PROPHECY LPN LVN A EXAM SUMMER 2026/2027 |
Updated Complete Answered Solutions | Pass Guaranteed -
A+ Graded
Test Plan Alignment: NCSBN NCLEX-PN Summer 2026/2027 | LPN Scope of
Practice | Clinical Judgment Measurement Model
[Section 1: Fundamentals of Practical Nursing (Questions 1-15)]
Question 1
An LPN is caring for a client with a new ileostomy. The client asks the LPN to explain
how to change the ostomy appliance at home. Which action by the LPN is most
appropriate?
A. Provide comprehensive initial teaching about ostomy care and appliance changes
B. Reinforce teaching previously provided by the RN and demonstrate the procedure
C. Refer the client to the wound care nurse for all ostomy teaching
D. Document that the client refused teaching and notify the charge nurse
Correct Answer: B. Reinforce teaching previously provided by the RN and
demonstrate the procedure [CORRECT]
Rationale: LPNs can reinforce teaching and demonstrate skills but cannot provide
initial comprehensive teaching or discharge teaching independently. Option A exceeds
LPN scope—initial teaching requires RN or specialty certification. Option C is
unnecessary when the LPN can reinforce appropriately. Option D is incorrect—the
client did not refuse teaching. Retake strategy: ATI/Prophecy signature trap—LPNs
"reinforce" teaching; RNs provide "initial" and "discharge" teaching. Watch for scope-of-
practice language.
,Question 2
A UAP reports to the LPN that a client's blood pressure is 188/96 mmHg. The client's
baseline BP is 140/88 mmHg. Which action by the LPN is the priority?
A. Delegate the UAP to recheck the blood pressure in 30 minutes
B. Collect additional data and report the finding to the RN or provider
C. Instruct the UAP to administer the client's scheduled antihypertensive medication
D. Document the vital sign and continue with routine monitoring
Correct Answer: B. Collect additional data and report the finding to the RN or
provider [CORRECT]
Rationale: LPNs collect data and report abnormal findings to the RN or provider for
assessment and intervention decisions. Option A delays appropriate action. Option C is
outside UAP scope—UAPs cannot administer medications. Option D ignores a
significant change from baseline. Retake strategy: Prophecy tests that LPNs collect data,
not assess—report significant changes to the RN/provider; UAPs never administer
medications.
Question 3
A client is admitted with suspected tuberculosis. Which PPE should the LPN don before
entering the client's room?
A. Gloves and gown only
B. Surgical mask and gloves
C. N95 respirator, gloves, and gown
D. Face shield and surgical mask
Correct Answer: C. N95 respirator, gloves, and gown [CORRECT]
Rationale: TB requires airborne precautions—N95 respirator (fit-tested), gloves, and
gown. Negative pressure room is also required. Option A describes contact precautions.
Option B describes droplet precautions. Option D is insufficient for airborne
transmission. Retake strategy: Prophecy tests PPE by transmission type—airborne =
N95 + negative pressure; droplet = surgical mask; contact = gloves + gown. TB is
airborne.
,Question 4
A client with Clostridioides difficile (C. diff) infection needs assistance with toileting.
Which hand hygiene method should the LPN use after providing care?
A. Alcohol-based hand rub (ABHR) for 20 seconds
B. Soap and water for at least 20 seconds
C. Antiseptic hand wipe
D. ABHR followed by soap and water
Correct Answer: B. Soap and water for at least 20 seconds [CORRECT]
Rationale: C. diff spores are not killed by alcohol-based hand rub. Soap and water with
mechanical friction is required. Option A is appropriate for most pathogens but not C.
diff spores. Options C and D are incorrect—ABHR does not eliminate C. diff spores.
Retake strategy: Prophecy signature trap—C. diff ALWAYS requires soap and water,
never ABHR alone. This is tested repeatedly.
Question 5
The LPN is caring for four clients on a medical-surgical unit. Which task is most
appropriate to delegate to the UAP?
