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NCLEX-PN 2026 Comprehensive Exam
Bank: 220 Next Generation NCLEX (NGN)
Questions for Practical/Vocational Nurses
with Expert Rationales
SECTION I: SAFE AND EFFECTIVE CARE ENVIRONMENT (Questions 1–65)
Management of Care — Delegation, Prioritization, and Client Rights (Questions 1–25)
Question 1
A charge nurse is assigning care for a medical-surgical unit. Which client should the charge nurse
assign to the most experienced licensed practical/vocational nurse (LPN/VN)?
A) A 45-year-old client with type 1 diabetes mellitus requiring insulin administration
B) A 68-year-old client with stable COPD requiring oxygen therapy and pulse oximetry
monitoring
C) A 72-year-old client who is 2 days post-operative following a total hip replacement and
requires wound care
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D) A 58-year-old client with new-onset atrial fibrillation on a continuous telemetry monitor
E) A 62-year-old client with pneumonia requiring IV antibiotics every 8 hours
CorreCt Answer: D
Rationale: The client with new-onset atrial fibrillation on continuous telemetry requires the
most advanced assessment and monitoring skills. This client is at risk for hemodynamic
instability, thromboembolic events, and requires close monitoring of cardiac rhythm and vital
signs. The LPN/VN with the most experience should be assigned to this client because they
need to recognize changes in cardiac status and intervene appropriately. Options A, B, C, and E
involve stable clients with predictable care needs that can be managed by an LPN/VN with
standard competencies.
Question 2
A registered nurse (RN) is delegating tasks to an LPN/VN and an unlicensed assistive personnel
(UAP). Which task is most appropriate for the LPN/VN to perform?
A) Assisting a client with ambulation using a gait belt
B) Obtaining a clean-catch midstream urine specimen
C) Administering an oral hypoglycemic medication to a client with diabetes
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D) Feeding a client who has dysphagia
E) Making an occupied bed for a client on bed rest
CorreCt Answer: C
Rationale: Administering medications (including oral hypoglycemic agents) is within the scope
of practice for an LPN/VN. The LPN/VN can administer oral, topical, and some parenteral
medications under the supervision of an RN or provider. Assisting with ambulation (A),
obtaining specimens (B), feeding clients (D), and making beds (E) are tasks that can be
appropriately delegated to UAPs, as they do not require nursing judgment or specialized clinical
skills.
Question 3
A client with end-stage renal disease has a Do Not Resuscitate (DNR) order. The client's family
member requests that the DNR be rescinded because they believe the client would want
"everything done." Which action should the nurse take first?
A) Contact the healthcare provider immediately to request a change in the DNR order
B) Discuss the family member's concerns with the client (if the client is capable of making
decisions)
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C) Honor the family member's request and remove the DNR order
D) Ignore the family member's request and follow the existing DNR order
E) Request an ethics committee consultation
CorreCt Answer: B
Rationale: The nurse should first discuss the family member's concerns with the client (if the
client has decision-making capacity). The client's advance directive and current wishes take
precedence over family preferences. If the client is unable to communicate, the nurse should
review the client's documented wishes and involve the healthcare provider and/or ethics
committee as needed. DNR orders cannot be rescinded by family members without the client's
consent or a legal determination that the client's wishes have changed.
Question 4
A nurse is caring for a client who is scheduled for surgery and has signed an informed consent.
The client now states, "I don't think I want to go through with this surgery." Which action should
the nurse take?
A) Explain the risks and benefits of the surgery to the client
B) Notify the healthcare provider of the client's decision
NCLEX-PN 2026 Comprehensive Exam
Bank: 220 Next Generation NCLEX (NGN)
Questions for Practical/Vocational Nurses
with Expert Rationales
SECTION I: SAFE AND EFFECTIVE CARE ENVIRONMENT (Questions 1–65)
Management of Care — Delegation, Prioritization, and Client Rights (Questions 1–25)
Question 1
A charge nurse is assigning care for a medical-surgical unit. Which client should the charge nurse
assign to the most experienced licensed practical/vocational nurse (LPN/VN)?
A) A 45-year-old client with type 1 diabetes mellitus requiring insulin administration
B) A 68-year-old client with stable COPD requiring oxygen therapy and pulse oximetry
monitoring
C) A 72-year-old client who is 2 days post-operative following a total hip replacement and
requires wound care
,2
D) A 58-year-old client with new-onset atrial fibrillation on a continuous telemetry monitor
E) A 62-year-old client with pneumonia requiring IV antibiotics every 8 hours
CorreCt Answer: D
Rationale: The client with new-onset atrial fibrillation on continuous telemetry requires the
most advanced assessment and monitoring skills. This client is at risk for hemodynamic
instability, thromboembolic events, and requires close monitoring of cardiac rhythm and vital
signs. The LPN/VN with the most experience should be assigned to this client because they
need to recognize changes in cardiac status and intervene appropriately. Options A, B, C, and E
involve stable clients with predictable care needs that can be managed by an LPN/VN with
standard competencies.
Question 2
A registered nurse (RN) is delegating tasks to an LPN/VN and an unlicensed assistive personnel
(UAP). Which task is most appropriate for the LPN/VN to perform?
A) Assisting a client with ambulation using a gait belt
B) Obtaining a clean-catch midstream urine specimen
C) Administering an oral hypoglycemic medication to a client with diabetes
,3
D) Feeding a client who has dysphagia
E) Making an occupied bed for a client on bed rest
CorreCt Answer: C
Rationale: Administering medications (including oral hypoglycemic agents) is within the scope
of practice for an LPN/VN. The LPN/VN can administer oral, topical, and some parenteral
medications under the supervision of an RN or provider. Assisting with ambulation (A),
obtaining specimens (B), feeding clients (D), and making beds (E) are tasks that can be
appropriately delegated to UAPs, as they do not require nursing judgment or specialized clinical
skills.
Question 3
A client with end-stage renal disease has a Do Not Resuscitate (DNR) order. The client's family
member requests that the DNR be rescinded because they believe the client would want
"everything done." Which action should the nurse take first?
A) Contact the healthcare provider immediately to request a change in the DNR order
B) Discuss the family member's concerns with the client (if the client is capable of making
decisions)
, 4
C) Honor the family member's request and remove the DNR order
D) Ignore the family member's request and follow the existing DNR order
E) Request an ethics committee consultation
CorreCt Answer: B
Rationale: The nurse should first discuss the family member's concerns with the client (if the
client has decision-making capacity). The client's advance directive and current wishes take
precedence over family preferences. If the client is unable to communicate, the nurse should
review the client's documented wishes and involve the healthcare provider and/or ethics
committee as needed. DNR orders cannot be rescinded by family members without the client's
consent or a legal determination that the client's wishes have changed.
Question 4
A nurse is caring for a client who is scheduled for surgery and has signed an informed consent.
The client now states, "I don't think I want to go through with this surgery." Which action should
the nurse take?
A) Explain the risks and benefits of the surgery to the client
B) Notify the healthcare provider of the client's decision
