NCLEX PN Actual Exam Style Questions 2026
leaked Exam Complete Questions and
Answers with Detailed Rationales – Pass
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Section 1: Safe & Effective Care Environment (22 Questions)
Q1: The charge nurse assigns four clients to the LPN. Which client requires the LPN to
contact the RN for further guidance before proceeding with care?
A. A client with a new colostomy needing bag emptying
B. A client with heart failure receiving IV push furosemide [CORRECT]
C. A client post-appendectomy requesting oral pain medication
D. A client with diabetes needing routine blood glucose monitoring
Correct Answer: B
Rationale: The best answer is B. This choice is correct because IV push medications are
outside the LPN scope of practice in most states, so the LPN needs the RN to
administer this med. For NCLEX-PN priority questions, remember that scope of practice
issues always take precedence over routine tasks.
Q2: A client with tuberculosis is admitted to the medical unit. The LPN enters the room
to take vital signs. What action should the LPN take first?
A. Put on a gown and gloves before entering
B. Place the client in a negative-pressure room
C. Don an N95 respirator mask prior to contact [CORRECT]
,D. Ask the client to wear a surgical mask
Correct Answer: C
Rationale: The best answer is C. This choice is correct because airborne precautions
require an N95 respirator before any contact with the client. The LPN's role in this
situation is to protect themselves first with proper PPE; the negative-pressure room
should already be done by admission, and the N95 protects staff better than a surgical
mask on the client alone.
Q3: Which task is most appropriate for the LPN to delegate to unlicensed assistive
personnel (UAP)?
A. Assessing a post-op client for signs of hemorrhage
B. Obtaining a stool sample from a client with C. diff [CORRECT]
C. Teaching a newly diagnosed diabetic about foot care
D. Evaluating a client's response to pain medication
Correct Answer: B
Rationale: The best answer is B. This choice is correct because collecting specimens is
within UAP scope, though the LPN should ensure proper PPE for C. diff. The other
options involve assessment, teaching, and evaluation, which are nursing responsibilities
that can't be delegated to UAP.
Q4: Four clients are waiting for morning medications. Who should the LPN see first?
A. Client with hypertension requesting a refill of home medications
B. Client with atrial fibrillation due for warfarin whose INR is 4.2 [CORRECT]
C. Client with osteoarthritis requesting PRN acetaminophen for mild stiffness
D. Client with hypothyroidism due for routine levothyroxine
Correct Answer: B
Rationale: The best answer is B. This choice is correct because an INR of 4.2 indicates
supratherapeutic anticoagulation, and giving warfarin could cause bleeding. For
,NCLEX-PN priority questions, remember to check critical lab values before
administering medications that could worsen the situation.
Q5: An 82-year-old client with dementia attempts to get out of bed unassisted. The LPN
finds the client on the floor, alert and crying. What is the priority action?
A. Help the client back into bed immediately
B. Perform a head-to-toe assessment and check for injuries [CORRECT]
C. Call the family to report the incident
D. Fill out the incident report before doing anything else
Correct Answer: B
Rationale: The best answer is B. This choice is correct because the nurse must assess
for injuries before moving the client, since moving someone with a fracture or spinal
injury could cause more harm. The incident report comes after ensuring client safety.
Q6: The LPN witnesses a medication error where another nurse gives insulin to the
wrong client. What is the first action the LPN should take?
A. Complete an incident report
B. Notify the nursing supervisor
C. Assess the wrong client for signs of hypoglycemia [CORRECT]
D. Confront the nurse who made the error
Correct Answer: C
Rationale: The best answer is C. This choice is correct because client safety is always
the priority; the LPN needs to check the client who received the wrong medication for
adverse effects. The incident report and supervisor notification happen after the client
is stabilized.
Q7: A client is scheduled for surgery and tells the LPN, "I changed my mind. I don't want
the operation." The consent form is already signed. What should the LPN do?
A. Tell the client it's too late to change their mind
B. Notify the surgeon and document the client's statement [CORRECT]
C. Have the client sign a refusal form and leave it at that
, D. Reassure the client that everything will be fine
Correct Answer: B
Rationale: The best answer is B. This choice is correct because clients have the right to
withdraw consent at any time, and the surgeon needs to be notified immediately to
discuss alternatives or cancel the procedure. The LPN's role is to advocate for the client
and communicate their wishes to the provider.
Q8: Which client should the LPN assess first after receiving shift report?
A. Client with pneumonia whose oxygen saturation is 92% on room air
B. Client with a new ileostomy who reports feeling anxious
C. Client with COPD who is suddenly confused and pulling at their IV [CORRECT]
D. Client with a fractured hip who needs a scheduled dressing change
Correct Answer: C
Rationale: The best answer is C. This choice is correct because sudden confusion in a
COPD client signals possible hypoxemia or hypercapnia, which is life-threatening. For
NCLEX-PN priority questions, remember that acute mental status changes often
indicate physiological deterioration and take priority over stable or expected findings.
Q9: The LPN is caring for a client in isolation for MRSA. Which action demonstrates
proper technique?
A. Removing the gown and reusing it for the next visit to save supplies
B. Performing hand hygiene after removing all PPE [CORRECT]
C. Wearing the same gloves when moving from the bed to the IV pump
D. Leaving isolation supplies in the hallway for easy access
Correct Answer: B
Rationale: The best answer is B. This choice is correct because hand hygiene is always
the final step after doffing PPE to prevent contamination. Gloves should never be reused
between tasks, and isolation supplies stay in the room to prevent cross-contamination.
leaked Exam Complete Questions and
Answers with Detailed Rationales – Pass
Guaranteed – A+ Graded
Section 1: Safe & Effective Care Environment (22 Questions)
Q1: The charge nurse assigns four clients to the LPN. Which client requires the LPN to
contact the RN for further guidance before proceeding with care?
