N E XT G E N E RATION N C L E X-PN
A+
Verified
NGN NCLEX PN
Actual Exam
2026/2027
A comprehensive 200-question practice examination
aligned with the 2026-2027 NCSBN NCLEX-PN Test Plan
and Next Generation NCLEX (NGN) standards, integrating
the Clinical Judgment Measurement Model (CJMM)
across all content areas.
200 Questions | 8 Content Sections + NGN Case Studies
CJMM Integration | PN Scope of Practice
SATA | Matrix | Extended Multiple Response | Bowtie Items
NCSBN NCLEX-PN TEST PLAN ALIGNMENT
, NGN NCLEX PN Actual Exam 2026/2027 | 200 Questions | NCSBN Test Plan Aligned | CJMM Integration
Section 1: Client Needs – Safe and Effective Care Environment (Management of Care, Safety, and
Infection Control) [Q1-Q40]
[Delegation/Scope]
Q1: A PN is assigned to care for four clients on a medical-surgical unit. Which task is most appropriate for the PN to
delegate to an unlicensed assistive personnel (UAP)?
A. Assessing a client's wound for signs of infection
B. Measuring and recording vital signs for a stable postoperative client
C. Administering oral medications to a client with diabetes
D. Teaching a client how to use an incentive spirometer
Correct Answer: B
Rationale: B is correct because measuring and recording vital signs for a stable client is within the UAP scope of practice and does
not require clinical judgment. A is incorrect because assessment is a nursing function that requires licensed personnel. C is
incorrect because medication administration requires a licensed nurse. D is incorrect because client teaching requires clinical
knowledge and judgment that the PN must perform.
[Multiple Choice]
Q2: A client scheduled for a colonoscopy tells the PN, 'I don't really understand what this procedure involves.' What is
the PN's best action?
A. Explain the procedure in detail to the client
B. Notify the registered nurse (RN) or provider performing the procedure
C. Have the client sign the consent form and proceed
D. Document that the client refused the procedure
Correct Answer: B
Rationale: B is correct because the provider performing the procedure is responsible for obtaining informed consent and
explaining risks, benefits, and alternatives. The PN should notify the RN or provider so they can address the client's knowledge
deficit. A is incorrect because while the PN can reinforce teaching, the primary responsibility for obtaining informed consent rests
with the provider. C is incorrect because signing without understanding invalidates the consent. D is incorrect because the client
has not refused; they expressed a lack of understanding.
[Multiple Choice]
Q3: A PN is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order. Which action by the PN
is most appropriate?
A. Remove the code cart from the client's room
B. Verify the DNR order is in the chart and communicate it to team members
C. Ask the family to confirm the DNR status daily
D. Decline to perform CPR if the client experiences cardiac arrest
Correct Answer: B
Rationale: B is correct because the PN should verify the DNR order is properly documented and ensure all team members are
aware, promoting continuity of care. A is incorrect because removing the code cart is unnecessary and may compromise safety for
other patients. C is incorrect because repeatedly asking the family to confirm can be distressing and is not standard practice. D is
incorrect because while a DNR guides care, the PN should follow facility policy and the RN should be notified immediately if the
client codes.
[Multiple Choice]
Q4: A PN is caring for a client with a new diagnosis of HIV. The client's roommate asks, 'What's wrong with him?' What
is the PN's best response?
A. Tell the roommate the client has HIV because they share a room
B. Explain that you cannot share any client information without permission
C. Ask the client if it is okay to share the diagnosis
D. Tell the roommate to ask the client directly
Correct Answer: B
Page 1
, NGN NCLEX PN Actual Exam 2026/2027 | 200 Questions | NCSBN Test Plan Aligned | CJMM Integration
Rationale: B is correct because HIPAA prohibits disclosure of protected health information (PHI) to anyone without the client's
authorization. A is incorrect because sharing a diagnosis without consent is a HIPAA violation regardless of the living situation. C is
incorrect because the PN should not facilitate disclosure; the client has the right to share or withhold their own information. D is
incorrect because directing the roommate to the client puts pressure on the client and is inappropriate.
[Multiple Choice]
Q5: A PN is caring for a client who has wrist restraints applied. Which action by the PN demonstrates correct restraint
management?
A. Secure the restraints tightly to prevent the client from slipping out
B. Remove the restraints every 2 hours to assess circulation and skin integrity
C. Tie the restraints to the side rail for easy access
D. Apply restraints without a provider's order and obtain it later
Correct Answer: B
Rationale: B is correct because restraints must be removed at least every 2 hours to assess circulation, sensation, skin integrity,
and range of motion. A is incorrect because restraints should be snug enough to prevent escape but must allow for two fingers to
slide underneath. C is incorrect because tying restraints to a movable side rail is dangerous; they must be secured to the bed
frame. D is incorrect because an order from the provider is required before or immediately after applying restraints, never after
the fact.
