NCLEX-PN (National Council Licensure Examination for Practical Nurses) — Questions and Answers

Question 1: A 16-year-old patient arrives alone requesting treatment for a sexually transmitted infection. In most U.S. states, the LVN should:

Proceed with care, as minors are typically allowed to consent for STI treatment (Correct answer)
Require a court order before treating
Refuse to treat without parental consent
Contact the parents immediately before any treatment

Correct answer: Proceed with care, as minors are typically allowed to consent for STI treatment

Most states have emancipated minor laws allowing minors to consent to STI treatment without parental consent to encourage them to seek care.

Question 2: During a routine prenatal visit at 28 weeks, a Rh-negative client with a Rh-positive partner is prescribed Rho(D) immune globulin (RhoGAM). What is the purpose?

Boost maternal immunity against infections
Induce labor at term
Prevent maternal sensitization to Rh-positive fetal blood cells (Correct answer)
Treat existing maternal Rh antibodies

Correct answer: Prevent maternal sensitization to Rh-positive fetal blood cells

RhoGAM prevents Rh sensitization by destroying any fetal Rh-positive cells before the mother's immune system can produce antibodies.

Question 3: Which environmental surface in a patient room is considered a high-touch surface requiring more frequent disinfection?

Ceiling tiles
Window ledges above bed height
Floor under the bed
Call light button and bed rails (Correct answer)

Correct answer: Call light button and bed rails

High-touch surfaces like call lights and bed rails are frequently contacted by patients and staff, increasing pathogen transmission risk.

Question 4: Which therapeutic communication technique is the LVN using when they say, 'It sounds like you're feeling frustrated that no one listens to you'?

Summarizing
Clarification
Offering self
Reflection (Correct answer)

Correct answer: Reflection

Reflection restates the patient's feelings to show understanding and encourage further exploration of emotions.

Question 5: An LVN overhears two nurses loudly discussing a patient's HIV status in a public hallway. The LVN should:

Ignore it as it does not involve their patient
Join the conversation to gather clinical information
Report it directly to the patient
Address the breach and remind colleagues to maintain confidentiality (Correct answer)

Correct answer: Address the breach and remind colleagues to maintain confidentiality

LVNs have a professional and ethical obligation to uphold patient confidentiality and address violations by colleagues.

Question 6: Which assessment finding indicates a patient may be experiencing fluid volume deficit (dehydration)?

Rapid weight gain of 2 kg in 24 hours
Bounding pulse, hypertension, and periorbital edema
Crackles in lung bases and jugular vein distension
Urine specific gravity of 1.030, tachycardia, and poor skin turgor (Correct answer)

Correct answer: Urine specific gravity of 1.030, tachycardia, and poor skin turgor

Concentrated urine (high specific gravity), tachycardia, and poor skin turgor are classic signs of fluid volume deficit as the body attempts to retain water.

Question 7: How should LVN professionals handle confidential information related to maternal & newborn nursing?

Delete all records after project completion
Follow established protocols for data protection, access control, and disclosure in accordance with applicable regulations (Correct answer)
Store information without any security measures
Share freely with all colleagues for transparency

Correct answer: Follow established protocols for data protection, access control, and disclosure in accordance with applicable regulations

Confidential information must be handled according to established protocols, regulatory requirements, and professional ethics standards, including proper access control and disclosure procedures.

Question 8: The physician orders potassium chloride 40 mEq in 100 mL NS to infuse over 1 hour. What is the priority nursing action before administration?

Verify the patient has adequate urine output (Correct answer)
Administer via IV push for fastest delivery
Refrigerate the solution until infusion time
Give a fluid bolus of 500 mL NS first

Correct answer: Verify the patient has adequate urine output

Adequate urine output (≥30 mL/hr) confirms renal function, preventing dangerous hyperkalemia from KCl administration.

Question 9: Which of the following best describes a key competency required for iv therapy & fluid management in LVN practice?

Memorization of all relevant regulations without understanding context
Reliance on a single methodology for all situations
Strong analytical skills combined with effective communication and ethical judgment (Correct answer)
The ability to work independently without any oversight

Correct answer: Strong analytical skills combined with effective communication and ethical judgment

LVN professionals working in iv therapy & fluid management need analytical skills to assess situations, communication skills to convey findings, and ethical judgment to make sound decisions.

Question 10: When a LVN professional encounters an unfamiliar challenge in iv therapy & fluid management, what is the recommended first course of action?

Postpone addressing the issue indefinitely
Research applicable standards, consult with subject matter experts, and document the approach (Correct answer)
Apply the solution used for the most recent similar problem without adaptation
Proceed based on personal intuition alone

Correct answer: Research applicable standards, consult with subject matter experts, and document the approach

Professional practice requires a methodical approach to unfamiliar challenges: research the applicable standards, consult experts when needed, and document the reasoning for the chosen approach.

