history of panic attacks develops new chest pain and shortness of breath during a clinic visit. These symptoms have not yet been medically evaluated. What should the LPN do?
  • ☐ A. Guide the client through the usual panic exercise before reporting the new symptoms
  • ☐ B. Review the panic treatment history at the next routine appointment
  • ☐ C. Focus first on identifying a psychological trigger
  • ☐ D. Arrange prompt clinical assessment while remaining supportive
Show answer and explanation

Response: D

Final answer: Arrange prompt clinical assessment while remaining supportive
New chest pain and breathlessness need prompt medical assessment even in a client with a history of panic attacks. The cause is not established. Support the frightened client during that assessment rather than let a familiar diagnosis or a breathing exercise postpone consideration of a separate physical problem.

Question 37

A client taking warfarin reports new unusual bruising. Which findings identify a new medication exposure or the anticoagulant dose and monitoring data needed for clinical review? Select all that apply.
  • ☐ A. Ibuprofen started yesterday for joint pain
  • ☐ B. An antibiotic newly prescribed by another clinician
  • ☐ C. The current warfarin dose and recent INR result
  • ☐ D. The client continues the previously documented usual amount of vitamin K foods
  • ☐ E. A recently added herbal supplement
  • ☐ F. The same weekly pill-organiser system has been used without a reported dosing error
Show answer and explanation

Response: A,B,C,E

Final answer: Ibuprofen started yesterday for joint pain; An antibiotic newly prescribed by another clinician; The current warfarin dose and recent INR result; A recently added herbal supplement
Ibuprofen can add to bleeding risk. The new antibiotic and herbal product can also affect warfarin response and belong in the report together with the current dose and recent INR. The unchanged vitamin K intake and pill-organiser routine introduce no reported new exposure or dosing error.

Question 38

A postoperative client had a urinary catheter removed at 0800. At 1000 the client has not voided and a trained staff member records a bladder-scan volume of 250 mL. At 1200 the scan is 420 mL. At 1400 the client passes 25 mL, reports increasing lower abdominal pressure, and the scan remains 590 mL after voiding. The LPN is authorised to report findings and obtain the RN/provider plan, not to independently prescribe treatment. Which conclusion should guide the next report?
  • ☐ A. The small void establishes that bladder emptying has resumed adequately
  • ☐ B. The rising scan values primarily indicate insufficient urine production
  • ☐ C. The discomfort should be treated as expected postoperative soreness before the bladder findings are reported
  • ☐ D. The small void with a large residual and increasing pressure suggests urinary retention needing prompt evaluation
Show answer and explanation

Response: D

Final answer: The small void with a large residual and increasing pressure suggests urinary retention needing prompt evaluation
The bladder volume increased over time, and 590 mL remains after a void of only 25 mL with increasing pressure. The bladder has not emptied. Report that pattern promptly for urinary-retention evaluation, since the scan documents accumulating urine rather than supporting insufficient production or adequate emptying after the small void.

Question 39

A stable client says, "I sleep best between 2300 and 0500." No medicines or monitoring are required during that interval. The team can complete routine hygiene and room tidying either before 2300 or at 0100. Which schedule best supports the agreed rest plan?
  • ☐ A. Complete both tasks at 0100 to combine staff visits
  • ☐ B. Ask the client to rest after 0100 instead of following the agreed interval
  • ☐ C. Complete routine hygiene and tidying before 2300
  • ☐ D. Complete hygiene at 0100 and tidying before 2300
Show answer and explanation

Response: C

Final answer: Complete routine hygiene and tidying before 2300
Complete routine hygiene and tidying before the agreed sleep interval so the client can rest without those interruptions. The stem excludes any required medicine or monitoring during that period, allowing the routine tasks to be moved safely without omitting necessary treatment or assuming that all night-time care can always be deferred.

Question 40

A client 4 days after giving birth reports a severe headache and blurred vision. The LPN is answering a follow-up call. Which response is appropriate?
  • ☐ A. Arrange a routine postpartum visit if the headache persists
  • ☐ B. Recommend rest first and seek assessment only if a fever develops
  • ☐ C. Direct the client to obtain urgent medical care and communicate the warning symptoms
  • ☐ D. Provide routine headache advice and call again tomorrow
Show answer and explanation

Response: C

Final answer: Direct the client to obtain urgent medical care and communicate the warning symptoms
Severe headache and blurred vision four days after birth are urgent maternal warning findings that require medical care. The timing belongs in the report. Routine headache advice with a later callback would delay evaluation of a symptom pattern that already warrants prompt attention.

Question 41

A stable client is being transferred to another unit. A potassium specimen was sent 20 minutes ago, the result is pending, and the current order requires the receiving nurse to notify the prescriber if it is outside the stated limits. Which information is most important to include in the handoff?
  • ☐ A. The pending specimen, collection time and required follow-up responsibility
  • ☐ B. The remote history, with the receiving team expected to discover pending work
  • ☐ C. The last completed medication task, without the pending result
  • ☐ D. The specimen name, without indicating whether a result or follow-up is outstanding
Show answer and explanation

Response: A

Final answer: The pending specimen, collection time and required follow-up responsibility
The receiving nurse needs to know that the potassium result is still pending, when the specimen was collected and which follow-up the order requires. Transfer moves that unfinished responsibility to the receiving team, so a list of completed tasks or remote history cannot substitute for communicating the outstanding test and its action plan.

