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NCLEX-PN: 1019 Online Flashcards

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NCLEX-PN (National Council Licensure Examination for Practical Nurses) exam prep: 1019 question-and-answer flashcards covering pathology, management, procedures. Try 30 free below — no sign-up required.

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📚 managementmedium

A charge nurse is assigning tasks. Which patient is MOST appropriate for the LPN/LVN?

A)Newly admitted with crushing chest pain.
B)Chronic COPD requiring scheduled nebulizer.
C)Post-op day 1 requiring titration of vasopressors.
D)Suspected bowel obstruction needing initial assessment.
#management#scope
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Card #1
Answer
B is correct. LPNs care for stable patients with predictable outcomes. A patient with chronic COPD receiving scheduled meds is considered stable. Options A and D require initial assessments and diagnostic reasoning (RN role). Option C involves critical care titration, which is outside the LPN scope. Strategy: Look for chronic, stable, or routine for the LPN.
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Card #1
2
📚 managementhard

An LPN is supervising a UAP. Which task is INAPPROPRIATE to delegate?

A)Documenting intake and output.
B)Applying a cold pack to a sprained ankle.
C)Reinforcing teaching on insulin injection.
D)Assisting a stable patient with a shower.
#management#delegation
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Card #2
Answer
C is correct. While LPNs can reinforce teaching initiated by an RN, UAPs cannot perform any level of teaching or reinforcement. UAPs perform routine ADLs and simple, non-invasive procedures (like cold packs if per policy). Strategy: Remember TAPE (Teaching, Assessment, Planning, Evaluation) cannot be delegated to UAPs.
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Card #2
3
📚 managementmedium

An LPN asks a UAP to check on the patient in room 4. Which Right of Delegation has been violated?

#management#delegation
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Card #3
Answer
The Right Direction and Communication. The LPN failed to provide specific instructions, expected outcomes, and timeframes. Effective delegation requires the Four Cs: Clear, Concise, Correct, and Complete instructions. The LPN should specify what to check (e.g., pain level, vitals) and when to report back.
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Card #3
4
📚 managementhard

Which IV-related task is typically within the LPN scope of practice for a patient with a peripheral IV?

A)Initial IV push of a high-alert medication.
B)Monitoring the site for infiltration.
C)Titrating a Heparin drip based on PTT.
D)Inserting a PICC line.
#management#scope
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Card #4
Answer
B is correct. LPNs are responsible for data collection and monitoring. Monitoring an IV site for signs of infiltration or phlebitis is a core LPN competency. High-alert IV pushes, titration of critical drips, and central line (PICC) insertion are RN or advanced roles. Note: State boards vary, but NCLEX-PN focuses on this distinction.
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Card #4
5
📚 managementmedium

During the nursing process, which step is the LPN primarily responsible for contributing to, rather than initiating independently?

A)Evaluation of the entire care plan.
B)Formulating the initial nursing diagnosis.
C)Data collection and reporting.
D)Developing the original goals.
#management#scope
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Card #5
Answer
C is correct. The LPN scope focuses on data collection (vitals, physical findings) and reporting to the RN. The RN is responsible for the ANA steps: Assessment (initial/comprehensive), Nursing Diagnosis, and Analysis. The LPN contributes to the plan but does not create the framework.
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Card #5
6
📚 managementhard

The LPN is assigned four patients. Which patient should be seen FIRST?

A)Post-op patient 4 hours out with 50mL serosanguinous drainage.
B)Patient with DM whose morning glucose is 160 mg/dL.
C)Patient with asthma who just received a PRN albuterol treatment for wheezing.
#management#prioritization
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Card #6
Answer
C is correct. Using the ABC (Airway, Breathing, Circulation) priority framework, the patient with active wheezing and respiratory distress requiring PRN intervention is the least stable. Options A and B represent expected post-op findings and mild hyperglycemia, which are lower priority than active respiratory issues.
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Card #6
7
📚 managementmedium

An RN has just completed initial teaching for a patient with a new colostomy. What is the appropriate role for the LPN?

A)Modifying the teaching plan.
B)Reinforcing the steps of bag changes.
C)Evaluating the patient's readiness to learn.
D)Choosing the educational materials.
#management#scope
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Card #7
Answer
B is correct. LPNs reinforce teaching that has already been established by the RN. They cannot create the plan, choose the materials, or perform the initial evaluation of learning readiness. Strategy: LPN = Reinforcement; RN = Initial Teaching/Evaluation.
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Card #7
8
📚 managementhard

An LPN is considering delegating vitals to a UAP. In which scenario is this INAPPROPRIATE?