Question 11: When removing a contaminated gown, which surface is considered 'clean' to touch?

Inner surface of the gown (Correct answer)
Outer chest area of the gown
Sleeves of the gown
Front of the gown below the waist

Correct answer: Inner surface of the gown

The inner surface of the gown (facing the wearer's body) remains uncontaminated and should be used when removing the gown.

Question 12: Which behavior by a long-term care staff member constitutes elder abuse?

Documenting a resident's refusal of care
Yelling at a resident to hurry up during morning care (Correct answer)
Offering a resident a choice between two meal options
Assisting a resident with ambulation using a gait belt

Correct answer: Yelling at a resident to hurry up during morning care

Yelling at a resident is psychological/emotional abuse, which is a form of elder abuse and violates residents' rights.

Question 13: A patient taking a statin medication (e.g., atorvastatin) reports muscle pain and weakness. The LVN should:

Reassure the patient that this is a normal expected side effect
Report to the charge nurse/physician immediately as this may indicate rhabdomyolysis (Correct answer)
Advise the patient to take the medication with food
Suggest the patient increase physical activity

Correct answer: Report to the charge nurse/physician immediately as this may indicate rhabdomyolysis

Muscle pain and weakness in a patient on statins may indicate rhabdomyolysis, a serious condition causing muscle breakdown and potential kidney failure.

Question 14: When using the RED-YELLOW-BLACK (RYB) wound assessment system, a wound with a black wound bed should be managed by:

Using negative pressure wound therapy immediately
Irrigating daily and covering with gauze
Applying a moisture-retentive dressing to promote autolysis (Correct answer)
Packing with iodoform gauze and leaving in place 5 days

Correct answer: Applying a moisture-retentive dressing to promote autolysis

Black wounds contain eschar that should be debrided; moisture-retentive dressings promote autolytic debridement of the necrotic tissue.

Question 15: In the context of LVN certification, what is the most important consideration when implementing wound care & dressing techniques?

Completing implementation as quickly as possible regardless of quality
Ensuring alignment with established standards, stakeholder needs, and best practices (Correct answer)
Minimizing documentation to save time
Delegating all responsibilities to junior staff

Correct answer: Ensuring alignment with established standards, stakeholder needs, and best practices

When implementing wound care & dressing techniques, LVN professionals must ensure alignment with industry standards and stakeholder needs. Hasty implementation without proper planning often leads to compliance issues and suboptimal outcomes.

Question 16: Which defense mechanism is a patient using when they say, 'I don't drink too much; my wife just exaggerates everything'?

Denial (Correct answer)
Rationalization
Displacement
Projection

Correct answer: Denial

Denial involves refusing to acknowledge a painful or threatening reality, as when a person refuses to admit they have a problem with alcohol.

Question 17: A patient has a central venous catheter (CVC). When changing the IV tubing, the patient should be positioned in which manner to prevent air embolism?

Trendelenburg or flat with Valsalva maneuver (Correct answer)
Sitting upright with legs dangling
High Fowler's with head elevated
Prone position

Correct answer: Trendelenburg or flat with Valsalva maneuver

Trendelenburg position or flat with a Valsalva maneuver increases intrathoracic pressure to prevent air from entering the central venous system.

Question 18: A patient is prescribed a nitroglycerin patch for angina. The LVN knows to rotate application sites to prevent:

Systemic toxicity
Both A and B (Correct answer)
Skin irritation and dermatitis
Drug tolerance

Correct answer: Both A and B

Rotating nitroglycerin patch sites prevents both skin irritation from prolonged contact and development of nitrate tolerance.

Question 19: During auscultation, the nurse notes a harsh systolic murmur at the left sternal border in a 3-month-old. This finding is most consistent with which defect?

Ventricular septal defect (VSD) (Correct answer)
Patent ductus arteriosus (PDA)
Pulmonary stenosis
Aortic regurgitation

Correct answer: Ventricular septal defect (VSD)

A harsh holosystolic murmur best heard at the left lower sternal border is characteristic of a ventricular septal defect.

Question 20: A patient taking lithium reports nausea, vomiting, tremors, and confusion. The LVN should first:

Encourage the patient to increase fluid intake
Document the findings and monitor for further changes
Hold the next lithium dose and notify the charge nurse immediately (Correct answer)
Administer an antiemetic and reassure the patient

Correct answer: Hold the next lithium dose and notify the charge nurse immediately

These signs indicate lithium toxicity; the LVN should hold the medication and notify the charge nurse immediately so the lithium level can be checked and treatment initiated.

