SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
NCLEX-PN® Comprehensive Review Questions
Chapter 1: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Question 1
Reference: The Pyramid to Success; Computer Adaptive
Testing; Examination Process
Clinical Scenario: A practical nursing student is reviewing the
NCLEX-PN® examination format with a peer. The student
,correctly states that the examination uses computer adaptive
testing (CAT). The peer asks, "What is the primary purpose of
the CAT format used for the NCLEX-PN®?"
Options: A. To ensure all candidates receive exactly the same
number of questions B. To adjust the difficulty of questions
based on the candidate's ability level C. To allow candidates to
select their preferred content areas for testing D. To provide
immediate pass-or-fail results upon completion of the
examination
Correct Answer: B. To adjust the difficulty of questions based
on the candidate's ability level
Rationale: The NCLEX-PN® examination uses computer
adaptive testing (CAT), which selects questions based on the
candidate's performance. As the candidate answers correctly,
the computer presents more difficult questions; incorrect
answers result in less difficult questions. This allows the
examination to accurately determine the candidate's ability
level and whether they meet the passing standard .
Option A: Incorrect. Candidates do not all receive the same
number of questions; the number varies based on performance
and how quickly the computer can determine with confidence
whether the candidate meets the passing standard.
, Option C: Incorrect. Candidates do not select content areas;
the computer selects questions from various content areas
according to the test plan to ensure comprehensive evaluation.
Option D: Incorrect. While the computer scores the
examination, official results are processed and released at a
later time; immediate pass-or-fail decisions are not given to
candidates at the testing center.
Teaching Point: CAT tailors question difficulty to each
candidate's ability, providing a precise and individualized
measurement of nursing competency.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 2
Reference: Development of the Test Plan; Test Plan; Client
Needs
Clinical Scenario: A nursing student is studying the NCLEX-PN®
test plan to understand what content will be covered on the
examination. The student correctly identifies that the test plan
is organized around a framework that includes four major
categories. Which of the following describes the correct
organization of the NCLEX-PN® test plan?
,Options: A. Client Needs categories, Integrated Processes, and
Cognitive Levels B. Medical diagnoses, nursing interventions,
and pharmacological therapies C. Disease processes, nursing
specialties, and clinical settings D. Assessment, Planning,
Implementation, and Evaluation
Correct Answer: A. Client Needs categories, Integrated
Processes, and Cognitive Levels
Rationale: The NCLEX-PN® test plan is organized using
three major components: Client Needs (which includes
categories like Safe and Effective Care Environment, Health
Promotion and Maintenance, Psychosocial Integrity, and
Physiological Integrity), Integrated Processes (such as Nursing
Process, Communication, and Teaching/Learning), and Levels of
Cognitive Ability (ranging from recall to analysis and clinical
judgment). This framework ensures comprehensive evaluation
of practical nursing competency.
Option B: Incorrect. While medical diagnoses, nursing
interventions, and therapies are included in the examination
content, these are not the primary organizing framework of the
test plan.
Option C: Incorrect. The test plan is not organized by
disease processes or clinical settings; it uses the Client Needs
,framework to ensure comprehensive coverage of nursing
knowledge and skills.
Option D: Incorrect. Although the nursing process is
important and included as an Integrated Process, the test plan
is not organized solely around Assessment, Planning,
Implementation, and Evaluation.
Teaching Point: The NCLEX-PN® test plan is structured around
Client Needs, Integrated Processes, and Cognitive Levels to
evaluate safe nursing practice.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 3
Reference: Level of Cognitive Ability; Clinical Judgment and
Next Generation NCLEX® Items
Clinical Scenario: A practical nursing student is analyzing the
cognitive levels tested on the NCLEX-PN® examination. The
student understands that the examination emphasizes higher-
order thinking skills. A question that asks the candidate to
"analyze assessment findings to determine the most
appropriate nursing action" would primarily assess which level
of cognitive ability?