Question 42

A client with hearing loss says, "I understand best when you face me and speak clearly. My hearing aid is working." The LPN is reinforcing discharge instructions. Which approach best follows that preference?
  • ☐ A. Give the explanation to the companion and provide a summary to the client
  • ☐ B. Face the client, reduce background noise and check understanding through the client's response
  • ☐ C. Speak more loudly while facing the computer to keep notes accurate
  • ☐ D. Provide printed instructions alone without checking the stated communication preference
Show answer and explanation

Response: B

Final answer: Face the client, reduce background noise and check understanding through the client's response
Face the client, reduce competing noise and check understanding while using clear speech and the working hearing aid. The client specified this preference. A companion or handout may help if wanted, but neither automatically replaces the direct, accessible teaching the person has requested.

Question 43

An adult suddenly has a generalized seizure in a waiting area. The LPN calls for assistance. Which additional actions are appropriate? Select all that apply.
  • ☐ A. Clear nearby objects that could cause injury
  • ☐ B. Time the seizure
  • ☐ C. Place a hard object between the teeth
  • ☐ D. Gently position the person on the side when feasible and protect the head
  • ☐ E. Hold the arms and legs down firmly
  • ☐ F. Give water before the person is fully alert
Show answer and explanation

Response: A,B,D

Final answer: Clear nearby objects that could cause injury; Time the seizure; Gently position the person on the side when feasible and protect the head
Clear hazards, time the seizure, protect the head and gently support side positioning when possible. Restraining the movements or putting an object in the mouth can cause injury, and water must wait until the person is fully alert enough to swallow safely rather than being used during the seizure.

Question 44

The LPN catches a wrong-client medication selection before the medicine reaches either client. Facility policy requires reporting intercepted medication errors through the near-miss process. Which action follows that policy?
  • ☐ A. Report the intercepted event so the team can examine how it occurred
  • ☐ B. File an administration-error report stating that the client received the wrong medicine
  • ☐ C. Tell the next shift verbally without using the required near-miss process
  • ☐ D. Record the selection only in a personal reminder because it was intercepted
Show answer and explanation

Response: A

Final answer: Report the intercepted event so the team can examine how it occurred
Follow the required near-miss reporting route so the intercepted selection error can be reviewed accurately. No dose reached the client. Describe the interception, rather than document an administration that did not occur or leave the event in a private reminder that the designated review process would never receive.

Question 45

A client taking digoxin has new nausea, loss of appetite and visual disturbance after kidney function worsened. A drug level obtained earlier this week was within the laboratory's usual range. The next dose is due. What should the LPN do?
  • ☐ A. Escalate the current symptoms and renal change for prompt review before the due dose
  • ☐ B. Give the due dose and ask about symptoms at the next routine review
  • ☐ C. Request a repeat concentration but give the dose while waiting because the earlier result was in range
  • ☐ D. Consider only the concentration result when deciding whether to report the symptoms
Show answer and explanation

Response: A

Final answer: Escalate the current symptoms and renal change for prompt review before the due dose
The new symptoms and renal deterioration warrant prompt digoxin review before the due dose, even if an earlier concentration appeared reassuring. Reduced clearance and the current nausea, poor appetite and visual changes matter together, so an old value or a request for another level cannot justify disregarding the change while waiting.

Question 46

A client previously walked independently but is now bedbound after a change in condition and has reduced sensation in both feet. The earlier risk score was reassuring. For each proposed skin-risk response, select whether it is appropriate now. Reassess current risks and update the individualized plan
  • ☐ A. Appropriate
  • ☐ B. Not appropriate
Inspect heels and skin under devices
  • ☐ C. Appropriate
  • ☐ D. Not appropriate
Retain the old plan solely because the earlier score was reassuring
  • ☐ E. Appropriate
  • ☐ F. Not appropriate
Rely only on pain reports to identify pressure areas
  • ☐ G. Appropriate
  • ☐ H. Not appropriate
Show answer and explanation

Response: A,C,F,H

Final answer: Row 1: Appropriate; Row 2: Appropriate; Row 3: Not appropriate; Row 4: Not appropriate
New immobility and reduced sensation change the client's present risk, requiring reassessment and inspection of heels and tissue beneath devices. Pain may not warn this client. The earlier score therefore cannot replace a current check or establish that the previous prevention plan is still sufficient.

Question 47

Assistive personnel tell the LPN that a client's usual intake has fallen and provide the measured amounts. Which activity must the LPN retain rather than assign as routine measurement?
  • ☐ A. Bring the agreed meal tray
  • ☐ B. Interpret the change and contribute to the care-plan update with the RN
  • ☐ C. Record a measured drink volume
  • ☐ D. Report that a drink was left untouched
Show answer and explanation

Response: B

Final answer: Interpret the change and contribute to the care-plan update with the RN
Routine collection and reporting of intake can be assigned under the role described, whereas interpreting a change and contributing to the care plan require licensed nursing judgment. The measurements should inform the LPN's focused follow-up with the RN, rather than transferring interpretation to the person who collected them.

Question 48

A client has missed two clinic visits and says, "The bus route changed, and I cannot afford a taxi." What response best begins to address this treatment barrier?
  • ☐ A. Ask about available transport and involve the appropriate support service in finding an accessible option
  • ☐ B. Arrange another appointment without addressing travel access
  • ☐ C. Review the importance of attendance before asking about transport
  • ☐ D. Repeat the appointment instructions in a larger print size
Show answer and explanation

Response: A

Final answer: Ask about available transport and involve the appropriate support service in finding an accessible option
The changed bus route and unaffordable taxi identify transport as the specific barrier to attendance. Explore accessible travel support with the client and team rather than simply repeat attendance advice, change the appointment date or enlarge the printed directions, none of which resolves the reported difficulty reaching care.

