Coordinated Care
NCLEX-PN® practice.

Free practice set · 4 questions

4 more free coordinated care NCLEX-PN® practice questions

Real questions from the same bank the app serves. Pick an answer in your head, then open the rationale to see why the correct option holds and why each other option falls short. No account needed for these.

1. Question 1 of 4 · Nursing Leadership, Delegation & Advocacy

   A 22-year-old female resident of a long-term care facility is recovering on postoperative day 2 following a colostomy for traumatic bowel injury. The health care provider has ordered a wound revision procedure at the bedside for a small area of dehiscence. The LPN/VN reviews the chart and finds a consent form signed by the client and witnessed by the RN the previous evening. When the LPN/VN enters the room to prepare the client, the client states, "I don't really understand why they need to redo part of my surgery site, I thought it was healing fine." The client is alert, oriented, and has no cognitive impairment or sedation on board. What should the LPN/VN do first?

   1. ANotify the RN or provider that the client has voiced confusion about the procedure.
   2. BDocument the client's comment in the chart and continue with routine wound care as planned.
   3. CExplain the risks and benefits of the wound revision so the client feels reassured.
   4. DProceed to prepare the client for the procedure since the consent form is already signed.
   Show the answer and rationale

   Correct answer: A. Notify the RN or provider that the client has voiced confusion about the procedure.

   The client's statement reveals she does not understand the reason for the wound revision, even though a signed and witnessed consent form is already on the chart. Consent is only valid if the client's understanding persists through the time of the procedure; new confusion means the earlier consent may no longer be informed. Per the "report client questions or apparent misunderstanding" rule, the LPN/VN must halt preparation and notify the RN or provider so the client's questions can be clarified and, if necessary, consent re-obtained before proceeding. This upholds the client's right to informed consent and self-determination, consistent with the NFLPN/ANA code of ethics obligation to advocate for clients and protect their autonomy. Legally, per the "the provider obtains informed consent; the nurse witnesses" rule and the LPN/VN scope of practice defined by the state Nurse Practice Act, only the provider performing the procedure may explain risks/benefits and obtain informed consent; the LPN/VN's role is limited to witnessing the signature, verifying the form is complete, and reporting concerns, not independently teaching, reassuring, or proceeding despite ambiguity. Escalating this finding rather than acting on it or ignoring it keeps the LPN/VN within her legal role of collecting data and communicating findings, rather than independently managing the plan of care.

   A. Notify the RN or provider that the client has voiced confusion about the procedure.

   The client's confusion should be halted and escalated to the RN/provider, satisfying the "report client questions or apparent misunderstanding" rule. This aligns with the "the provider obtains informed consent; the nurse witnesses" rule, since only the provider re-clarifies and re-obtains consent.

   B. Document the client's comment in the chart and continue with routine wound care as planned.

   Simply documenting and continuing care without notifying the RN/provider fails to escalate an abnormal finding, violating the "report client questions or apparent misunderstanding" rule.

   C. Explain the risks and benefits of the wound revision so the client feels reassured.

   This is wrong scope because only the provider performing the procedure may explain risks/benefits and obtain informed consent, violating the "the provider obtains informed consent; the nurse witnesses" rule.

   D. Proceed to prepare the client for the procedure since the consent form is already signed.

   Proceeding despite the client's stated confusion ignores that new misunderstanding must be reported and clarified before the procedure, violating the "report client questions or apparent misunderstanding" rule.

2. Question 2 of 4 · Ethics, Advocacy & Health Policy

   A 22-year-old client in a rehabilitation unit has a sacral pressure injury and autonomic neuropathy after a spinal cord injury. Her baseline temperature is 36.8°C and heart rate is 78/min. Today, the electronic record shows 38.2°C and heart rate 104/min, with increased wound drainage. The client reports chills. A nursing assistant mentions an old note saying the wound “looked better.” The current orders address dressing changes only, with no infection evaluation. What should the LPN/VN do first?

   1. AFollow the nursing assistant’s older observation and continue the ordered dressing schedule without escalation.
   2. BNotify the RN of the current findings and the credible sources supporting a possible change in condition.
   3. CRevise the plan of care to include infection treatment and daily provider evaluation.
   4. DApply an additional antimicrobial dressing and reassess the wound at the next scheduled dressing change.
   Show the answer and rationale

   Correct answer: B. Notify the RN of the current findings and the credible sources supporting a possible change in condition.