,Options: A. Recall B. Comprehension C. Application D. Clinical
Judgment
Correct Answer: D. Clinical Judgment
Rationale: The Next Generation NCLEX (NGN)-PN® places
increased emphasis on Clinical Judgment, which involves
analyzing cues, prioritizing hypotheses, generating solutions,
taking action, and evaluating outcomes. Questions requiring
candidates to analyze assessment findings and determine
appropriate nursing actions assess the complex thinking
required in clinical practice, representing the highest level of
cognitive ability .
Option A: Incorrect. Recall involves remembering or
recognizing factual information, not analyzing and applying
findings to clinical situations.
Option B: Incorrect. Comprehension involves
understanding information, but not necessarily applying it to
complex clinical scenarios requiring clinical judgment.
Option C: Incorrect. While application involves using
knowledge in clinical situations, clinical judgment goes beyond
application to include analysis, synthesis, and evaluation of
multiple factors.
,Teaching Point: Clinical Judgment questions require analysis
and decision-making in complex patient scenarios, reflecting
real-world nursing practice.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 4
Reference: Integrated Processes; Clinical Judgment and Next
Generation NCLEX® Items
Clinical Scenario: A practical nurse is caring for a patient with
diabetes who requires insulin administration. The nurse
assesses the patient's blood glucose level, reviews the
prescribed sliding scale, administers the appropriate dose of
insulin, and later evaluates the patient's response. The nurse is
demonstrating which Integrated Process?
Options: A. Teaching/Learning B. Communication C. Nursing
Process D. Documentation
Correct Answer: C. Nursing Process
Rationale: The Nursing Process is an Integrated Process on
the NCLEX-PN® that includes Assessment, Analysis/Diagnosis,
Planning, Implementation, and Evaluation. The practical nurse
,in this scenario is following the nursing process by assessing
blood glucose, analyzing the need for insulin, implementing the
administration, and evaluating the patient's response.
Option A: Incorrect. While patient education is important,
the scenario describes the nurse's actions in providing patient
care through the nursing process, not specifically teaching the
patient.
Option B: Incorrect. Although communication is important
in nursing, the scenario focuses on the steps of providing care
(assessment, implementation, evaluation) rather than
interpersonal communication.
Option D: Incorrect. Documentation is a component of
nursing care, but the scenario primarily demonstrates
application of the nursing process rather than the act of
documenting findings.
Teaching Point: The nursing process is a systematic, patient-
centered framework guiding nursing actions from assessment
through evaluation.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 5
,Reference: Types of Questions on the Examination and Scoring;
Multiple-Choice Questions
Clinical Scenario: A practical nursing candidate is preparing for
the NCLEX-PN® examination and is reviewing the types of
questions included. The candidate correctly identifies that the
most common question format on the NCLEX-PN® is the
multiple-choice question. Which statement accurately
describes the structure of a multiple-choice question?
Options: A. A stem with four or more answer choices and one
correct answer B. A case study with three questions to answer
C. An incomplete statement with options to fill in the blank D. A
clinical scenario with audio and visual components
Correct Answer: A. A stem with four or more answer choices
and one correct answer
Rationale: Multiple-choice questions on the NCLEX-PN®
consist of a stem (which may include a clinical scenario) and
four or more answer choices, with one correct or best answer.
The candidate must select the best option based on nursing
knowledge and clinical judgment .
Option B: Incorrect. This describes case study questions,
which are a separate NGN item type, not standard multiple-
choice questions.
, Option C: Incorrect. This describes fill-in-the-blank
questions, which are a different format requiring the candidate
to provide a short answer, not a multiple-choice structure .
Option D: Incorrect. This describes audio or multimedia
questions, which are alternate item formats, not the standard
multiple-choice format.
Teaching Point: Multiple-choice questions are the most
common format on the NCLEX-PN®, requiring selection of the
single best answer.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 6
Reference: Fill-in-the-Blank Questions; Types of Questions on
the Examination and Scoring
Clinical Scenario: A practical nursing student is taking a practice
examination and encounters a fill-in-the-blank question. The
student understands that for this question type, the correct
response must be entered in a specific format. Which of the
following is true about fill-in-the-blank questions on the NCLEX-
PN®?