A. Perform sterile wound irrigation on a client with a surgical incision
B. Obtain vital signs on a client who is stable and recovering from appendectomy
C. Administer a scheduled dose of metformin to a client with type 2 diabetes
D. Assess a client's pain level using a 0-10 numeric rating scale
Correct Answer: B. Obtain vital signs on a client who is stable and recovering from
appendectomy [CORRECT]
Rationale: UAPs can obtain vital signs on stable clients. Option A requires sterile
technique and nursing judgment—LPN or RN task. Option C is medication
administration—outside UAP scope in all states. Option D involves assessment—UAPs
cannot assess; they can report observations. Retake strategy: Prophecy tests delegation
, by task complexity and client stability—vital signs on stable clients = UAP; anything
requiring judgment, sterile technique, or medication = LPN/RN.
Question 6
An LPN is reviewing a client's medication administration record (MAR). The provider
has ordered digoxin 0.25 mg PO daily. Before administering the medication, which
assessment should the LPN perform?
A. Check the client's potassium level and apical pulse for 1 full minute
B. Perform a comprehensive cardiac assessment including all heart sounds
C. Evaluate the client's liver function tests and renal panel
D. Assess the client's respiratory rate and oxygen saturation
Correct Answer: A. Check the client's potassium level and apical pulse for 1 full
minute [CORRECT]
Rationale: Digoxin is contraindicated if apical pulse is <60 bpm (bradycardia risk) and
toxicity risk increases with hypokalemia. Option B exceeds LPN scope—comprehensive
assessment is RN. Option C is important but not the priority before each dose. Option D
is relevant for respiratory medications, not digoxin. Retake strategy: Prophecy tests
digoxin administration protocol—apical pulse for 60 seconds + potassium check are
mandatory before each dose.
Question 7
A client requires insertion of a nasogastric (NG) tube for gastric decompression. Which
statement by the LPN indicates correct understanding of scope of practice?
A. "I can insert the NG tube and verify placement by auscultating for air insufflation."
B. "I can insert the NG tube under RN supervision, but X-ray verification is required."
C. "NG tube insertion is outside LPN scope. Only the RN can perform this procedure."
D. "I can insert the NG tube and verify placement by checking aspirate pH."
Updated Complete Answered Solutions | Pass Guaranteed -
A+ Graded
Test Plan Alignment: NCSBN NCLEX-PN Summer 2026/2027 | LPN Scope of
Practice | Clinical Judgment Measurement Model
[Section 1: Fundamentals of Practical Nursing (Questions 1-15)]
Question 1
An LPN is caring for a client with a new ileostomy. The client asks the LPN to explain
how to change the ostomy appliance at home. Which action by the LPN is most
appropriate?
A. Provide comprehensive initial teaching about ostomy care and appliance changes
B. Reinforce teaching previously provided by the RN and demonstrate the procedure
C. Refer the client to the wound care nurse for all ostomy teaching
D. Document that the client refused teaching and notify the charge nurse
Correct Answer: B. Reinforce teaching previously provided by the RN and
demonstrate the procedure [CORRECT]
Rationale: LPNs can reinforce teaching and demonstrate skills but cannot provide
initial comprehensive teaching or discharge teaching independently. Option A exceeds
LPN scope—initial teaching requires RN or specialty certification. Option C is
unnecessary when the LPN can reinforce appropriately. Option D is incorrect—the
client did not refuse teaching. Retake strategy: ATI/Prophecy signature trap—LPNs
"reinforce" teaching; RNs provide "initial" and "discharge" teaching. Watch for scope-of-
practice language.
,Question 2
A UAP reports to the LPN that a client's blood pressure is 188/96 mmHg. The client's
baseline BP is 140/88 mmHg. Which action by the LPN is the priority?
A. Delegate the UAP to recheck the blood pressure in 30 minutes
B. Collect additional data and report the finding to the RN or provider
C. Instruct the UAP to administer the client's scheduled antihypertensive medication
D. Document the vital sign and continue with routine monitoring
Correct Answer: B. Collect additional data and report the finding to the RN or
provider [CORRECT]
Rationale: LPNs collect data and report abnormal findings to the RN or provider for
assessment and intervention decisions. Option A delays appropriate action. Option C is
outside UAP scope—UAPs cannot administer medications. Option D ignores a
significant change from baseline. Retake strategy: Prophecy tests that LPNs collect data,
not assess—report significant changes to the RN/provider; UAPs never administer
medications.
