SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
20 NCLEX-PN®-Style Multiple-Choice Questions
Question 1
Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing student is reviewing the
NCLEX-PN® test plan and notes that the examination uses
Computer Adaptive Testing (CAT). The student asks the
instructor how CAT determines which questions are presented
,during the examination. The practical nursing instructor's
response should be based on which understanding of CAT?
Options:
A. The computer selects questions based on the candidate's
previous responses to determine the difficulty level of
subsequent items.
B. The computer presents questions in a predetermined
sequence based on the test plan regardless of candidate
performance.
C. The computer adjusts the number of questions based on
how quickly the candidate completes each item.
D. The computer selects questions based on the candidate's
nursing program performance and clinical evaluation scores.
Correct Answer: A
Rationale for Correct Answer: The correct answer is A.
Computer Adaptive Testing (CAT) selects questions based on
the candidate's previous responses. The computer continuously
estimates the candidate's ability level and selects subsequent
questions that are appropriate for that ability level. This
adaptive mechanism allows the examination to more precisely
measure the candidate's nursing knowledge and clinical
,judgment by tailoring question difficulty to individual
performance.
Rationale for Incorrect Answers:
• B: The computer does not present questions in a
predetermined sequence. The CAT algorithm adapts
question selection based on candidate performance, not a
fixed order.
• C: The number of questions is not adjusted based on the
speed of completion. The examination has a minimum and
maximum number of questions determined by the test
plan and candidate performance.
• D: The computer does not use nursing program
performance or clinical evaluations to select questions.
Question selection is based solely on responses to items
during the examination.
Teaching Point: Computer Adaptive Testing (CAT) tailors
question difficulty to each candidate's ability level based on
real-time performance.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
,Question 2
Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing graduate is preparing for
the NCLEX-PN® examination and is reviewing the test plan. The
graduate correctly identifies that the examination is organized
around which two major frameworks that form the basis for
safe and effective nursing practice?
Options:
A. Client Needs categories and Integrated Processes
B. Nursing Process and Maslow's Hierarchy of Needs
C. Health Promotion and Physiological Adaptation
D. Pharmacological Therapies and Reduction of Risk Potential
Correct Answer: A
Rationale for Correct Answer: The correct answer is A. The
NCLEX-PN® test plan is organized around two major
frameworks: Client Needs categories and Integrated Processes.
The Client Needs categories include Safe and Effective Care
Environment, Health Promotion and Maintenance, and
Psychosocial Integrity, as well as Physiological Integrity.
,Integrated Processes include caring, communication and
documentation, nursing process, and teaching and learning.
Rationale for Incorrect Answers:
• B: Although the Nursing Process and Maslow's Hierarchy
are important frameworks in nursing, they are not the two
major organizing frameworks of the NCLEX-PN® test plan.
• C: Health Promotion and Physiological Adaptation are
subcategories within the Client Needs framework but do
not represent the two major frameworks of the test plan.
• D: Pharmacological Therapies and Reduction of Risk
Potential are subcategories of Physiological Integrity, not
the major test plan frameworks.
Teaching Point: The NCLEX-PN® test plan is organized by Client
Needs categories and Integrated Processes, which guide 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: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing student is reviewing the
Client Needs categories in the NCLEX-PN® test plan. The
student is studying the "Safe and Effective Care Environment"
category. Which of the following nursing actions would be
classified under this Client Needs category?
Options:
A. Teaching a patient about the adverse effects of a prescribed
medication
B. Monitoring a patient's blood pressure for changes indicating
hypovolemia
C. Using proper hand hygiene before providing wound care to a
surgical patient
D. Encouraging a patient to express feelings about a new
diagnosis of diabetes
Correct Answer: C
Rationale for Correct Answer: The correct answer is C. Safe and
Effective Care Environment includes nursing actions that
promote safety and infection control. Using proper hand
hygiene before providing wound care is a fundamental
,infection prevention measure that ensures a safe care
environment for the patient, which directly aligns with this
Client Needs category.
