ATI PN MEDICAL-SURGICAL ACTUAL FINAL EXAM
2026/2027 | LPN/LVN Scope | NCLEX-PN Aligned |
Content Mastery 12.0 | A+ Graded | Pass Guaranteed - A+
Graded
Section 1: Cardiovascular & Hematologic Disorders (Questions
1-18)
Q1. An LPN is caring for a client with heart failure who is prescribed digoxin 0.125 mg
PO daily. Which assessment finding should the LPN report to the RN immediately
before administering the dose?
A. Blood pressure 138/84 mmHg
B. Apical heart rate 52 beats/minute
C. Weight increase of 1 lb from yesterday
D. Respiratory rate 18 breaths/minute
Correct Answer: B. Apical heart rate 52 beats/minute [CORRECT]
Rationale: Digoxin is contraindicated when apical pulse is below 60 bpm due to risk
of severe bradycardia and toxicity; the LPN must hold the dose and notify the RN. A,
C, and D are expected findings in heart failure and do not require holding digoxin.
Q2. A client with newly diagnosed hypertension asks the LPN about lifestyle
modifications. Which instruction is most appropriate for the LPN to reinforce?
A. Increase sodium intake to maintain fluid balance
B. Begin a moderate aerobic exercise program as prescribed
C. Stop all prescribed medications once blood pressure normalizes
D. Consume 4-5 alcoholic beverages daily to reduce stress
Correct Answer: B. Begin a moderate aerobic exercise program as prescribed
[CORRECT]
Rationale: The LPN can reinforce teaching about regular exercise, DASH diet, and
,medication adherence; A, C, and D are dangerous misconceptions that contradict
hypertension management guidelines.
Q3. The LPN is monitoring a client on warfarin therapy. Which laboratory value
indicates therapeutic anticoagulation?
A. aPTT 45 seconds
B. PT 12 seconds, INR 1.0
C. PT 22 seconds, INR 2.5
D. Platelet count 450,000/mm³
Correct Answer: C. PT 22 seconds, INR 2.5 [CORRECT]
Rationale: Warfarin monitoring uses PT/INR with a therapeutic INR range of 2.0-3.0
for most conditions; aPTT monitors heparin, and INR 1.0 indicates no anticoagulant
effect.
Q4. An LPN is caring for a client with peripheral arterial disease (PAD). Which client
statement indicates understanding of proper foot care?
A. "I will soak my feet in hot water every evening to improve circulation."
B. "I will apply moisturizing lotion between my toes after bathing."
C. "I will wear clean, dry socks and well-fitting shoes daily."
D. "I will use a heating pad on my legs when they feel cold at night."
Correct Answer: C. "I will wear clean, dry socks and well-fitting shoes daily."
[CORRECT]
Rationale: Proper footwear and dry socks prevent injury and infection in PAD; hot
water soaks, heating pads, and lotion between toes increase burn and fungal
infection risks.
,Q5. A client is receiving heparin IV infusion. The aPTT result is 90 seconds (control 30
seconds). What is the LPN's priority action?
A. Increase the heparin infusion rate per protocol
B. Continue the current infusion rate and recheck in 4 hours
C. Stop the infusion immediately and notify the RN
D. Administer protamine sulfate without consulting the RN
Correct Answer: C. Stop the infusion immediately and notify the RN [CORRECT]
Rationale: An aPTT of 90 seconds indicates supratherapeutic heparin levels with
bleeding risk; the LPN must stop the infusion and notify the RN. Only the RN or
provider orders protamine sulfate.
Q6. A client with iron-deficiency anemia asks the LPN about dietary sources of iron.
Which food should the LPN include in the teaching?
A. Whole milk and cottage cheese
B. Oranges and strawberries
C. Lean red meat and fortified cereals
D. White bread and rice
Correct Answer: C. Lean red meat and fortified cereals [CORRECT]
Rationale: Heme iron in lean red meat and fortified cereals are optimal sources for
iron-deficiency anemia; vitamin C (B) enhances absorption but is not an iron source,
and dairy and refined grains are poor iron sources.
