NCLEX-PN NGN Practice Exam 2026/2027
NCLEX-PN
National Council Licensure Examination
for Practical/Vocational Nurses
Next Generation NCLEX (NGN) Integrated Practice Examination
2026/2027 Academic Year | NCSBN/Pearson VUE Aligned
Examination Overview
Total Questions: 100 (Adaptive Range: 85–150) | Maximum Time: 5 Hours
NGN Item Types: MCQ, SATA, Ordered Response, Trend, Case Study
Framework: NCSBN Clinical Judgment Measurement Model (CJMM)
Passing Standard: Criterion-referenced (NCSBN logit measure, not percentage-based)
Select the one best answer unless otherwise indicated. For SATA, select all correct options.
1
, NCLEX-PN NGN Practice Exam 2026/2027
CLIENT NEEDS I: SAFE AND EFFECTIVE CARE ENVIRONMENT
Coordinated Care (18–24%)
1. The charge nurse on a medical-surgical unit asks the LPN to supervise a newly hired
unlicensed assistive personnel (UAP) during a shift. Which response by the LPN is most
appropriate?
A. "I will supervise the UAP and report any concerns to you."
B. "Supervising unlicensed personnel is the responsibility of the registered nurse (RN), not the LPN."
C. "I can observe the UAP but cannot provide formal evaluation."
D. "I will delegate tasks to the UAP and assume responsibility for the outcomes."
Correct Answer: B. Supervising unlicensed personnel is the responsibility of the
registered nurse (RN), not the LPN.
Rationale: According to the NCSBN and most state Nurse Practice Acts, the supervisory role over
unlicensed assistive personnel falls under the scope of the registered nurse. The LPN may assign tasks
within their own scope but is not responsible for formally supervising or evaluating UAPs. Option A
implies acceptance of a role outside PN scope. Option C is partially correct but does not address the
core issue. Option D incorrectly assigns supervisory responsibility to the LPN.
2. A client with heart failure develops new-onset dyspnea and bilateral ankle edema. The
LPN contacts the RN using SBAR communication. Which statement best represents the "A"
(Assessment) component?
A. "The client reports shortness of breath that started two hours ago and has 2+ pitting edema in both
ankles."
B. "I think the client may be experiencing fluid overload related to their heart failure."
C. "The client needs a diuretic and oxygen to relieve their symptoms."
D. "The vital signs show BP 148/92 mmHg, HR 98 bpm, respiratory rate 28 breaths/min, and SpO2
91% on room air."
Correct Answer: B. "I think the client may be experiencing fluid overload related to their
heart failure."
Rationale: In SBAR, the "A" stands for Assessment — the nurse's clinical judgment about the situation.
Option B provides the LPN's interpretation of the data (fluid overload). Option A describes the
Situation (what is happening now). Option D contains objective data that fits under Background.
Option C is a Recommendation, not an assessment. Recognizing the difference between data reporting
and clinical interpretation is essential for clear interprofessional communication.
3. A client is scheduled for a colonoscopy and tells the LPN, "I signed the form, but I really
don't understand what they're going to do during the procedure." Which action should the
LPN take first?
A. Explain the colonoscopy procedure in detail to the client.
B. Notify the registered nurse (RN) and the healthcare provider performing the procedure.
C. Document the client's statement in the medical record and continue preparation.
D. Ask the client to sign a new consent form after reading the educational brochure.
Correct Answer: B. Notify the registered nurse (RN) and the healthcare provider
performing the procedure.
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, NCLEX-PN NGN Practice Exam 2026/2027
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and
alternatives. The LPN may witness the signature on a consent form but does not have the authority to
provide the detailed explanation required for informed consent — that is the responsibility of the
healthcare provider performing the procedure. The LPN should notify the RN and provider so the client
can receive proper education before the procedure proceeds. Explaining the procedure independently
(Option A) is outside the LPN's scope for informed consent. Proceeding without ensuring
understanding (Option C) violates the client's rights.
4. Which of the following actions are within the scope of practice for a licensed practical
nurse (LPN)? (Select all that apply.) [SATA]
A. Reinforcing discharge teaching provided by the registered nurse (RN)
B. Performing the initial comprehensive admission assessment
C. Administering oral and intramuscular medications prescribed by the healthcare provider
D. Developing the initial plan of care for a newly admitted client
E. Obtaining a client's vital signs and reporting abnormal findings to the RN
F. Initiating a blood transfusion independently
Correct Answer: A, C, E. Reinforcing discharge teaching provided by the RN,
Administering oral and intramuscular medications prescribed by the healthcare provider,
Obtaining a client's vital signs and reporting abnormal findings to the RN
Rationale: The LPN scope includes reinforcing teaching (not providing initial education),
administering prescribed medications (including oral, IM, and some IV medications under certain
state regulations or with additional certification), and obtaining vital signs with appropriate
reporting. The initial comprehensive admission assessment (B) and developing the initial plan of care
(D) are RN responsibilities, as they require the broader nursing knowledge base and clinical judgment
characteristic of the registered nurse. Initiating a blood transfusion independently (F) is typically an
RN-level skill in most facilities, as it requires advanced assessment for transfusion reactions.
