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NCLEx-PN-Bootcamp Initial

Total questions: 75

Worksheet time: 47mins

Name
Class
Date
1.

An LPN notes that a client is restless and slightly confused with a heart rate of 118/min. What is the priority action?

a)

A. Reorient the client

b)

B. Document the findings

c)

C. Report the findings to the RN

d)

D. Administer the prescribed PRN medication

2.

Which findings should an LPN recognize as early signs of clinical deterioration? (Select all that apply.)

a)

A. Restlessness

b)

B. Decreasing urine output

c)

C. Mild incisional pain

d)

D. New confusion

e)

E. Blood pressure of 120/78

3.

Which task is outside the LPN scope of practice?

a)

A. Monitoring intake and output

b)

B. Reinforcing patient teaching

c)

C. Performing the initial patient assessment

d)

D. Administering oral medications

4.

Which actions are included in standard precautions? (Select all that apply.)

a)

A. Hand hygiene

b)

B. Wearing gloves when in contact with body fluids

c)

C. Wearing an N95 mask for all patients

d)

D. Using eye protection if splashing is possible

e)

E. Wearing a gown for all patient care

5.

A client has an indwelling Foley catheter. This places the client at highest risk for which complication?

a)

A. Hypoglycemia

b)

B. Infection

c)

C. Dehydration

d)

D. Hypertension

6.

Which findings should the LPN report immediately to the RN? (Select all that apply.)

a)

A. Oxygen saturation of 88%

b)

B. New onset chest pain

c)

C. Chronic knee pain

d)

D. Respiratory rate of 8/min

e)

E. Stable vital signs

7.

Which vital sign is most concerning?

a)

A. Heart rate of 102/min

b)

B. Temperature of 99.0°F

c)

C. Respiratory rate of 8/min

d)

D. Blood pressure of 138/84

8.

Which clients are at increased risk for falls? (Select all that apply.)

a)

A. Client receiving opioid pain medication

b)

B. Client with recent surgery

c)

C. Alert client ambulating independently

d)

D. Client who feels dizzy when standing

e)

E. Client wearing non-skid footwear

9.

A post-operative client is tachycardic with decreasing blood pressure. Which complication should the LPN suspect first?

a)

A. Infection

b)

B. Hemorrhage

c)

C. Atelectasis

d)

D. Deep vein thrombosis

10.

Which client requires immediate attention by the LPN?

a)

A. Client requesting PRN pain medication

b)

B. Client eating breakfast

c)

C. Client with new confusion

d)

D. Client watching television

11.

Which actions are appropriate when caring for a client on contact precautions? (Select all that apply.)

a)

A. Wear gloves

b)

B. Wear a gown

c)

C. Use alcohol-based hand sanitizer after caring for C. diff

d)

D. Remove PPE before leaving the room

e)

E. Wear a surgical mask at all times

12.

Which situation requires the LPN to notify the RN immediately?

a)

A. Mild post-operative pain

b)

B. Urine output of 20 mL/hr

c)

C. Client reports hunger

d)

D. Stable vital signs

13.

Which findings indicate poor tissue perfusion? (Select all that apply.)

a)

A. Cool extremities

b)

B. Capillary refill greater than 3 seconds

c)

C. Bounding pulses

d)

D. Decreased urine output

e)

E. Cyanosis

14.

Which tasks may be performed by an LPN? (Select all that apply.)

a)

A. Monitoring vital signs

b)

B. Performing initial patient assessment

c)

C. Administering prescribed medications

d)

D. Reinforcing teaching

e)

E. Evaluating patient response

15.

Which findings suggest a deep vein thrombosis (DVT)? (Select all that apply.)

a)

A. Unilateral leg swelling

b)

B. Calf pain

c)

C. Bilateral ankle edema

d)

D. Warmth in one extremity

e)

E. Bradycardia

16.

Which interventions help reduce the risk of post-operative complications? (Select all that apply.)

a)

A. Incentive spirometer use

b)

B. Early ambulation

c)

C. Strict bedrest

d)

D. Turning every 2 hours

e)

E. Adequate pain control

17.

n IV site appears swollen, cool, and pale. What should the LPN do first?

a)

A. Restart the IV

b)

B. Slow the infusion

c)

C. Stop the infusion

d)

D. Apply heat

18.

Which findings suggest early hypovolemia? (Select all that apply.)

a)

A. Tachycardia

b)

B. Hypotension

c)

C. Decreasing urine output

d)

D. Warm, flushed skin

e)

E. Restlessness

19.

An LPN is caring for a client who suddenly becomes restless and diaphoretic. What is the priority action?

a)

A. Reassure the client

b)

B. Check vital signs

c)

C. Administer prescribed PRN medication

d)

D. Document the findings

20.

