1
Next Generation NCLEX-PN® Comprehensive Advanced Practice
Examination 180 Multiple-Choice & NGN-Style Questions | Advanced
Difficulty | With Detailed Rationales
EXAM TITLE: Next Generation NCLEX-PN® Mastery Examination — A Comprehensive, Clinical
Judgment-Focused Review for Licensed Practical/Vocational Nurse Licensure (Effective 2026
NCSBN Test Plan)
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT — COORDINATED CARE (18–24%)
Questions 1–20
1. A 68-year-old client is being discharged home after a total hip replacement. The LPN is
reinforcing discharge teaching provided by the RN. Which of the following client statements
indicates a correct understanding of the teaching?
A. "I can cross my legs at the ankles when sitting."
B. "I should use a raised toilet seat for the first 6 weeks."
C. "I can bend forward at the waist to pick up objects from the floor."
D. "I should sleep on my stomach to keep my hip straight."
,2
Correct Answer: B
Rationale: After total hip replacement, clients must avoid hip flexion >90 degrees, adduction
past midline, and internal rotation. A raised toilet seat helps maintain hip precautions. Crossing
legs (A), bending forward at the waist (C), and sleeping on the stomach (D) all violate hip
precautions and could cause dislocation.
2. The LPN is caring for four clients on a medical-surgical unit. Which client should the LPN
assess first?
A. A client with pneumonia who has an oxygen saturation of 92% on 2 L/min nasal cannula
B. A client with diabetes who has a blood glucose of 180 mg/dL
C. A client with heart failure who has new-onset confusion and urine output of 20 mL over 2
hours
D. A client with hypertension who has a blood pressure of 148/92 mmHg
Correct Answer: C
Rationale: New-onset confusion with oliguria (<30 mL/hour) in a heart failure client suggests
worsening renal perfusion and possible acute kidney injury or cardiorenal syndrome. This is the
,3
most unstable client and requires immediate assessment. Oxygen saturation of 92% is
acceptable on supplemental oxygen. Blood glucose of 180 mg/dL and BP of 148/92 mmHg
require monitoring but are not immediately life-threatening.
3. The LPN is assisting with the admission of a client who speaks limited English. An
interpreter is not immediately available. Which of the following actions is most appropriate?
A. Use the client's family member as an interpreter
B. Speak loudly and slowly in English
C. Use a certified medical interpreter via telephone or video
D. Complete the admission assessment and wait for an interpreter later
Correct Answer: C
Rationale: A certified medical interpreter (in-person, telephone, or video) is the gold standard
for providing language-appropriate care. Family members should not be used as interpreters
due to privacy concerns and potential misinterpretation of medical information. Speaking loudly
does not improve understanding.
, 4
4. The LPN is reinforcing teaching with a client who has a new diagnosis of type 2 diabetes.
Which of the following statements by the client indicates a need for further teaching?
A. "I will check my blood sugar before meals and at bedtime."
B. "I will rotate my insulin injection sites to prevent lipohypertrophy."
C. "I will take my metformin with meals to prevent stomach upset."
D. "I can stop taking my medication once my blood sugar is normal."
Correct Answer: D
Rationale: Clients with diabetes must understand that diabetes is a chronic condition requiring
lifelong management. Stopping medication when blood glucose normalizes can lead to
hyperglycemia and complications. The other statements demonstrate correct understanding of
diabetes management.
5. The LPN is caring for a client who has a do-not-resuscitate (DNR) order. The client's family
requests that CPR be initiated if the client's heart stops. Which of the following actions should
the LPN take?
Next Generation NCLEX-PN® Comprehensive Advanced Practice
Examination 180 Multiple-Choice & NGN-Style Questions | Advanced
Difficulty | With Detailed Rationales
EXAM TITLE: Next Generation NCLEX-PN® Mastery Examination — A Comprehensive, Clinical
Judgment-Focused Review for Licensed Practical/Vocational Nurse Licensure (Effective 2026
NCSBN Test Plan)
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT — COORDINATED CARE (18–24%)
Questions 1–20
1. A 68-year-old client is being discharged home after a total hip replacement. The LPN is
reinforcing discharge teaching provided by the RN. Which of the following client statements
indicates a correct understanding of the teaching?
A. "I can cross my legs at the ankles when sitting."
B. "I should use a raised toilet seat for the first 6 weeks."
C. "I can bend forward at the waist to pick up objects from the floor."
D. "I should sleep on my stomach to keep my hip straight."
,2
Correct Answer: B
Rationale: After total hip replacement, clients must avoid hip flexion >90 degrees, adduction
past midline, and internal rotation. A raised toilet seat helps maintain hip precautions. Crossing
legs (A), bending forward at the waist (C), and sleeping on the stomach (D) all violate hip
precautions and could cause dislocation.
2. The LPN is caring for four clients on a medical-surgical unit. Which client should the LPN
assess first?
A. A client with pneumonia who has an oxygen saturation of 92% on 2 L/min nasal cannula
B. A client with diabetes who has a blood glucose of 180 mg/dL
C. A client with heart failure who has new-onset confusion and urine output of 20 mL over 2
hours
D. A client with hypertension who has a blood pressure of 148/92 mmHg
Correct Answer: C
Rationale: New-onset confusion with oliguria (<30 mL/hour) in a heart failure client suggests
worsening renal perfusion and possible acute kidney injury or cardiorenal syndrome. This is the
,3
most unstable client and requires immediate assessment. Oxygen saturation of 92% is
acceptable on supplemental oxygen. Blood glucose of 180 mg/dL and BP of 148/92 mmHg
require monitoring but are not immediately life-threatening.
3. The LPN is assisting with the admission of a client who speaks limited English. An
interpreter is not immediately available. Which of the following actions is most appropriate?
A. Use the client's family member as an interpreter
B. Speak loudly and slowly in English
C. Use a certified medical interpreter via telephone or video
D. Complete the admission assessment and wait for an interpreter later
Correct Answer: C
Rationale: A certified medical interpreter (in-person, telephone, or video) is the gold standard
for providing language-appropriate care. Family members should not be used as interpreters
due to privacy concerns and potential misinterpretation of medical information. Speaking loudly
does not improve understanding.
, 4
4. The LPN is reinforcing teaching with a client who has a new diagnosis of type 2 diabetes.
Which of the following statements by the client indicates a need for further teaching?
A. "I will check my blood sugar before meals and at bedtime."
B. "I will rotate my insulin injection sites to prevent lipohypertrophy."
C. "I will take my metformin with meals to prevent stomach upset."
D. "I can stop taking my medication once my blood sugar is normal."
Correct Answer: D
Rationale: Clients with diabetes must understand that diabetes is a chronic condition requiring
lifelong management. Stopping medication when blood glucose normalizes can lead to
hyperglycemia and complications. The other statements demonstrate correct understanding of
diabetes management.
5. The LPN is caring for a client who has a do-not-resuscitate (DNR) order. The client's family
requests that CPR be initiated if the client's heart stops. Which of the following actions should
the LPN take?