A. A client with a new colostomy needing bag emptying
B. A client with heart failure receiving IV push furosemide [CORRECT]
C. A client post-appendectomy requesting oral pain medication
D. A client with diabetes needing routine blood glucose monitoring
Correct Answer: B
Rationale: The best answer is B. This choice is correct because IV push medications are
outside the LPN scope of practice in most states, so the LPN needs the RN to
administer this med. For NCLEX-PN priority questions, remember that scope of practice
issues always take precedence over routine tasks.
Q2: A client with tuberculosis is admitted to the medical unit. The LPN enters the room
to take vital signs. What action should the LPN take first?
A. Put on a gown and gloves before entering
B. Place the client in a negative-pressure room
C. Don an N95 respirator mask prior to contact [CORRECT]
,D. Ask the client to wear a surgical mask
Correct Answer: C
Rationale: The best answer is C. This choice is correct because airborne precautions
require an N95 respirator before any contact with the client. The LPN's role in this
situation is to protect themselves first with proper PPE; the negative-pressure room
should already be done by admission, and the N95 protects staff better than a surgical
mask on the client alone.
Q3: Which task is most appropriate for the LPN to delegate to unlicensed assistive
personnel (UAP)?
A. Assessing a post-op client for signs of hemorrhage
B. Obtaining a stool sample from a client with C. diff [CORRECT]
C. Teaching a newly diagnosed diabetic about foot care
D. Evaluating a client's response to pain medication
Correct Answer: B
Rationale: The best answer is B. This choice is correct because collecting specimens is
within UAP scope, though the LPN should ensure proper PPE for C. diff. The other
options involve assessment, teaching, and evaluation, which are nursing responsibilities
that can't be delegated to UAP.
Q4: Four clients are waiting for morning medications. Who should the LPN see first?
A. Client with hypertension requesting a refill of home medications
B. Client with atrial fibrillation due for warfarin whose INR is 4.2 [CORRECT]
C. Client with osteoarthritis requesting PRN acetaminophen for mild stiffness
D. Client with hypothyroidism due for routine levothyroxine
Correct Answer: B
Rationale: The best answer is B. This choice is correct because an INR of 4.2 indicates
supratherapeutic anticoagulation, and giving warfarin could cause bleeding. For
,NCLEX-PN priority questions, remember to check critical lab values before
administering medications that could worsen the situation.
Q5: An 82-year-old client with dementia attempts to get out of bed unassisted. The LPN
finds the client on the floor, alert and crying. What is the priority action?
A. Help the client back into bed immediately
B. Perform a head-to-toe assessment and check for injuries [CORRECT]
C. Call the family to report the incident
D. Fill out the incident report before doing anything else
Correct Answer: B
Rationale: The best answer is B. This choice is correct because the nurse must assess
for injuries before moving the client, since moving someone with a fracture or spinal
injury could cause more harm. The incident report comes after ensuring client safety.
Q6: The LPN witnesses a medication error where another nurse gives insulin to the
wrong client. What is the first action the LPN should take?
A. Complete an incident report
B. Notify the nursing supervisor
C. Assess the wrong client for signs of hypoglycemia [CORRECT]
D. Confront the nurse who made the error
Correct Answer: C
Rationale: The best answer is C. This choice is correct because client safety is always
the priority; the LPN needs to check the client who received the wrong medication for
adverse effects. The incident report and supervisor notification happen after the client
is stabilized.
Q7: A client is scheduled for surgery and tells the LPN, "I changed my mind. I don't want
the operation." The consent form is already signed. What should the LPN do?
A. Tell the client it's too late to change their mind
B. Notify the surgeon and document the client's statement [CORRECT]
C. Have the client sign a refusal form and leave it at that
, D. Reassure the client that everything will be fine
Correct Answer: B
Rationale: The best answer is B. This choice is correct because clients have the right to
withdraw consent at any time, and the surgeon needs to be notified immediately to
discuss alternatives or cancel the procedure. The LPN's role is to advocate for the client
and communicate their wishes to the provider.
Q8: Which client should the LPN assess first after receiving shift report?
A. Client with pneumonia whose oxygen saturation is 92% on room air
B. Client with a new ileostomy who reports feeling anxious
C. Client with COPD who is suddenly confused and pulling at their IV [CORRECT]
D. Client with a fractured hip who needs a scheduled dressing change
Correct Answer: C
Rationale: The best answer is C. This choice is correct because sudden confusion in a
COPD client signals possible hypoxemia or hypercapnia, which is life-threatening. For
NCLEX-PN priority questions, remember that acute mental status changes often
indicate physiological deterioration and take priority over stable or expected findings.
Q9: The LPN is caring for a client in isolation for MRSA. Which action demonstrates
proper technique?
A. Removing the gown and reusing it for the next visit to save supplies
B. Performing hand hygiene after removing all PPE [CORRECT]
C. Wearing the same gloves when moving from the bed to the IV pump
D. Leaving isolation supplies in the hallway for easy access
Correct Answer: B
Rationale: The best answer is B. This choice is correct because hand hygiene is always
the final step after doffing PPE to prevent contamination. Gloves should never be reused
between tasks, and isolation supplies stay in the room to prevent cross-contamination.