5. The LPN is delegating tasks to an unlicensed assistive personnel (UAP). Which tasks are
appropriate to delegate to the UAP? (Select all that apply.) [SATA]
A. Ambulating a stable post-operative client with a walker
B. Administering a PRN pain medication to a client reporting 4/10 pain
C. Measuring and recording intake and output for a client on fluid restriction
D. Performing an initial admission assessment on a new client
E. Assisting a client with total bed bath and oral hygiene
F. Feeding a client who had a stroke and has a swallow evaluation on file
Correct Answer: A, C, E, F. Ambulating a stable post-operative client with a walker,
Measuring and recording intake and output for a client on fluid restriction, Assisting a
client with total bed bath and oral hygiene, Feeding a client who had a stroke and has a
swallow evaluation on file
Rationale: The LPN may delegate routine, repetitive tasks that do not require nursing judgment to the
UAP. Ambulating a stable client (A), measuring I&O (C), assisting with hygiene (E), and feeding a
client with a completed swallow evaluation (F) are all appropriate. The UAP cannot administer
medications (B) — this requires a nursing license. Performing an initial admission assessment (D)
requires RN-level assessment skills and clinical judgment and cannot be delegated to UAPs. The LPN
must ensure the UAP has been trained in the specific task and provide clear instructions.
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, NCLEX-PN NGN Practice Exam 2026/2027
6. The LPN is caring for a client who is a local television personality. A coworker from
another unit asks the LPN, "What is your celebrity patient in for?" Which response by the
LPN demonstrates compliance with HIPAA regulations?
A. "I can tell you, but you need to keep it confidential."
B. "I'm sorry, but I cannot discuss any client information with you."
C. "The client is here for a routine procedure, nothing serious."
D. "You should ask the charge nurse for that information."
Correct Answer: B. "I'm sorry, but I cannot discuss any client information with you."
Rationale: HIPAA (Health Insurance Portability and Accountability Act) protects all protected health
information (PHI) regardless of the client's public status. The LPN must not disclose any client
information to unauthorized individuals, even coworkers who are not directly involved in the client's
care. Option A shares information conditionally, which is still a HIPAA violation. Option C provides
specific clinical information, even though minimized. Option D defers to the charge nurse but implies
information could be shared through another channel. The only fully compliant response is a clear,
direct refusal (Option B).
7. An 84-year-old client is admitted to the hospital with pneumonia. The client's daughter
presents a durable power of attorney for healthcare (DPOA-HC) document and states, "My
mother would not want to be placed on a ventilator." The client is currently alert and
oriented. Which action should the LPN take?
A. Follow the DPOA-HC directive and document the client's wishes in the chart.
B. Notify the RN and healthcare provider that a DPOA-HC exists and document its presence.
C. Ask the client directly about their preferences since they are currently alert and capable of decision-
making.
D. Explain to the daughter that the DPOA-HC cannot be honored unless the client is unconscious.
Correct Answer: C. Ask the client directly about their preferences since they are currently
alert and capable of decision-making.
Rationale: A durable power of attorney for healthcare becomes effective when the client loses decision-
making capacity. Since the client is alert and oriented, the client's own wishes take precedence. The
LPN should facilitate the client's expression of their own preferences. While notifying the RN/provider
(Option B) is appropriate, the immediate priority is to honor the client's current autonomy. Option A
incorrectly activates the DPOA-HC prematurely. Option D provides inaccurate information — the
DPOA-HC is not limited to unconsciousness but to any loss of decision-making capacity.
8. The LPN is assigned to care for four clients. Which client should the LPN assess first?
A. A client who is 2 days post-operative right hip replacement and reports pain at a level of 4/10
B. A client with heart failure who reports increasing dyspnea over the past hour
C. A client with type 2 diabetes who has a fasting blood glucose of 168 mg/dL
D. A client receiving IV antibiotics for cellulitis whose IV site appears red with slight swelling
Correct Answer: B. A client with heart failure who reports increasing dyspnea over the
past hour
Rationale: Using the ABC (Airway, Breathing, Circulation) framework and Maslow's hierarchy of
needs, increasing dyspnea in a heart failure client indicates potential fluid overload or respiratory
compromise — a life-threatening change that requires immediate assessment and intervention. Post-
operative pain (A), elevated blood glucose (C), and a localized IV site reaction (D) are important but
3
NCLEX-PN
National Council Licensure Examination
for Practical/Vocational Nurses
Next Generation NCLEX (NGN) Integrated Practice Examination
2026/2027 Academic Year | NCSBN/Pearson VUE Aligned
Examination Overview
Total Questions: 100 (Adaptive Range: 85–150) | Maximum Time: 5 Hours
NGN Item Types: MCQ, SATA, Ordered Response, Trend, Case Study
Framework: NCSBN Clinical Judgment Measurement Model (CJMM)
Passing Standard: Criterion-referenced (NCSBN logit measure, not percentage-based)
Select the one best answer unless otherwise indicated. For SATA, select all correct options.