[Multiple Choice]
Q6: A PN enters the room of a client who is on contact precautions for Clostridioides difficile infection. Which personal
protective equipment (PPE) should the PN don before entering the room?
A. N95 respirator and face shield
B. Gown and gloves
C. Surgical mask and eye protection
D. Gloves only
Correct Answer: B
Rationale: B is correct because contact precautions require a gown and gloves to prevent the spread of organisms transmitted by
direct or indirect contact. C. difficile is spread through spores in the environment. A is incorrect because an N95 respirator is for
airborne precautions. C is incorrect because a surgical mask and eye protection are used for droplet precautions. D is incorrect
because gloves alone are insufficient; a gown is also required for contact precautions.
[Multiple Choice]
Q7: A client is admitted with suspected pulmonary tuberculosis (TB). Which type of transmission-based precautions
should the PN implement?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
Correct Answer: C
Rationale: C is correct because TB is transmitted via airborne droplet nuclei that remain suspended in the air, requiring a
negative-pressure room and N95 respirator. A is incorrect because contact precautions are for organisms spread by direct or
indirect contact. B is incorrect because droplet precautions are for organisms spread by large respiratory droplets within 3 to 6
feet. D is incorrect because standard precautions are applied to all clients but are not sufficient for TB.
[Multiple Choice]
Q8: A PN is caring for a client diagnosed with meningococcal meningitis. Which precaution is essential when coming
within 3 feet of the client?
A. Wear an N95 respirator
B. Wear a surgical mask
C. Place the client in a negative-pressure room
D. Double-glove before entering the room
Page 2
, NGN NCLEX PN Actual Exam 2026/2027 | 200 Questions | NCSBN Test Plan Aligned | CJMM Integration
Correct Answer: B
Rationale: B is correct because meningococcal meningitis requires droplet precautions, which include wearing a surgical mask
when within 3 feet of the client. A is incorrect because an N95 is for airborne precautions. C is incorrect because a
negative-pressure room is required for airborne, not droplet, precautions. D is incorrect because double-gloving is not a standard
requirement for droplet precautions.
[Multiple Choice]
Q9: A PN has just removed gloves after emptying a urinary drainage bag for a client. What is the next action the PN
should take?
A. Apply hand sanitizer because gloves were worn
B. Wash hands with soap and water for at least 20 seconds
C. Document the drainage output and then wash hands
D. Use a paper towel to turn off the faucet before washing
Correct Answer: B
Rationale: B is correct because hand hygiene with soap and water is required after glove removal, especially after contact with
body fluids. Glove use does not replace the need for hand hygiene. A is incorrect because while alcohol-based hand sanitizer is
effective for many situations, soap and water are preferred when hands are visibly soiled or after contact with body fluids. C is
incorrect because hand hygiene should occur immediately after glove removal, not after documentation. D describes correct
technique after washing, not before.
[Multiple Choice]
Q10: A PN is removing PPE after caring for a client on contact precautions. In which order should the PN remove the
equipment?
A. Mask, gloves, gown, then perform hand hygiene
B. Gloves, gown, mask, then perform hand hygiene
C. Gown, gloves, mask, then perform hand hygiene
D. Gloves, mask, gown, then perform hand hygiene
Correct Answer: B
Rationale: B is correct because the correct PPE removal order is gloves first (most contaminated), then gown, then mask or face
shield, followed immediately by hand hygiene. This sequence minimizes the risk of self-contamination. A is incorrect because the
mask should not be removed first; gloves are the most contaminated item. C is incorrect because gloves should be removed before
the gown. D is incorrect because the gown should be removed before the mask.
[Multiple Choice]
Q11: A PN is conducting a fall risk assessment for an 82-year-old client who is ambulatory but takes diuretics and has
had a recent fall. Which intervention is most appropriate to include in the care plan?
A. Keep all four side rails raised at all times
B. Place the call light within reach and ensure the bed is in the lowest position
C. Restrict the client to bed rest to prevent further falls
D. Apply soft wrist restraints during nighttime hours
Correct Answer: B
Rationale: B is correct because keeping the call light within reach, lowering the bed, and using non-skid footwear are
evidence-based fall prevention interventions. A is incorrect because raising all four side rails is considered a restraint and requires
an order. C is incorrect because restricting to bed rest is unnecessary and can lead to deconditioning. D is incorrect because
restraints should only be used as a last resort after less restrictive alternatives have failed.
[Multiple Choice]
Q12: A PN witnesses a client fall in the hallway. After ensuring the client is safe and assessing for injuries, what is the
PN's next action?