Question 21: A patient taking clozapine (Clozaril) must have routine blood tests because this medication carries a risk of:

Hyperthyroidism
Hepatotoxicity
Agranulocytosis (Correct answer)
Hypertension and tachycardia

Correct answer: Agranulocytosis

Clozapine can cause agranulocytosis, a life-threatening drop in white blood cells, requiring regular WBC and ANC monitoring throughout treatment.

Question 22: Which assessment finding in a newborn requires immediate reporting to the provider?

Anterior fontanelle that is soft and flat
Respiratory rate of 44 breaths/min
Grunting with each exhalation (Correct answer)
Acrocyanosis of the hands and feet at 2 hours of age

Correct answer: Grunting with each exhalation

Expiratory grunting is a sign of respiratory distress as the newborn attempts to maintain residual lung volume, requiring immediate evaluation.

Question 23: The nurse is caring for a patient experiencing a panic attack. Which intervention should be implemented first?

Leave the patient in a quiet room to calm down independently
Stay with the patient and speak in a calm, reassuring voice (Correct answer)
Teach diaphragmatic breathing techniques
Administer a PRN anxiolytic as ordered

Correct answer: Stay with the patient and speak in a calm, reassuring voice

The immediate priority during a panic attack is to stay with the patient and use a calm, reassuring presence to reduce fear and prevent escalation before other interventions.

Question 24: In the context of LVN certification, what is the most important consideration when implementing iv therapy & fluid management?

Completing implementation as quickly as possible regardless of quality
Ensuring alignment with established standards, stakeholder needs, and best practices (Correct answer)
Minimizing documentation to save time
Delegating all responsibilities to junior staff

Correct answer: Ensuring alignment with established standards, stakeholder needs, and best practices

When implementing iv therapy & fluid management, LVN professionals must ensure alignment with industry standards and stakeholder needs. Hasty implementation without proper planning often leads to compliance issues and suboptimal outcomes.

Question 25: Which statement best describes the concept of 'milieu therapy' in a psychiatric setting?

Use of the total therapeutic environment to promote healing and recovery (Correct answer)
One-on-one psychotherapy between patient and psychiatrist
Group cognitive behavioral therapy sessions
Administration of medications to stabilize mood

Correct answer: Use of the total therapeutic environment to promote healing and recovery

Milieu therapy uses the entire therapeutic environment—physical space, staff interactions, and peer relationships—as a tool for treatment and recovery.

Question 26: Which macronutrient provides the MOST calories per gram?

Alcohol (5 kcal/g)
Fat (9 kcal/g) (Correct answer)
Carbohydrates (4 kcal/g)
Protein (4 kcal/g)

Correct answer: Fat (9 kcal/g)

Fat provides 9 kilocalories per gram, more than twice the energy density of carbohydrates or protein.

Question 27: An LVN is floated to a unit where they have no experience with the patient population. The LVN's best response is to:

Perform all tasks and document as if trained to avoid conflict
Inform the supervisor of their limitations and request appropriate orientation or adjusted assignment (Correct answer)
Refuse to work on the unit and go home
Accept all assignments without question to demonstrate flexibility

Correct answer: Inform the supervisor of their limitations and request appropriate orientation or adjusted assignment

LVNs must communicate competency limitations honestly; accepting tasks beyond their training jeopardizes patient safety and their license.

Question 28: Which IV solution is used primarily for patients with increased intracranial pressure to reduce cerebral edema?

Mannitol 20% (Correct answer)
0.45% NaCl
D5W
Lactated Ringer's

Correct answer: Mannitol 20%

Mannitol is an osmotic diuretic that draws fluid from brain cells into the vasculature, reducing intracranial pressure and cerebral edema.

Question 29: The LVN is caring for a ventilated patient. Which alarm requires immediate assessment?

Battery-backup activation alarm
Humidifier temperature alert
Low-priority equipment check alarm
High-pressure or low-pressure ventilator alarm (Correct answer)

Correct answer: High-pressure or low-pressure ventilator alarm

High- or low-pressure alarms signal airway obstruction, circuit disconnection, or other life-threatening ventilation changes.

Question 30: Which side effect of antipsychotic medications involves involuntary, rhythmic, repetitive movements of the face, tongue, and extremities that appear after long-term use?

Tardive dyskinesia (Correct answer)
Akathisia
Acute dystonia
Pseudoparkinsonism

Correct answer: Tardive dyskinesia

Tardive dyskinesia is a late-onset, potentially irreversible extrapyramidal side effect of long-term antipsychotic use characterized by repetitive involuntary movements.

Question 31: Which dietary modification is MOST appropriate for a patient with dumping syndrome after gastric surgery?

Eat small, frequent meals and avoid simple sugars (Correct answer)
Increase dietary fiber intake significantly
Drink large amounts of fluids with meals
Eat three large meals per day

Correct answer: Eat small, frequent meals and avoid simple sugars

Small, frequent meals and avoiding simple sugars slow gastric emptying and reduce dumping syndrome symptoms.

