NCLEX-PN – NCLEX Practical Nursing Practice Exam | Complete Study
Guide with Verified Questions & Detailed Rationales | Updated 2026 |
Adult Health Nursing, Pharmacology, Maternal-Newborn, Pediatrics,
Psychiatric Nursing, Fundamentals of Nursing, Prioritization &
Delegation, Safety & Infection Control, Clinical Judgment & Patient-
Centered Care
Question 1: A licensed practical nurse (LPN) is caring for a client with a new
diagnosis of type 2 diabetes mellitus. The client asks why they need to check their
feet every day. Which response by the LPN is most appropriate?
A. "Checking your feet helps you lose weight faster."
B. "Daily foot checks are required by insurance companies."
C. "Diabetes can cause decreased sensation, making it hard to feel injuries that could
lead to infection."
D. "You need to check your feet to ensure your shoes fit properly."
CORRECT ANSWER: C. Diabetes can cause decreased sensation, making it hard to
feel injuries that could lead to infection.
Rationale: Diabetes mellitus often leads to peripheral neuropathy, which reduces
sensation in the extremities. Clients may not feel cuts, blisters, or sores, which can
quickly become infected and lead to serious complications like gangrene or
amputation. Daily inspection is crucial for early detection. Options A, B, and D do not
address the primary pathophysiological risk associated with diabetic foot care.
Question 2: An LPN is preparing to administer a subcutaneous injection of insulin
to a client. Which site is the most appropriate for this administration?
A. The deltoid muscle
B. The abdomen, at least 2 inches away from the umbilicus
C. The ventrogluteal muscle
D. The forearm
CORRECT ANSWER: B. The abdomen, at least 2 inches away from the umbilicus
Rationale: The abdomen is a preferred site for subcutaneous insulin injections because
it offers consistent and rapid absorption. The area within 2 inches of the umbilicus
should be avoided due to potential variability in absorption. The deltoid and
ventrogluteal sites are typically used for intramuscular injections, and the forearm is
less common for routine insulin administration due to variable absorption rates.
Question 3: A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via a nasal cannula at 2 L/min. The client's spouse asks why the
flow rate cannot be increased if the client seems short of breath. What is the LPN's
best response?
A. "Higher oxygen levels can cause the client to stop breathing."
B. "Increasing oxygen too much can dry out the nasal passages."
,C. "The physician prefers low oxygen levels for all COPD patients."
D. "High oxygen concentrations can suppress the hypoxic drive to breathe in some
COPD clients."
CORRECT ANSWER: D. High oxygen concentrations can suppress the hypoxic drive
to breathe in some COPD clients.
Rationale: Some clients with severe COPD rely on a hypoxic drive (low oxygen levels)
rather than a hypercapnic drive (high carbon dioxide levels) to stimulate breathing.
Administering high concentrations of oxygen can remove this stimulus, leading to
respiratory depression. While option A is a simplified version of this concept, option D
provides the accurate physiological explanation. Options B and C are incorrect
rationales.
Question 4: An LPN is assessing a client who is 2 hours postoperative following a
total hip arthroplasty. Which finding requires immediate notification of the
registered nurse (RN) or provider?
A. Pain rated 6 out of 10 at the surgical site
B. Small amount of serosanguinous drainage on the dressing
C. Shortening of the affected leg and external rotation
D. Temperature of 99.1°F (37.3°C)
CORRECT ANSWER: C. Shortening of the affected leg and external rotation
Rationale: Shortening of the affected leg and external rotation are classic signs of hip
dislocation, a serious complication following total hip arthroplasty that requires
immediate medical intervention. Pain and small amounts of drainage are expected
findings in the immediate postoperative period. A temperature of 99.1°F is a mild
elevation often seen post-surgery due to inflammation and is not immediately alarming
unless it rises significantly.
Question 5: A client is prescribed digoxin (Lanoxin) 0.25 mg orally daily. Before
administering the medication, the LPN assesses the client's apical pulse for one
minute and finds it to be 54 beats per minute. What action should the LPN take?
A. Administer the medication as prescribed.
B. Administer half the dose and recheck the pulse in an hour.
C. Withhold the medication and notify the RN or provider.
D. Encourage the client to drink more fluids and then administer the medication.
CORRECT ANSWER: C. Withhold the medication and notify the RN or provider.