A. Call the client's family to inform them of the fall
B. Complete an incident report and notify the RN and provider
C. Document the fall in the client's medical record only
Page 3
A+
Verified
NGN NCLEX PN
Actual Exam
2026/2027
A comprehensive 200-question practice examination
aligned with the 2026-2027 NCSBN NCLEX-PN Test Plan
and Next Generation NCLEX (NGN) standards, integrating
the Clinical Judgment Measurement Model (CJMM)
across all content areas.
200 Questions | 8 Content Sections + NGN Case Studies
CJMM Integration | PN Scope of Practice
SATA | Matrix | Extended Multiple Response | Bowtie Items
NCSBN NCLEX-PN TEST PLAN ALIGNMENT
, NGN NCLEX PN Actual Exam 2026/2027 | 200 Questions | NCSBN Test Plan Aligned | CJMM Integration
Section 1: Client Needs – Safe and Effective Care Environment (Management of Care, Safety, and
Infection Control) [Q1-Q40]
[Delegation/Scope]
Q1: A PN is assigned to care for four clients on a medical-surgical unit. Which task is most appropriate for the PN to
delegate to an unlicensed assistive personnel (UAP)?
A. Assessing a client's wound for signs of infection
B. Measuring and recording vital signs for a stable postoperative client
C. Administering oral medications to a client with diabetes
D. Teaching a client how to use an incentive spirometer
Correct Answer: B
Rationale: B is correct because measuring and recording vital signs for a stable client is within the UAP scope of practice and does
not require clinical judgment. A is incorrect because assessment is a nursing function that requires licensed personnel. C is
incorrect because medication administration requires a licensed nurse. D is incorrect because client teaching requires clinical
knowledge and judgment that the PN must perform.
[Multiple Choice]
Q2: A client scheduled for a colonoscopy tells the PN, 'I don't really understand what this procedure involves.' What is
the PN's best action?
A. Explain the procedure in detail to the client
B. Notify the registered nurse (RN) or provider performing the procedure
C. Have the client sign the consent form and proceed
D. Document that the client refused the procedure
Correct Answer: B
Rationale: B is correct because the provider performing the procedure is responsible for obtaining informed consent and
explaining risks, benefits, and alternatives. The PN should notify the RN or provider so they can address the client's knowledge
deficit. A is incorrect because while the PN can reinforce teaching, the primary responsibility for obtaining informed consent rests
with the provider. C is incorrect because signing without understanding invalidates the consent. D is incorrect because the client
has not refused; they expressed a lack of understanding.
[Multiple Choice]
Q3: A PN is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order. Which action by the PN
is most appropriate?
A. Remove the code cart from the client's room
B. Verify the DNR order is in the chart and communicate it to team members
C. Ask the family to confirm the DNR status daily
D. Decline to perform CPR if the client experiences cardiac arrest
Correct Answer: B
Rationale: B is correct because the PN should verify the DNR order is properly documented and ensure all team members are
aware, promoting continuity of care. A is incorrect because removing the code cart is unnecessary and may compromise safety for
other patients. C is incorrect because repeatedly asking the family to confirm can be distressing and is not standard practice. D is
incorrect because while a DNR guides care, the PN should follow facility policy and the RN should be notified immediately if the
client codes.
[Multiple Choice]
Q4: A PN is caring for a client with a new diagnosis of HIV. The client's roommate asks, 'What's wrong with him?' What
is the PN's best response?
A. Tell the roommate the client has HIV because they share a room
B. Explain that you cannot share any client information without permission
C. Ask the client if it is okay to share the diagnosis
D. Tell the roommate to ask the client directly
Correct Answer: B
Page 1
, NGN NCLEX PN Actual Exam 2026/2027 | 200 Questions | NCSBN Test Plan Aligned | CJMM Integration
Rationale: B is correct because HIPAA prohibits disclosure of protected health information (PHI) to anyone without the client's
authorization. A is incorrect because sharing a diagnosis without consent is a HIPAA violation regardless of the living situation. C is
incorrect because the PN should not facilitate disclosure; the client has the right to share or withhold their own information. D is
incorrect because directing the roommate to the client puts pressure on the client and is inappropriate.
[Multiple Choice]
Q5: A PN is caring for a client who has wrist restraints applied. Which action by the PN demonstrates correct restraint
management?
A. Secure the restraints tightly to prevent the client from slipping out
B. Remove the restraints every 2 hours to assess circulation and skin integrity
C. Tie the restraints to the side rail for easy access
D. Apply restraints without a provider's order and obtain it later
Correct Answer: B
Rationale: B is correct because restraints must be removed at least every 2 hours to assess circulation, sensation, skin integrity,
and range of motion. A is incorrect because restraints should be snug enough to prevent escape but must allow for two fingers to
slide underneath. C is incorrect because tying restraints to a movable side rail is dangerous; they must be secured to the bed
frame. D is incorrect because an order from the provider is required before or immediately after applying restraints, never after
the fact.