Question 49

A client receiving active cancer treatment asks what a palliative care team could help with now. Which needs can be addressed? Select all that apply.
  • ☐ A. Pain and nausea during treatment
  • ☐ B. Anxiety and coping with the illness
  • ☐ C. Caregiver strain and practical support needs
  • ☐ D. Independent adjustment of the cancer regimen by the LPN
  • ☐ E. Discussion of the client's goals and spiritual concerns
  • ☐ F. Automatic enrolment in hospice solely because the consultation is requested
Show answer and explanation

Response: A,B,C,E

Final answer: Pain and nausea during treatment; Anxiety and coping with the illness; Caregiver strain and practical support needs; Discussion of the client's goals and spiritual concerns
The team can address symptoms, emotional coping, caregiver and practical needs, and the client's goals and beliefs while cancer treatment continues. Hospice is a different decision. A consultation alone neither enrols the client in hospice nor authorises the LPN to change the cancer regimen independently.

Question 50

The LPN assists the RN with telephone triage for four children who have diarrhea. Which caregiver report calls for the most immediate clinical assessment?
  • ☐ A. A 4-year-old has markedly reduced urine, a dry mouth and unusual lethargy
  • ☐ B. A 3-year-old has four loose stools since yesterday, is alert and has usual urine output
  • ☐ C. A 6-year-old is alert, tolerating the prescribed oral rehydration plan and has usual urine output
  • ☐ D. A 5-year-old remains active with a moist mouth and had one loose stool today
Show answer and explanation

Response: A

Final answer: A 4-year-old has markedly reduced urine, a dry mouth and unusual lethargy
The 4-year-old's markedly reduced urine, dry mouth and unusual lethargy identify a concerning dehydration pattern that takes priority over the other calls. Stool count alone is insufficient. Preserved activity, alertness or urine in the other reports does not provide the same current cluster of warning findings.

Question 51

A verified order directs an infusion of 240 mL over 3 hours. The LPN is trained and authorized to set this infusion pump and has completed the required checks. What rate in mL/hour should be entered? Write the numeric answer. Response:
Show answer and explanation

Response: 80

Final answer: 80 mL/hour
Divide the prescribed 240 mL by the three-hour duration to obtain a rate of 80 mL/hour. At that rate, three hours delivers the ordered volume, whereas entering 240 mL/hour would finish it in one hour and using the number of minutes without converting units would answer a different rate question.

Question 52

A capable client has a current verified directive declining CPR, and the documented care plan permits treatment of other symptoms. The client develops increased breathlessness but has a pulse and is breathing. The client asks for help. Which action is appropriate?
  • ☐ A. Ask the family to approve symptom care despite the capable client's request
  • ☐ B. Delay symptom care until the directive is rewritten as a new form
  • ☐ C. Provide symptom care within the current plan and notify the responsible clinician of the change
  • ☐ D. Withhold breathlessness treatment until the CPR directive is revoked
Show answer and explanation

Response: C

Final answer: Provide symptom care within the current plan and notify the responsible clinician of the change
The verified directive declines CPR, while the current care plan still allows symptom treatment that this capable client is requesting. Breathlessness still needs care. Follow that plan and report the change instead of treating the directive as an instruction to withhold all help or seek a new family permission.

Question 53

A client's urinary catheter was inserted for postoperative retention. The prescriber's current protocol calls for removal when retention has resolved and no other accepted indication remains. Today the team documents resolved retention and no other indication. Which contribution should the LPN make?
  • ☐ A. Replace the current catheter before beginning bladder monitoring
  • ☐ B. Follow the authorized removal process and support ongoing bladder monitoring
  • ☐ C. Retain the catheter for one additional shift to simplify output records
  • ☐ D. Keep the catheter until every later episode of retention has been ruled out
Show answer and explanation

Response: B

Final answer: Follow the authorized removal process and support ongoing bladder monitoring
With retention resolved and no accepted indication remaining, follow the authorised catheter-removal process and continue bladder monitoring. Easier documentation or toileting does not establish an indication to retain the catheter, and replacing it would continue the exposure that the removal decision is intended to end.

Question 54

Before a procedure, a client reports a latex allergy. The equipment package does not state whether its components contain latex. Facility policy requires verified latex-safe equipment for clients with this allergy. What should the LPN do?
  • ☐ A. Ask about allergy severity after opening and using the package
  • ☐ B. Rely on the absence of a latex warning as verification of safety
  • ☐ C. Verify safe equipment and alert the team before beginning
  • ☐ D. Use the package because a previous procedure was tolerated
Show answer and explanation

Response: C

Final answer: Verify safe equipment and alert the team before beginning
Verify that the equipment is latex-safe and communicate the allergy before the procedure. The package is not yet verified. A previous tolerated visit cannot establish the contents of today's equipment, so proceeding on that history would omit the check required before exposure.

Question 55

A client is learning a new home-care plan with wound care, medicines and warning signs. After the LPN explains all three topics at once, the client can describe wound care but confuses when to call for help. The LPN has time to continue the lesson. Which teaching approach is most useful?
  • ☐ A. Repeat all three topics together, then ask whether the entire plan is understood
  • ☐ B. Give the complete handout and ask the client to read its warning section aloud as the check
  • ☐ C. Explain one small part, ask the client to describe its use in their own words, and then move to the next part
  • ☐ D. Use wound-care recall as evidence that the warning instructions can be reviewed independently later
Show answer and explanation

Response: C

Final answer: Explain one small part, ask the client to describe its use in their own words, and then move to the next part
Explaining one small part and asking the client to apply it in their own words allows the nurse to check understanding before adding another topic. Recalling wound care does not establish recall of warning signs, and reading the handout aloud may reproduce wording without showing how the client would use the plan at home.