Question 32: A nurse is teaching a client about signs of postpartum depression (PPD). Which symptom most distinguishes PPD from baby blues?

Persistent feelings of worthlessness and inability to care for the infant lasting >2 weeks (Correct answer)
Mood swings lasting 2–3 days
Tearfulness in the first 3 days after delivery
Mild anxiety about newborn care

Correct answer: Persistent feelings of worthlessness and inability to care for the infant lasting >2 weeks

PPD is distinguished from baby blues by symptoms lasting more than 2 weeks and significantly impairing the mother's functioning.

Question 33: The nurse is caring for a child with croup. Which intervention is the priority for managing mild croup at home?

Expose the child to cool mist or night air (Correct answer)
Administer IV corticosteroids
Begin broad-spectrum antibiotics
Perform chest physiotherapy every 2 hours

Correct answer: Expose the child to cool mist or night air

Cool mist or cool night air reduces laryngeal edema and relieves mild croup symptoms; humidified air is the first-line home management.

Question 34: Which adverse effect is most associated with long-term corticosteroid use?

Hypoglycemia
Hyponatremia
Osteoporosis (Correct answer)
Bradycardia

Correct answer: Osteoporosis

Chronic corticosteroid therapy inhibits calcium absorption and bone formation, leading to osteoporosis over time.

Question 35: A nurse prepares to don sterile gloves using the closed-glove technique. At which point should the outer wrapper of the glove package be opened?

Before putting on the sterile gown
Any time before touching the sterile field
After pulling hands through the gown cuffs
After the gown is fully on with hands inside the cuffs (Correct answer)

Correct answer: After the gown is fully on with hands inside the cuffs

In the closed-glove technique, glove packages are opened while hands remain inside the gown cuffs to prevent bare-hand contamination.

Question 36: A patient on the psychiatric unit threatens to harm another patient. After ensuring immediate safety, the LVN's next action is to:

Administer a PRN sedative without consulting the charge nurse
Document the threat in the medical record
Notify the charge nurse and follow the unit's protocol for aggressive behavior (Correct answer)
Ask the patient to explain why they made the threat

Correct answer: Notify the charge nurse and follow the unit's protocol for aggressive behavior

After ensuring immediate safety, the LVN must notify the charge nurse and follow established protocols, which may include seclusion, restraint, or medication orders from the provider.

Question 37: A patient with nephrotic syndrome requires increased intake of which nutrient to compensate for urinary losses?

Carbohydrates
Dietary fat
Simple sugars
Protein (Correct answer)

Correct answer: Protein

Nephrotic syndrome causes massive proteinuria, so adequate protein intake is needed to replace urinary protein losses and maintain oncotic pressure.

Question 38: A patient's IV infusion infiltrates. The fluid being infused is a vesicant. What is the priority nursing action?

Slow the infusion rate and continue monitoring
Aspirate from the catheter before removing it
Stop the infusion and remove the IV catheter immediately (Correct answer)
Apply a warm compress to improve absorption

Correct answer: Stop the infusion and remove the IV catheter immediately

Vesicant solutions cause tissue necrosis if they infiltrate; the infusion must be stopped and the catheter removed immediately to minimize tissue damage.

Question 39: A breastfeeding mother asks the nurse why her infant feeds every 1.5 to 2 hours. What is the best response?

The infant may have a metabolic disorder
Your milk supply is likely insufficient
Frequent feeding indicates the infant is not latching correctly
Breast milk digests quickly and the stomach empties faster than formula (Correct answer)

Correct answer: Breast milk digests quickly and the stomach empties faster than formula

Breast milk is more easily digested than formula, causing the stomach to empty faster and prompting more frequent feeding.

Question 40: Which document legally designates another person to make healthcare decisions for a patient who becomes incapacitated?

Durable power of attorney for healthcare (Correct answer)
Do-not-resuscitate order
Living will
Advance beneficiary notice

Correct answer: Durable power of attorney for healthcare

A durable power of attorney for healthcare (healthcare proxy) legally designates a surrogate decision-maker if the patient loses capacity.

Question 41: Which cleaning agent is the gold standard for eliminating C. difficile spores from environmental surfaces?

Alcohol-based wipes
Diluted bleach solution (1:10) (Correct answer)
Hydrogen peroxide spray
Quaternary ammonium compounds

Correct answer: Diluted bleach solution (1:10)

C. difficile spores are resistant to alcohol and most disinfectants; a 1:10 bleach (sodium hypochlorite) solution is sporicidal and recommended by the CDC.