   Notify the RN of the current findings and their credible sources. The client’s report of chills, current electronic-record vital signs, and increased drainage together represent a meaningful change from baseline and fall outside dressing-only orders. The LPN/VN collects and reports data, monitors the client, assists with care, and contributes to, not independently develops, the plan under the state Nurse Practice Act and NCSBN LPN/VN role. The RN, health care provider, and interdisciplinary team can assess, verify, and revise care through the chain of command. An old secondhand observation cannot outweigh current corroborated findings.

   A. Follow the nursing assistant’s older observation and continue the ordered dressing schedule without escalation.

   The nursing assistant’s old, secondhand observation is not a sufficient basis for a current clinical decision, especially when it conflicts with the client’s report and current record. Reliable, current data must be verified and reconciled. Continuing without escalation ignores a change from baseline and delays RN or provider evaluation of findings outside the existing plan.

   B. Notify the RN of the current findings and the credible sources supporting a possible change in condition.

   This is correct because the client’s current report, present vital signs, and wound change are more credible and clinically relevant than an old secondhand comment. Together they suggest a change outside the dressing-only plan, so the LPN/VN should promptly report to the RN for further assessment and provider or interdisciplinary collaboration. Reporting and monitoring are within LPN/VN scope; independently diagnosing or changing treatment is not.

   C. Revise the plan of care to include infection treatment and daily provider evaluation.

   The LPN/VN may contribute observations and suggest concerns, but does not independently develop or finalize the plan of care. Decisions about infection evaluation and treatment require collaboration with the RN and health care provider, using verified current data. Changing the plan alone exceeds the LPN/VN role under the Nurse Practice Act and the nursing chain of command.

   D. Apply an additional antimicrobial dressing and reassess the wound at the next scheduled dressing change.

   Adding treatment without reporting bypasses the chain of command. Although wound care may be part of the LPN/VN role, fever, tachycardia, chills, and increased drainage represent a possible change in condition outside the established orders. The LPN/VN should collect and communicate these findings to the RN rather than independently treating an ambiguous problem and delaying evaluation.

3. Question 3 of 4 · Community & Population Health

   An LPN is making a home health visit to a 32-year-old man with type 1 diabetes managed with insulin glargine 20 units nightly and insulin lispro per sliding scale, per the current plan of care. The client's baseline morning fingerstick glucose has ranged 90-120 mg/dL over the past week per the home glucose log. Today the client's wife tells the LPN that her mother, a retired nurse, said she read online that "insulin glargine should be split into two smaller doses" and that she gave her husband only 10 units last night "just to try it." The client's fingerstick this morning is 210 mg/dL, and he reports increased thirst since yesterday. What should the LPN do first?

   1. ARevise the client's insulin regimen to a split-dose schedule based on the grandmother's suggestion.
   2. BInstruct the wife to continue the split-dosing since a retired nurse recommended it online.
   3. CReport the missed insulin dose and elevated glucose to the RN or provider before any dose change.
   4. DGive the client an extra dose of insulin lispro now to correct the elevated glucose reading.
   Show the answer and rationale

   Correct answer: C. Report the missed insulin dose and elevated glucose to the RN or provider before any dose change.

   The secondhand, uncorroborated online suggestion relayed through a family member, attributed loosely to a retired nurse, is not a credible basis for changing therapy. The client's glucose of 210 mg/dL and new thirst represent a meaningful change from his established baseline of 90-120 mg/dL, and the altered dosing falls outside the current provider-ordered plan of care; this conflicting, out-of-plan data must be reported before any action is taken. These findings require weighing source credibility before acting on data and reporting data that falls outside the established plan. Per the LPN/VN's legal scope of practice under the Nurse Practice Act and NCSBN model, the LPN monitors, collects data, and contributes to the plan of care but does not independently diagnose, alter medication regimens, or finalize treatment changes, those require RN or provider direction. Because the finding is abnormal, ambiguous in cause, and diverges from ordered therapy, the LPN's responsibility is to escalate through the chain of command, notifying the RN case manager or the client's provider, rather than acting unilaterally, self-treating, or endorsing an unverified change. This ensures safe, coordinated care and keeps the LPN within scope while protecting client safety.

