CRAM NCLEX-PN NURSING PRACTICE EXAM | 2026/2027
Comprehensive NCLEX-PN® Practice Examination with Complete Questions & Verified Answers |
Latest Version
Overview
This 2026/2027 updated resource contains the latest CRAM NCLEX-PN® Comprehensive
Practice Examination with the exact 200 questions and verified answers, following current NCSBN
NCLEX-PN® test plan, practical/vocational nursing standards, and evidence-based nursing practice
across all client needs categories and content areas.
Key Features
● ✓ Actual NCLEX-PN® exam format with the official 200 questions
● ✓ Comprehensive coverage of all NCLEX-PN® client needs categories
● ✓ Updated 2026/2027 test plan revisions and content emphasis areas
● ✓ Practical nursing scenario applications with clinical judgment integration
● ✓ Next Generation NCLEX (NGN) style items for practical nurses
Core Content Areas (200 Total Questions)
● Safe and Effective Care Environment (55 Qs)
● Health Promotion and Maintenance (45 Qs)
● Psychosocial Integrity (35 Qs)
● Physiological Integrity (65 Qs)
Detailed Content Breakdown
● Coordinated Care & Case Management (25 Qs)
● Safety & Infection Control (30 Qs)
● Health Promotion & Disease Prevention (25 Qs)
● Basic Care & Comfort (30 Qs)
● Pharmacological Therapies (25 Qs)
● Reduction of Risk Potential (25 Qs)
● Physiological Adaptation (20 Qs)
● Psychosocial Adaptation (20 Qs)
NGN Item Types Included
● Matrix Items – Multiple selection with rationale for nursing interventions
● Bowtie Items – Risk assessment and prevention strategies
● Highlight Text – Identification of critical assessment findings
● Extended Multiple Response – Complex clinical judgment scenarios
● Trend Items – Recognition of changing client status
● Drag-and-Drop – Prioritization of nursing actions
Answer Format
Correct answers are marked in bold green and include:
● NCLEX-PN® test plan content area applications
● Practical nursing scope of practice considerations
, ● Clinical judgment model step applications
● Medication administration safety protocols
● Delegation and supervision principles
● Patient education and health literacy adaptations
Updates for 2026/2027
● 🔹
🔹 Reflects 2026-2027 NCLEX-PN® test plan comprehensive revisions
●
● 🔹
🔹
Enhanced clinical judgment measurement model integration
Updated telehealth nursing applications for practical nurses
●
● 🔹
🔹
New health equity and cultural competence standards
Revised infection control protocols and emerging pathogen guidelines
●
●
●
🔹 Updated medication safety and error prevention standards
🔹 New technology integration in practical nursing practice
Revised delegation and team communication standards
NCLEX-PN PRACTICE EXAM QUESTIONS (1–200)
1. A licensed practical nurse (LPN) is assigned to care for a client with a new colostomy.
Which action is within the LPN’s scope of practice?
A. Ordering colostomy supplies
B. Emptying the colostomy bag and documenting output
C. Determining the need for surgical revision
D. Teaching the client about long-term colostomy management for the first time
Rationale: LPNs may perform routine stoma care, empty appliances, and document output. Initial
comprehensive teaching and surgical decisions are outside LPN scope and require an RN or provider
(NCSBN Scope of Practice, 2026).
2. A client with diabetes mellitus type 2 is prescribed metformin. The LPN should monitor
for which potential adverse effect?
A. Hyperglycemia
B. Hypertension
C. Lactic acidosis (rare but serious)
D. Constipation
, Rationale: Metformin carries a black box warning for lactic acidosis, especially in clients with renal
impairment, heart failure, or liver disease. LPNs should report symptoms like muscle pain,
weakness, or dyspnea (NCLEX-PN Pharmacology Guidelines, 2026).
3. During morning care, the LPN observes redness over a client’s sacrum that does not
blanch. The priority action is to:
A. Massage the area to improve circulation
B. Apply a heating pad
C. Report findings to the RN immediately and ensure the client is repositioned
D. Document and continue routine care
Rationale: Non-blanchable redness indicates Stage 1 pressure injury. LPNs must report skin changes
promptly and implement basic prevention (repositioning, offloading), but comprehensive wound
care planning requires RN involvement (NCSBN, 2026).