Q7. During a blood transfusion, an LPN notes the client has developed chills, back
pain, and tachycardia. What is the first action the LPN should take?
A. Slow the transfusion rate and call the RN
B. Stop the transfusion immediately, maintain IV with normal saline, and notify the
RN
C. Administer diphenhydramine and continue the transfusion
D. Document the findings and continue monitoring every 15 minutes
, Correct Answer: B. Stop the transfusion immediately, maintain IV with normal
saline, and notify the RN [CORRECT]
Rationale: Chills, back pain, and tachycardia indicate an acute hemolytic transfusion
reaction requiring immediate cessation, saline line maintenance, and RN notification
per protocol.
Q8. An LPN is caring for a client with heart failure who has a 3-lb weight gain in 2
days. Which intervention should the LPN anticipate?
A. Increase daily fluid allowance by 500 mL
B. Reinforce the prescribed fluid restriction and daily weight monitoring
C. Discontinue diuretic therapy until weight stabilizes
D. Encourage the client to consume salty snacks for energy
Correct Answer: B. Reinforce the prescribed fluid restriction and daily weight
monitoring [CORRECT]
Rationale: Rapid weight gain in heart failure indicates fluid retention; the LPN
reinforces fluid restriction, daily weights, and diuretic compliance. Increasing fluids or
salt worsens volume overload.
Q9. A client with a history of DVT is being discharged on warfarin. Which instruction
is appropriate for the LPN to reinforce?
A. "You should eat large amounts of leafy green vegetables daily."
B. "You must have your INR checked regularly as prescribed."
C. "You can take aspirin or ibuprofen for any pain."
D. "You may stop taking this medication once your leg pain resolves."
Correct Answer: B. "You must have your INR checked regularly as prescribed."
[CORRECT]
Rationale: Consistent INR monitoring is essential for warfarin safety; leafy greens alter
INR, NSAIDs increase bleeding risk, and warfarin requires completion of prescribed
duration.
2026/2027 | LPN/LVN Scope | NCLEX-PN Aligned |
Content Mastery 12.0 | A+ Graded | Pass Guaranteed - A+
Graded
Section 1: Cardiovascular & Hematologic Disorders (Questions
1-18)
Q1. An LPN is caring for a client with heart failure who is prescribed digoxin 0.125 mg
PO daily. Which assessment finding should the LPN report to the RN immediately
before administering the dose?
A. Blood pressure 138/84 mmHg
B. Apical heart rate 52 beats/minute
C. Weight increase of 1 lb from yesterday
D. Respiratory rate 18 breaths/minute
Correct Answer: B. Apical heart rate 52 beats/minute [CORRECT]
Rationale: Digoxin is contraindicated when apical pulse is below 60 bpm due to risk
of severe bradycardia and toxicity; the LPN must hold the dose and notify the RN. A,
C, and D are expected findings in heart failure and do not require holding digoxin.
Q2. A client with newly diagnosed hypertension asks the LPN about lifestyle
modifications. Which instruction is most appropriate for the LPN to reinforce?
A. Increase sodium intake to maintain fluid balance
B. Begin a moderate aerobic exercise program as prescribed
C. Stop all prescribed medications once blood pressure normalizes
D. Consume 4-5 alcoholic beverages daily to reduce stress
Correct Answer: B. Begin a moderate aerobic exercise program as prescribed
[CORRECT]
Rationale: The LPN can reinforce teaching about regular exercise, DASH diet, and
,medication adherence; A, C, and D are dangerous misconceptions that contradict
hypertension management guidelines.
Q3. The LPN is monitoring a client on warfarin therapy. Which laboratory value
indicates therapeutic anticoagulation?
A. aPTT 45 seconds
B. PT 12 seconds, INR 1.0
C. PT 22 seconds, INR 2.5
D. Platelet count 450,000/mm³
Correct Answer: C. PT 22 seconds, INR 2.5 [CORRECT]
Rationale: Warfarin monitoring uses PT/INR with a therapeutic INR range of 2.0-3.0
for most conditions; aPTT monitors heparin, and INR 1.0 indicates no anticoagulant
effect.
