NCLEX-PN NURSING EXAM – PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
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CORE DOMAINS
Safe and Effective Care EnvironmentHealth Promotion and MaintenancePsychosocial IntegrityPhysiological IntegrityPharmacological and Parenteral
TherapiesReduction of Risk PotentialBasic Care and ComfortCoordinated Care
INTRODUCTION
The purpose of this comprehensive practice assessment is to prepare candidates for the National Council Licensure Examination for Practical Nurses.
This exam evaluates the essential skills and knowledge required to provide safe, effective nursing care at the entry level. The structure includes a
diverse range of multiple-choice and scenario-based questions designed to simulate the actual testing environment. Emphasis is placed on real-world
application, clinical judgment, and critical decision-making. Candidates are assessed on their ability to integrate foundational nursing theory with
practical interventions, ensuring they meet the regulatory, ethical, and professional standards necessary for high-quality patient outcomes in various
healthcare settings.
SECTION ONE: QUESTIONS 1–100
1. A licensed practical nurse (LPN) is caring for a client with a history of heart failure. The client reports a sudden weight gain of 3 pounds in 24
hours. Which action should the nurse take first?
A. Document the finding in the medical record.
B. Instruct the client to restrict fluid intake.
C. Assess the client for peripheral edema and lung sounds.
D. Administer a PRN dose of a diuretic.
🟢 C. Assess the client for peripheral edema and lung sounds.
🔴 RATIONALE: Sudden weight gain is a primary indicator of fluid retention in heart failure clients. The nurse must first assess the client's physical
status to determine the severity of the fluid volume excess before intervening or reporting.
2. A nurse is preparing to administer an intramuscular injection to an infant. Which site is most appropriate for this population?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
,🟢 D. Vastus lateralis
🔴 RATIONALE: The vastus lateralis muscle is the preferred site for intramuscular injections in infants and toddlers because it is the most
developed muscle at this age and lacks major nerves or blood vessels.
3. Which of the following clients should the nurse see first after receiving the change-of-shift report?
A. A client with diabetes whose morning blood glucose is 140 mg/dL.
B. A client with pneumonia who has a pulse oximetry reading of 88%.
C. A client scheduled for physical therapy in 30 minutes.
D. A client requesting a dressing change for a surgical wound.
🟢 B. A client with pneumonia who has a pulse oximetry reading of 88%.
🔴 RATIONALE: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with a low oxygen saturation level (normal is typically
>95%) requires immediate assessment and intervention to ensure adequate oxygenation.
4. A client is prescribed warfarin for the treatment of deep vein thrombosis. Which laboratory value should the nurse monitor to evaluate the
effectiveness of this medication?
A. Prothrombin time (PT) / International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Complete blood count (CBC)
D. Serum potassium levels
🟢 A. Prothrombin time (PT) / International Normalized Ratio (INR)
🔴 RATIONALE: PT/INR is the standard laboratory test used to monitor the therapeutic effect of warfarin. aPTT is used to monitor heparin therapy.
5. An LPN is assisting with the care of a client who has a chest tube. The nurse notes that the water-seal chamber is bubbling continuously.
What does this finding suggest?
A. The system is functioning normally.
B. The client has a pneumothorax.
C. There is an air leak in the system.
D. The suction is set too high.
🟢 C. There is an air leak in the system.
,🔴 RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak between the client and the water seal. Intermittent bubbling
is expected in a client with a pneumothorax during expiration or coughing.
6. A nurse is reinforcing teaching about a low-sodium diet for a client with hypertension. Which food choice by the client indicates an
understanding of the teaching?
A. Canned vegetable soup
B. Fresh baked chicken breast
C. Salami and cheese sandwich
D. Pickled cucumbers
🟢 B. Fresh baked chicken breast
🔴 RATIONALE: Fresh meats are naturally low in sodium compared to processed, canned, or pickled foods, which contain high levels of sodium as
a preservative.
7. A client with a hip fracture is placed in Buck’s traction. Which nursing intervention is essential for maintaining the effectiveness of the
traction?
A. Removing the weights for 10 minutes every shift.
B. Ensuring the weights hang freely and do not touch the floor.
C. Positioning the client in a high-Fowler’s position.
D. Keeping the affected leg in an adducted position.
🟢 B. Ensuring the weights hang freely and do not touch the floor.
