Lpn/lvn Exit Exam Preparation in California

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Sample questions from Lpn/lvn Exit Exam Preparation in California

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a home visit, a client with COPD who uses oxygen at 2 L/min by nasal cannula reports increased shortness of breath. Which finding requires the practical nurse to notify the RN promptly?

   • A.The client has a productive cough with a small amount of clear sputum.
   • B.The client asks whether the oxygen tubing can be repositioned behind the ears.
   • C.The client has an SpO2 of 88% on the prescribed oxygen and is newly confused.
   • D.The client reports a dry mouth after using oxygen.

   Rationale: An SpO2 of 88% despite prescribed oxygen together with new confusion may indicate worsening hypoxemia and requires prompt reporting. Dry mouth can occur with oxygen use, and clear sputum can be expected with chronic respiratory disease, but neither finding alone signals the same immediate deterioration. Repositioning tubing to reduce pressure is routine comfort care. The exam takeaway is to recognize acute changes in oxygenation and mental status and promptly report them.

2. 2.Refer to the client's chart. Which actions should the practical nurse take or report promptly in response to the findings? Select all that apply.

   • A.Report the potassium of 6.1 mEq/L and new peaked T waves to the RN immediately.
   • B.Place the client on a cardiac monitor if this is within facility protocol and promptly alert the RN to the rhythm change.
   • C.Ask the client about weakness or palpitations while promptly reporting the abnormal findings.
   • D.Recheck the potassium level at the next routine laboratory draw before notifying the RN.
   • E.Give the scheduled oral potassium supplement to maintain the prescribed regimen.

   Rationale: The potassium of 6.1 mEq/L, peaked T waves, and reported muscle weakness are concerning for potentially dangerous hyperkalemia, so the practical nurse should immediately report these findings and gather focused data. Applying cardiac monitoring is appropriate when permitted by facility protocol and should not delay notification. Administering potassium could worsen the hyperkalemia, and waiting for the next routine laboratory draw delays response to an urgent change. The exam takeaway is to promptly escalate critical electrolyte abnormalities and associated ECG changes.

3. 3.After total hip arthroplasty, a client reports sudden shortness of breath and sharp chest pain when taking a breath. What is the practical nurse's priority action?

   • A.Apply sequential compression devices and document the symptoms.
   • B.Raise the head of the bed, stay with the client, and immediately alert the RN.
   • C.Assist the client to walk in the hallway to improve circulation.
   • D.Offer prescribed oral analgesia and reassess the pain in 1 hour.

   Rationale: Sudden dyspnea and pleuritic chest pain after surgery may indicate pulmonary embolism, so the practical nurse should support breathing, remain with the client, and urgently notify the RN. Walking could worsen instability, and analgesia alone could delay evaluation of a life-threatening change. Compression devices are used for prevention, not as the response to acute symptoms. The exam takeaway is to recognize possible embolism and escalate immediately rather than focus on routine prophylaxis.

4. 4.A client with type 1 diabetes is awake, diaphoretic, and shaky before lunch. The blood glucose is 54 mg/dL. Which action is appropriate for the practical nurse?

   • A.Give a high-fat snack and recheck the glucose in 1 hour.
   • B.Withhold all food and insulin until the client is no longer diaphoretic.
   • C.Administer the scheduled rapid-acting insulin before the meal.
   • D.Give 15 g of a rapid-acting oral carbohydrate and recheck glucose in 15 minutes.

   Answer and rationale are in the full material.

5. 5.A toddler with asthma is receiving a prescribed nebulized bronchodilator in the clinic. Which finding should the practical nurse report to the RN immediately?

   • A.The child has retractions, decreasing breath sounds, and becomes difficult to arouse.
   • B.The child has a respiratory rate of 26/min and speaks in short phrases while crying.
   • C.The child is playful and has mild expiratory wheezing.
   • D.The child asks for water after the nebulizer treatment.

   Answer and rationale are in the full material.