A)Routine vitals on a stable geriatric patient.
B)Vitals every 15 minutes for a patient receiving a blood transfusion.
C)Vitals for a patient being discharged.
#management#delegation
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Card #8
Answer
B is correct. This violates the Right Circumstance. Patients receiving blood products are unstable and at high risk for acute reactions. The nurse must perform these assessments to identify subtle changes. Routine or discharge vitals for stable patients are appropriate for UAPs.
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Card #8
9
📚 managementmedium

Which medication administration task is generally excluded from the LPN scope on the NCLEX-PN?

A)Administering a PRN oral analgesic.
B)Giving a subcutaneous insulin injection.
C)Administering IV chemotherapy.
D)Applying a topical nitroglycerin patch.
#management#scope
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Card #9
Answer
C is correct. Complex, high-risk medications like chemotherapy or certain IV push medications are generally reserved for RNs with specialized certification. LPNs routinely give oral, SQ, IM, and some IV piggyback medications (depending on state/facility) but not high-acuity specialty meds.
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Card #9
10
📚 managementhard

A UAP reports a blood pressure of 88/50 mmHg for a patient who just returned from surgery. What is the LPN's first action?

A)Tell the UAP to re-check it in 30 minutes.
B)Document the finding.
C)Immediately assess the patient's clinical status.
D)Call the surgeon.
#management#delegation
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Card #10
Answer
C is correct. When a UAP reports an abnormal or critical finding, the nurse's priority is to validate the data by personally assessing the patient. The nurse must check for signs of shock (tachycardia, pallor, altered LOC) before calling the provider or delegating further. Never ignore a critical value reported by a UAP.
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Card #10
11
📚 managementmedium

A client with terminal cancer has a Do Not Resuscitate (DNR) order. The client's daughter demands everything be done if the client stops breathing. What is the priority action by the PN?

#advocacy#ethics#legal
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Card #11
Answer
The PN must honor the client's documented wishes as long as they were competent when the DNR was signed. Priority: 1. Respect the DNR. 2. Support the daughter by explaining the order reflects the client's wishes. 3. Notify the RN/provider of the family's distress. NCSBN Tip: Client autonomy is the priority; family wishes cannot override a legal DNR order or a competent client's stated preference.
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Card #11
12
📚 managementmedium

The PN is asked to witness a client's signature on an informed consent form for a surgical procedure. What does the PN's signature as a witness specifically verify?

#informed-consent#legal
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Card #12
Answer
The PN's signature verifies: 1. The signature is authentic (the person is who they say they are). 2. The client signed voluntarily. 3. The client appears to have the mental capacity to sign. PN Role: The PN does NOT explain the procedure, risks, or benefits; that is the provider's responsibility. If the client has questions, the PN must notify the provider to return.
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Card #12
13
📚 managementmedium

During admission, a client says, I don't need an Advance Directive; my kids know what I want. Per the Patient Self-Determination Act (PSDA), what is the PN's required action?

#PSDA#legal
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Card #13
Answer
The PSDA requires facilities to: 1. Provide written info about rights to accept/refuse care. 2. Ask if the client has an Advance Directive. 3. Document the status in the chart. PN Role: Inform the client of their rights and offer resources (social work) if they change their mind. Strategy: You cannot force a client to create one, but you must provide the info and document the refusal.
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Card #13
14
📚 managementmedium

A client is scheduled for surgery. When the PN arrives to prep the client, the client says, I'm not sure I want this surgery anymore; I'm scared. What is the best response by the PN?

#advocacy#refusal
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Card #14
Answer
Advocacy involves supporting the client's right to refuse. Action: 1. Acknowledge the client's feelings. 2. Notify the surgeon and RN immediately. 3. Ensure the client understands they have the right to withdraw consent at any time. Strategy: The PN should not try to talk the client into the surgery; the goal is to facilitate communication between the client and the provider.
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Card #14
15
📚 managementmedium

A client's family is arguing about whether to continue life support for a client who lacks capacity. There is no Advance Directive. Who is the legal decision-maker in the absence of a DPOA?

#legal#ethics
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Card #15
Answer
Hierarchy varies by state but generally follows: Spouse, adult children, parents, then adult siblings. If conflict persists or no family exists, an ethics committee or court-appointed guardian is involved. PN Role: Support the family, provide factual data as reported by the provider, and notify the RN/Social Worker to facilitate an ethics consult. Strategy: Ethics committees resolve conflicts.
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Card #15
16
📚 managementhard

An alert client expresses they no longer want life-sustaining treatment but hasn't updated their written Advance Directive. The family disagrees. How should the PN advocate for this client?

#autonomy#advocacy
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Card #16
Answer
A competent client has the right to change their mind at any time, orally or in writing. The PN's role is to advocate for the client's current expressed wishes. Action: Document the client's statement, notify the RN and provider immediately, and facilitate a care conference. Strategy: NCLEX focuses on Client Autonomy. A currently competent client's verbalized wish takes precedence over documents.
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Card #16
17
📚 managementhard

A client with an Advance Directive is admitted in a comatose state. The family provides a copy of a Durable Power of Attorney for Healthcare (DPOA-HC). When does this document become active?

