Coordinated Care — NCLEX-PN practice questions

Which is an example of negligence by the LPN?

1. Documenting medication two minutes after administration
2. Failing to raise the side rails on a confused elderly patient who then falls
3. Asking the RN to clarify a confusing order
4. Calling the provider about a low blood pressure

Answer: B — Failing to raise the side rails on a confused elderly patient who then falls

A) Acceptable practice. B) Correct — omission of standard safety measures with foreseeable harm meets the elements of negligence. C) Appropriate use of the team. D) Appropriate escalation.

The LPN identifies a near-miss when a look-alike medication was almost given. Best action?

1. Discard the wrong medication and move on
2. Tell the patient and apologize
3. Complete an incident or safety event report
4. Wait to see if anyone else noticed

Answer: C — Complete an incident or safety event report

A) System learning is lost. B) Disclosure rules apply to actual harm; near-misses are reported through safety systems. C) Correct — incident reports capture near-misses to prevent recurrence. D) Patient safety culture requires reporting.

The LPN's scope differs from the RN's in that the LPN:

1. Cannot administer medications
2. Cannot work in hospitals
3. Practices under RN/MD supervision and doesn't initiate the nursing care plan
4. Has identical scope as the RN

Answer: C — Practices under RN/MD supervision and doesn't initiate the nursing care plan

A) LPNs do administer many medications. B) LPNs work in many hospital settings. C) Correct — LPN reinforces teaching but doesn't initiate it; RN performs initial assessment and care planning; LPN updates and implements under supervision. D) Different scopes; RN has broader autonomy.

Informed consent — the LPN's role is to:

1. Explain the procedure to the patient
2. Witness the signature and verify understanding
3. Sign for the patient
4. Determine if surgery is appropriate

Answer: B — Witness the signature and verify understanding

A) MD must provide procedure explanation. B) Correct — LPN/RN witnesses signature, ensures patient is competent/not pre-medicated, verifies understanding. Can call MD if questions remain. C) Never sign for patient. D) MD decision.

The LPN finds an incorrect dose was charted by another nurse but the dose was correct. Best action?

1. Erase the entry
2. Write over the entry
3. Notify the charting nurse so a late-entry correction can be made per policy
4. Ignore it

Answer: C — Notify the charting nurse so a late-entry correction can be made per policy

A,B) Never alter another's documentation; never erase. C) Correct — the original author corrects with a proper late entry. D) Inaccurate record persists.

A patient with hearing loss removes hearing aids before sleep. To communicate during the night shift, the LPN should:

1. Speak loudly through the door
2. Face the patient, speak clearly at normal volume, and ensure adequate lighting
3. Use only written notes
4. Ask the family to translate

Answer: B — Face the patient, speak clearly at normal volume, and ensure adequate lighting

A) Volume distorts speech; visual cues lost. B) Correct — face-to-face communication with lipreading cues is most effective. C) Written communication can supplement but is not primary. D) Inappropriate after hours and not a translation issue.

Mandatory reporting applies to all EXCEPT:

1. Suspected child abuse
2. Suspected elder abuse
3. Patient's diet preferences
4. Suspected impaired colleague

Answer: C — Patient's diet preferences

A) Required. B) Required. C) Correct — diet preferences are not legally reportable. D) Required — impaired practice endangers patients.

An LPN receives a verbal order over the phone from a provider. Which step is essential?

1. Write the order and read it back to the provider for confirmation
2. Carry out the order before documenting
3. Have the UAP take the order
4. Sign the order with the provider's name

Answer: A — Write the order and read it back to the provider for confirmation

A) Correct — read-back of verbal/telephone orders is a Joint Commission safety practice and reduces transcription error. B) Document before implementing. C) UAP cannot take orders. D) Never sign for another clinician.

Which patient should the LPN see FIRST?

1. Patient with new-onset chest pain
2. Patient with chronic stable pain
3. Patient requesting discharge teaching
4. Patient asking for warm blankets

Answer: A — Patient with new-onset chest pain

B) Chronic stable — non-urgent. A) Correct — new chest pain could indicate cardiac event (ACS, MI); always evaluate first. C) Teaching is important but not time-critical. D) Comfort, not urgent.

During shift handoff, which method best supports patient safety?

1. A written note left at the bedside
2. An emailed summary to the oncoming nurse
3. A brief verbal report in the breakroom
4. A structured SBAR handoff at the bedside with the patient included when possible

Answer: D — A structured SBAR handoff at the bedside with the patient included when possible

A) No verification or two-way exchange. D) Correct — SBAR is structured, bedside handoff allows the patient to confirm and the nurse to verify equipment, lines, and skin. C) Lacks bedside verification. B) Email cannot replace synchronous handoff.

Documentation rules?

Objective, timely, accurate, legible. Sign with name + credential. Never alter — line through errors and initial.

Who takes NCLEX-PN?

Graduates of approved practical/vocational nursing programs seeking LPN or LVN licensure.

The 4 Client Needs categories?

Safe & Effective Care Environment, Health Promotion & Maintenance, Psychosocial Integrity, Physiological Integrity.

What does NCLEX-PN stand for?

National Council Licensure Examination for Practical Nurses (LPN/LVN).