NCLEX-PN LATEST UPDATE 2025-2026| Practice Questions &
Rationales – Next Generation NGN Exam Prep with Saunders,
Kaplan & UWorld-Style Qbank for LPN/LVN Licensure 2025-2026
A licensed practical nurse (LPN) is caring for a client who is postoperative day 1 following a
cholecystectomy. Which finding should the LPN report to the registered nurse (RN)
immediately?
○ A. Pain rated 5 on a scale of 0-10
○ B. Temperature of 99.8°F (37.7°C)
○ C. Serosanguineous drainage on the dressing
○ D. Oxygen saturation of 88% on room air
CORRECT ANSWER: D. Oxygen saturation of 88% on room air
RATIONALE: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention. Pain, low-grade fever, and serosanguineous drainage are expected postoperative
findings.
A client with diabetes mellitus type 2 is prescribed metformin. Which side effect should the
LPN monitor for?
○ A. Weight gain
○ B. Hypoglycemia
○ C. Lactic acidosis
○ D. Hyperglycemia
CORRECT ANSWER: C. Lactic acidosis
RATIONALE: Metformin can cause lactic acidosis, a rare but serious side effect, especially in
clients with renal impairment. Weight gain is not typical. Hypoglycemia is rare with metformin
alone.
A client is receiving IV fluids and develops crackles in the lungs, jugular venous distension, and
shortness of breath. Which complication is the client experiencing?
,○ A. Anaphylactic reaction
○ B. Fluid volume overload
○ C. Hypovolemia
○ D. Pulmonary embolism
CORRECT ANSWER: B. Fluid volume overload
RATIONALE: Crackles, jugular venous distension, and shortness of breath are classic signs of
fluid volume overload. Anaphylaxis presents with urticaria and hypotension. Hypovolemia
presents with tachycardia and hypotension.
A client with a history of heart failure is prescribed furosemide. Which finding indicates the
medication is effective?
○ A. Increased urine output
○ B. Increased blood pressure
○ C. Weight gain
○ D. Decreased heart rate
CORRECT ANSWER: A. Increased urine output
RATIONALE: Furosemide reduces fluid volume by increasing urine output. Blood pressure
should decrease, weight should decrease, and heart rate may decrease but is not the primary
indicator.
A client is prescribed warfarin. Which laboratory value should the LPN monitor?
○ A. Activated partial thromboplastin time (aPTT)
○ B. Prothrombin time (PT) and International Normalized Ratio (INR)
○ C. Platelet count
○ D. Bleeding time
CORRECT ANSWER: B. Prothrombin time (PT) and International Normalized Ratio (INR)
RATIONALE: Warfarin is monitored using PT and INR, with a therapeutic INR typically between
2-3. aPTT is used for heparin. Platelet count and bleeding time are not specific for warfarin.
,A client with a history of chronic obstructive pulmonary disease (COPD) has a pulse oximetry
reading of 88%. Which intervention should the LPN implement first?
○ A. Administer oxygen at 2 L/min via nasal cannula
○ B. Administer oxygen at 4 L/min via nasal cannula
○ C. Administer oxygen at 6 L/min via face mask
○ D. Notify the healthcare provider
CORRECT ANSWER: A. Administer oxygen at 2 L/min via nasal cannula
RATIONALE: In COPD clients, oxygen should be started at the lowest possible flow rate (1-2
L/min) to avoid suppressing the hypoxic drive. Higher flow rates can lead to respiratory
depression.
A client is diagnosed with a urinary tract infection (UTI). Which symptom is most common in
older adults?
○ A. Dysuria
○ B. Frequency
○ C. Incontinence
○ D. Confusion
CORRECT ANSWER: D. Confusion
RATIONALE: In older adults, confusion may be the first sign of a UTI. Dysuria, frequency, and
urgency may be absent.
A client with a history of seizures is prescribed phenytoin. Which side effect requires immediate
intervention?
○ A. Nystagmus
○ B. Ataxia
○ C. Gingival hyperplasia
○ D. Severe rash
CORRECT ANSWER: D. Severe rash
RATIONALE: A severe rash may indicate Stevens-Johnson syndrome, a life-threatening
hypersensitivity reaction. Nystagmus, ataxia, and gingival hyperplasia are side effects that do
not require immediate intervention.
, A nurse is providing teaching to a client with a new colostomy. Which food should the client
avoid to prevent blockage?
○ A. Applesauce
○ B. Bananas
○ C. Nuts
○ D. White rice
CORRECT ANSWER: C. Nuts
RATIONALE: Nuts are high-fiber foods that can cause blockage in a client with a colostomy.
Applesauce, bananas, and white rice are low-fiber and safe.
A client is prescribed an opioid for chronic pain. Which side effect should the LPN monitor for?
○ A. Diarrhea
○ B. Tachycardia
○ C. Constipation
○ D. Hyperglycemia
CORRECT ANSWER: C. Constipation
RATIONALE: Constipation is the most common side effect of opioid therapy due to decreased
gastrointestinal motility. Diarrhea, tachycardia, and hyperglycemia are not typical.
A client with a history of heart failure is prescribed digoxin. Which finding indicates digoxin
toxicity?
○ A. Tachycardia
○ B. Nausea and vomiting
○ C. Weight gain
○ D. Increased urine output
CORRECT ANSWER: B. Nausea and vomiting
RATIONALE: Nausea and vomiting are early signs of digoxin toxicity. Bradycardia, not
tachycardia, is more common. Weight gain and increased urine output are not signs of toxicity.