Question 42: A breastfeeding mother asks the LVN about calcium needs. The recommended daily calcium intake for a lactating woman is:

1,500 mg
1,000 mg (Correct answer)
2,000 mg
800 mg

Correct answer: 1,000 mg

The recommended dietary allowance for calcium in lactating women is 1,000 mg per day, the same as for non-pregnant adult women.

Question 43: Which IV access site is preferred for rapid large-volume fluid resuscitation in an adult?

External jugular with 20-gauge catheter
Antecubital vein with 16-gauge catheter (Correct answer)
Scalp vein with 22-gauge catheter
Hand vein with 24-gauge catheter

Correct answer: Antecubital vein with 16-gauge catheter

A large-bore catheter (16-gauge or larger) in the antecubital vein allows rapid high-volume fluid delivery needed in emergencies.

Question 44: Which characteristic distinguishes a partial-thickness wound from a full-thickness wound?

Partial-thickness wounds take longer to heal than full-thickness wounds
Partial-thickness wounds always require surgical closure
Partial-thickness wounds involve only the epidermis and possibly dermis (Correct answer)
Partial-thickness wounds extend into subcutaneous tissue

Correct answer: Partial-thickness wounds involve only the epidermis and possibly dermis

Partial-thickness wounds involve the epidermis and possibly dermis and heal by re-epithelialization without granulation tissue.

Question 45: What role does continuous improvement play in pediatric nursing care for LVN certified professionals?

It is optional and only necessary during certification renewal
It focuses exclusively on cost reduction
It drives ongoing enhancement of practices, processes, and outcomes through systematic evaluation (Correct answer)
It applies only to new professionals in their first year

Correct answer: It drives ongoing enhancement of practices, processes, and outcomes through systematic evaluation

Continuous improvement is fundamental to professional practice in pediatric nursing care, involving regular evaluation, feedback integration, and process enhancement to maintain high standards.

Question 46: The nurse is preparing to administer a subcutaneous injection. Which gauge and length needle is most appropriate for a subcutaneous injection in an average-sized adult?

14 gauge, 1 inch
21 gauge, 1 inch
25 gauge, 5/8 inch (Correct answer)
18 gauge, 1.5 inches

Correct answer: 25 gauge, 5/8 inch

Subcutaneous injections require a fine-gauge (25–27 G), short (5/8–1/2 inch) needle to reach the subcutaneous tissue without penetrating muscle.

Question 47: A patient with phenylketonuria (PKU) must restrict which amino acid?

Methionine
Tyrosine
Phenylalanine (Correct answer)
Tryptophan

Correct answer: Phenylalanine

PKU is caused by a deficiency of phenylalanine hydroxylase, so phenylalanine must be restricted to prevent neurotoxic accumulation.

Question 48: A patient with generalized anxiety disorder asks about buspirone (Buspar). Which statement by the LVN is accurate?

'It works immediately and can be taken as needed for acute anxiety.'
'It will cause drowsiness, so avoid driving while taking it.'
'It is only effective when combined with a benzodiazepine.'
'It takes 2–4 weeks to reach full therapeutic effect and is not habit-forming.' (Correct answer)

Correct answer: 'It takes 2–4 weeks to reach full therapeutic effect and is not habit-forming.'

Buspirone is a non-benzodiazepine anxiolytic that requires 2–4 weeks for full effect, does not cause dependency, and generally does not cause significant sedation.

Question 49: Which principle is central to nursing ethics?

Autonomy (Correct answer)
Authority
Proximity
Conformity

Correct answer: Autonomy

Autonomy is a central principle in nursing ethics, emphasizing the patient's right to make informed decisions about their own healthcare. Nurses uphold autonomy by providing comprehensive information, respecting patient choices, and advocating for their preferences, even if they differ from the nurse's own views.

Question 50: The ethical concept of 'veracity' in nursing practice refers to:

Treating all patients equally
Telling the truth to patients (Correct answer)
Doing good for the patient
Avoiding harm to patients

Correct answer: Telling the truth to patients

Veracity is the ethical obligation to be honest and truthful in all communications with patients.

Question 51: What is the purpose of a Minimum Data Set (MDS) in long-term care facilities?

To document shift-change reports
To calculate Medicare reimbursement for physicians only
To determine staff-to-patient ratios
To standardize comprehensive assessment and care planning for residents (Correct answer)

Correct answer: To standardize comprehensive assessment and care planning for residents

The MDS is a federally mandated comprehensive assessment tool used in long-term care to guide care planning and support reimbursement decisions.

Question 52: An LVN notices signs of nurse burnout in a team member. The most helpful initial response is to:

Privately express concern and encourage the nurse to seek support resources (Correct answer)
Report the nurse to administration for poor performance
Take over the nurse's patients to reduce their burden
Ignore the situation as burnout is a personal matter

Correct answer: Privately express concern and encourage the nurse to seek support resources

Expressing concern privately and directing a colleague to support resources is the most supportive and professional response.