Rationale: Digoxin slows the heart rate. If the apical pulse is below 60 beats per minute
in an adult, the medication should be withheld, and the provider notified to prevent
severe bradycardia or heart block. Administering the drug (Option A) or a partial dose
(Option B) could be dangerous. Fluid intake (Option D) does not correct bradycardia
caused by digoxin toxicity or sensitivity.
,Question 6: An LPN is caring for a client with a nasogastric (NG) tube connected to
low intermittent suction. The client complains of nausea. What is the first action
the LPN should take?
A. Increase the suction pressure to high continuous.
B. Irrigate the NG tube with normal saline.
C. Check the patency of the NG tube.
D. Administer an antiemetic medication immediately.
CORRECT ANSWER: C. Check the patency of the NG tube.
Rationale: Nausea in a client with an NG tube often indicates that the tube is clogged or
not functioning properly, leading to gastric distension. The first step is to assess the
tube's patency. Irrigation (Option B) may be necessary but only after confirming the
need and checking facility protocol/provider orders. Increasing suction (Option A)
without assessment can damage the gastric mucosa. Administering medication (Option
D) treats the symptom but not the underlying mechanical issue.
Question 7: A client with a history of deep vein thrombosis (DVT) is taking warfarin
(Coumadin). Which statement by the client indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush to prevent gum bleeding."
B. "I will avoid eating large amounts of green leafy vegetables."
C. "I will take ibuprofen for headaches instead of acetaminophen."
D. "I will wear a medical alert bracelet stating I am on warfarin."
CORRECT ANSWER: C. I will take ibuprofen for headaches instead of
acetaminophen.
Rationale: Ibuprofen and other NSAIDs increase the risk of bleeding when taken with
warfarin by affecting platelet function and irritating the gastric lining. Acetaminophen is
generally the preferred analgesic for clients on anticoagulants. Options A, B, and D
demonstrate correct understanding of safety measures and dietary consistency
(vitamin K intake) while on warfarin.
Question 8: An LPN is assisting with the care of a client who is experiencing a
seizure. Which action is the priority during the active phase of the seizure?
A. Insert a padded tongue blade into the client's mouth.
B. Restrain the client's limbs to prevent injury.
C. Turn the client to the side and protect the head.
D. Begin CPR immediately.
CORRECT ANSWER: C. Turn the client to the side and protect the head.
Rationale: During a seizure, the priority is to maintain a patent airway and prevent
aspiration by turning the client to the side. Protecting the head from trauma is also
essential. Inserting objects into the mouth (Option A) can cause dental injury or airway
obstruction. Restraining the client (Option B) can cause musculoskeletal injury. CPR
, (Option D) is only indicated if the client does not resume breathing after the seizure
ends.
Question 9: A client with heart failure is prescribed furosemide (Lasix). Which
laboratory value should the LPN monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum glucose
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes the excretion of water and
electrolytes, particularly potassium. Hypokalemia is a common and dangerous side
effect that can lead to cardiac dysrhythmias. While sodium and other electrolytes may
be affected, potassium is the critical concern with loop diuretics. Glucose is not directly
affected by furosemide.
Question 10: An LPN is caring for a client with a chest tube connected to a water-
seal drainage system. The LPN notices constant bubbling in the water-seal
chamber. What does this indicate?
A. Normal functioning of the system
B. An air leak in the system
C. The lung has fully re-expanded
D. The suction pressure is too high
CORRECT ANSWER: B. An air leak in the system
Rationale: Constant bubbling in the water-seal chamber indicates an air leak
somewhere in the system or from the patient's pleural space. Intermittent bubbling with
coughing or exhalation is normal if a pneumothorax is present, but constant bubbling
suggests a leak that needs investigation. A fully re-expanded lung would result in no
bubbling. Suction pressure issues are assessed in the suction control chamber, not the
water-seal chamber.
