LPN Midterm Review & NCLEX-PN Practice Exam 2026/2027 UPDATE
1. A nurse is caring for a client who is 4 hours postoperative. Which of the
following findings is the priority to report to the provider?
A. Pain level of 6 on a scale of 0 to 10
B. Urinary output of 20 mL/hr over the last 2 hours
C. Serosanguineous drainage on the dressing
D. Blood pressure of 118/76 mmHg
Answer: B
Rationale: A urinary output of less than 30 mL/hr can indicate decreased renal perfusion
or hypovolemia and is a priority finding that must be reported.
2. A client is prescribed digoxin for heart failure. Before administering the
medication, the nurse should check which of the following?
A. Blood pressure
B. Respiratory rate
C. Temperature
D. Apical pulse for 1 full minute
Answer: D
Rationale: Digoxin slows the heart rate. The nurse must assess the apical pulse for 60
seconds; if it is below 60 bpm in an adult, the dose is typically withheld.
,3. The LPN is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which
task is appropriate for the UAP?
A. Evaluating a client’s response to pain medication
B. Teaching a client how to use a walker
C. Assisting a stable client with ambulation
D. Performing an admission assessment
Answer: C
Rationale: UAPs can assist stable clients with activities of daily living (ADLs) such as
ambulation. Evaluation, teaching, and assessment require nursing judgment.
4. A nurse is preparing to administer regular insulin and NPH insulin in the same
syringe. Which action should the nurse take first?
A. Inject air into the NPH vial
B. Inject air into the regular vial
C. Draw up the NPH insulin
D. Draw up the regular insulin
Answer: A
Rationale: The correct sequence is air into NPH (cloudy), air into regular (clear), draw up
regular, then draw up NPH to avoid contaminating clear insulin with cloudy.
5. A client with a suspected diagnosis of pulmonary tuberculosis (TB) is
admitted. Which type of precautions should the nurse implement?
A. Contact precautions
B. Airborne precautions
C. Droplet precautions
D. Standard precautions only
Answer: B
Rationale: Tuberculosis is transmitted via small droplets that remain suspended in the air,
requiring airborne precautions (N95 respirator and negative pressure room).
, 6. Which of the following lab values should the nurse monitor for a client
receiving warfarin?
A. Partial thromboplastin time (PTT)
B. Hemoglobin A1c
C. Potassium levels
D. International Normalized Ratio (INR)
Answer: D
Rationale: INR (along with Prothrombin Time/PT) is used to monitor the effectiveness
and safety of warfarin therapy.
7. A client is recovering from a total hip arthroplasty. The nurse should position
the client’s affected extremity in which manner?
A. Adduction
B. Internal rotation
C. External rotation
D. Abduction
Answer: D
Rationale: Abduction (moving away from the midline) helps prevent dislocation of the
new hip prosthesis. An abductor pillow is often used.
8. The nurse observes a client with a leg cast reporting severe pain that is not
relieved by elevation or medication. What is the nurse’s priority action?
A. Apply an ice pack to the cast
B. Check for pedal pulses and capillary refill
C. Administer an extra dose of pain medication
D. Encourage the client to sleep
Answer: B
Rationale: These symptoms are classic signs of compartment syndrome. Assessing
neurovascular status (pulses, refill, sensation) is the priority action.
1. A nurse is caring for a client who is 4 hours postoperative. Which of the
following findings is the priority to report to the provider?
A. Pain level of 6 on a scale of 0 to 10
B. Urinary output of 20 mL/hr over the last 2 hours
C. Serosanguineous drainage on the dressing
D. Blood pressure of 118/76 mmHg
Answer: B
Rationale: A urinary output of less than 30 mL/hr can indicate decreased renal perfusion
or hypovolemia and is a priority finding that must be reported.
2. A client is prescribed digoxin for heart failure. Before administering the
medication, the nurse should check which of the following?
A. Blood pressure
B. Respiratory rate
C. Temperature
D. Apical pulse for 1 full minute
Answer: D
Rationale: Digoxin slows the heart rate. The nurse must assess the apical pulse for 60
seconds; if it is below 60 bpm in an adult, the dose is typically withheld.
,3. The LPN is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which
task is appropriate for the UAP?
A. Evaluating a client’s response to pain medication
B. Teaching a client how to use a walker
C. Assisting a stable client with ambulation
D. Performing an admission assessment
Answer: C
Rationale: UAPs can assist stable clients with activities of daily living (ADLs) such as
ambulation. Evaluation, teaching, and assessment require nursing judgment.
4. A nurse is preparing to administer regular insulin and NPH insulin in the same
syringe. Which action should the nurse take first?
A. Inject air into the NPH vial
B. Inject air into the regular vial
C. Draw up the NPH insulin
D. Draw up the regular insulin
Answer: A
Rationale: The correct sequence is air into NPH (cloudy), air into regular (clear), draw up
regular, then draw up NPH to avoid contaminating clear insulin with cloudy.
5. A client with a suspected diagnosis of pulmonary tuberculosis (TB) is
admitted. Which type of precautions should the nurse implement?
A. Contact precautions
B. Airborne precautions
C. Droplet precautions
D. Standard precautions only
Answer: B
Rationale: Tuberculosis is transmitted via small droplets that remain suspended in the air,
requiring airborne precautions (N95 respirator and negative pressure room).
, 6. Which of the following lab values should the nurse monitor for a client
receiving warfarin?
A. Partial thromboplastin time (PTT)
B. Hemoglobin A1c
C. Potassium levels
D. International Normalized Ratio (INR)
Answer: D
Rationale: INR (along with Prothrombin Time/PT) is used to monitor the effectiveness
and safety of warfarin therapy.
7. A client is recovering from a total hip arthroplasty. The nurse should position
the client’s affected extremity in which manner?
A. Adduction
B. Internal rotation
C. External rotation
D. Abduction
Answer: D
Rationale: Abduction (moving away from the midline) helps prevent dislocation of the
new hip prosthesis. An abductor pillow is often used.
8. The nurse observes a client with a leg cast reporting severe pain that is not
relieved by elevation or medication. What is the nurse’s priority action?
A. Apply an ice pack to the cast
B. Check for pedal pulses and capillary refill
C. Administer an extra dose of pain medication
D. Encourage the client to sleep
Answer: B
Rationale: These symptoms are classic signs of compartment syndrome. Assessing
neurovascular status (pulses, refill, sensation) is the priority action.