Rationales – Next Generation NGN Exam Prep with Saunders,
Kaplan & UWorld-Style Qbank for LPN/LVN Licensure 2025-2026
A licensed practical nurse (LPN) is caring for a client who is postoperative day 1 following a
cholecystectomy. Which finding should the LPN report to the registered nurse (RN)
immediately?
○ A. Pain rated 5 on a scale of 0-10
○ B. Temperature of 99.8°F (37.7°C)
○ C. Serosanguineous drainage on the dressing
○ D. Oxygen saturation of 88% on room air
CORRECT ANSWER: D. Oxygen saturation of 88% on room air
RATIONALE: An oxygen saturation of 88% indicates hypoxemia and requires immediate
intervention. Pain, low-grade fever, and serosanguineous drainage are expected postoperative
findings.
A client with diabetes mellitus type 2 is prescribed metformin. Which side effect should the
LPN monitor for?
○ A. Weight gain
○ B. Hypoglycemia
○ C. Lactic acidosis
○ D. Hyperglycemia
CORRECT ANSWER: C. Lactic acidosis
RATIONALE: Metformin can cause lactic acidosis, a rare but serious side effect, especially in
clients with renal impairment. Weight gain is not typical. Hypoglycemia is rare with metformin
alone.
A client is receiving IV fluids and develops crackles in the lungs, jugular venous distension, and
shortness of breath. Which complication is the client experiencing?
,○ A. Anaphylactic reaction
○ B. Fluid volume overload
○ C. Hypovolemia
○ D. Pulmonary embolism
CORRECT ANSWER: B. Fluid volume overload
RATIONALE: Crackles, jugular venous distension, and shortness of breath are classic signs of
fluid volume overload. Anaphylaxis presents with urticaria and hypotension. Hypovolemia
presents with tachycardia and hypotension.
A client with a history of heart failure is prescribed furosemide. Which finding indicates the
medication is effective?
○ A. Increased urine output
○ B. Increased blood pressure
○ C. Weight gain
○ D. Decreased heart rate
CORRECT ANSWER: A. Increased urine output
RATIONALE: Furosemide reduces fluid volume by increasing urine output. Blood pressure
should decrease, weight should decrease, and heart rate may decrease but is not the primary
indicator.
A client is prescribed warfarin. Which laboratory value should the LPN monitor?
○ A. Activated partial thromboplastin time (aPTT)
○ B. Prothrombin time (PT) and International Normalized Ratio (INR)
○ C. Platelet count
○ D. Bleeding time
CORRECT ANSWER: B. Prothrombin time (PT) and International Normalized Ratio (INR)
RATIONALE: Warfarin is monitored using PT and INR, with a therapeutic INR typically between
2-3. aPTT is used for heparin. Platelet count and bleeding time are not specific for warfarin.
,A client with a history of chronic obstructive pulmonary disease (COPD) has a pulse oximetry
reading of 88%. Which intervention should the LPN implement first?
○ A. Administer oxygen at 2 L/min via nasal cannula
○ B. Administer oxygen at 4 L/min via nasal cannula
○ C. Administer oxygen at 6 L/min via face mask
○ D. Notify the healthcare provider
CORRECT ANSWER: A. Administer oxygen at 2 L/min via nasal cannula
RATIONALE: In COPD clients, oxygen should be started at the lowest possible flow rate (1-2
L/min) to avoid suppressing the hypoxic drive. Higher flow rates can lead to respiratory
depression.
A client is diagnosed with a urinary tract infection (UTI). Which symptom is most common in
older adults?
○ A. Dysuria
○ B. Frequency
○ C. Incontinence
○ D. Confusion
CORRECT ANSWER: D. Confusion
RATIONALE: In older adults, confusion may be the first sign of a UTI. Dysuria, frequency, and
urgency may be absent.
A client with a history of seizures is prescribed phenytoin. Which side effect requires immediate
intervention?
○ A. Nystagmus
○ B. Ataxia
○ C. Gingival hyperplasia
○ D. Severe rash
CORRECT ANSWER: D. Severe rash
RATIONALE: A severe rash may indicate Stevens-Johnson syndrome, a life-threatening
hypersensitivity reaction. Nystagmus, ataxia, and gingival hyperplasia are side effects that do
not require immediate intervention.
, A nurse is providing teaching to a client with a new colostomy. Which food should the client
avoid to prevent blockage?
○ A. Applesauce
○ B. Bananas
○ C. Nuts
○ D. White rice
CORRECT ANSWER: C. Nuts
RATIONALE: Nuts are high-fiber foods that can cause blockage in a client with a colostomy.
Applesauce, bananas, and white rice are low-fiber and safe.
A client is prescribed an opioid for chronic pain. Which side effect should the LPN monitor for?
○ A. Diarrhea
○ B. Tachycardia
○ C. Constipation
○ D. Hyperglycemia
CORRECT ANSWER: C. Constipation
RATIONALE: Constipation is the most common side effect of opioid therapy due to decreased
gastrointestinal motility. Diarrhea, tachycardia, and hyperglycemia are not typical.
A client with a history of heart failure is prescribed digoxin. Which finding indicates digoxin
toxicity?
○ A. Tachycardia
○ B. Nausea and vomiting
○ C. Weight gain
○ D. Increased urine output
CORRECT ANSWER: B. Nausea and vomiting
RATIONALE: Nausea and vomiting are early signs of digoxin toxicity. Bradycardia, not
tachycardia, is more common. Weight gain and increased urine output are not signs of toxicity.
