NCLEX PN FINAL ACTUAL EXAM TEST BANK 2026/2027 | PN
NCLEX EXIT Newest Version | Complete Questions & Verified
Answers with Rationales | Already Graded A+ | Brand New |
Pass Guaranteed - A+ Graded
Section 1: Safe & Effective Care Environment: Management of Care & Safety (Q1–Q40)
Q1: The LPN is caring for four clients on the medical-surgical unit. Which client should
the LPN see first?
A. A client with a new colostomy who reports stoma color is dark purple
B. A client with pneumonia who is receiving oxygen at 2 L/min via nasal cannula and is
resting comfortably
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with a fractured hip who is scheduled for physical therapy in 30 minutes
A. A client with a new colostomy who reports stoma color is dark purple
B. A client with pneumonia who is receiving oxygen at 2 L/min via nasal cannula and is
resting comfortably
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with a fractured hip who is scheduled for physical therapy in 30 minutes
A. A client with a new colostomy who reports stoma color is dark purple [CORRECT]
Correct Answer: A
Rationale: The correct answer is A because a dark purple stoma indicates ischemia and
compromised blood flow to the stoma, which is an airway and circulation issue that
requires immediate assessment and intervention. On NCLEX, always think ABCs first —
this is an acute change that threatens tissue viability. The client with pneumonia on
,stable oxygen is stable, the heart failure client has chronic findings, and the hip fracture
client has a scheduled activity that can wait. I see students miss this all the time, but
the best answer is the one that signals an acute, life-threatening change.
Q2: The LPN is reviewing the morning assignments with the charge RN. Which task is
most appropriate to assign to the unlicensed assistive personnel (UAP)?
A. Assisting a client with a new ileostomy to empty and measure the pouch output
B. Feeding a client who is at high risk for aspiration and requires chin-tuck positioning
C. Obtaining a fingerstick blood glucose on a client with type 2 diabetes
D. Applying a sterile dressing to a stage 2 pressure ulcer on the sacrum
C. Obtaining a fingerstick blood glucose on a client with type 2 diabetes [CORRECT]
Correct Answer: C
Rationale: The correct answer is C because obtaining a fingerstick blood glucose is a
routine, non-invasive task that falls within the UAP's scope of practice after proper
training and validation. Remember your delegation rights — right task, right person, right
circumstances. The UAP should not perform sterile procedures like dressing changes,
manage complex ostomy care that requires assessment, or feed high-risk aspiration
clients where positioning and monitoring are critical nursing judgments.
Q3: A client is admitted to the long-term care facility. The LPN notes the client has a
living will and a durable power of attorney for health care (DPAHC) on file. Which action
by the LPN is most appropriate?
A. Place the documents in the client's medical record and notify the primary health care
provider
B. Ask the client to explain what the advance directives mean to them
C. Inform the family that the advance directives override their decision-making authority
D. File the documents in the administrative office and proceed with standard care
,A. Place the documents in the client's medical record and notify the primary health care
provider [CORRECT]
Correct Answer: A
Rationale: The correct answer is A because the LPN's role with advance directives is to
verify their existence, ensure they are accessible in the medical record, and
communicate this information to the appropriate members of the health care team. The
LPN does not interpret the legal meaning of these documents or override family
discussions — that's the provider's role. What the exam wants you to recognize here is
that the LPN acts as an advocate by ensuring the client's documented wishes are
known and available when needed.
Q4: The LPN is caring for a client with tuberculosis who is on airborne precautions.
Which personal protective equipment (PPE) is required when entering the client's room?
Select all that apply.
A. N95 respirator or higher-level respirator [CORRECT]
B. Gown
C. Gloves
D. Face shield
E. Surgical mask
Correct Answers: A, B, C
Rationale: The correct answers are A, B, and C because airborne precautions for
tuberculosis require an N95 respirator or higher (not a surgical mask), plus standard
precautions which include gloves and gown as needed for anticipated contact with the
client or environment. A face shield is used for splash protection, which isn't the primary
concern with TB, and a surgical mask does not provide adequate filtration for airborne
particles. For final exam level, you need to know that TB, measles, and chickenpox all
, require airborne precautions with an N95 — this is foundational infection control
knowledge.
Q5: The LPN is reviewing the medication administration record for a client receiving
warfarin 5 mg PO daily. The client's INR is 4.2. Which action should the LPN take first?
A. Hold the warfarin dose and notify the RN immediately
B. Administer the warfarin as ordered since it is within the therapeutic range
C. Check the client's PT level before making any decisions
D. Administer vitamin K as the antidote and document the intervention
A. Hold the warfarin dose and notify the RN immediately [CORRECT]
Correct Answer: A
Rationale: The correct answer is A because an INR of 4.2 is above the therapeutic range
of 2.0–3.0 for most clients on warfarin, indicating an increased bleeding risk. The LPN
should hold the dose and report this critical value to the RN right away — this is a safety
issue that cannot wait. The LPN cannot independently administer vitamin K or make
dosing decisions; those are provider-level actions. Think about Maslow — physiological
safety from bleeding comes before anything else here.
Q6: The LPN is caring for a client who is refusing a blood transfusion based on religious
beliefs. The client is alert and oriented, and the health care provider has explained the
risks of refusal. Which action by the LPN demonstrates appropriate advocacy?