Which actions help prevent healthcare-associated infections? (Select all that apply.)

a)

A. Performing hand hygiene before patient contact

b)

B. Changing gloves between tasks on the same patient

c)

C. Reusing PPE if it appears clean

d)

D. Cleaning shared equipment between patients

e)

E. Performing hand hygiene after removing gloves

21.

Which situation requires the LPN to communicate immediately with the RN?

a)

A. Client reports pain level of 4/10

b)

B. Client has new onset confusion

c)

C. Client requests assistance to the bathroom

d)

D. Client is eating poorly

22.

Which clients are at increased risk for aspiration? (Select all that apply.)

a)

A. Client with decreased level of consciousness

b)

B. Client with difficulty swallowing

c)

C. Client positioned upright

d)

D. Client receiving tube feedings

e)

E. Alert client eating independently

23.

Which actions promote client comfort and safety? (Select all that apply.)

a)

A. Repositioning every 2 hours

b)

B. Ensuring call light is within reach

c)

C. Withholding pain medication

d)

D. Providing non-skid footwear

e)

E. Keeping bed in highest position

24.

Which action reflects appropriate LPN clinical judgment?

a)

A. Making an independent nursing diagnosis

b)

B. Reporting abnormal findings to the RN

c)

C. Changing a plan of care

d)

D. Prescribing oxygen therapy

25.

Which clients are at high risk for pressure injuries? (Select all that apply.)

a)

A. Immobile client

b)

B. Client with poor nutrition

c)

C. Client ambulating frequently

d)

D. Client with incontinence

e)

E. Client repositioned every 2 hours

26.

Which PPE is required for contact precautions?

a)

A. Mask

b)

B. Gloves and gown

c)

C. N95 respirator

d)

D. Face shield only

27.

Which intervention best prevents post-operative pneumonia?

a)

A. Strict bedrest

b)

B. Incentive spirometer use

c)

C. Fluid restriction

d)

D. Pain medication only

28.

An LPN notes the following in a post-operative client: HR 124/min, BP 88/54, cool clammy skin, and urine output of 15 mL/hr. Which interpretation is MOST accurate?

a)

A. Expected post-operative response

b)

B. Anxiety-related response

c)

C. Developing hypovolemic shock

d)

D. Pain-related sympathetic response

29.

A client with a Foley catheter has cloudy urine, foul odor, and a temperature of 101.4°F. What is the LPN’s priority action?

a)

A. Encourage oral fluids

b)

B. Obtain a urine specimen

c)

C. Notify the RN

d)

D. Administer prescribed antipyretic

30.

Which situation best reflects appropriate LPN clinical judgment?

a)

A. Adjusting oxygen flow rate independently

b)

B. Recognizing abnormal findings and reporting them

c)

C. Changing the plan of care

d)

D. Delaying escalation until reassessment

31.

While disposing of a used needle, the LPN accidentally sustains a needlestick injury. What is the priority action?

a)

A. Wash the area with soap and water

b)

B. Apply a sterile dressing

c)

C. Report at end of shift

d)

D. Complete an incident report first

32.

Which actions are appropriate when collecting a clean-catch urine specimen? (Select all that apply.)

a)

A. Use sterile container without touching inside

b)

B. Collect the first urine that comes out

c)

C. Cleanse the perineal area before collection

d)

D. Collect midstream urine

e)

E. Refrigerate specimen if it cannot be sent immediately

33.

An RN asks the LPN to perform a task on a newly admitted client. Which task should the LPN question?

a)

A. Obtain vital signs

b)

B. Administer scheduled oral meds

c)

C. Perform the initial admission assessment

d)

D. Reinforce teaching about incentive spirometry

34.

Which interventions help prevent constipation in an immobile client? (Select all that apply.)

a)

A. Encourage fluids if not contraindicated

b)

B. Encourage high-fiber foods

c)

C. Promote activity as tolerated

d)

D. Restrict all oral intake

e)

E. Monitor bowel pattern

35.

A client receiving enteral tube feeding develops coughing and increased respiratory secretions. What should the LPN do first?

a)

A. Increase the feeding rate

b)

B. Lower the head of the bed

c)

C. Stop the feeding and notify the RN

d)

D. Flush the tube with water

36.

Which actions reduce the risk of aspiration for a client receiving tube feedings? (Select all that apply.)

a)

A. Keep HOB elevated 30–45°

b)

B. Verify tube placement per policy

c)

C. Check residuals per facility policy

d)

D. Place client flat after feeding

e)

E. Pause feeding during repositioning if needed

37.

Before administering insulin, which action is most important?

a)

A. Ask the client when they last ate

b)

B. Verify the blood glucose result

c)

C. Document the medication first

d)

D. Massage the injection site

38.

