Next Generation NCLEX (NGN) Practice Exam
PN Fundamentals – 2026 Proctored Assessment
Preparation
100+ Original Practice Questions with Answers &
Rationales
Questions 1–105
Question 1 (NGN: Standalone Multiple Choice)
A practical nurse is preparing to administer morning medications to
a client with hypertension. Which action should the nurse take FIRST
to ensure client safety? A. Verify the client's identity using two
identifiers
B. Check the client's blood pressure reading
C. Review the medication administration record (MAR)
D. Explain the purpose of each medication to the client
Correct Answer: A
Rationale: Client safety begins with accurate identification using two
unique identifiers (e.g., name and date of birth) before any
intervention, per National Patient Safety Goals. While checking BP,
reviewing the MAR, and providing education are important, they
occur AFTER confirming the right client. This prevents medication
errors and aligns with the "Right Patient" principle of medication
safety.
,Question 2 (NGN: Extended Multiple Response)
A client is at risk for falls. Which interventions should the practical
nurse include in the plan of care? Select all that apply. ☐ Keep the
bed in the lowest position
☐ Place frequently used items within easy reach
☐ Use a bed alarm as a restraint alternative
☐ Encourage the client to call for assistance before ambulating
☐ Leave the side rails up at all times
Correct Answers: Keep the bed in the lowest position; Place
frequently used items within easy reach; Use a bed alarm as a
restraint alternative; Encourage the client to call for assistance
before ambulating
Rationale: Evidence-based fall prevention includes environmental
modifications (low bed, accessible items), assistive devices (bed
alarms), and promoting client participation (calling for help). Leaving
side rails up at all times is considered a restraint unless clinically
justified and requires a provider order; it can increase fall risk if the
client climbs over them.
Question 3 (NGN: Cloze/Drop-down)
When performing hand hygiene, the practical nurse knows that
alcohol-based hand rub is appropriate EXCEPT when hands are
__________ or contaminated with __________.
Drop-down options:
, 1. visibly soiled / blood or body fluids
2. dry / non-enveloped viruses
3. gloved / spore-forming bacteria
4. moisturized / fungal organisms
Correct Answer: visibly soiled / blood or body fluids
Rationale: CDC guidelines state that alcohol-based hand rub is
ineffective when hands are visibly dirty or contaminated with
blood/body fluids. In these cases, soap and water must be used to
mechanically remove organic material and pathogens. This supports
infection control standards and prevents transmission.
Question 4 (NGN: Standalone Multiple Choice)
A client reports pain rated 7/10 after abdominal surgery. The PRN
opioid analgesic was administered 2 hours ago. What is the nurse's
BEST initial action?
A. Administer another dose of the opioid early
B. Assess the pain location, quality, and associated symptoms
C. Notify the provider immediately
D. Apply a warm compress to the abdomen
Correct Answer: B
Rationale: Before intervening, the nurse must assess the pain
thoroughly to determine if it is expected postoperative pain or a sign
of complication (e.g., hemorrhage, infection). Reassessment guides
, safe, effective care. Administering opioids outside the prescribed
interval without assessment risks respiratory depression.
Notification or non-pharmacologic measures may follow assessment.
Question 5 (NGN: Matrix Multiple Choice)
Match the nursing action to the correct ethical principle.
Nursing Action Ethical Principle
1. Respecting a client's refusal of blood
A. Beneficence
transfusion
B.