A. Respect the client's decision and ensure the refusal is documented appropriately
B. Attempt to convince the client to accept the transfusion for their own safety
C. Contact the client's family to override the client's decision
D. Administer the transfusion when the client is sleeping since it is medically necessary
NCLEX EXIT Newest Version | Complete Questions & Verified
Answers with Rationales | Already Graded A+ | Brand New |
Pass Guaranteed - A+ Graded
Section 1: Safe & Effective Care Environment: Management of Care & Safety (Q1–Q40)
Q1: The LPN is caring for four clients on the medical-surgical unit. Which client should
the LPN see first?
A. A client with a new colostomy who reports stoma color is dark purple
B. A client with pneumonia who is receiving oxygen at 2 L/min via nasal cannula and is
resting comfortably
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with a fractured hip who is scheduled for physical therapy in 30 minutes
A. A client with a new colostomy who reports stoma color is dark purple
B. A client with pneumonia who is receiving oxygen at 2 L/min via nasal cannula and is
resting comfortably
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with a fractured hip who is scheduled for physical therapy in 30 minutes
A. A client with a new colostomy who reports stoma color is dark purple [CORRECT]
Correct Answer: A
Rationale: The correct answer is A because a dark purple stoma indicates ischemia and
compromised blood flow to the stoma, which is an airway and circulation issue that
requires immediate assessment and intervention. On NCLEX, always think ABCs first —
this is an acute change that threatens tissue viability. The client with pneumonia on
,stable oxygen is stable, the heart failure client has chronic findings, and the hip fracture
client has a scheduled activity that can wait. I see students miss this all the time, but
the best answer is the one that signals an acute, life-threatening change.
Q2: The LPN is reviewing the morning assignments with the charge RN. Which task is
most appropriate to assign to the unlicensed assistive personnel (UAP)?
A. Assisting a client with a new ileostomy to empty and measure the pouch output
B. Feeding a client who is at high risk for aspiration and requires chin-tuck positioning
C. Obtaining a fingerstick blood glucose on a client with type 2 diabetes
D. Applying a sterile dressing to a stage 2 pressure ulcer on the sacrum
C. Obtaining a fingerstick blood glucose on a client with type 2 diabetes [CORRECT]
Correct Answer: C
Rationale: The correct answer is C because obtaining a fingerstick blood glucose is a
routine, non-invasive task that falls within the UAP's scope of practice after proper
training and validation. Remember your delegation rights — right task, right person, right
circumstances. The UAP should not perform sterile procedures like dressing changes,
manage complex ostomy care that requires assessment, or feed high-risk aspiration
clients where positioning and monitoring are critical nursing judgments.
Q3: A client is admitted to the long-term care facility. The LPN notes the client has a
living will and a durable power of attorney for health care (DPAHC) on file. Which action
by the LPN is most appropriate?
A. Place the documents in the client's medical record and notify the primary health care
provider
B. Ask the client to explain what the advance directives mean to them
C. Inform the family that the advance directives override their decision-making authority
D. File the documents in the administrative office and proceed with standard care
,A. Place the documents in the client's medical record and notify the primary health care
provider [CORRECT]
Correct Answer: A
Rationale: The correct answer is A because the LPN's role with advance directives is to
verify their existence, ensure they are accessible in the medical record, and
communicate this information to the appropriate members of the health care team. The
LPN does not interpret the legal meaning of these documents or override family
discussions — that's the provider's role. What the exam wants you to recognize here is
that the LPN acts as an advocate by ensuring the client's documented wishes are
known and available when needed.
Q4: The LPN is caring for a client with tuberculosis who is on airborne precautions.
Which personal protective equipment (PPE) is required when entering the client's room?
Select all that apply.
A. N95 respirator or higher-level respirator [CORRECT]
B. Gown
C. Gloves
D. Face shield
E. Surgical mask
Correct Answers: A, B, C
Rationale: The correct answers are A, B, and C because airborne precautions for
tuberculosis require an N95 respirator or higher (not a surgical mask), plus standard
precautions which include gloves and gown as needed for anticipated contact with the
client or environment. A face shield is used for splash protection, which isn't the primary
concern with TB, and a surgical mask does not provide adequate filtration for airborne
particles. For final exam level, you need to know that TB, measles, and chickenpox all
, require airborne precautions with an N95 — this is foundational infection control
knowledge.
Q5: The LPN is reviewing the medication administration record for a client receiving
warfarin 5 mg PO daily. The client's INR is 4.2. Which action should the LPN take first?
A. Hold the warfarin dose and notify the RN immediately
B. Administer the warfarin as ordered since it is within the therapeutic range
C. Check the client's PT level before making any decisions
D. Administer vitamin K as the antidote and document the intervention
A. Hold the warfarin dose and notify the RN immediately [CORRECT]
Correct Answer: A
Rationale: The correct answer is A because an INR of 4.2 is above the therapeutic range
of 2.0–3.0 for most clients on warfarin, indicating an increased bleeding risk. The LPN
should hold the dose and report this critical value to the RN right away — this is a safety
issue that cannot wait. The LPN cannot independently administer vitamin K or make
dosing decisions; those are provider-level actions. Think about Maslow — physiological
safety from bleeding comes before anything else here.
Q6: The LPN is caring for a client who is refusing a blood transfusion based on religious
beliefs. The client is alert and oriented, and the health care provider has explained the
risks of refusal. Which action by the LPN demonstrates appropriate advocacy?
A. Respect the client's decision and ensure the refusal is documented appropriately
B. Attempt to convince the client to accept the transfusion for their own safety
C. Contact the client's family to override the client's decision
D. Administer the transfusion when the client is sleeping since it is medically necessary