   A. Revise the client's insulin regimen to a split-dose schedule based on the grandmother's suggestion.

   Expands the "independently develops or finalizes the plan of care" error pattern: the LPN independently finalizes a new insulin regimen based on family input, which exceeds LPN scope, plan changes require provider/RN direction, not independent action.

   B. Instruct the wife to continue the split-dosing since a retired nurse recommended it online.

   Expands the "acts on a single uncorroborated or outdated source" error pattern: endorsing an unverified, secondhand online recommendation as valid violates the rule to verify source credibility before acting on or reinforcing clinical data.

   C. Report the missed insulin dose and elevated glucose to the RN or provider before any dose change.

   Correct: reports the out-of-plan dosing change and the reportable glucose elevation to the RN/provider, honoring both source-credibility verification and the duty to escalate conflicting data before acting.

   D. Give the client an extra dose of insulin lispro now to correct the elevated glucose reading.

   Expands the "acts on an abnormal finding without reporting" error pattern: the LPN independently treats the abnormal glucose with an extra dose instead of reporting, violating the requirement to escalate findings outside the plan before acting.

4. Question 4 of 4 · Nursing Leadership, Delegation & Advocacy

   A 34-year-old man with bipolar disorder is on a medical-surgical unit for pneumonia. His baseline is calm, sleeps 6 to 7 hours, and denies hallucinations. During the current assessment, he reliably reports hearing a voice commanding him to harm himself and says he has slept 2 hours nightly for 2 nights. The medication-reconciliation list is outdated, and his brother reports by telephone that he is “fine.” The plan includes routine rounding and assessment each shift, with no constant observation ordered. Which action should the nurse take first?

   1. AAsk the brother to confirm the hallucinations, then follow the brother’s report if he denies any concern.
   2. BRewrite the plan of care to include constant observation and psychiatric consultation.
   3. CNotify the RN immediately, report the client’s current statements and sleep change, and reconcile the conflicting sources.
   4. DGive the prescribed as-needed anxiolytic and continue routine rounding without notifying the RN.
   Show the answer and rationale

   Correct answer: C. Notify the RN immediately, report the client’s current statements and sleep change, and reconcile the conflicting sources.

   Notify the RN immediately and reconcile the conflicting sources. The client’s direct, current report is a credible assessment finding, and the marked change from his baseline, command hallucination, and severe sleep reduction fall outside routine rounding and require prompt escalation. The outdated medication list and reassuring secondhand report cannot override current findings. Under the state Nurse Practice Act and the NCSBN LPN/VN role, the practical nurse collects data, monitors, assists, reinforces teaching, and contributes to, not independently develops, the plan of care. Report to the RN, who can collaborate with the primary health care provider and interdisciplinary team to determine safety precautions and treatment.

   A. Ask the brother to confirm the hallucinations, then follow the brother’s report if he denies any concern.

   The brother’s telephone report is secondhand and cannot validate or dismiss the client’s current report. Relying on it would allow an uncorroborated source to override direct, current assessment data and would ignore the significant change from baseline. The LPN/VN should use credible current findings, report them to the RN, and support further assessment and safety decisions through the chain of command.

   B. Rewrite the plan of care to include constant observation and psychiatric consultation.

   The findings may justify constant observation or psychiatric consultation, but an LPN/VN does not independently rewrite or finalize the plan of care. The practical nurse should document and report the current findings to the RN, who collaborates with the provider and interdisciplinary team to revise orders and safety measures. Independent plan development exceeds the LPN/VN role.

   C. Notify the RN immediately, report the client’s current statements and sleep change, and reconcile the conflicting sources.

   This is correct because the client’s current, direct report is more credible than an outdated medication list or secondhand reassurance. The change from baseline and command hallucination conflict with the existing routine plan, so the LPN/VN should report promptly to the RN and help reconcile the information. This action stays within the practical nurse’s role of collecting data, monitoring, and contributing to care under RN and provider direction.

   D. Give the prescribed as-needed anxiolytic and continue routine rounding without notifying the RN.

   Administering a prescribed medication may be within LPN/VN scope, but treating the symptom without reporting a new command hallucination and major sleep change fails to escalate a potentially dangerous change in condition. The RN must be informed so the finding can be evaluated and the primary health care provider or mental health team can be involved. Medication administration does not replace collaboration or reassessment.