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This guide is a content review resource for LPN and LVN students who need to strengthen their foundational nursing knowledge before the NCLEX-PN. It covers the clinical topics that appear most frequently on the exam — organized by body system and nursing concept, not by test plan category.
Looking for the NCLEX-PN exam strategy, test plan, and prep resource recommendations instead? Use our NCLEX-PN Study Guide.
Key Takeaways
- This guide covers the core nursing content LPN students need to review: pharmacology, anatomy, clinical skills, and nursing concepts by body system.
- Organized by clinical topic for content review, not by NCLEX test plan structure.
- Focus your review time on the topics you missed on your baseline practice test.
- After content review, transition to practice questions using our LPN practice test.
How to Use This Study Guide
- Take a baseline assessment — try our LPN practice test first
- Identify your weakest topics from the results
- Study those topics first using the sections below
- After reviewing, do practice questions in each topic to confirm retention
- When content feels solid, move to NCLEX-PN practice questions for exam-format practice
Cardiovascular System
Essential Topics
- Heart anatomy and blood flow pathway (right atrium → right ventricle → pulmonary artery → lungs → pulmonary vein → left atrium → left ventricle → aorta)
- Normal vital sign ranges for adults (HR: 60–100, BP: <120/80, RR: 12–20, Temp: 97.8–99.1°F)
- Heart failure: left-sided (pulmonary symptoms — crackles, dyspnea, orthopnea) vs right-sided (systemic symptoms — JVD, peripheral edema, hepatomegaly)
- Hypertension: classification, lifestyle modifications, common medications (ACE inhibitors, ARBs, calcium channel blockers, beta-blockers)
Key Medications
| Drug | Class | Key Point |
|---|---|---|
| Lisinopril | ACE inhibitor | Monitor for hyperkalemia, dry cough |
| Metoprolol | Beta-blocker | Hold if HR <60, monitor for bradycardia |
| Amlodipine | Calcium channel blocker | Monitor for peripheral edema, dizziness |
| Furosemide | Loop diuretic | Monitor potassium (hypokalemia), I&O |
Respiratory System
Essential Topics
- Breath sounds: normal (vesicular, bronchial, bronchovesicular) vs abnormal (crackles, wheezes, stridor, rhonchi)
- Oxygen delivery devices: nasal cannula (1–6 L, 24–44% FiO2), simple mask (5–8 L, 40–60%), non-rebreather (10–15 L, 80–95%)
- COPD vs asthma: COPD is chronic and irreversible, asthma is episodic and reversible
- Tuberculosis: airborne precautions, N95 respirator, negative-pressure room, Mantoux test interpretation (≥5mm for high-risk, ≥10mm for moderate risk, ≥15mm for low risk)
Nursing Priorities
- ABCs — always assess airway first
- Position COPD patients in high Fowler's or tripod position for breathing
- Never give high-flow oxygen to COPD patients (removes hypoxic drive)
- Incentive spirometry teaching: 10 breaths per hour while awake post-operatively
Gastrointestinal System
Essential Topics
- Upper GI: GERD (avoid lying down after meals, elevate HOB 30°), peptic ulcer disease (H. pylori treatment: triple therapy — PPI + 2 antibiotics)
- Lower GI: Crohn's disease (transmural, skip lesions, right lower quadrant pain) vs ulcerative colitis (mucosal only, continuous, left lower quadrant, bloody diarrhea)
- Liver disease: signs of hepatic failure (jaundice, ascites, hepatic encephalopathy), lactulose for ammonia reduction
- NG tube management: verify placement (pH testing, X-ray), irrigation with NS, document drainage character and volume
Diet Modifications
| Condition | Diet |
|---|---|
| GERD | Low-fat, small frequent meals, no eating 2–3 hours before bed |
| Liver disease | Low-sodium, protein restriction (if encephalopathy) |
| Diverticulitis (acute) | Clear liquids → low fiber. High fiber when resolved. |
| Celiac disease | Strict gluten-free (no wheat, barley, rye, oats unless certified) |
Endocrine System
Essential Topics
- Diabetes mellitus: Type 1 (insulin-dependent, autoimmune, younger onset) vs Type 2 (insulin-resistant, lifestyle-related, older onset)
- Insulin administration: rotate injection sites, roll vial (don't shake), draw clear insulin before cloudy (regular before NPH)
- Hypoglycemia (<70 mg/dL): sweating, tremors, confusion, tachycardia → treat with 15g fast-acting carbohydrate, recheck in 15 minutes (Rule of 15)
- Hyperglycemia: polyuria, polydipsia, polyphagia → monitor blood glucose, administer insulin as ordered