🔴 RATIONALE: For traction to be effective, the weights must hang freely. If weights touch the floor or the bed, the pulling force is lost, and the
purpose of the traction is defeated.
8. When performing a sterile dressing change, which action by the nurse would contaminate the sterile field?
A. Opening the sterile pack away from the body.
B. Keeping the sterile field above waist level.
C. Dropping a sterile gauze onto the center of the field.
D. Reaching over the sterile field to pick up a tool.
🟢 D. Reaching over the sterile field to pick up a tool.
🔴 RATIONALE: Reaching over a sterile field violates sterile technique as microorganisms from the nurse's clothing or skin can fall onto the field.
, 9. A client is diagnosed with suspected meningitis. Which type of precautions should the nurse implement?
A. Airborne
B. Droplet
C. Contact
D. Standard only
🟢 B. Droplet
🔴 RATIONALE: Meningitis (specifically bacterial) is transmitted via large-particle droplets. Droplet precautions require the use of a mask when
within three feet of the client.
10. Which statement by a client with a new prescription for nitroglycerin sublingual tablets indicates a need for further teaching?
A. "I will keep the tablets in their original dark glass bottle."
B. "I can take up to three tablets, five minutes apart, if chest pain occurs."
C. "I should swallow the tablet with a full glass of water."
D. "I might feel a slight tingling sensation under my tongue."
🟢 C. "I should swallow the tablet with a full glass of water."
🔴 RATIONALE: Sublingual nitroglycerin must be dissolved under the tongue to be absorbed directly into the bloodstream. Swallowing the tablet
will lead to it being inactivated by gastric acid and the liver's first-pass effect.
11. A client is receiving a continuous intravenous infusion of heparin. The nurse should have which medication available as an antidote?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Atropine
🟢 B. Protamine sulfate
🔴 RATIONALE: Protamine sulfate is the specific antidote used to reverse the effects of heparin. Vitamin K is the antidote for warfarin.
12. An elderly client is admitted with dehydration. Which assessment finding should the nurse expect?
A. Bradycardia
B. Hypertension
INSTANT DOWNLOAD PDF.
CORE DOMAINS
Safe and Effective Care EnvironmentHealth Promotion and MaintenancePsychosocial IntegrityPhysiological IntegrityPharmacological and Parenteral
TherapiesReduction of Risk PotentialBasic Care and ComfortCoordinated Care
INTRODUCTION
The purpose of this comprehensive practice assessment is to prepare candidates for the National Council Licensure Examination for Practical Nurses.
This exam evaluates the essential skills and knowledge required to provide safe, effective nursing care at the entry level. The structure includes a
diverse range of multiple-choice and scenario-based questions designed to simulate the actual testing environment. Emphasis is placed on real-world
application, clinical judgment, and critical decision-making. Candidates are assessed on their ability to integrate foundational nursing theory with
practical interventions, ensuring they meet the regulatory, ethical, and professional standards necessary for high-quality patient outcomes in various
healthcare settings.
SECTION ONE: QUESTIONS 1–100
1. A licensed practical nurse (LPN) is caring for a client with a history of heart failure. The client reports a sudden weight gain of 3 pounds in 24
hours. Which action should the nurse take first?
A. Document the finding in the medical record.
B. Instruct the client to restrict fluid intake.
C. Assess the client for peripheral edema and lung sounds.
D. Administer a PRN dose of a diuretic.
🟢 C. Assess the client for peripheral edema and lung sounds.
🔴 RATIONALE: Sudden weight gain is a primary indicator of fluid retention in heart failure clients. The nurse must first assess the client's physical
status to determine the severity of the fluid volume excess before intervening or reporting.
2. A nurse is preparing to administer an intramuscular injection to an infant. Which site is most appropriate for this population?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
,🟢 D. Vastus lateralis
🔴 RATIONALE: The vastus lateralis muscle is the preferred site for intramuscular injections in infants and toddlers because it is the most
developed muscle at this age and lacks major nerves or blood vessels.