Which findings suggest hypoglycemia? (Select all that apply.)

a)

A. Diaphoresis

b)

B. Tremors

c)

C. Confusion

d)

D. Fruity breath

e)

E. Tachycardia

39.

Which action is appropriate for an LPN caring for a client with suspected tuberculosis?

a)

A. Place the client on contact precautions

b)

B. Wear an N95 respirator per airborne precautions

c)

C. Wear a surgical mask only

d)

D. Use standard precautions only

40.

A client reports pain 7/10 after receiving pain medication 30 minutes ago. What is the best action?

a)

A. Tell the client to wait longer

b)

B. Reassess pain and report inadequate relief to the RN

c)

C. Document “pain improved”

d)

D. Encourage the client to sleep

41.

A client has a new cast and reports increasing pain not relieved by medication. The toes are cool and pale. What should the LPN do?

.

a)

A. Elevate the extremity and reassess in 1 hour

b)

B. Notify the RN immediately

c)

C. Encourage ambulation

d)

D. Apply heat to the cast

42.

Which findings indicate circulation problems in an extremity? (Select all that apply.)

a)

A. Capillary refill > 3 seconds

b)

B. Tingling/numbness

c)

C. Warm pink skin

d)

D. Weak pulses

e)

E. Increasing pain

43.

A fire occurs in a client’s room. What is the nurse’s priority action using RACE?

a)

A. Extinguish the fire

b)

B. Remove the client from danger

c)

C. Activate the alarm

d)

D. Close all doors

44.

Which findings suggest a client may be at risk for self-harm? (Select all that apply.)

a)

A. Giving away personal belongings

b)

B. Sudden calmness after severe depression

c)

C. Talking about future plans

d)

D. Stating “Everyone would be better off without me”

e)

E. Refusing visitors

45.

Which actions support safe medication administration? (Select all that apply.)

a)

A. Use two identifiers

b)

B. Verify allergies

c)

C. Interpret unclear orders independently

d)

D. Check expiration dates

e)

E. Document right after administering

46.

Which actions are appropriate for ostomy care? (Select all that apply.)

a)

A. Measure the stoma and cut wafer to fit

b)

B. Expect stoma to be pale and cool

c)

C. Cleanse skin gently and pat dry

d)

D. Empty pouch when one-third full

e)

E. Use skin barrier to protect peristomal skin

47.

Which medications should an LPN question if prescribed without further clarification? (Select all that apply.)

a)

A. Morphine IM for a client with RR 10/min

b)

B. Insulin lispro for a client who is NPO

c)

C. Acetaminophen for fever of 101.2°F

d)

D. Potassium chloride IV push

e)

E. Stool softener for a bedridden client

48.

A client with a nasogastric tube suddenly becomes nauseated and gagging. What should the LPN do first?

a)

A. Flush the tube

b)

B. Lower the head of the bed

c)

C. Stop suction and assess tube placement

d)

D. Administer antiemetic

49.

Which situation requires the LPN to initiate incident reporting?

a)

A. Client refuses medication

b)

B. Medication administered late

c)

C. Client falls without injury

d)

D. Lab result is abnormal

50.

Which findings are consistent with metabolic acidosis? (Select all that apply.)

a)

A. Kussmaul respirations

b)

B. Decreased pH

c)

C. Decreased bicarbonate

d)

D. Bradypnea

e)

E. Confusion

51.

A client with a history of alcohol use becomes confused, diaphoretic, and tachycardic. What should the LPN suspect?

a)

A. Opioid overdose

b)

B. Alcohol withdrawal

c)

C. Stroke

d)

D. Hypothermia

52.

Which actions violate restraint safety? (Select all that apply.)

a)

A. Tying restraints to side rails

b)

B. Checking circulation every shift

c)

C. Using restraints without an order

d)

D. Removing restraints for ROM

e)

E. Using restraints for staff convenience

53.

Which finding indicates a pressure injury is worsening?

a)

A. Blanchable redness

b)

B. Warm skin

c)

C. Non-blanchable erythema

d)

D. Dry intact skin

54.

Which findings require neurovascular compromise evaluation? (Select all that apply.)

a)

A. Pallor

b)

B. Paresthesia

c)

C. Increased capillary refill time

d)

D. Increased appetite

e)

E. Pain unrelieved by medication

55.

Which instruction is MOST important when administering nitroglycerin?

a)

A. Swallow the tablet whole

b)

B. Sit or lie down before taking

c)

C. Take with food

d)

D. Store in plastic container

56.

Which behaviors indicate acute anxiety? (Select all that apply.)

a)

A. Rapid speech

b)

B. Difficulty concentrating

c)

C. Flat affect

d)

D. Palpitations

e)

E. Hyperventilation

57.

The LPN disagrees with a provider’s order that seems unsafe. What is the best action?

a)

A. Carry out the order

b)

B. Document concern only

c)

C. Clarify through the RN or chain of command

d)

D. Ask another LPN

58.