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
NCLEX-PN® Comprehensive Review Questions
Chapter 1: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Question 1
Reference: The Pyramid to Success; Computer Adaptive
Testing; Examination Process
Clinical Scenario: A practical nursing student is reviewing the
NCLEX-PN® examination format with a peer. The student
,correctly states that the examination uses computer adaptive
testing (CAT). The peer asks, "What is the primary purpose of
the CAT format used for the NCLEX-PN®?"
Options: A. To ensure all candidates receive exactly the same
number of questions B. To adjust the difficulty of questions
based on the candidate's ability level C. To allow candidates to
select their preferred content areas for testing D. To provide
immediate pass-or-fail results upon completion of the
examination
Correct Answer: B. To adjust the difficulty of questions based
on the candidate's ability level
Rationale: The NCLEX-PN® examination uses computer
adaptive testing (CAT), which selects questions based on the
candidate's performance. As the candidate answers correctly,
the computer presents more difficult questions; incorrect
answers result in less difficult questions. This allows the
examination to accurately determine the candidate's ability
level and whether they meet the passing standard .
Option A: Incorrect. Candidates do not all receive the same
number of questions; the number varies based on performance
and how quickly the computer can determine with confidence
whether the candidate meets the passing standard.
, Option C: Incorrect. Candidates do not select content areas;
the computer selects questions from various content areas
according to the test plan to ensure comprehensive evaluation.
Option D: Incorrect. While the computer scores the
examination, official results are processed and released at a
later time; immediate pass-or-fail decisions are not given to
candidates at the testing center.
Teaching Point: CAT tailors question difficulty to each
candidate's ability, providing a precise and individualized
measurement of nursing competency.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 2
Reference: Development of the Test Plan; Test Plan; Client
Needs
Clinical Scenario: A nursing student is studying the NCLEX-PN®
test plan to understand what content will be covered on the
examination. The student correctly identifies that the test plan
is organized around a framework that includes four major
categories. Which of the following describes the correct
organization of the NCLEX-PN® test plan?
,Options: A. Client Needs categories, Integrated Processes, and
Cognitive Levels B. Medical diagnoses, nursing interventions,
and pharmacological therapies C. Disease processes, nursing
specialties, and clinical settings D. Assessment, Planning,
Implementation, and Evaluation
Correct Answer: A. Client Needs categories, Integrated
Processes, and Cognitive Levels
Rationale: The NCLEX-PN® test plan is organized using
three major components: Client Needs (which includes
categories like Safe and Effective Care Environment, Health
Promotion and Maintenance, Psychosocial Integrity, and
Physiological Integrity), Integrated Processes (such as Nursing
Process, Communication, and Teaching/Learning), and Levels of
Cognitive Ability (ranging from recall to analysis and clinical
judgment). This framework ensures comprehensive evaluation
of practical nursing competency.
Option B: Incorrect. While medical diagnoses, nursing
interventions, and therapies are included in the examination
content, these are not the primary organizing framework of the
test plan.
Option C: Incorrect. The test plan is not organized by
disease processes or clinical settings; it uses the Client Needs
,framework to ensure comprehensive coverage of nursing
knowledge and skills.
Option D: Incorrect. Although the nursing process is
important and included as an Integrated Process, the test plan
is not organized solely around Assessment, Planning,
Implementation, and Evaluation.
Teaching Point: The NCLEX-PN® test plan is structured around
Client Needs, Integrated Processes, and Cognitive Levels to
evaluate safe nursing practice.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 3
Reference: Level of Cognitive Ability; Clinical Judgment and
Next Generation NCLEX® Items
Clinical Scenario: A practical nursing student is analyzing the
cognitive levels tested on the NCLEX-PN® examination. The
student understands that the examination emphasizes higher-
order thinking skills. A question that asks the candidate to
"analyze assessment findings to determine the most
appropriate nursing action" would primarily assess which level
of cognitive ability?