#DPOA#legal
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Card #17
Answer
The DPOA-HC (Healthcare Proxy) becomes active ONLY when the client is determined by a provider to lack the capacity to make their own decisions (e.g., unconsciousness). The agent then makes decisions based on the client's known wishes. NCLEX Tip: Distinguish between a Living Will (treatments) and DPOA (person). The PN must ensure the DPOA is documented in the electronic health record.
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Card #17
18
📚 managementhard

A PN observes a provider performing an invasive procedure without having obtained signed informed consent. The client is confused and unable to provide verbal consent. What is the priority action?

#advocacy#malpractice
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Card #18
Answer
The PN must intervene immediately. Priority: 1. Stop the procedure if safe to do so. 2. Notify the nursing supervisor or charge nurse. 3. Document the incident objectively. Advocacy means being the voice for the vulnerable. NCLEX Distractor: Do not wait for the procedure to finish to report; immediate intervention is required to protect the client's rights and safety.
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Card #18
19
📚 managementhard

An LPN is caring for a client with a Living Will that specifies no intubation. The client develops respiratory failure. The provider orders immediate intubation. What is the LPN's first action?

#living-will#advocacy
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Card #19
Answer
First action: Verify the presence of the Advance Directive in the medical record and bring it to the provider's attention immediately. Advocacy: The PN must ensure the medical team is aware of the client's legal refusal of specific treatments. If the provider persists, the PN should notify the nursing supervisor. Clinical Pearl: Living Wills are legally binding refusals of specific care.
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Card #19
20
📚 managementhard

A PN is assigned to a client who is a victim of elder abuse. The client begs the PN not to tell anyone because they fear retaliation. What is the PN's legal and advocacy obligation?

#legal#abuse#mandated-reporter
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Card #20
Answer
The PN is a Mandated Reporter. Legal obligation: Report the suspected abuse to the appropriate authorities (Adult Protective Services) and the nursing chain of command, regardless of the client's request. Advocacy: Protecting the client from further harm outweighs the client's request for secrecy in cases of suspected criminal neglect or abuse. NCLEX Tip: Mandated reporting is non-negotiable.
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Card #20
21
📚 managementmedium

An LPN is asked to witness a patient's signature on a surgical consent form. The patient asks\, What are the risks of this procedure? What is the LPN's priority action?

#legal#consent
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Card #21
Answer
The LPN must notify the surgeon that the patient has questions about the procedure. The LPN's role as a witness is limited to verifying that the signature is authentic\, voluntary\, and the patient is competent. The provider (surgeon) is legally responsible for explaining risks\, benefits\, and alternatives. Strategy: Never witness a signature if the patient expresses a lack of understanding.
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Card #21
22
📚 managementmedium

A 17-year-old patient who is married and lives independently arrives at the clinic for an elective procedure. Who is legally authorized to sign the informed consent?

#legal#minors
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Card #22
Answer
The patient. As an emancipated minor (due to marriage and independence)\, the patient has the legal right to provide their own informed consent. Other criteria for emancipation often include pregnancy\, parenthood\, or military service. NCLEX Tip: Standard minors (under 18) require a parent or legal guardian\, but emancipation grants full adult legal rights regarding healthcare.
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Card #22
23
📚 managementmedium

An LPN discovers a medication error and immediately assesses the patient. After notifying the provider\, the LPN completes an incident report. Where should the LPN document this report?

#legal#documentation
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Card #23
Answer
The LPN should file the report according to facility policy (usually Risk Management) and NOT mention it in the medical record. The medical record should only contain factual data: the error\, the patient's assessment\, and that the provider was notified. Strategy: Mentioning an incident report in the chart makes the report discoverable in a lawsuit\, increasing legal liability.
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Card #23
24
📚 managementmedium

An LPN suspects physical abuse after observing unexplained burns on a 4-year-old child. What is the LPN's primary legal obligation in this situation?

#legal#reporting
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Card #24
Answer
The LPN is a mandatory reporter and must report suspected abuse to the appropriate local authorities or social services immediately. Proof is not required; only a reasonable suspicion is necessary. Failure to report can result in criminal charges and loss of licensure. NCLEX Strategy: Do not delay reporting to investigate or confront the parents; reporting is the priority.
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Card #24
25
📚 managementmedium

An adult daughter calls the nursing unit to ask about her father's condition. The father is alert and oriented. What must the LPN confirm before sharing any information?