Question 56

A client with diabetes and reduced sensation in the feet asks about a daily care routine. Which statement should the LPN reinforce?
  • ☐ A. I will use a heating pad on low for cold feet and inspect afterward
  • ☐ B. I will soak my feet each evening to keep the skin soft
  • ☐ C. I will check my feet daily and wear shoes that protect them
  • ☐ D. I will use a medicated corn remover rather than trim the area myself
Show answer and explanation

Response: C

Final answer: I will check my feet daily and wear shoes that protect them
Daily inspection can reveal an injury that reduced sensation prevents the client from feeling, while protective shoes reduce everyday exposure. Heat can cause an unnoticed burn. Routine soaking and medicated corn removers can damage vulnerable skin, making them poor substitutes for the protective routine offered in the correct statement.

Question 57

A client taking prescribed furosemide reports new dry mouth, marked weakness and very little urine after several days of illness. Which response is appropriate?
  • ☐ A. Recommend routine hydration advice without reporting the new symptom cluster
  • ☐ B. Attribute the weakness to illness and check again at the next scheduled visit
  • ☐ C. Promptly report the symptoms and obtain clinical review of fluid status and treatment
  • ☐ D. Report only urine volume and omit the associated dry mouth and weakness
Show answer and explanation

Response: C

Final answer: Promptly report the symptoms and obtain clinical review of fluid status and treatment
Reduced urine, dry mouth and new weakness after illness call for prompt review of fluid status and furosemide treatment. Those findings need reporting as a cluster rather than being accepted individually as expected diuretic effects or left until the routine visit, because the illness has changed the context in which the medicine is being used.

Question 58

Case 3: A 20-month-old child has had watery diarrhea for 2 days. The parent reports one wet diaper during the last 24 hours. The child has a dry mouth, cries without tears and is less active than usual. Temperature is 37.4 degrees C. The child wakes to the parent's voice but is unusually drowsy. The LPN is collecting focused data while the RN arranges an immediate provider assessment. Which selectable findings support concern about dehydration? Select all that apply.
  • ☐ A. Only one wet diaper in 24 hours
  • ☐ B. Dry mouth
  • ☐ C. Crying without tears
  • ☐ D. Unusual drowsiness and reduced activity
  • ☐ E. Temperature 37.4 degrees C
  • ☐ F. The parent being present
Show answer and explanation

Response: A,B,C,D

Final answer: Only one wet diaper in 24 hours; Dry mouth; Crying without tears; Unusual drowsiness and reduced activity
One wet diaper in 24 hours, absent tears, dry mouth and unusual drowsiness are concerning during ongoing diarrheal losses. Temperature is near normal. That observation does not establish replacement of the lost fluid or cancel the urine and responsiveness findings requiring prompt assessment.

Question 59

Case 3: A 20-month-old child has had watery diarrhea for 2 days. The parent reports one wet diaper during the last 24 hours. The child has a dry mouth, cries without tears and is less active than usual. Temperature is 37.4 degrees C. The child wakes to the parent's voice but is unusually drowsy. The LPN is collecting focused data while the RN arranges an immediate provider assessment. Choose the most relevant interpretation for each finding. One wet diaper in 24 hours
  • ☐ A. Supports reduced urine output in the fluid-loss assessment
  • ☐ B. Suggests the diaper count can be set aside because stool output is high
  • ☐ C. Makes the duration of the illness a better hydration measure than urine output
Unusual drowsiness
  • ☐ D. Suggests rest alone should be assessed before the other findings
  • ☐ E. Adds concern about the child's condition and about safe intake
  • ☐ F. Supports starting an unobserved full bottle because the child wakes to a voice
Dry mouth and absent tears
  • ☐ G. Can be explained solely by not drinking just before the examination
  • ☐ H. Suggest fever is the necessary next finding before fluid loss is considered
  • ☐ I. Support the fluid-loss concern when combined with the low urine output
Show answer and explanation

Response: A,E,I

Final answer: Row 1: Supports reduced urine output in the fluid-loss assessment; Row 2: Adds concern about the child's condition and about safe intake; Row 3: Support the fluid-loss concern when combined with the low urine output
The low diaper count indicates reduced urine, unusual drowsiness adds concern about the child's condition and safe intake, and dry mouth with absent tears supports the fluid-loss assessment. Read the findings together rather than attributing the dryness solely to the moment before examination or requiring fever before considering dehydration.

Question 60

Case 3: A 20-month-old child has had watery diarrhea for 2 days. The parent reports one wet diaper during the last 24 hours. The child has a dry mouth, cries without tears and is less active than usual. Temperature is 37.4 degrees C. The child wakes to the parent's voice but is unusually drowsy. The LPN is collecting focused data while the RN arranges an immediate provider assessment. Complete the priority statement: The team should promptly evaluate [Row 1], supported by [Row 2]. Row 1: priority concern
  • ☐ A. Dehydration from ongoing gastrointestinal losses
  • ☐ B. Sleep disruption as the main explanation for the entire cluster
  • ☐ C. A food intolerance without a significant fluid-status change
Row 2: strongest supporting cluster
  • ☐ D. Diarrhea duration and near-normal temperature without the urine findings
  • ☐ E. One wet diaper, dry mouth, absent tears and unusual drowsiness
  • ☐ F. Waking to a voice and the absence of recorded vomiting without the urine findings
Show answer and explanation

Response: A,E

Final answer: Row 1: Dehydration from ongoing gastrointestinal losses; Row 2: One wet diaper, dry mouth, absent tears and unusual drowsiness
Dehydration is supported by the low urine output, dry mouth, absent tears and drowsiness during continuing diarrhea. This cluster is the strongest evidence. Duration alone, near-normal temperature or waking to a voice does not explain the full fluid-status change or make sleep disruption the primary concern.