Question 53: A resident with Parkinson's disease is at greatest risk for which complication during mealtimes?

Aspiration due to dysphagia (Correct answer)
Hypoglycemia
Hypertensive crisis
Allergic reaction to food

Correct answer: Aspiration due to dysphagia

Parkinson's disease impairs the swallowing mechanism, placing residents at high risk for aspiration and aspiration pneumonia during eating.

Question 54: Which class of medication requires the LVN to monitor the patient's blood pressure before administration?

Antacids
Antihistamines
Antihypertensives (Correct answer)
Antifungals

Correct answer: Antihypertensives

Antihypertensive medications lower blood pressure, so the LVN must assess baseline BP to prevent dangerous hypotension.

Question 55: Which statement about hand hygiene timing is correct according to the WHO 'Five Moments'?

Hand hygiene is required only after contact with the patient
Hand hygiene before touching a patient is required only for invasive procedures
Hand hygiene must occur before and after patient contact, and after contact with the patient's environment (Correct answer)
Hand hygiene is required only when gloves are not worn

Correct answer: Hand hygiene must occur before and after patient contact, and after contact with the patient's environment

The WHO Five Moments include: before patient contact, before aseptic tasks, after body fluid exposure, after patient contact, and after touching the patient's environment.

Question 56: Which of the following best describes a key competency required for maternal & newborn nursing in LVN practice?

Memorization of all relevant regulations without understanding context
Reliance on a single methodology for all situations
The ability to work independently without any oversight
Strong analytical skills combined with effective communication and ethical judgment (Correct answer)

Correct answer: Strong analytical skills combined with effective communication and ethical judgment

LVN professionals working in maternal & newborn nursing need analytical skills to assess situations, communication skills to convey findings, and ethical judgment to make sound decisions.

Question 57: Which finding best indicates that an alcohol-based hand rub is NOT appropriate and soap and water must be used?

The nurse just removed sterile gloves
The patient has MRSA
Hands are visibly soiled with feces (Correct answer)
Hands are visibly moist from perspiration

Correct answer: Hands are visibly soiled with feces

Visibly soiled hands must be washed with soap and water because alcohol-based rubs do not mechanically remove dirt or C. difficile spores.

Question 58: Which position is most appropriate for a patient experiencing an acute asthma attack?

High Fowler's (90 degrees) (Correct answer)
Left lateral (Sims') position
Supine with legs elevated
Trendelenburg position

Correct answer: High Fowler's (90 degrees)

High Fowler's position maximizes lung expansion and reduces the work of breathing during respiratory distress.

Question 59: Which situation represents a breach of patient confidentiality by an LVN?

Reporting a patient's gunshot wound to law enforcement as required by state law
Sharing patient records with another treating physician
Reporting suspected child abuse to child protective services
Discussing patient details with a friend who is not involved in care (Correct answer)

Correct answer: Discussing patient details with a friend who is not involved in care

Discussing identifiable patient information with anyone not involved in the patient's care is a breach of confidentiality and HIPAA.

Question 60: Which pain medication requires the LVN to have naloxone readily available at the bedside?

Ibuprofen
Aspirin
Morphine sulfate (Correct answer)
Acetaminophen

Correct answer: Morphine sulfate

Naloxone is the opioid reversal agent and must be available when administering opioids like morphine due to the risk of respiratory depression.

Question 61: Which assessment finding indicates that a peripheral IV site has developed phlebitis?

Decreased blood pressure
Increased urine output
Cool, pale skin around the insertion site
Redness, warmth, and tenderness along the vein (Correct answer)

Correct answer: Redness, warmth, and tenderness along the vein

Phlebitis is characterized by the classic inflammatory signs: redness, warmth, and tenderness along the affected vein.

Question 62: Which congenital heart defect causes a 'boot-shaped' heart on chest X-ray and cyanosis that worsens with crying?

Coarctation of the aorta
Atrial septal defect (ASD)
Tetralogy of Fallot (ToF) (Correct answer)
Patent ductus arteriosus (PDA)

Correct answer: Tetralogy of Fallot (ToF)

Tetralogy of Fallot produces a boot-shaped heart (coeur en sabot) on X-ray due to right ventricular hypertrophy and decreased pulmonary vascularity.

Question 63: A patient receiving heparin develops signs of bleeding. Which medication should be available as the antidote?

Flumazenil
Vitamin K
Protamine sulfate (Correct answer)
Naloxone

Correct answer: Protamine sulfate

Protamine sulfate binds to heparin and neutralizes its anticoagulant effect, making it the specific antidote for heparin toxicity.

Question 64: A nurse sustains a needlestick injury. After washing the site, what is the immediate next step?