Q4. An LPN is caring for a client with peripheral arterial disease (PAD). Which client
statement indicates understanding of proper foot care?
A. "I will soak my feet in hot water every evening to improve circulation."
B. "I will apply moisturizing lotion between my toes after bathing."
C. "I will wear clean, dry socks and well-fitting shoes daily."
D. "I will use a heating pad on my legs when they feel cold at night."
Correct Answer: C. "I will wear clean, dry socks and well-fitting shoes daily."
[CORRECT]
Rationale: Proper footwear and dry socks prevent injury and infection in PAD; hot
water soaks, heating pads, and lotion between toes increase burn and fungal
infection risks.
,Q5. A client is receiving heparin IV infusion. The aPTT result is 90 seconds (control 30
seconds). What is the LPN's priority action?
A. Increase the heparin infusion rate per protocol
B. Continue the current infusion rate and recheck in 4 hours
C. Stop the infusion immediately and notify the RN
D. Administer protamine sulfate without consulting the RN
Correct Answer: C. Stop the infusion immediately and notify the RN [CORRECT]
Rationale: An aPTT of 90 seconds indicates supratherapeutic heparin levels with
bleeding risk; the LPN must stop the infusion and notify the RN. Only the RN or
provider orders protamine sulfate.
Q6. A client with iron-deficiency anemia asks the LPN about dietary sources of iron.
Which food should the LPN include in the teaching?
A. Whole milk and cottage cheese
B. Oranges and strawberries
C. Lean red meat and fortified cereals
D. White bread and rice
Correct Answer: C. Lean red meat and fortified cereals [CORRECT]
Rationale: Heme iron in lean red meat and fortified cereals are optimal sources for
iron-deficiency anemia; vitamin C (B) enhances absorption but is not an iron source,
and dairy and refined grains are poor iron sources.
Q7. During a blood transfusion, an LPN notes the client has developed chills, back
pain, and tachycardia. What is the first action the LPN should take?
A. Slow the transfusion rate and call the RN
B. Stop the transfusion immediately, maintain IV with normal saline, and notify the
RN
C. Administer diphenhydramine and continue the transfusion
D. Document the findings and continue monitoring every 15 minutes
, Correct Answer: B. Stop the transfusion immediately, maintain IV with normal
saline, and notify the RN [CORRECT]
Rationale: Chills, back pain, and tachycardia indicate an acute hemolytic transfusion
reaction requiring immediate cessation, saline line maintenance, and RN notification
per protocol.
Q8. An LPN is caring for a client with heart failure who has a 3-lb weight gain in 2
days. Which intervention should the LPN anticipate?
A. Increase daily fluid allowance by 500 mL
B. Reinforce the prescribed fluid restriction and daily weight monitoring
C. Discontinue diuretic therapy until weight stabilizes
D. Encourage the client to consume salty snacks for energy
Correct Answer: B. Reinforce the prescribed fluid restriction and daily weight
monitoring [CORRECT]
Rationale: Rapid weight gain in heart failure indicates fluid retention; the LPN
reinforces fluid restriction, daily weights, and diuretic compliance. Increasing fluids or
salt worsens volume overload.
Q9. A client with a history of DVT is being discharged on warfarin. Which instruction
is appropriate for the LPN to reinforce?
A. "You should eat large amounts of leafy green vegetables daily."
B. "You must have your INR checked regularly as prescribed."
C. "You can take aspirin or ibuprofen for any pain."
D. "You may stop taking this medication once your leg pain resolves."
Correct Answer: B. "You must have your INR checked regularly as prescribed."
[CORRECT]
Rationale: Consistent INR monitoring is essential for warfarin safety; leafy greens alter
INR, NSAIDs increase bleeding risk, and warfarin requires completion of prescribed
duration.