Question 61

Case 3: A 20-month-old child has had watery diarrhea for 2 days. The parent reports one wet diaper during the last 24 hours. The child has a dry mouth, cries without tears and is less active than usual. Temperature is 37.4 degrees C. The child wakes to the parent's voice but is unusually drowsy. The LPN is collecting focused data while the RN arranges an immediate provider assessment. Which actions should the LPN include while the immediate assessment is arranged? Select all that apply.
  • ☐ A. Report the decreased urine and change in activity to the RN
  • ☐ B. Collect the timing and amounts of recent fluids and losses as available
  • ☐ C. Recheck responsiveness and swallowing safety before any oral intake
  • ☐ D. Offer a large bottle of juice before swallowing is reassessed
  • ☐ E. Wait for exact fluid totals before passing on the known warning findings
  • ☐ F. Reassure the parent that waking to a voice outweighs the other findings
Show answer and explanation

Response: A,B,C

Final answer: Report the decreased urine and change in activity to the RN; Collect the timing and amounts of recent fluids and losses as available; Recheck responsiveness and swallowing safety before any oral intake
Report the known warning findings while gathering available fluid and loss details, and check responsiveness and swallowing safety before oral intake. Exact totals can improve assessment but are not a prerequisite for passing on low urine and changed activity, while a large drink before that safety check would assume a route not yet established as appropriate.

Question 62

Case 3 updated record: The child has been assessed by the provider and is now alert, upright and swallowing safely. The provider orders oral rehydration solution in small frequent measured amounts, with reassessment of intake, losses and tolerance. There is no shock, and the RN confirms the LPN may implement this plan. Which action follows the order?
  • ☐ A. Measure intake but stop recording losses and urine after alertness improves
  • ☐ B. Offer a large unmeasured bottle to replace losses more quickly
  • ☐ C. Offer the prescribed oral rehydration solution in small measured amounts and monitor tolerance
  • ☐ D. Replace measured amounts with unrestricted clear water alone
Show answer and explanation

Response: C

Final answer: Offer the prescribed oral rehydration solution in small measured amounts and monitor tolerance
The updated assessment establishes safe swallowing and the provider orders small measured amounts of oral rehydration solution, which the authorised LPN can provide while tracking tolerance and losses. The order is now specific. An unmeasured bottle or substitution would alter it, and improved alertness does not make monitoring unnecessary.

Question 63

Case 3 follow-up: Before treatment the child had one wet diaper in 24 hours, a dry mouth and unusual drowsiness. After the prescribed rehydration plan, the child is alert and more active, the mouth is moist, and there have been two wet diapers during the last 4 hours. Diarrhea continues. Which evaluation is best?
  • ☐ A. Activity, moisture and urine output suggest improvement, but ongoing losses still require monitoring
  • ☐ B. The moist mouth alone establishes that all replacement can stop
  • ☐ C. Continued diarrhea outweighs the improved activity and urine findings
  • ☐ D. Two wet diapers establish that further fluid monitoring is unnecessary
Show answer and explanation

Response: A

Final answer: Activity, moisture and urine output suggest improvement, but ongoing losses still require monitoring
Improved alertness, a moist mouth and increased urine indicate a favourable response to replacement. Continuing diarrhea still creates losses, so recognise the improvement while maintaining the prescribed fluid monitoring and replacement plan instead of treating those better findings as proof that all hydration care can stop.

Question 64

A facility's glucose-meter procedure requires a new strip after an invalid sample message and prohibits adding blood to a used strip. The meter displays "invalid sample" after the first attempt. The client is stable and a repeat measurement is needed. Which action follows the procedure?
  • ☐ A. Use yesterday's valid value while documenting today's invalid message
  • ☐ B. Repeat with a new strip using the required collection procedure
  • ☐ C. Add blood to the first strip and use the first numeric result
  • ☐ D. Repeat with the used strip after wiping it clean
Show answer and explanation

Response: B

Final answer: Repeat with a new strip using the required collection procedure
The meter rejected the sample, so repeat collection correctly with a new strip under the supplied procedure. No current valid result exists. Adding blood to the used strip or substituting a past value would not correct the rejected measurement and would violate the method given in the question.

Question 65

A quality committee compares catheter-associated infections using the same definitions in two periods. Period 1 had 2 infections during 400 catheter-days; Period 2 had 4 infections during 1000 catheter-days. Rates are calculated per 1000 catheter-days. Which conclusion is accurate?
  • ☐ A. Period 1 had 5 per 1000 catheter-days, higher than Period 2's 4 per 1000
  • ☐ B. Period 1 had 0.5 per 1000 and Period 2 had 0.4 per 1000
  • ☐ C. Period 1 had 2 per 1000 and Period 2 had 4 per 1000 because those were the counts
  • ☐ D. Period 1 had 20 per 1000 and Period 2 had 40 per 1000
Show answer and explanation

Response: A

Final answer: Period 1 had 5 per 1000 catheter-days, higher than Period 2's 4 per 1000
Period 1 is 2 divided by 400 times 1000, or 5 infections per 1000 catheter-days, while Period 2 is 4 per 1000 and therefore lower. The common denominator matters. Comparing infection counts alone would reverse the result because the periods have different amounts of catheter exposure.