1
, NCLEX-PN NGN Practice Exam 2026/2027
CLIENT NEEDS I: SAFE AND EFFECTIVE CARE ENVIRONMENT
Coordinated Care (18–24%)
1. The charge nurse on a medical-surgical unit asks the LPN to supervise a newly hired
unlicensed assistive personnel (UAP) during a shift. Which response by the LPN is most
appropriate?
A. "I will supervise the UAP and report any concerns to you."
B. "Supervising unlicensed personnel is the responsibility of the registered nurse (RN), not the LPN."
C. "I can observe the UAP but cannot provide formal evaluation."
D. "I will delegate tasks to the UAP and assume responsibility for the outcomes."
Correct Answer: B. Supervising unlicensed personnel is the responsibility of the
registered nurse (RN), not the LPN.
Rationale: According to the NCSBN and most state Nurse Practice Acts, the supervisory role over
unlicensed assistive personnel falls under the scope of the registered nurse. The LPN may assign tasks
within their own scope but is not responsible for formally supervising or evaluating UAPs. Option A
implies acceptance of a role outside PN scope. Option C is partially correct but does not address the
core issue. Option D incorrectly assigns supervisory responsibility to the LPN.
2. A client with heart failure develops new-onset dyspnea and bilateral ankle edema. The
LPN contacts the RN using SBAR communication. Which statement best represents the "A"
(Assessment) component?
A. "The client reports shortness of breath that started two hours ago and has 2+ pitting edema in both
ankles."
B. "I think the client may be experiencing fluid overload related to their heart failure."
C. "The client needs a diuretic and oxygen to relieve their symptoms."
D. "The vital signs show BP 148/92 mmHg, HR 98 bpm, respiratory rate 28 breaths/min, and SpO2
91% on room air."
Correct Answer: B. "I think the client may be experiencing fluid overload related to their
heart failure."
Rationale: In SBAR, the "A" stands for Assessment — the nurse's clinical judgment about the situation.
Option B provides the LPN's interpretation of the data (fluid overload). Option A describes the
Situation (what is happening now). Option D contains objective data that fits under Background.
Option C is a Recommendation, not an assessment. Recognizing the difference between data reporting
and clinical interpretation is essential for clear interprofessional communication.
3. A client is scheduled for a colonoscopy and tells the LPN, "I signed the form, but I really
don't understand what they're going to do during the procedure." Which action should the
LPN take first?
A. Explain the colonoscopy procedure in detail to the client.
B. Notify the registered nurse (RN) and the healthcare provider performing the procedure.
C. Document the client's statement in the medical record and continue preparation.
D. Ask the client to sign a new consent form after reading the educational brochure.
Correct Answer: B. Notify the registered nurse (RN) and the healthcare provider
performing the procedure.
1
, NCLEX-PN NGN Practice Exam 2026/2027
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and
alternatives. The LPN may witness the signature on a consent form but does not have the authority to
provide the detailed explanation required for informed consent — that is the responsibility of the
healthcare provider performing the procedure. The LPN should notify the RN and provider so the client
can receive proper education before the procedure proceeds. Explaining the procedure independently
(Option A) is outside the LPN's scope for informed consent. Proceeding without ensuring
understanding (Option C) violates the client's rights.
4. Which of the following actions are within the scope of practice for a licensed practical
nurse (LPN)? (Select all that apply.) [SATA]
A. Reinforcing discharge teaching provided by the registered nurse (RN)
B. Performing the initial comprehensive admission assessment
C. Administering oral and intramuscular medications prescribed by the healthcare provider
D. Developing the initial plan of care for a newly admitted client
E. Obtaining a client's vital signs and reporting abnormal findings to the RN
F. Initiating a blood transfusion independently
Correct Answer: A, C, E. Reinforcing discharge teaching provided by the RN,
Administering oral and intramuscular medications prescribed by the healthcare provider,
Obtaining a client's vital signs and reporting abnormal findings to the RN
Rationale: The LPN scope includes reinforcing teaching (not providing initial education),
administering prescribed medications (including oral, IM, and some IV medications under certain
state regulations or with additional certification), and obtaining vital signs with appropriate
reporting. The initial comprehensive admission assessment (B) and developing the initial plan of care
(D) are RN responsibilities, as they require the broader nursing knowledge base and clinical judgment
characteristic of the registered nurse. Initiating a blood transfusion independently (F) is typically an
RN-level skill in most facilities, as it requires advanced assessment for transfusion reactions.