[Multiple Choice]
Q6: A PN enters the room of a client who is on contact precautions for Clostridioides difficile infection. Which personal
protective equipment (PPE) should the PN don before entering the room?
A. N95 respirator and face shield
B. Gown and gloves
C. Surgical mask and eye protection
D. Gloves only
Correct Answer: B
Rationale: B is correct because contact precautions require a gown and gloves to prevent the spread of organisms transmitted by
direct or indirect contact. C. difficile is spread through spores in the environment. A is incorrect because an N95 respirator is for
airborne precautions. C is incorrect because a surgical mask and eye protection are used for droplet precautions. D is incorrect
because gloves alone are insufficient; a gown is also required for contact precautions.
[Multiple Choice]
Q7: A client is admitted with suspected pulmonary tuberculosis (TB). Which type of transmission-based precautions
should the PN implement?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
Correct Answer: C
Rationale: C is correct because TB is transmitted via airborne droplet nuclei that remain suspended in the air, requiring a
negative-pressure room and N95 respirator. A is incorrect because contact precautions are for organisms spread by direct or
indirect contact. B is incorrect because droplet precautions are for organisms spread by large respiratory droplets within 3 to 6
feet. D is incorrect because standard precautions are applied to all clients but are not sufficient for TB.
[Multiple Choice]
Q8: A PN is caring for a client diagnosed with meningococcal meningitis. Which precaution is essential when coming
within 3 feet of the client?
A. Wear an N95 respirator
B. Wear a surgical mask
C. Place the client in a negative-pressure room
D. Double-glove before entering the room
Page 2
, NGN NCLEX PN Actual Exam 2026/2027 | 200 Questions | NCSBN Test Plan Aligned | CJMM Integration
Correct Answer: B
Rationale: B is correct because meningococcal meningitis requires droplet precautions, which include wearing a surgical mask
when within 3 feet of the client. A is incorrect because an N95 is for airborne precautions. C is incorrect because a
negative-pressure room is required for airborne, not droplet, precautions. D is incorrect because double-gloving is not a standard
requirement for droplet precautions.
[Multiple Choice]
Q9: A PN has just removed gloves after emptying a urinary drainage bag for a client. What is the next action the PN
should take?
A. Apply hand sanitizer because gloves were worn
B. Wash hands with soap and water for at least 20 seconds
C. Document the drainage output and then wash hands
D. Use a paper towel to turn off the faucet before washing
Correct Answer: B
Rationale: B is correct because hand hygiene with soap and water is required after glove removal, especially after contact with
body fluids. Glove use does not replace the need for hand hygiene. A is incorrect because while alcohol-based hand sanitizer is
effective for many situations, soap and water are preferred when hands are visibly soiled or after contact with body fluids. C is
incorrect because hand hygiene should occur immediately after glove removal, not after documentation. D describes correct
technique after washing, not before.
[Multiple Choice]
Q10: A PN is removing PPE after caring for a client on contact precautions. In which order should the PN remove the
equipment?
A. Mask, gloves, gown, then perform hand hygiene
B. Gloves, gown, mask, then perform hand hygiene
C. Gown, gloves, mask, then perform hand hygiene
D. Gloves, mask, gown, then perform hand hygiene
Correct Answer: B
Rationale: B is correct because the correct PPE removal order is gloves first (most contaminated), then gown, then mask or face
shield, followed immediately by hand hygiene. This sequence minimizes the risk of self-contamination. A is incorrect because the
mask should not be removed first; gloves are the most contaminated item. C is incorrect because gloves should be removed before
the gown. D is incorrect because the gown should be removed before the mask.
[Multiple Choice]
Q11: A PN is conducting a fall risk assessment for an 82-year-old client who is ambulatory but takes diuretics and has
had a recent fall. Which intervention is most appropriate to include in the care plan?
A. Keep all four side rails raised at all times
B. Place the call light within reach and ensure the bed is in the lowest position
C. Restrict the client to bed rest to prevent further falls
D. Apply soft wrist restraints during nighttime hours
Correct Answer: B
Rationale: B is correct because keeping the call light within reach, lowering the bed, and using non-skid footwear are
evidence-based fall prevention interventions. A is incorrect because raising all four side rails is considered a restraint and requires
an order. C is incorrect because restricting to bed rest is unnecessary and can lead to deconditioning. D is incorrect because
restraints should only be used as a last resort after less restrictive alternatives have failed.
[Multiple Choice]
Q12: A PN witnesses a client fall in the hallway. After ensuring the client is safe and assessing for injuries, what is the
PN's next action?
A. Call the client's family to inform them of the fall
B. Complete an incident report and notify the RN and provider
C. Document the fall in the client's medical record only
Page 3