Question 66

An adult has received prescribed hydromorphone and reports taking a prescribed sedating medicine earlier. The LPN is collecting medication-safety data before another dose. Complete the statement: The combination raises concern about [Row 1], so the focused check should include [Row 2]. Row 1: medication concern
  • ☐ A. Additive central nervous system and respiratory depression
  • ☐ B. Reduced opioid absorption as the primary interaction risk
  • ☐ C. Opioid withdrawal caused by combining the medicines
Row 2: focused check
  • ☐ D. Only current pain severity and location
  • ☐ E. Current arousal, respiratory rate and depth, and timing of sedating doses
  • ☐ F. Only whether the prior opioid dose relieved pain
Show answer and explanation

Response: A,E

Final answer: Row 1: Additive central nervous system and respiratory depression; Row 2: Current arousal, respiratory rate and depth, and timing of sedating doses
Collect the rate and depth of breathing, responsiveness and dose timing for both the opioid and the additional sedating medicine. Their effects can combine, so pain intensity alone cannot establish safety of the regimen or replace the respiratory and sedation observations needed when these medicines are used together.

Question 67

A client with diabetes is unresponsive and has a capillary glucose of 38 mg/dL. The facility provides a reference interval of 70 to 125 mg/dL for these adult random capillary-glucose readings. The client is breathing but cannot swallow safely. The facility emergency plan authorizes immediate help, airway protection and the prescribed rescue treatment administered by qualified staff. Which response is appropriate?
  • ☐ A. Obtain a second glucose sample before activating help or giving rescue treatment
  • ☐ B. Activate the emergency response, protect the airway and obtain the authorized rescue treatment
  • ☐ C. Place glucose gel inside the cheek and use swallowing as the next response check
  • ☐ D. Apply oxygen and monitor for awakening before obtaining the rescue treatment
Show answer and explanation

Response: B

Final answer: Activate the emergency response, protect the airway and obtain the authorized rescue treatment
The client is unresponsive with glucose of 38 mg/dL and cannot swallow safely, requiring help, airway protection and the authorised rescue through qualified staff. Oral treatment is unsafe here. Glucose gel, oxygen alone or waiting for a second sample would leave some part of that immediate rescue incomplete.

Question 68

The LPN is asked to start a scheduled dressing change while another assigned client develops new severe breathlessness. Facility process directs staff to report competing urgent needs to the charge RN for coordinated reassignment. Which action best follows that process?
  • ☐ A. Leave the dressing task without a report while searching for another staff member
  • ☐ B. Complete the scheduled dressing, then report the new symptoms
  • ☐ C. Ask the RN to reassign the scheduled task without mentioning the urgent clinical change
  • ☐ D. Alert the charge RN to the urgent change and arrange safe coverage for the scheduled task
Show answer and explanation

Response: D

Final answer: Alert the charge RN to the urgent change and arrange safe coverage for the scheduled task
Tell the charge RN about the severe breathlessness and the competing dressing assignment so urgent care and coverage can be coordinated through the process supplied. Silently leaving would leave the dressing task without an explained handoff.

Question 69

A client with advanced cancer tells the LPN, "The team has asked about my goals. I am afraid that talking about future care means I am letting my family down." The client is able to make decisions and has not asked the LPN to choose treatment. Which response best supports the client now?
  • ☐ A. Your family will understand, so you can put that worry aside and complete the questions
  • ☐ B. You should ask your family to choose the goals so the responsibility is shared
  • ☐ C. What feels most difficult about that conversation, and what would you want the team to understand?
  • ☐ D. It may be easier to postpone the goals discussion until you feel certain about every decision
Show answer and explanation

Response: C

Final answer: What feels most difficult about that conversation, and what would you want the team to understand?
Asking what feels difficult and what the client wants understood invites the person to explain the fear and values affecting the care conversation. The client still makes decisions. Reassurance about how the family will react, transfer of choice to relatives or automatic postponement would move past that expressed concern rather than explore it.

Question 70

A client tells the LPN the name and pronouns the client uses and asks for privacy while changing. The record still displays an older name. Which action best supports the client's stated needs while maintaining accurate care?
  • ☐ A. Use the expressed name in private but retain the older name in every spoken handoff
  • ☐ B. Change the displayed name alone and use the new name as the sole treatment identifier
  • ☐ C. Explain the preference to visitors while reconciling the record so they can assist
  • ☐ D. Use the expressed name and pronouns, provide privacy and follow the process for reconciling identifiers
Show answer and explanation

Response: D

Final answer: Use the expressed name and pronouns, provide privacy and follow the process for reconciling identifiers
The nurse can respect the expressed name, pronouns and privacy while following the process that keeps treatment correctly identified. A name change alone does not replace the established identifier checks, and telling visitors about the preference would disclose information unnecessarily instead of attending to the client's stated needs.

Question 71

During a 2-year-old's visit, the LPN uses a developmental milestone checklist to organize observations. Which statements accurately describe its use? Select all that apply.
  • ☐ A. Using at least two words together is a listed observation at this age
  • ☐ B. Loss of a skill deserves discussion and timely follow-up
  • ☐ C. The checklist alone diagnoses a developmental disorder
  • ☐ D. The checklist is not a replacement for validated developmental screening
  • ☐ E. Using the checklist permits deferring screening until each observation has been checked off
  • ☐ F. Parent observations can help identify concerns
Show answer and explanation

Response: A,B,D,F

Final answer: Using at least two words together is a listed observation at this age; Loss of a skill deserves discussion and timely follow-up; The checklist is not a replacement for validated developmental screening; Parent observations can help identify concerns
The milestone checklist organises observations, including two-word combinations and any loss of skills that should be discussed with the provider. It is not a diagnosis. A concern may lead to screening or referral, but the checklist cannot replace validated screening or justify delaying screening until each observation is recorded.