5. The LPN is delegating tasks to an unlicensed assistive personnel (UAP). Which tasks are
appropriate to delegate to the UAP? (Select all that apply.) [SATA]
A. Ambulating a stable post-operative client with a walker
B. Administering a PRN pain medication to a client reporting 4/10 pain
C. Measuring and recording intake and output for a client on fluid restriction
D. Performing an initial admission assessment on a new client
E. Assisting a client with total bed bath and oral hygiene
F. Feeding a client who had a stroke and has a swallow evaluation on file
Correct Answer: A, C, E, F. Ambulating a stable post-operative client with a walker,
Measuring and recording intake and output for a client on fluid restriction, Assisting a
client with total bed bath and oral hygiene, Feeding a client who had a stroke and has a
swallow evaluation on file
Rationale: The LPN may delegate routine, repetitive tasks that do not require nursing judgment to the
UAP. Ambulating a stable client (A), measuring I&O (C), assisting with hygiene (E), and feeding a
client with a completed swallow evaluation (F) are all appropriate. The UAP cannot administer
medications (B) — this requires a nursing license. Performing an initial admission assessment (D)
requires RN-level assessment skills and clinical judgment and cannot be delegated to UAPs. The LPN
must ensure the UAP has been trained in the specific task and provide clear instructions.
2
, NCLEX-PN NGN Practice Exam 2026/2027
6. The LPN is caring for a client who is a local television personality. A coworker from
another unit asks the LPN, "What is your celebrity patient in for?" Which response by the
LPN demonstrates compliance with HIPAA regulations?
A. "I can tell you, but you need to keep it confidential."
B. "I'm sorry, but I cannot discuss any client information with you."
C. "The client is here for a routine procedure, nothing serious."
D. "You should ask the charge nurse for that information."
Correct Answer: B. "I'm sorry, but I cannot discuss any client information with you."
Rationale: HIPAA (Health Insurance Portability and Accountability Act) protects all protected health
information (PHI) regardless of the client's public status. The LPN must not disclose any client
information to unauthorized individuals, even coworkers who are not directly involved in the client's
care. Option A shares information conditionally, which is still a HIPAA violation. Option C provides
specific clinical information, even though minimized. Option D defers to the charge nurse but implies
information could be shared through another channel. The only fully compliant response is a clear,
direct refusal (Option B).
7. An 84-year-old client is admitted to the hospital with pneumonia. The client's daughter
presents a durable power of attorney for healthcare (DPOA-HC) document and states, "My
mother would not want to be placed on a ventilator." The client is currently alert and
oriented. Which action should the LPN take?
A. Follow the DPOA-HC directive and document the client's wishes in the chart.
B. Notify the RN and healthcare provider that a DPOA-HC exists and document its presence.
C. Ask the client directly about their preferences since they are currently alert and capable of decision-
making.
D. Explain to the daughter that the DPOA-HC cannot be honored unless the client is unconscious.
Correct Answer: C. Ask the client directly about their preferences since they are currently
alert and capable of decision-making.
Rationale: A durable power of attorney for healthcare becomes effective when the client loses decision-
making capacity. Since the client is alert and oriented, the client's own wishes take precedence. The
LPN should facilitate the client's expression of their own preferences. While notifying the RN/provider
(Option B) is appropriate, the immediate priority is to honor the client's current autonomy. Option A
incorrectly activates the DPOA-HC prematurely. Option D provides inaccurate information — the
DPOA-HC is not limited to unconsciousness but to any loss of decision-making capacity.
8. The LPN is assigned to care for four clients. Which client should the LPN assess first?
A. A client who is 2 days post-operative right hip replacement and reports pain at a level of 4/10
B. A client with heart failure who reports increasing dyspnea over the past hour
C. A client with type 2 diabetes who has a fasting blood glucose of 168 mg/dL
D. A client receiving IV antibiotics for cellulitis whose IV site appears red with slight swelling
Correct Answer: B. A client with heart failure who reports increasing dyspnea over the
past hour
Rationale: Using the ABC (Airway, Breathing, Circulation) framework and Maslow's hierarchy of
needs, increasing dyspnea in a heart failure client indicates potential fluid overload or respiratory
compromise — a life-threatening change that requires immediate assessment and intervention. Post-
operative pain (A), elevated blood glucose (C), and a localized IV site reaction (D) are important but
3