Report the exposure to the supervisor and occupational health (Correct answer)
Squeeze the wound vigorously to expel blood
Apply a tourniquet above the injury site
Apply antibiotic ointment and return to work

Correct answer: Report the exposure to the supervisor and occupational health

After washing, the nurse must immediately report the exposure so baseline testing and post-exposure prophylaxis can be initiated promptly.

Question 65: A newborn has an Apgar score of 4 at 1 minute. What is the priority nursing action?

Place the infant skin-to-skin with the mother
Administer epinephrine
Begin positive pressure ventilation (Correct answer)
Continue observation and rescore at 5 minutes

Correct answer: Begin positive pressure ventilation

An Apgar score of 4–6 indicates moderate distress and requires stimulation and positive pressure ventilation if breathing is inadequate.

Question 66: Which action is essential before administering any medication to a patient?

Verify the 'Rights' of medication administration (Correct answer)
Assess the patient's pain level
Review the patient's insurance
Check the patient's diet

Correct answer: Verify the 'Rights' of medication administration

The Rights of medication administration (right patient, drug, dose, route, time, documentation) must be verified before every medication administration.

Question 67: Which respiratory pattern alternates between cycles of increasing depth, decreasing depth, and apnea, commonly seen in heart failure and CNS disorders?

Kussmaul breathing
Biot's respiration
Cheyne-Stokes respiration (Correct answer)
Apneustic breathing

Correct answer: Cheyne-Stokes respiration

Cheyne-Stokes respiration is characterized by crescendo-decrescendo breathing cycles alternating with apnea, seen in heart failure and brain injury.

Question 68: What is the most effective way to measure success in leadership & team collaboration within LVN professional practice?

Rely solely on supervisor opinion
Use a combination of quantitative metrics, qualitative assessments, and stakeholder feedback aligned with defined objectives (Correct answer)
Compare only with industry averages without considering context
Count only the number of activities completed

Correct answer: Use a combination of quantitative metrics, qualitative assessments, and stakeholder feedback aligned with defined objectives

Effective measurement combines multiple data sources — quantitative metrics, qualitative assessments, and stakeholder feedback — all aligned with clearly defined objectives for a comprehensive evaluation.

Question 69: A patient receiving a blood transfusion develops chills, fever, and back pain within 15 minutes of initiation. What is the priority nursing action?

Administer acetaminophen
Notify the physician only
Stop the transfusion immediately (Correct answer)
Slow the infusion rate

Correct answer: Stop the transfusion immediately

These signs indicate a hemolytic transfusion reaction; the nurse must stop the transfusion immediately to prevent further harm.

Question 70: A postpartum client reports excessive lochia and saturates a pad in 15 minutes. Fundal massage yields large clots. What medication should the nurse anticipate administering?

Betamethasone
Terbutaline
Oxytocin (Pitocin) (Correct answer)
Magnesium sulfate

Correct answer: Oxytocin (Pitocin)

Oxytocin promotes uterine contraction and is the first-line uterotonic agent for postpartum hemorrhage due to uterine atony.

Question 71: A nurse notes that a patient's indwelling urinary catheter drainage bag contains 30 mL of urine over 2 hours. What is the priority action?

Document the finding as normal output
Check for catheter kinks or obstruction, then notify the provider (Correct answer)
Remove and replace the catheter immediately
Increase IV fluids without a provider order

Correct answer: Check for catheter kinks or obstruction, then notify the provider

Output less than 30 mL/hr suggests oliguria; the nurse should first check for mechanical obstruction, then report to the provider.

Question 72: A patient diagnosed with atrial fibrillation is at greatest risk for which serious complication?

Renal calculi
Hypoglycemia
Respiratory alkalosis
Thromboembolism and stroke (Correct answer)

Correct answer: Thromboembolism and stroke

Atrial fibrillation causes blood to pool in the atria, promoting clot formation that can travel to the brain and cause stroke.

Question 73: Which ethical principle requires the LVN to keep a promise made to a patient?

Justice
Non-maleficence
Beneficence
Fidelity (Correct answer)

Correct answer: Fidelity

Fidelity refers to the duty to keep promises and honor commitments made to patients.

Question 74: An LVN is caring for a resident with dementia who is agitated. Which non-pharmacologic intervention should be tried first?

Isolate the resident in their room
Administer a PRN sedative
Redirect the resident with a calm voice and familiar activity (Correct answer)
Apply physical restraints

Correct answer: Redirect the resident with a calm voice and familiar activity

Redirection with a calm voice and familiar activity is the first-line non-pharmacologic approach to managing agitation in dementia patients.

Question 75: A patient receiving a blood transfusion develops chills, fever, and back pain 15 minutes into the infusion. What is the nurse's first action?