Question 72

During a C. difficile outbreak, the LPN removes gloves after stool care and sees visible soil on the hands. Which hand-cleansing action is appropriate?
  • ☐ A. Wipe the visible soil away with a dry towel, then put on fresh gloves
  • ☐ B. Use soap and water to wash the hands
  • ☐ C. Use alcohol hand rub as the only cleansing method
  • ☐ D. Use an environmental disinfectant wipe to clean the hands
Show answer and explanation

Response: B

Final answer: Use soap and water to wash the hands
Visible soil calls for soap-and-water washing, with the outbreak context also supporting the facility's cleansing precautions. Dry wiping, alcohol rub alone or an environmental disinfectant wipe does not supply the handwashing needed here, even though alcohol hand rub is preferred in many clinical situations where hands are not visibly soiled.

Question 73

A client received a labeled 240 mL drink and left 60 mL in that container. The client also consumed 90 mL from a second labeled cup. No other intake occurred during the recorded interval. What oral intake should the LPN document?
  • ☐ A. 270 mL
  • ☐ B. 150 mL
  • ☐ C. 330 mL
  • ☐ D. 180 mL
Show answer and explanation

Response: A

Final answer: 270 mL
Subtract the 60 mL remaining from the first 240 mL container to obtain 180 mL consumed, then add the 90 mL from the second container. The total is 270 mL. Counting what was offered would overstate intake, since some of the first drink remained untouched.

Question 74

The current verified order specifies Medicine X by mouth. A package labeled Medicine X for injection is on the cart beside an oral package. Both contain the same drug name but have different concentrations. Which action is correct?
  • ☐ A. Use the previous package's concentration without checking the current label
  • ☐ B. Select and verify the oral preparation against the current order before measuring the dose
  • ☐ C. Use the injection concentration for the oral dose because the drug name matches
  • ☐ D. Choose the smaller-volume package and then calculate from that label
Show answer and explanation

Response: B

Final answer: Select and verify the oral preparation against the current order before measuring the dose
Verify that the selected medicine is the ordered oral preparation at the correct concentration before measuring it. The same drug name on an injection package does not establish route interchangeability, and choosing the smallest container or relying on a previous label would not verify today's ordered dose.

Question 75

After a treatment, a previously stable client reports dizziness when sitting up. Blood pressure has fallen from 126/74 to 88/54 mmHg. Facility policy directs staff to keep a dizzy client safely positioned and promptly report symptomatic hypotension. Which report best supports immediate follow-up?
  • ☐ A. Blood pressure was 126/74 earlier and is 88/54 now. I will continue routine observation
  • ☐ B. The client is dizzy after treatment. I have kept the client in bed and will obtain observations later
  • ☐ C. Blood pressure is 88/54 after a previous 126/74, with new dizziness. I have kept the client safely positioned
  • ☐ D. The client had dizziness on sitting up, so I will repeat the transfer to see whether it recurs
Show answer and explanation

Response: C

Final answer: Blood pressure is 88/54 after a previous 126/74, with new dizziness. I have kept the client safely positioned
The complete report gives the current 88/54 pressure, the prior 126/74, the new dizziness and the immediate safety measure. This is symptomatic deterioration. A report lacking observations or one proposing routine follow-up leaves out information or urgency that the receiving clinician needs to act on the change.

Question 76

A client in a community setting had sudden left-arm weakness and trouble speaking for 8 minutes. Both symptoms have now resolved. Which response should the LPN recommend?
  • ☐ A. Obtain urgent medical evaluation and communicate the symptoms and timing
  • ☐ B. Arrange routine follow-up because the symptoms have resolved
  • ☐ C. Schedule assessment if symptoms return
  • ☐ D. Begin a weekly home strength log before contacting the care team
Show answer and explanation

Response: A

Final answer: Obtain urgent medical evaluation and communicate the symptoms and timing
The episode may have been transient. Sudden focal symptoms still require urgent medical evaluation even after they resolve, because a transient ischemic episode can signal serious risk and its timing belongs in the report. The resolution does not make recurrence a prerequisite for assessment, so a routine appointment or weekly strength log would postpone attention to the event already described.

Question 77

An employee from another department asks the LPN to open a client's chart out of curiosity. The employee is not involved in the client's care, and facility policy restricts record access to authorized work needs. What should the LPN do?
  • ☐ A. Decline the request and follow the access policy
  • ☐ B. Describe the treatment verbally without opening the chart
  • ☐ C. Show a limited diagnosis summary rather than the entire chart
  • ☐ D. Open the chart after confirming the employee's workplace identity
Show answer and explanation

Response: A

Final answer: Decline the request and follow the access policy
The employee has no authorised work purpose for accessing this client's information, so decline the curiosity request under the supplied rule. Employment alone is insufficient. Giving a small summary would still disclose treatment information without the required purpose, just as opening the full chart would.

Question 78

An infusion pump fails its required function check. A checked replacement pump is available. Facility policy requires tagging failed equipment, removing it from use and notifying the designated service. Which action should the LPN take?
  • ☐ A. Follow the removal and notification process and use the checked replacement
  • ☐ B. Use the failed pump after documenting that a replacement is nearby
  • ☐ C. Use the replacement but leave the failed pump untagged on the cart
  • ☐ D. Repeat only the successful parts of the check and return the pump to use
Show answer and explanation

Response: A

Final answer: Follow the removal and notification process and use the checked replacement
Using a checked replacement meets the client's immediate equipment need, while tagging, removing and reporting the failed pump prevents its later reuse as though it were functioning normally. Both parts are required. Repeating only successful checks would leave the original failure unresolved and omit the designated equipment follow-up.