4. An LPN is preparing to administer insulin to a client. Which action demonstrates safe
medication practice?
A. Using the same insulin syringe for multiple clients to reduce waste
B. Administering insulin based on a verbal order from the provider
C. Verifying the client’s identity using two identifiers before administration
D. Storing opened insulin vials at room temperature for up to 6 months
Rationale: Using two client identifiers (e.g., name and DOB) is a Joint Commission safety standard.
Insulin must be given per written order, never shared between clients, and stored per manufacturer
guidelines (typically 28 days at room temp) (ISMP, 2026).
5. A client with dementia becomes agitated during bathing. The LPN’s best response is to:
A. Restrain the client to complete care quickly
B. Skip hygiene for the day
C. Pause, speak calmly, and try again later or modify the approach
D. Ask the family to bathe the client
, Rationale: Non-pharmacological de-escalation is essential. Forcing care increases agitation. LPNs
should adapt care to the client’s cognitive level and emotional state (NCLEX-PN Psychosocial
Integrity, 2026).
6. Which client should the LPN prioritize during routine rounds?
A. Client reporting mild headache
B. Client with stable vital signs post-hip replacement
C. Client with chest pain and diaphoresis
D. Client requesting a bed bath
Rationale: Chest pain with diaphoresis may indicate acute cardiac event. LPNs must recognize
urgent changes and notify the RN or provider immediately (Clinical Judgment Measurement
Model—Recognize Cues, 2026).
7. An LPN is assigned to assist with a dressing change on a client with MRSA. Which action
is essential?
A. Wearing only gloves
B. Wearing gloves and gown, and following contact precautions
C. Using standard precautions only
D. Wearing an N95 respirator
Rationale: MRSA requires contact precautions: gown and gloves upon room entry. N95 is for
airborne pathogens (e.g., TB). Standard precautions alone are insufficient (CDC, 2026).
8. A client asks the LPN, “What does my lab result mean?” The LPN should:
A. Interpret the result based on experience
B. Refer the client to the RN or provider for explanation
C. Tell the client to look it up online
D. Ignore the question
Comprehensive NCLEX-PN® Practice Examination with Complete Questions & Verified Answers |
Latest Version
Overview
This 2026/2027 updated resource contains the latest CRAM NCLEX-PN® Comprehensive
Practice Examination with the exact 200 questions and verified answers, following current NCSBN
NCLEX-PN® test plan, practical/vocational nursing standards, and evidence-based nursing practice
across all client needs categories and content areas.
Key Features
● ✓ Actual NCLEX-PN® exam format with the official 200 questions
● ✓ Comprehensive coverage of all NCLEX-PN® client needs categories
● ✓ Updated 2026/2027 test plan revisions and content emphasis areas
● ✓ Practical nursing scenario applications with clinical judgment integration
● ✓ Next Generation NCLEX (NGN) style items for practical nurses
Core Content Areas (200 Total Questions)
● Safe and Effective Care Environment (55 Qs)
● Health Promotion and Maintenance (45 Qs)
● Psychosocial Integrity (35 Qs)
● Physiological Integrity (65 Qs)
Detailed Content Breakdown
● Coordinated Care & Case Management (25 Qs)
● Safety & Infection Control (30 Qs)
● Health Promotion & Disease Prevention (25 Qs)
● Basic Care & Comfort (30 Qs)
● Pharmacological Therapies (25 Qs)
● Reduction of Risk Potential (25 Qs)
● Physiological Adaptation (20 Qs)
● Psychosocial Adaptation (20 Qs)
NGN Item Types Included
● Matrix Items – Multiple selection with rationale for nursing interventions
● Bowtie Items – Risk assessment and prevention strategies
● Highlight Text – Identification of critical assessment findings
● Extended Multiple Response – Complex clinical judgment scenarios
● Trend Items – Recognition of changing client status
● Drag-and-Drop – Prioritization of nursing actions
Answer Format
Correct answers are marked in bold green and include:
● NCLEX-PN® test plan content area applications
● Practical nursing scope of practice considerations
, ● Clinical judgment model step applications
● Medication administration safety protocols
● Delegation and supervision principles
● Patient education and health literacy adaptations
Updates for 2026/2027
● 🔹
🔹 Reflects 2026-2027 NCLEX-PN® test plan comprehensive revisions
●
● 🔹
🔹
Enhanced clinical judgment measurement model integration
Updated telehealth nursing applications for practical nurses
●
● 🔹
🔹
New health equity and cultural competence standards
Revised infection control protocols and emerging pathogen guidelines
●
●
●
🔹 Updated medication safety and error prevention standards
🔹 New technology integration in practical nursing practice
Revised delegation and team communication standards
NCLEX-PN PRACTICE EXAM QUESTIONS (1–200)