Question 11: A client is admitted with suspected tuberculosis (TB). Which
precaution should the LPN implement immediately?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
CORRECT ANSWER: C. Airborne precautions
Rationale: Tuberculosis is transmitted via airborne particles (droplet nuclei) that remain
suspended in the air. Airborne precautions, including placement in a negative-pressure
room and wearing an N95 respirator, are required. Contact precautions are for diseases
Guide with Verified Questions & Detailed Rationales | Updated 2026 |
Adult Health Nursing, Pharmacology, Maternal-Newborn, Pediatrics,
Psychiatric Nursing, Fundamentals of Nursing, Prioritization &
Delegation, Safety & Infection Control, Clinical Judgment & Patient-
Centered Care
Question 1: A licensed practical nurse (LPN) is caring for a client with a new
diagnosis of type 2 diabetes mellitus. The client asks why they need to check their
feet every day. Which response by the LPN is most appropriate?
A. "Checking your feet helps you lose weight faster."
B. "Daily foot checks are required by insurance companies."
C. "Diabetes can cause decreased sensation, making it hard to feel injuries that could
lead to infection."
D. "You need to check your feet to ensure your shoes fit properly."
CORRECT ANSWER: C. Diabetes can cause decreased sensation, making it hard to
feel injuries that could lead to infection.
Rationale: Diabetes mellitus often leads to peripheral neuropathy, which reduces
sensation in the extremities. Clients may not feel cuts, blisters, or sores, which can
quickly become infected and lead to serious complications like gangrene or
amputation. Daily inspection is crucial for early detection. Options A, B, and D do not
address the primary pathophysiological risk associated with diabetic foot care.
Question 2: An LPN is preparing to administer a subcutaneous injection of insulin
to a client. Which site is the most appropriate for this administration?
A. The deltoid muscle
B. The abdomen, at least 2 inches away from the umbilicus
C. The ventrogluteal muscle
D. The forearm
CORRECT ANSWER: B. The abdomen, at least 2 inches away from the umbilicus
Rationale: The abdomen is a preferred site for subcutaneous insulin injections because
it offers consistent and rapid absorption. The area within 2 inches of the umbilicus
should be avoided due to potential variability in absorption. The deltoid and
ventrogluteal sites are typically used for intramuscular injections, and the forearm is
less common for routine insulin administration due to variable absorption rates.
Question 3: A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via a nasal cannula at 2 L/min. The client's spouse asks why the
flow rate cannot be increased if the client seems short of breath. What is the LPN's
best response?
A. "Higher oxygen levels can cause the client to stop breathing."
B. "Increasing oxygen too much can dry out the nasal passages."
,C. "The physician prefers low oxygen levels for all COPD patients."
D. "High oxygen concentrations can suppress the hypoxic drive to breathe in some
COPD clients."
CORRECT ANSWER: D. High oxygen concentrations can suppress the hypoxic drive
to breathe in some COPD clients.
Rationale: Some clients with severe COPD rely on a hypoxic drive (low oxygen levels)
rather than a hypercapnic drive (high carbon dioxide levels) to stimulate breathing.
Administering high concentrations of oxygen can remove this stimulus, leading to
respiratory depression. While option A is a simplified version of this concept, option D
provides the accurate physiological explanation. Options B and C are incorrect
rationales.
Question 4: An LPN is assessing a client who is 2 hours postoperative following a
total hip arthroplasty. Which finding requires immediate notification of the
registered nurse (RN) or provider?
A. Pain rated 6 out of 10 at the surgical site
B. Small amount of serosanguinous drainage on the dressing
C. Shortening of the affected leg and external rotation
D. Temperature of 99.1°F (37.3°C)
CORRECT ANSWER: C. Shortening of the affected leg and external rotation
Rationale: Shortening of the affected leg and external rotation are classic signs of hip
dislocation, a serious complication following total hip arthroplasty that requires
immediate medical intervention. Pain and small amounts of drainage are expected
findings in the immediate postoperative period. A temperature of 99.1°F is a mild
elevation often seen post-surgery due to inflammation and is not immediately alarming
unless it rises significantly.
Question 5: A client is prescribed digoxin (Lanoxin) 0.25 mg orally daily. Before
administering the medication, the LPN assesses the client's apical pulse for one
minute and finds it to be 54 beats per minute. What action should the LPN take?
A. Administer the medication as prescribed.
B. Administer half the dose and recheck the pulse in an hour.
C. Withhold the medication and notify the RN or provider.
D. Encourage the client to drink more fluids and then administer the medication.
CORRECT ANSWER: C. Withhold the medication and notify the RN or provider.