Question 79

A client receiving cancer treatment says, "My partner is exhausted from caring for me and working nights. We need help planning support." Which response most directly addresses the stated need?
  • ☐ A. Offer referral to the appropriate support team to discuss caregiver resources and the family's priorities
  • ☐ B. Suggest discussing caregiver needs only after cancer treatment ends
  • ☐ C. Choose a respite arrangement before asking about preferences or access
  • ☐ D. Provide standard encouragement and leave practical planning for later
Show answer and explanation

Response: A

Final answer: Offer referral to the appropriate support team to discuss caregiver resources and the family's priorities
Explore the caregiver exhaustion and practical planning the family has named, and arrange relevant support in discussion with them. The useful service must fit their priorities and access needs, so encouragement alone or selecting an arrangement without that discussion may leave the requested help unavailable or unsuitable.

Question 80

A laboratory calls with a potassium result flagged as critical. The facility's critical-result procedure requires verifying the client and result, reading the value back, and promptly notifying the responsible clinician. Which action follows the procedure?
  • ☐ A. Read back the value but defer notification until the next scheduled round
  • ☐ B. Verify and read back the result, then promptly notify the responsible clinician
  • ☐ C. Enter the result in routine notes and leave notification to the next shift
  • ☐ D. Notify someone that a result is abnormal without verifying client or value
Show answer and explanation

Response: B

Final answer: Verify and read back the result, then promptly notify the responsible clinician
Verify the client and result, read the value back and promptly notify the responsible clinician as the critical-result procedure directs. That route protects identification, accuracy and follow-up. Routine notes alone or an unverified message omit parts of the immediate communication process rather than complete it.

Question 81

A client with COPD usually speaks in full sentences while seated. Today the client is breathless at rest, can speak only a few words at a time and is newly confused. Which response is appropriate?
  • ☐ A. Offer the usual paced-activity advice and assess its effect before calling the team
  • ☐ B. Obtain urgent team assessment and respiratory support within the authorized plan
  • ☐ C. Use the usual resting recovery time as the reporting threshold despite the new confusion
  • ☐ D. Arrange routine respiratory follow-up because COPD commonly causes breathlessness
Show answer and explanation

Response: B

Final answer: Obtain urgent team assessment and respiratory support within the authorized plan
New confusion and difficulty speaking comfortably at rest differ substantially from this client's usual full-sentence speech. The baseline has changed. Obtain urgent team assessment and respiratory support within the authorised plan rather than let the usual recovery routine or a later appointment postpone response to the deterioration.

Question 82

A client receiving professional treatment for panic disorder asks whether sleep, exercise and support from trusted people can help. Which reinforcement is accurate?
  • ☐ A. Use the routines as a trial replacement for the professional plan, then report if symptoms return
  • ☐ B. Wait until professional treatment has ended before starting the supportive routines
  • ☐ C. Begin exercise but leave sleep and trusted support out because they are not clinical treatments
  • ☐ D. Healthy routines can support recovery alongside the agreed treatment plan
Show answer and explanation

Response: D

Final answer: Healthy routines can support recovery alongside the agreed treatment plan
Sleep, exercise and trusted support can complement the agreed professional treatment for panic disorder. They are adjuncts to that plan rather than a trial replacement, and there is no reason to wait until treatment has ended before discussing them or to exclude sleep and social support because they are not medicines.

Question 83

During a safety round, a client has oxygen tubing resting against the ears. The visible cheek skin is intact. Which skin check should the LPN include?
  • ☐ A. Check the ears only if the client reports pain
  • ☐ B. Inspect the skin under and around the tubing contact points
  • ☐ C. Document the device as functioning and postpone the skin check
  • ☐ D. Record the cheek check as a complete device-contact examination
Show answer and explanation

Response: B

Final answer: Inspect the skin under and around the tubing contact points
Inspect the ears and tissue beneath the tubing, since those contact sites can develop pressure-related damage even while the cheeks remain intact. Check the actual contact sites. A working device and a pain question cannot supply the skin observations needed to complete this safety round.

Question 84

A client needs an accurate explanation of a new treatment and says, "I prefer a qualified interpreter." A relative offers to interpret. Facility policy requires arranging the qualified service when the client requests it. Which action best follows the request and policy?
  • ☐ A. Use the relative's translation and arrange qualified support only afterward
  • ☐ B. Arrange the qualified interpreter and include the client in the conversation
  • ☐ C. Provide translated written material in place of the requested interpreter
  • ☐ D. Explain the plan to the relative first and ask for a client summary later
Show answer and explanation

Response: B

Final answer: Arrange the qualified interpreter and include the client in the conversation
Arrange the qualified interpreter and communicate directly with the client through that service, because the stated request and facility policy both call for it. A relative's summary or translated page cannot replace the qualified conversation this client has requested.

Question 85

A child recovering from diarrhea is alert and tolerating the provider's oral rehydration plan. The caregiver asks what to track at home under the written follow-up instructions. Which response is best?
  • ☐ A. Stop measuring intake because the solution is currently tolerated
  • ☐ B. Wait for diarrhea to end before reporting any later reduction in urine
  • ☐ C. Track fluid tolerance, ongoing losses and urine output, and seek care for the listed warning changes
  • ☐ D. Track stool frequency alone and stop fluids once the child is more alert
Show answer and explanation

Response: C

Final answer: Track fluid tolerance, ongoing losses and urine output, and seek care for the listed warning changes
Track fluid tolerance, continuing losses and urine output, and use the listed warning changes to decide when further care is needed. Diarrhea may continue during improvement. Better alertness or stool frequency alone cannot establish that the replacement plan is meeting fluid needs or that monitoring can safely end.