NCLEX-PN Comprehensive Practice Exam |
2026–2027|Original Multiple-Choice Questions
with Detailed Answers And Rationales
1. A practical/vocational nurse (PN/LVN) is caring for four clients. Which client
should the nurse assess first?
A. A client requesting pain medication for chronic arthritis
B. A client with diabetes who is diaphoretic and confused
C. A client waiting for discharge instructions
D. A client scheduled for a routine dressing change
CORRECT ANSWER: B. A client with diabetes who is diaphoretic and confused
RATIONALE:
B is correct because diaphoresis and confusion are classic signs of hypoglycemia, a life-
threatening emergency that requires immediate assessment and intervention. Airway, breathing,
circulation, and acute neurological changes always take priority.
2. Which action is most appropriate when administering oral medications?
A. Crush all tablets before administration.
B. Verify the client's identity using at least two identifiers.
C. Leave medications at the bedside if the client is asleep.
D. Administer medications without explaining them to the client.
CORRECT ANSWER: B. Verify the client's identity using at least two identifiers.
RATIONALE:
B is correct because using at least two approved patient identifiers is a fundamental medication
safety practice that helps prevent medication errors.
,3. Which finding should the nurse report immediately after administering
morphine?
A. Pain decreases from 8/10 to 4/10.
B. Respiratory rate decreases to 8 breaths/min.
C. Client becomes drowsy.
D. Blood pressure decreases slightly from 138/84 mmHg to 128/80 mmHg.
CORRECT ANSWER: B. Respiratory rate decreases to 8 breaths/min.
RATIONALE:
B is correct because respiratory depression is the most serious adverse effect of opioid
medications and requires immediate intervention.
4. A client receiving warfarin should be instructed to report which finding
immediately?
A. Mild headache
B. Bleeding gums while brushing teeth
C. Increased appetite
D. Dry mouth
CORRECT ANSWER: B. Bleeding gums while brushing teeth
RATIONALE:
B is correct because unexpected bleeding may indicate excessive anticoagulation and should be
reported promptly.
5. Which client can the practical nurse safely assign to an experienced nursing
assistant?
A. A client requiring discharge teaching
B. A stable client needing assistance with bathing
, C. A client receiving a blood transfusion
D. A newly admitted client requiring assessment
CORRECT ANSWER: B. A stable client needing assistance with bathing
RATIONALE:
B is correct because assisting with activities of daily living (ADLs) for stable clients is within the
nursing assistant's scope of practice. Assessment, teaching, and blood transfusion monitoring
remain nursing responsibilities.
6. Which intervention best helps prevent pressure injuries in a bedridden client?
A. Reposition the client every two hours.
B. Massage reddened areas frequently.
C. Limit fluid intake.
D. Keep the head of the bed above 60 degrees continuously.
CORRECT ANSWER: A. Reposition the client every two hours.
RATIONALE:
A is correct because regular repositioning reduces prolonged pressure and improves tissue
perfusion, lowering the risk of pressure injury.
7. A client with chronic obstructive pulmonary disease (COPD) suddenly
becomes increasingly restless and confused. What should the nurse do first?
A. Encourage the client to walk.
B. Assess oxygenation and respiratory status.
C. Offer food and fluids.
D. Administer a sedative.
CORRECT ANSWER: B. Assess oxygenation and respiratory status.
2026–2027|Original Multiple-Choice Questions
with Detailed Answers And Rationales
1. A practical/vocational nurse (PN/LVN) is caring for four clients. Which client
should the nurse assess first?
A. A client requesting pain medication for chronic arthritis
B. A client with diabetes who is diaphoretic and confused
C. A client waiting for discharge instructions
D. A client scheduled for a routine dressing change
CORRECT ANSWER: B. A client with diabetes who is diaphoretic and confused
RATIONALE:
B is correct because diaphoresis and confusion are classic signs of hypoglycemia, a life-
threatening emergency that requires immediate assessment and intervention. Airway, breathing,
circulation, and acute neurological changes always take priority.
2. Which action is most appropriate when administering oral medications?
A. Crush all tablets before administration.
B. Verify the client's identity using at least two identifiers.
C. Leave medications at the bedside if the client is asleep.
D. Administer medications without explaining them to the client.
CORRECT ANSWER: B. Verify the client's identity using at least two identifiers.
RATIONALE:
B is correct because using at least two approved patient identifiers is a fundamental medication
safety practice that helps prevent medication errors.
,3. Which finding should the nurse report immediately after administering
morphine?
A. Pain decreases from 8/10 to 4/10.
B. Respiratory rate decreases to 8 breaths/min.
C. Client becomes drowsy.
D. Blood pressure decreases slightly from 138/84 mmHg to 128/80 mmHg.
CORRECT ANSWER: B. Respiratory rate decreases to 8 breaths/min.
RATIONALE:
B is correct because respiratory depression is the most serious adverse effect of opioid
medications and requires immediate intervention.
4. A client receiving warfarin should be instructed to report which finding
immediately?
A. Mild headache
B. Bleeding gums while brushing teeth
C. Increased appetite
D. Dry mouth
CORRECT ANSWER: B. Bleeding gums while brushing teeth
RATIONALE:
B is correct because unexpected bleeding may indicate excessive anticoagulation and should be
reported promptly.
5. Which client can the practical nurse safely assign to an experienced nursing
assistant?
A. A client requiring discharge teaching
B. A stable client needing assistance with bathing
, C. A client receiving a blood transfusion
D. A newly admitted client requiring assessment
CORRECT ANSWER: B. A stable client needing assistance with bathing
RATIONALE:
B is correct because assisting with activities of daily living (ADLs) for stable clients is within the
nursing assistant's scope of practice. Assessment, teaching, and blood transfusion monitoring
remain nursing responsibilities.
6. Which intervention best helps prevent pressure injuries in a bedridden client?
A. Reposition the client every two hours.
B. Massage reddened areas frequently.
C. Limit fluid intake.
D. Keep the head of the bed above 60 degrees continuously.
CORRECT ANSWER: A. Reposition the client every two hours.
RATIONALE:
A is correct because regular repositioning reduces prolonged pressure and improves tissue
perfusion, lowering the risk of pressure injury.
7. A client with chronic obstructive pulmonary disease (COPD) suddenly
becomes increasingly restless and confused. What should the nurse do first?
A. Encourage the client to walk.
B. Assess oxygenation and respiratory status.
C. Offer food and fluids.
D. Administer a sedative.
CORRECT ANSWER: B. Assess oxygenation and respiratory status.