3. Which of the following clients should the nurse see first after receiving the change-of-shift report?
A. A client with diabetes whose morning blood glucose is 140 mg/dL.
B. A client with pneumonia who has a pulse oximetry reading of 88%.
C. A client scheduled for physical therapy in 30 minutes.
D. A client requesting a dressing change for a surgical wound.
🟢 B. A client with pneumonia who has a pulse oximetry reading of 88%.
🔴 RATIONALE: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with a low oxygen saturation level (normal is typically
>95%) requires immediate assessment and intervention to ensure adequate oxygenation.
4. A client is prescribed warfarin for the treatment of deep vein thrombosis. Which laboratory value should the nurse monitor to evaluate the
effectiveness of this medication?
A. Prothrombin time (PT) / International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Complete blood count (CBC)
D. Serum potassium levels
🟢 A. Prothrombin time (PT) / International Normalized Ratio (INR)
🔴 RATIONALE: PT/INR is the standard laboratory test used to monitor the therapeutic effect of warfarin. aPTT is used to monitor heparin therapy.
5. An LPN is assisting with the care of a client who has a chest tube. The nurse notes that the water-seal chamber is bubbling continuously.
What does this finding suggest?
A. The system is functioning normally.
B. The client has a pneumothorax.
C. There is an air leak in the system.
D. The suction is set too high.
🟢 C. There is an air leak in the system.
,🔴 RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak between the client and the water seal. Intermittent bubbling
is expected in a client with a pneumothorax during expiration or coughing.
6. A nurse is reinforcing teaching about a low-sodium diet for a client with hypertension. Which food choice by the client indicates an
understanding of the teaching?
A. Canned vegetable soup
B. Fresh baked chicken breast
C. Salami and cheese sandwich
D. Pickled cucumbers
🟢 B. Fresh baked chicken breast
🔴 RATIONALE: Fresh meats are naturally low in sodium compared to processed, canned, or pickled foods, which contain high levels of sodium as
a preservative.
7. A client with a hip fracture is placed in Buck’s traction. Which nursing intervention is essential for maintaining the effectiveness of the
traction?
A. Removing the weights for 10 minutes every shift.
B. Ensuring the weights hang freely and do not touch the floor.
C. Positioning the client in a high-Fowler’s position.
D. Keeping the affected leg in an adducted position.
🟢 B. Ensuring the weights hang freely and do not touch the floor.
🔴 RATIONALE: For traction to be effective, the weights must hang freely. If weights touch the floor or the bed, the pulling force is lost, and the
purpose of the traction is defeated.
8. When performing a sterile dressing change, which action by the nurse would contaminate the sterile field?
A. Opening the sterile pack away from the body.
B. Keeping the sterile field above waist level.
C. Dropping a sterile gauze onto the center of the field.
D. Reaching over the sterile field to pick up a tool.
🟢 D. Reaching over the sterile field to pick up a tool.
🔴 RATIONALE: Reaching over a sterile field violates sterile technique as microorganisms from the nurse's clothing or skin can fall onto the field.
, 9. A client is diagnosed with suspected meningitis. Which type of precautions should the nurse implement?
A. Airborne
B. Droplet
C. Contact
D. Standard only
🟢 B. Droplet
🔴 RATIONALE: Meningitis (specifically bacterial) is transmitted via large-particle droplets. Droplet precautions require the use of a mask when
within three feet of the client.
10. Which statement by a client with a new prescription for nitroglycerin sublingual tablets indicates a need for further teaching?
A. "I will keep the tablets in their original dark glass bottle."
B. "I can take up to three tablets, five minutes apart, if chest pain occurs."
C. "I should swallow the tablet with a full glass of water."
D. "I might feel a slight tingling sensation under my tongue."
🟢 C. "I should swallow the tablet with a full glass of water."
🔴 RATIONALE: Sublingual nitroglycerin must be dissolved under the tongue to be absorbed directly into the bloodstream. Swallowing the tablet
will lead to it being inactivated by gastric acid and the liver's first-pass effect.
11. A client is receiving a continuous intravenous infusion of heparin. The nurse should have which medication available as an antidote?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Atropine
🟢 B. Protamine sulfate
🔴 RATIONALE: Protamine sulfate is the specific antidote used to reverse the effects of heparin. Vitamin K is the antidote for warfarin.
12. An elderly client is admitted with dehydration. Which assessment finding should the nurse expect?
A. Bradycardia
B. Hypertension