Which situations require droplet precautions? (Select all that apply.)

a)

A. Influenza

b)

B. Measles

c)

C. Meningococcal meningitis

d)

D. Tuberculosis

e)

E. Pertussis

59.

A client receiving blood transfusion develops chills and flank pain. What should the LPN do first?

a)

A. Slow the transfusion

b)

B. Stop the transfusion and notify RN

c)

C. Obtain vital signs

d)

D. Document findings

60.

Which findings suggest increased intracranial pressure? (Select all that apply.)

a)

A. Decreased level of consciousness

b)

B. Widening pulse pressure

c)

C. Bradycardia

d)

D. Fever

e)

E. Projectile vomiting

61.

Which actions are appropriate for central line care? (Select all that apply.)

a)

A. Scrub the hub

b)

B. Change dressing using sterile technique

c)

C. Use gloves only

d)

D. Monitor for signs of infection

e)

E. Flush with saline using aseptic technique

62.

Which client is at highest risk for electrolyte imbalance?

a)

A. Client receiving loop diuretics

b)

B. Client on antibiotics

c)

C. Client with mild anemia

d)

D. Client with controlled asthma

63.

Which instructions are appropriate for osteoporosis prevention? (Select all that apply.)

a)

A. Weight-bearing exercise

b)

B. Adequate calcium intake

c)

C. Smoking cessation

d)

D. Bedrest

e)

E. Vitamin D intake

64.

Which client assignment should the LPN question?

a)

A. Stable post-op day 2 client

b)

B. Client with new onset chest pain

c)

C. Client receiving oral antibiotics

d)

D. Client awaiting discharge

65.

Which findings indicate sepsis risk? (Select all that apply.)

a)

A. Fever

b)

B. Tachycardia

c)

C. Hypotension

d)

D. Elevated WBC

e)

E. Bradycardia

66.

An LPN is preparing to collect a stool specimen for occult blood. Which action is most important?

a)

A. Collect stool from the toilet bowl

b)

B. Instruct the client to avoid red meat before testing

c)

C. Refrigerate the specimen for 24 hours

d)

D. Add preservative to the sample

67.

Which actions are appropriate when discontinuing a peripheral IV catheter? (Select all that apply.)

a)

A. Apply pressure until bleeding stops

b)

B. Inspect catheter tip for integrity

c)

C. Apply warm compress immediately

d)

D. Cover site with sterile dressing

e)

E. Document removal and site condition

68.

Which IV fluids are considered isotonic? (Select all that apply.)

A. 0.9% normal saline

C. 0.45% saline
D. D5W (initially)
E. D10W

Correct Answers: A, B, D

Rationale:
Normal saline and LR are isotonic. D5W is isotonic in the bag (before metabolism). 0.45% is hypotonic.

a)

A. 0.9% normal saline

b)

B. Lactated Ringer’s

c)

C. 0.45% saline

d)

D. D5W (initially)

e)

E. D10W

69.

Which situation requires protective (reverse) isolation?

a)

A. Client with neutropenia

b)

B. Client with C. difficile

c)

C. Client with tuberculosis

d)

D. Client with influenza

70.

Which actions demonstrate appropriate documentation by an LPN? (Select all that apply.)

a)

A. Charting objective findings only

b)

B. Documenting after care is completed

c)

C. Altering documentation to correct an error

d)

D. Using approved abbreviations

e)

E. Recording client statements in quotes

71.

A client with dysphagia is prescribed thickened liquids. Which action is most appropriate?

a)

A. Encourage use of a straw

b)

B. Position the client supine

c)

C. Provide thickened liquids as ordered

d)

D. Offer thin liquids between meals

72.

Which findings suggest a client may be experiencing urinary retention? (Select all that apply.)

a)

A. Suprapubic distention

b)

B. Frequent small voids

c)

C. Decreased urine output

d)

D. Dysuria

e)

E. Bladder fullness on palpation

73.

Which actions are appropriate when caring for a client with a fecal management system? (Select all that apply.)

a)

A. Perform frequent skin assessment

b)

B. Apply skin barrier products

c)

C. Clamp the system during repositioning

d)

D. Maintain a closed drainage system

e)

E. Remove system daily for cleaning

74.

An LPN notes that a client’s morning weight increased by 2.5 kg (5.5 lb) in 24 hours. What is the best interpretation?

a)

A. Expected daily variation

b)

B. Increased nutritional intake

c)

C. Fluid retention

d)

D. Measurement error only

75.

Which findings in an older adult increase risk for dehydration? (Select all that apply.)

a)

A. Decreased thirst sensation

b)

B. Use of diuretics

c)

C. Dry mucous membranes

d)

D. Increased urine output

e)

E. Cognitive impairment