Question 3
A client is admitted with suspected tuberculosis. Which PPE should the LPN don before
entering the client's room?
A. Gloves and gown only
B. Surgical mask and gloves
C. N95 respirator, gloves, and gown
D. Face shield and surgical mask
Correct Answer: C. N95 respirator, gloves, and gown [CORRECT]
Rationale: TB requires airborne precautions—N95 respirator (fit-tested), gloves, and
gown. Negative pressure room is also required. Option A describes contact precautions.
Option B describes droplet precautions. Option D is insufficient for airborne
transmission. Retake strategy: Prophecy tests PPE by transmission type—airborne =
N95 + negative pressure; droplet = surgical mask; contact = gloves + gown. TB is
airborne.
,Question 4
A client with Clostridioides difficile (C. diff) infection needs assistance with toileting.
Which hand hygiene method should the LPN use after providing care?
A. Alcohol-based hand rub (ABHR) for 20 seconds
B. Soap and water for at least 20 seconds
C. Antiseptic hand wipe
D. ABHR followed by soap and water
Correct Answer: B. Soap and water for at least 20 seconds [CORRECT]
Rationale: C. diff spores are not killed by alcohol-based hand rub. Soap and water with
mechanical friction is required. Option A is appropriate for most pathogens but not C.
diff spores. Options C and D are incorrect—ABHR does not eliminate C. diff spores.
Retake strategy: Prophecy signature trap—C. diff ALWAYS requires soap and water,
never ABHR alone. This is tested repeatedly.
Question 5
The LPN is caring for four clients on a medical-surgical unit. Which task is most
appropriate to delegate to the UAP?
A. Perform sterile wound irrigation on a client with a surgical incision
B. Obtain vital signs on a client who is stable and recovering from appendectomy
C. Administer a scheduled dose of metformin to a client with type 2 diabetes
D. Assess a client's pain level using a 0-10 numeric rating scale
Correct Answer: B. Obtain vital signs on a client who is stable and recovering from
appendectomy [CORRECT]
Rationale: UAPs can obtain vital signs on stable clients. Option A requires sterile
technique and nursing judgment—LPN or RN task. Option C is medication
administration—outside UAP scope in all states. Option D involves assessment—UAPs
cannot assess; they can report observations. Retake strategy: Prophecy tests delegation
, by task complexity and client stability—vital signs on stable clients = UAP; anything
requiring judgment, sterile technique, or medication = LPN/RN.
Question 6
An LPN is reviewing a client's medication administration record (MAR). The provider
has ordered digoxin 0.25 mg PO daily. Before administering the medication, which
assessment should the LPN perform?
A. Check the client's potassium level and apical pulse for 1 full minute
B. Perform a comprehensive cardiac assessment including all heart sounds
C. Evaluate the client's liver function tests and renal panel
D. Assess the client's respiratory rate and oxygen saturation
Correct Answer: A. Check the client's potassium level and apical pulse for 1 full
minute [CORRECT]
Rationale: Digoxin is contraindicated if apical pulse is <60 bpm (bradycardia risk) and
toxicity risk increases with hypokalemia. Option B exceeds LPN scope—comprehensive
assessment is RN. Option C is important but not the priority before each dose. Option D
is relevant for respiratory medications, not digoxin. Retake strategy: Prophecy tests
digoxin administration protocol—apical pulse for 60 seconds + potassium check are
mandatory before each dose.
Question 7
A client requires insertion of a nasogastric (NG) tube for gastric decompression. Which
statement by the LPN indicates correct understanding of scope of practice?
A. "I can insert the NG tube and verify placement by auscultating for air insufflation."
B. "I can insert the NG tube under RN supervision, but X-ray verification is required."
C. "NG tube insertion is outside LPN scope. Only the RN can perform this procedure."
D. "I can insert the NG tube and verify placement by checking aspirate pH."