Rationale: Digoxin slows the heart rate. If the apical pulse is below 60 beats per minute
in an adult, the medication should be withheld, and the provider notified to prevent
severe bradycardia or heart block. Administering the drug (Option A) or a partial dose
(Option B) could be dangerous. Fluid intake (Option D) does not correct bradycardia
caused by digoxin toxicity or sensitivity.
,Question 6: An LPN is caring for a client with a nasogastric (NG) tube connected to
low intermittent suction. The client complains of nausea. What is the first action
the LPN should take?
A. Increase the suction pressure to high continuous.
B. Irrigate the NG tube with normal saline.
C. Check the patency of the NG tube.
D. Administer an antiemetic medication immediately.
CORRECT ANSWER: C. Check the patency of the NG tube.
Rationale: Nausea in a client with an NG tube often indicates that the tube is clogged or
not functioning properly, leading to gastric distension. The first step is to assess the
tube's patency. Irrigation (Option B) may be necessary but only after confirming the
need and checking facility protocol/provider orders. Increasing suction (Option A)
without assessment can damage the gastric mucosa. Administering medication (Option
D) treats the symptom but not the underlying mechanical issue.
Question 7: A client with a history of deep vein thrombosis (DVT) is taking warfarin
(Coumadin). Which statement by the client indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush to prevent gum bleeding."
B. "I will avoid eating large amounts of green leafy vegetables."
C. "I will take ibuprofen for headaches instead of acetaminophen."
D. "I will wear a medical alert bracelet stating I am on warfarin."
CORRECT ANSWER: C. I will take ibuprofen for headaches instead of
acetaminophen.
Rationale: Ibuprofen and other NSAIDs increase the risk of bleeding when taken with
warfarin by affecting platelet function and irritating the gastric lining. Acetaminophen is
generally the preferred analgesic for clients on anticoagulants. Options A, B, and D
demonstrate correct understanding of safety measures and dietary consistency
(vitamin K intake) while on warfarin.
Question 8: An LPN is assisting with the care of a client who is experiencing a
seizure. Which action is the priority during the active phase of the seizure?
A. Insert a padded tongue blade into the client's mouth.
B. Restrain the client's limbs to prevent injury.
C. Turn the client to the side and protect the head.
D. Begin CPR immediately.
CORRECT ANSWER: C. Turn the client to the side and protect the head.
Rationale: During a seizure, the priority is to maintain a patent airway and prevent
aspiration by turning the client to the side. Protecting the head from trauma is also
essential. Inserting objects into the mouth (Option A) can cause dental injury or airway
obstruction. Restraining the client (Option B) can cause musculoskeletal injury. CPR
, (Option D) is only indicated if the client does not resume breathing after the seizure
ends.
Question 9: A client with heart failure is prescribed furosemide (Lasix). Which
laboratory value should the LPN monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum glucose
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that causes the excretion of water and
electrolytes, particularly potassium. Hypokalemia is a common and dangerous side
effect that can lead to cardiac dysrhythmias. While sodium and other electrolytes may
be affected, potassium is the critical concern with loop diuretics. Glucose is not directly
affected by furosemide.
Question 10: An LPN is caring for a client with a chest tube connected to a water-
seal drainage system. The LPN notices constant bubbling in the water-seal
chamber. What does this indicate?
A. Normal functioning of the system
B. An air leak in the system
C. The lung has fully re-expanded
D. The suction pressure is too high
CORRECT ANSWER: B. An air leak in the system
Rationale: Constant bubbling in the water-seal chamber indicates an air leak
somewhere in the system or from the patient's pleural space. Intermittent bubbling with
coughing or exhalation is normal if a pneumothorax is present, but constant bubbling
suggests a leak that needs investigation. A fully re-expanded lung would result in no
bubbling. Suction pressure issues are assessed in the suction control chamber, not the
water-seal chamber.
Question 11: A client is admitted with suspected tuberculosis (TB). Which
precaution should the LPN implement immediately?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
CORRECT ANSWER: C. Airborne precautions
Rationale: Tuberculosis is transmitted via airborne particles (droplet nuclei) that remain
suspended in the air. Airborne precautions, including placement in a negative-pressure
room and wearing an N95 respirator, are required. Contact precautions are for diseases