1. A licensed practical nurse (LPN) is assigned to care for a client with a new colostomy.
Which action is within the LPN’s scope of practice?
A. Ordering colostomy supplies
B. Emptying the colostomy bag and documenting output
C. Determining the need for surgical revision
D. Teaching the client about long-term colostomy management for the first time
Rationale: LPNs may perform routine stoma care, empty appliances, and document output. Initial
comprehensive teaching and surgical decisions are outside LPN scope and require an RN or provider
(NCSBN Scope of Practice, 2026).
2. A client with diabetes mellitus type 2 is prescribed metformin. The LPN should monitor
for which potential adverse effect?
A. Hyperglycemia
B. Hypertension
C. Lactic acidosis (rare but serious)
D. Constipation
, Rationale: Metformin carries a black box warning for lactic acidosis, especially in clients with renal
impairment, heart failure, or liver disease. LPNs should report symptoms like muscle pain,
weakness, or dyspnea (NCLEX-PN Pharmacology Guidelines, 2026).
3. During morning care, the LPN observes redness over a client’s sacrum that does not
blanch. The priority action is to:
A. Massage the area to improve circulation
B. Apply a heating pad
C. Report findings to the RN immediately and ensure the client is repositioned
D. Document and continue routine care
Rationale: Non-blanchable redness indicates Stage 1 pressure injury. LPNs must report skin changes
promptly and implement basic prevention (repositioning, offloading), but comprehensive wound
care planning requires RN involvement (NCSBN, 2026).
4. An LPN is preparing to administer insulin to a client. Which action demonstrates safe
medication practice?
A. Using the same insulin syringe for multiple clients to reduce waste
B. Administering insulin based on a verbal order from the provider
C. Verifying the client’s identity using two identifiers before administration
D. Storing opened insulin vials at room temperature for up to 6 months
Rationale: Using two client identifiers (e.g., name and DOB) is a Joint Commission safety standard.
Insulin must be given per written order, never shared between clients, and stored per manufacturer
guidelines (typically 28 days at room temp) (ISMP, 2026).
5. A client with dementia becomes agitated during bathing. The LPN’s best response is to:
A. Restrain the client to complete care quickly
B. Skip hygiene for the day
C. Pause, speak calmly, and try again later or modify the approach
D. Ask the family to bathe the client
, Rationale: Non-pharmacological de-escalation is essential. Forcing care increases agitation. LPNs
should adapt care to the client’s cognitive level and emotional state (NCLEX-PN Psychosocial
Integrity, 2026).
6. Which client should the LPN prioritize during routine rounds?
A. Client reporting mild headache
B. Client with stable vital signs post-hip replacement
C. Client with chest pain and diaphoresis
D. Client requesting a bed bath
Rationale: Chest pain with diaphoresis may indicate acute cardiac event. LPNs must recognize
urgent changes and notify the RN or provider immediately (Clinical Judgment Measurement
Model—Recognize Cues, 2026).
7. An LPN is assigned to assist with a dressing change on a client with MRSA. Which action
is essential?
A. Wearing only gloves
B. Wearing gloves and gown, and following contact precautions
C. Using standard precautions only
D. Wearing an N95 respirator
Rationale: MRSA requires contact precautions: gown and gloves upon room entry. N95 is for
airborne pathogens (e.g., TB). Standard precautions alone are insufficient (CDC, 2026).
8. A client asks the LPN, “What does my lab result mean?” The LPN should:
A. Interpret the result based on experience
B. Refer the client to the RN or provider for explanation
C. Tell the client to look it up online
D. Ignore the question