,Options: A. Recall B. Comprehension C. Application D. Clinical
Judgment
Correct Answer: D. Clinical Judgment
Rationale: The Next Generation NCLEX (NGN)-PN® places
increased emphasis on Clinical Judgment, which involves
analyzing cues, prioritizing hypotheses, generating solutions,
taking action, and evaluating outcomes. Questions requiring
candidates to analyze assessment findings and determine
appropriate nursing actions assess the complex thinking
required in clinical practice, representing the highest level of
cognitive ability .
Option A: Incorrect. Recall involves remembering or
recognizing factual information, not analyzing and applying
findings to clinical situations.
Option B: Incorrect. Comprehension involves
understanding information, but not necessarily applying it to
complex clinical scenarios requiring clinical judgment.
Option C: Incorrect. While application involves using
knowledge in clinical situations, clinical judgment goes beyond
application to include analysis, synthesis, and evaluation of
multiple factors.
,Teaching Point: Clinical Judgment questions require analysis
and decision-making in complex patient scenarios, reflecting
real-world nursing practice.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 4
Reference: Integrated Processes; Clinical Judgment and Next
Generation NCLEX® Items
Clinical Scenario: A practical nurse is caring for a patient with
diabetes who requires insulin administration. The nurse
assesses the patient's blood glucose level, reviews the
prescribed sliding scale, administers the appropriate dose of
insulin, and later evaluates the patient's response. The nurse is
demonstrating which Integrated Process?
Options: A. Teaching/Learning B. Communication C. Nursing
Process D. Documentation
Correct Answer: C. Nursing Process
Rationale: The Nursing Process is an Integrated Process on
the NCLEX-PN® that includes Assessment, Analysis/Diagnosis,
Planning, Implementation, and Evaluation. The practical nurse
,in this scenario is following the nursing process by assessing
blood glucose, analyzing the need for insulin, implementing the
administration, and evaluating the patient's response.
Option A: Incorrect. While patient education is important,
the scenario describes the nurse's actions in providing patient
care through the nursing process, not specifically teaching the
patient.
Option B: Incorrect. Although communication is important
in nursing, the scenario focuses on the steps of providing care
(assessment, implementation, evaluation) rather than
interpersonal communication.
Option D: Incorrect. Documentation is a component of
nursing care, but the scenario primarily demonstrates
application of the nursing process rather than the act of
documenting findings.
Teaching Point: The nursing process is a systematic, patient-
centered framework guiding nursing actions from assessment
through evaluation.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 5
,Reference: Types of Questions on the Examination and Scoring;
Multiple-Choice Questions
Clinical Scenario: A practical nursing candidate is preparing for
the NCLEX-PN® examination and is reviewing the types of
questions included. The candidate correctly identifies that the
most common question format on the NCLEX-PN® is the
multiple-choice question. Which statement accurately
describes the structure of a multiple-choice question?
Options: A. A stem with four or more answer choices and one
correct answer B. A case study with three questions to answer
C. An incomplete statement with options to fill in the blank D. A
clinical scenario with audio and visual components
Correct Answer: A. A stem with four or more answer choices
and one correct answer
Rationale: Multiple-choice questions on the NCLEX-PN®
consist of a stem (which may include a clinical scenario) and
four or more answer choices, with one correct or best answer.
The candidate must select the best option based on nursing
knowledge and clinical judgment .
Option B: Incorrect. This describes case study questions,
which are a separate NGN item type, not standard multiple-
choice questions.
, Option C: Incorrect. This describes fill-in-the-blank
questions, which are a different format requiring the candidate
to provide a short answer, not a multiple-choice structure .
Option D: Incorrect. This describes audio or multimedia
questions, which are alternate item formats, not the standard
multiple-choice format.
Teaching Point: Multiple-choice questions are the most
common format on the NCLEX-PN®, requiring selection of the
single best answer.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 6
Reference: Fill-in-the-Blank Questions; Types of Questions on
the Examination and Scoring
Clinical Scenario: A practical nursing student is taking a practice
examination and encounters a fill-in-the-blank question. The
student understands that for this question type, the correct
response must be entered in a specific format. Which of the
following is true about fill-in-the-blank questions on the NCLEX-
PN®?