- Thyroid: hypothyroid (fatigue, weight gain, cold intolerance, constipation) vs hyperthyroid (weight loss, heat intolerance, tachycardia, anxiety)
Critical Lab Values
| Lab | Normal Range | Clinical Significance |
|---|---|---|
| Fasting glucose | 70–100 mg/dL | <70 = hypoglycemia, >126 = diabetes |
| HbA1C | <5.7% | 5.7–6.4% = prediabetes, ≥6.5% = diabetes |
| TSH | 0.4–4.0 mIU/L | High = hypothyroid, Low = hyperthyroid |
Musculoskeletal System
Essential Topics
- Fracture care: neurovascular checks (5 P's — Pain, Pallor, Pulselessness, Paresthesia, Paralysis)
- Cast care: do not insert objects under the cast, monitor for compartment syndrome (severe pain out of proportion, numbness, swelling)
- Hip replacement: no hip flexion >90°, no crossing legs, no internal rotation, elevated toilet seat
- Osteoporosis: calcium + vitamin D supplementation, weight-bearing exercise, bisphosphonates (take on empty stomach, upright for 30 minutes)
Renal System
Essential Topics
- Normal urine output: 30 mL/hour minimum (report if <30 mL/hour)
- Chronic kidney disease: stages 1–5, dialysis considerations, dietary restrictions (low sodium, low potassium, low phosphorus, fluid restriction)
- UTI: symptoms (dysuria, frequency, urgency, cloudy urine), prevention (increase fluid intake, front-to-back wiping, empty bladder after intercourse)
- Foley catheter care: maintain closed drainage system, keep bag below bladder level, secure tubing to prevent pulling
Electrolyte Imbalances
| Electrolyte | Normal | Low Signs | High Signs |
|---|---|---|---|
| Potassium | 3.5–5.0 mEq/L | Muscle weakness, flat T waves | Peaked T waves, arrhythmias |
| Sodium | 136–145 mEq/L | Confusion, seizures | Thirst, dry mucous membranes |
| Calcium | 8.5–10.5 mg/dL | Tetany, Chvostek sign | Constipation, kidney stones |
Mental Health Nursing
Essential Topics
- Therapeutic communication techniques: open-ended questions, reflection, active listening, restating
- Non-therapeutic responses to avoid: false reassurance, advice-giving, "why" questions, changing the subject
- Depression: risk factors, safety assessment, suicide precautions
- Anxiety levels: mild (increased alertness), moderate (narrowed focus), severe (difficulty concentrating), panic (loss of rational thought)
- Abuse recognition: unexplained injuries, inconsistent explanations, withdrawal — report suspected abuse per mandatory reporting laws
Infection Control Review
Standard Precautions
Applied to ALL patients, regardless of diagnosis:
- Hand hygiene before and after patient contact
- Gloves for contact with blood, body fluids, mucous membranes
- Gown if clothing may be soiled
- Mask + eye protection if splash/spray risk
Transmission-Based Precautions
| Type | Used For | PPE | Room |
|---|---|---|---|
| Contact | C. diff, MRSA, scabies | Gown + gloves | Private room preferred |
| Droplet | Influenza, meningococcus, pertussis | Surgical mask | Private room, door open OK |
| Airborne | TB, measles, varicella | N95 respirator | Negative-pressure, door closed |
What to Do After This Review
- Retake the LPN practice test to measure improvement
- If scoring 70%+, transition to NCLEX-PN practice questions
- Build your exam prep schedule with the NCLEX-PN study guide
- Compare QBank options in Best NCLEX-PN Prep
Related Resources
- LPN Practice Test — topic-based skills assessment
- NCLEX-PN Practice Questions — exam-format practice by client needs
- NCLEX-PN Study Guide — exam strategy and prep resource roadmap
- NCLEX Study Guide — the comprehensive overview
- NCLEX-RN vs NCLEX-PN — understand exam differences
Frequently Asked Questions
What's the difference between this guide and the NCLEX-PN Study Guide?
This guide focuses on clinical content review — the nursing knowledge you need to know (pharmacology, anatomy, disease processes). The NCLEX-PN study guide focuses on exam strategy — test plan structure, study schedule, QBank selection, and readiness benchmarks. Use both: this guide to learn the content, and the PN study guide to plan your exam prep.
How long should content review take?
One to two weeks for students with strong LPN program performance. Three to four weeks for students with significant content gaps. After content review, spend the remaining prep time on practice questions.
Should I review everything or just my weak areas?
Focus 70% of your review time on weak areas identified by your baseline practice test. Spend 30% maintaining your strong areas with light review to prevent knowledge decay.
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