2. Reporting a medication error promptly
Nonmaleficence
3. Providing timely pain medication C. Autonomy
4. Ensuring equal care regardless of background D. Justice
Correct Matches:
1 → C (Autonomy: respecting client's right to decide)
2 → B (Nonmaleficence: preventing further harm through
transparency)
3 → A (Beneficence: acting in client's best interest to relieve
suffering)
4 → D (Justice: fairness and equitable resource distribution)
Rationale: Understanding ethical principles guides moral decision-
making. Autonomy honors self-determination; nonmaleficence
PN Fundamentals – 2026 Proctored Assessment
Preparation
100+ Original Practice Questions with Answers &
Rationales
Questions 1–105
Question 1 (NGN: Standalone Multiple Choice)
A practical nurse is preparing to administer morning medications to
a client with hypertension. Which action should the nurse take FIRST
to ensure client safety? A. Verify the client's identity using two
identifiers
B. Check the client's blood pressure reading
C. Review the medication administration record (MAR)
D. Explain the purpose of each medication to the client
Correct Answer: A
Rationale: Client safety begins with accurate identification using two
unique identifiers (e.g., name and date of birth) before any
intervention, per National Patient Safety Goals. While checking BP,
reviewing the MAR, and providing education are important, they
occur AFTER confirming the right client. This prevents medication
errors and aligns with the "Right Patient" principle of medication
safety.
,Question 2 (NGN: Extended Multiple Response)
A client is at risk for falls. Which interventions should the practical
nurse include in the plan of care? Select all that apply. ☐ Keep the
bed in the lowest position
☐ Place frequently used items within easy reach
☐ Use a bed alarm as a restraint alternative
☐ Encourage the client to call for assistance before ambulating
☐ Leave the side rails up at all times
Correct Answers: Keep the bed in the lowest position; Place
frequently used items within easy reach; Use a bed alarm as a
restraint alternative; Encourage the client to call for assistance
before ambulating
Rationale: Evidence-based fall prevention includes environmental
modifications (low bed, accessible items), assistive devices (bed
alarms), and promoting client participation (calling for help). Leaving
side rails up at all times is considered a restraint unless clinically
justified and requires a provider order; it can increase fall risk if the
client climbs over them.
Question 3 (NGN: Cloze/Drop-down)
When performing hand hygiene, the practical nurse knows that
alcohol-based hand rub is appropriate EXCEPT when hands are
__________ or contaminated with __________.
Drop-down options:
, 1. visibly soiled / blood or body fluids
2. dry / non-enveloped viruses
3. gloved / spore-forming bacteria
4. moisturized / fungal organisms
Correct Answer: visibly soiled / blood or body fluids
Rationale: CDC guidelines state that alcohol-based hand rub is
ineffective when hands are visibly dirty or contaminated with
blood/body fluids. In these cases, soap and water must be used to
mechanically remove organic material and pathogens. This supports
infection control standards and prevents transmission.
Question 4 (NGN: Standalone Multiple Choice)
A client reports pain rated 7/10 after abdominal surgery. The PRN
opioid analgesic was administered 2 hours ago. What is the nurse's
BEST initial action?
A. Administer another dose of the opioid early
B. Assess the pain location, quality, and associated symptoms
C. Notify the provider immediately
D. Apply a warm compress to the abdomen
Correct Answer: B
Rationale: Before intervening, the nurse must assess the pain
thoroughly to determine if it is expected postoperative pain or a sign
of complication (e.g., hemorrhage, infection). Reassessment guides
, safe, effective care. Administering opioids outside the prescribed
interval without assessment risks respiratory depression.
Notification or non-pharmacologic measures may follow assessment.
Question 5 (NGN: Matrix Multiple Choice)
Match the nursing action to the correct ethical principle.
Nursing Action Ethical Principle
1. Respecting a client's refusal of blood
A. Beneficence
transfusion
B.
2. Reporting a medication error promptly
Nonmaleficence
3. Providing timely pain medication C. Autonomy
4. Ensuring equal care regardless of background D. Justice
Correct Matches:
1 → C (Autonomy: respecting client's right to decide)
2 → B (Nonmaleficence: preventing further harm through
transparency)
3 → A (Beneficence: acting in client's best interest to relieve
suffering)
4 → D (Justice: fairness and equitable resource distribution)
Rationale: Understanding ethical principles guides moral decision-
making. Autonomy honors self-determination; nonmaleficence