#legal#privacy
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Card #25
Answer
The LPN must confirm that the patient has provided written consent (HIPAA release) for that specific individual to receive medical information. Even if the caller is a close relative\, the patient's right to privacy is absolute unless they are incapacitated. Strategy: Check the patient's privacy code or approved contact list before disclosing any clinical data.
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Card #25
26
📚 managementhard

A patient is brought to the ED unconscious with massive internal bleeding. No family is present. The surgeon proceeds with emergency surgery without a signed consent. This is an example of:

#legal#consent
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Card #26
Answer
Implied Consent. In life-threatening emergencies where the patient cannot consent and a legal surrogate is unavailable\, the law assumes the patient would want life-saving treatment. Clinical Pearl: The healthcare team must document the emergency nature of the situation and the inability to obtain express consent to protect against battery/negligence claims.
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Card #26
27
📚 managementhard

A patient with a valid Do Not Resuscitate (DNR) order tells the LPN\, I've changed my mind. I want to live if my heart stops. What is the LPN's priority action?

#legal#directives
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Card #27
Answer
Immediately honor the patient's verbal request to revoke the DNR and notify the healthcare provider to update the medical orders. Patients have the legal right to revoke or change Advance Directives at any time\, regardless of written status. Strategy: Verbal revocation is legally binding in the clinical setting; the LPN must ensure the entire team is notified immediately.
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Card #27
28
📚 managementhard

An LPN fails to follow a fall-prevention protocol for a confused patient\, resulting in a fall and a fractured hip. Which element of malpractice is met by the hip fracture itself?

#legal#malpractice
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Card #28
Answer
Damages (or Injury). Malpractice requires four elements: 1. Duty (the LPN owed care)\, 2. Breach of Duty (failure to follow protocol)\, 3. Proximate Cause (the breach caused the fall)\, and 4. Damages (the actual physical injury\, like the fracture). NCLEX Focus: Without actual damage or harm\, a nurse's mistake may be a near miss or breach\, but it does not constitute malpractice.
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Card #28
29
📚 managementhard

A patient with an active pulmonary embolism insists on leaving the hospital against medical advice (AMA). What is the LPN's most critical legal responsibility?

#legal#ama
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Card #29
Answer
The LPN must ensure the patient is informed of the specific risks of leaving\, including the risk of death. The LPN should notify the provider and facilitate the signing of an AMA form. Strategy: If the patient refuses to sign the AMA form\, the LPN must document this refusal. Crucially\, the LPN cannot physically restrain the patient\, as this would be false imprisonment.
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Card #29
30
📚 managementhard

A provider gives a telephone order for a STAT dose of IV medication. What specific action must the LPN take to ensure legal and patient safety?

#legal#documentation
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Card #30
Answer
The LPN must perform a Read-Back (write the order down\, read it back to the provider\, and receive verbal confirmation). The LPN must also ensure the provider signs the order within the facility-mandated timeframe (usually 24 hours). NCLEX Strategy: Telephone and verbal orders are high-risk; always prioritize Read-Back to prevent communication errors and legal disputes.
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Card #30

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About This Collection

In my years mentoring practical nursing students and graduates, I have found that the difference between a near-miss and a confident pass often comes down to the depth of preparation. The NCLEX-PN is not merely a test of fact recall; it is a comprehensive assessment of your ability to make safe clinical judgments. I created this complete collection because I believe you need a systematic way to review the vast amount of material required for licensure without feeling overwhelmed by unstructured data. This full collection includes 1,019 flashcards, covering the essential domains you will face on exam day. When I work with candidates, I emphasize that you cannot rely on surface-level knowledge. You need to dive deep into pharmacology, understanding not just the drug class but the specific nursing interventions and adverse effects. We cover pathology, diagnostics, and physiology extensively here because a strong foundation in these basics is what allows you to answer the complex, higher-level questions correctly. I have seen too many students struggle because they memorized a disease name but did not understand the underlying physiology. Beyond the biological sciences, I have ensured this collection addresses the critical operational aspects of nursing. Topics like management of care, safety protocols, and ergonomics are heavily weighted on the exam because they are vital for patient safety in the real world. I often tell my colleagues that understanding safety assessments and procedures is what keeps your license safe and your patients alive. This collection treats these topics with the seriousness they deserve, ensuring you are ready for the priority-setting scenarios the exam will present. To get the most out of these 1,019 flashcards, I recommend a consistent, daily study routine. Do not try to cram this material in a week. In my experience, the most successful candidates break their study sessions into manageable chunks, focusing on one category like diagnostics or assessment at a time. Use these cards to identify your weak spots. If you find yourself struggling with a specific procedure or concept, pause and review your textbooks, then come back to the card. Active recall is one of the most effective ways to solidify your clinical judgment. Preparing for licensure is perhaps the most significant investment you will make in your early career. It requires discipline, patience, and the right resources. By committing to mastering this comprehensive set of materials, you are doing more than just studying for a test; you are building the professional confidence required to step onto the floor as a licensed nurse. I look forward to hearing about your success.