Administer diphenhydramine and continue the transfusion
Increase the transfusion rate to complete it quickly
Stop the transfusion and keep the IV line open with normal saline (Correct answer)
Slow the transfusion rate and monitor closely

Correct answer: Stop the transfusion and keep the IV line open with normal saline

These are signs of a hemolytic transfusion reaction; the transfusion must be stopped immediately and the IV kept open with NS for possible medications.

Question 76: What is the primary purpose of a nurse practice act (NPA)?

To regulate nursing school curricula only
To set salary standards for nurses
To define the scope of practice and protect public safety (Correct answer)
To determine hospital staffing ratios

Correct answer: To define the scope of practice and protect public safety

The Nurse Practice Act in each state defines the legal scope of nursing practice and exists primarily to protect the public from unsafe practitioners.

Question 77: What is the most effective way to measure success in maternal & newborn nursing within LVN professional practice?

Count only the number of activities completed
Use a combination of quantitative metrics, qualitative assessments, and stakeholder feedback aligned with defined objectives (Correct answer)
Compare only with industry averages without considering context
Rely solely on supervisor opinion

Correct answer: Use a combination of quantitative metrics, qualitative assessments, and stakeholder feedback aligned with defined objectives

Question 78: Which nutrient is the body's preferred source of energy?

Protein
Fat
Vitamins
Carbohydrates (Correct answer)

Correct answer: Carbohydrates

Carbohydrates are the body's primary and most efficient fuel source, providing 4 kcal per gram and rapid conversion to glucose.

Question 79: An LVN administers a medication and the patient experiences a severe adverse reaction. The nurse's notes should reflect:

Only the interventions and outcomes, not the initial error
The medication given, the patient's reaction, interventions taken, and provider notification (Correct answer)
A statement that the reaction was unexpected and unavoidable
Only the medication given and nothing about the reaction to avoid liability

Correct answer: The medication given, the patient's reaction, interventions taken, and provider notification

Accurate and complete documentation of the event, response, and communication is both a legal and professional obligation.

Question 80: The concept of 'shared governance' in nursing teams means:

The charge nurse rotates responsibilities equally among all nurses
All decisions are made democratically by a majority vote of all staff
Staff nurses have a voice in decisions that affect their practice (Correct answer)
Nurses share administrative duties with hospital executives

Correct answer: Staff nurses have a voice in decisions that affect their practice

Shared governance empowers bedside nurses to participate in decisions that shape nursing practice and patient care.

Question 81: What term refers to the failure to provide reasonable care resulting in harm?

Malpractice
Negligence (Correct answer)
Abandonment
Fraud

Correct answer: Negligence

Negligence is when a nurse fails to act with the expected level of care, leading to patient harm.

Question 82: Which of the following best describes a key competency required for mental health & psychiatric nursing in LVN practice?

The ability to work independently without any oversight
Memorization of all relevant regulations without understanding context
Strong analytical skills combined with effective communication and ethical judgment (Correct answer)
Reliance on a single methodology for all situations

Correct answer: Strong analytical skills combined with effective communication and ethical judgment

LVN professionals working in mental health & psychiatric nursing need analytical skills to assess situations, communication skills to convey findings, and ethical judgment to make sound decisions.

Question 83: Which statement correctly describes the difference between delirium and dementia?

Dementia causes hallucinations while delirium does not
Both are irreversible but delirium is more treatable
Delirium has an abrupt onset and is often reversible; dementia develops gradually and is generally irreversible (Correct answer)
Delirium develops gradually over years; dementia has an abrupt onset

Correct answer: Delirium has an abrupt onset and is often reversible; dementia develops gradually and is generally irreversible

Delirium is characterized by acute onset and fluctuating course and is often reversible with treatment of the underlying cause, while dementia is a progressive, irreversible decline.

Question 84: A patient with borderline personality disorder frequently tells the nurse, 'You're the only one who understands me; the other nurses are terrible.' This behavior is known as:

Transference
Splitting (Correct answer)
Countertransference
Manipulation

Correct answer: Splitting

Splitting is a defense mechanism common in borderline personality disorder where people are viewed as all good or all bad, with no middle ground.

Question 85: Which electrolyte imbalance is a common side effect of loop diuretics such as furosemide?

Hypernatremia
Hyperkalemia
Hypokalemia (Correct answer)
Hypercalcemia

Correct answer: Hypokalemia

Loop diuretics cause increased excretion of potassium in the urine, leading to hypokalemia.

NCLEX-PN (National Council Licensure Examination for Practical Nurses)

The NCLEX-PN exam determines if it's safe for you to begin practice as an entry-level practical or vocational nurse. It assesses your knowledge, skills, and abilities essential for providing safe and effective patient care.

Questions

300 min

Time Limit

70%

To Pass

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Exam Rules

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