1|Page
NCLEX-PN EXAM CRAM PRACTICE QUESTIONS, 5TH
EDITION
## WILDA RINEHART, DIANN SLOAN & CLARA HURD
### 2025/2026 SUCCESS GUIDE | FIRST-ATTEMPT PASS
| ALIGNED WITH APRIL 2026 NCSBN UPDATES
# DOMAIN 1: SAFE, EFFECTIVE CARE ENVIRONMENT – COORDINATED
CARE (18–24%)
**1. A charge nurse is making assignments on a medical-surgical unit. Which
client should be assigned to a newly licensed PN?**
A) A client with unstable angina on a telemetry monitor
B) A client with a new tracheostomy requiring frequent suctioning
C) A client with a hip fracture who is stable and awaiting surgery
D) A client with active seizures every 2 hours
**Correct Answer: C**
*Rationale:* Assign stable, predictable clients to newly licensed nurses. The hip
fracture client is stable and low acuity. Unstable angina, new tracheostomy, and
active seizures require experienced staff .
---
,2|Page
**2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate?**
A) Measure intake and output on a client with heart failure
B) Assess a client's pain level after surgery
C) Administer a tube feeding via gastrostomy tube
D) Teach a client how to use an incentive spirometer
**Correct Answer: A**
*Rationale:* UAP can measure and record intake and output for stable clients.
Assessment, administration of tube feedings, and teaching require nursing
judgment and are not within UAP scope .
---
**3. A nurse receives a telephone order from a provider for a new medication.
Which action is most important?**
A) Write the order and implement immediately
B) Write the order, read it back verbatim to the provider, and obtain confirmation
C) Ask another nurse to listen on speakerphone
D) Document the order without reading it back
**Correct Answer: B**
*Rationale:* The Joint Commission requires read-back verification for all
telephone orders to prevent errors. The nurse writes the order, reads it back word-
for-word, and receives confirmation .
,3|Page
---
**4. A nurse is caring for a client with a prescription for physical restraints. Which
finding requires immediate removal of the restraints?**
A) The client is trying to remove the restraints
B) The restrained hand is cool and cyanotic
C) The client is sleeping quietly
D) The restraint has been in place for 2 hours
**Correct Answer: B**
*Rationale:* Cyanosis or coolness indicates impaired circulation, which can lead
to tissue damage. The restraint must be removed or loosened immediately.
Restraints should be removed and repositioned every 2 hours .
---
**5. A nurse is caring for a client with a valid Do Not Resuscitate (DNR) order.
The client goes into cardiac arrest. What should the nurse do?**
A) Start CPR immediately
B) Honor the DNR order and provide comfort care
C) Call a code before checking the DNR
D) Ask the family for permission
**Correct Answer: B**
, 4|Page
*Rationale:* A valid DNR order means no resuscitation efforts should be
attempted. The nurse should verify the order, then provide comfort care and notify
the provider .
---
**6. A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. The client is competent. Which action is correct?**
A) Administer the transfusion because it is medically necessary
B) Respect the client's refusal and notify the provider
C) Ask the client's family to override the decision
D) Call a hospital ethics committee immediately
**Correct Answer: B**
*Rationale:* Competent adults have the legal and ethical right to refuse treatment,
even life-saving treatment. The nurse must respect the refusal and document it .
---
**7. A nurse is preparing to discharge a client who speaks limited English. Which
action is most appropriate?**
A) Provide written discharge instructions in English only
B) Use the client's 12-year-old child as an interpreter
C) Use a certified medical interpreter via telephone or in person
D) Speak loudly and slowly in English
NCLEX-PN EXAM CRAM PRACTICE QUESTIONS, 5TH
EDITION
## WILDA RINEHART, DIANN SLOAN & CLARA HURD
### 2025/2026 SUCCESS GUIDE | FIRST-ATTEMPT PASS
| ALIGNED WITH APRIL 2026 NCSBN UPDATES
# DOMAIN 1: SAFE, EFFECTIVE CARE ENVIRONMENT – COORDINATED
CARE (18–24%)
**1. A charge nurse is making assignments on a medical-surgical unit. Which
client should be assigned to a newly licensed PN?**
A) A client with unstable angina on a telemetry monitor
B) A client with a new tracheostomy requiring frequent suctioning
C) A client with a hip fracture who is stable and awaiting surgery
D) A client with active seizures every 2 hours
**Correct Answer: C**
*Rationale:* Assign stable, predictable clients to newly licensed nurses. The hip
fracture client is stable and low acuity. Unstable angina, new tracheostomy, and
active seizures require experienced staff .
---
,2|Page
**2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate?**
A) Measure intake and output on a client with heart failure
B) Assess a client's pain level after surgery
C) Administer a tube feeding via gastrostomy tube
D) Teach a client how to use an incentive spirometer
**Correct Answer: A**
*Rationale:* UAP can measure and record intake and output for stable clients.
Assessment, administration of tube feedings, and teaching require nursing
judgment and are not within UAP scope .
---
**3. A nurse receives a telephone order from a provider for a new medication.
Which action is most important?**
A) Write the order and implement immediately
B) Write the order, read it back verbatim to the provider, and obtain confirmation
C) Ask another nurse to listen on speakerphone
D) Document the order without reading it back
**Correct Answer: B**
*Rationale:* The Joint Commission requires read-back verification for all
telephone orders to prevent errors. The nurse writes the order, reads it back word-
for-word, and receives confirmation .
,3|Page
---
**4. A nurse is caring for a client with a prescription for physical restraints. Which
finding requires immediate removal of the restraints?**
A) The client is trying to remove the restraints
B) The restrained hand is cool and cyanotic
C) The client is sleeping quietly
D) The restraint has been in place for 2 hours
**Correct Answer: B**
*Rationale:* Cyanosis or coolness indicates impaired circulation, which can lead
to tissue damage. The restraint must be removed or loosened immediately.
Restraints should be removed and repositioned every 2 hours .
---
**5. A nurse is caring for a client with a valid Do Not Resuscitate (DNR) order.
The client goes into cardiac arrest. What should the nurse do?**
A) Start CPR immediately
B) Honor the DNR order and provide comfort care
C) Call a code before checking the DNR
D) Ask the family for permission
**Correct Answer: B**
, 4|Page
*Rationale:* A valid DNR order means no resuscitation efforts should be
attempted. The nurse should verify the order, then provide comfort care and notify
the provider .
---
**6. A nurse is caring for a client who refuses a blood transfusion due to religious
beliefs. The client is competent. Which action is correct?**
A) Administer the transfusion because it is medically necessary
B) Respect the client's refusal and notify the provider
C) Ask the client's family to override the decision
D) Call a hospital ethics committee immediately
**Correct Answer: B**
*Rationale:* Competent adults have the legal and ethical right to refuse treatment,
even life-saving treatment. The nurse must respect the refusal and document it .
---
**7. A nurse is preparing to discharge a client who speaks limited English. Which
action is most appropriate?**
A) Provide written discharge instructions in English only
B) Use the client's 12-year-old child as an interpreter
C) Use a certified medical interpreter via telephone or in person
D) Speak loudly and slowly in English