Rationale for Incorrect Answers:
• A: Teaching about medication adverse effects falls under
the Client Needs category of Physiological Integrity,
specifically Pharmacological and Parenteral Therapies.
• B: Monitoring blood pressure for changes indicating
hypovolemia is classified under Physiological Integrity,
specifically Reduction of Risk Potential.
• D: Encouraging expression of feelings about a new
diagnosis falls under Psychosocial Integrity, which focuses
on emotional and mental health needs.
Teaching Point: Safe and Effective Care Environment includes
infection control, safety, and management of care
responsibilities.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 4
,Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing student is preparing for
the NCLEX-PN® examination and encounters a question
requiring the student to analyze assessment data to determine
the priority nursing intervention. At which level of cognitive
ability is this question written?
Options:
A. Knowledge
B. Comprehension
C. Application
D. Analysis
Correct Answer: D
Rationale for Correct Answer: The correct answer is D. Analysis
involves breaking down information and examining
relationships, including identifying priorities based on
assessment data. When a question requires the candidate to
analyze assessment findings to determine the priority nursing
intervention, it is testing at the analysis level of cognitive
ability.
Rationale for Incorrect Answers:
, • A: Knowledge involves recall of facts and information, not
the analysis of data to determine priorities.
• B: Comprehension involves understanding the meaning of
information but does not require breaking down data or
determining priorities.
• C: Application involves using knowledge in a specific
situation but may not require the higher-level thinking of
analyzing and prioritizing data.
Teaching Point: Analysis-level questions require breaking down
assessment data and identifying priority nursing actions based
on clinical judgment.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 5
Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing candidate is taking the
NCLEX-PN® examination and encounters a question format that
includes a scenario with an exhibit that can be opened to reveal
, additional information. The candidate must review the scenario
and the exhibit to answer the question correctly. Which type of
question format is the candidate experiencing?
Options:
A. Multiple-Response Question
B. Ordered-Response Question
C. Scenario/Exhibit Question
D. Figure or Hot Spot Question
Correct Answer: C
Rationale for Correct Answer: The correct answer is C. A
Scenario/Exhibit Question presents a clinical scenario along
with an exhibit that the candidate can open to view additional
information. The exhibit may contain laboratory values, vital
signs, or other relevant clinical data. The candidate must review
both the scenario and the exhibit to answer the question,
which tests the ability to gather and interpret data.
Rationale for Incorrect Answers:
• A: A Multiple-Response Question requires the candidate to
select more than one correct answer from a list of options,
not to review an exhibit.
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
20 NCLEX-PN®-Style Multiple-Choice Questions
Question 1
Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing student is reviewing the
NCLEX-PN® test plan and notes that the examination uses
Computer Adaptive Testing (CAT). The student asks the
instructor how CAT determines which questions are presented
,during the examination. The practical nursing instructor's
response should be based on which understanding of CAT?
Options:
A. The computer selects questions based on the candidate's
previous responses to determine the difficulty level of
subsequent items.
B. The computer presents questions in a predetermined
sequence based on the test plan regardless of candidate
performance.
C. The computer adjusts the number of questions based on
how quickly the candidate completes each item.
D. The computer selects questions based on the candidate's
nursing program performance and clinical evaluation scores.
Correct Answer: A
Rationale for Correct Answer: The correct answer is A.
Computer Adaptive Testing (CAT) selects questions based on
the candidate's previous responses. The computer continuously
estimates the candidate's ability level and selects subsequent
questions that are appropriate for that ability level. This
adaptive mechanism allows the examination to more precisely
measure the candidate's nursing knowledge and clinical
,judgment by tailoring question difficulty to individual
performance.
Rationale for Incorrect Answers:
• B: The computer does not present questions in a
predetermined sequence. The CAT algorithm adapts
question selection based on candidate performance, not a
fixed order.
• C: The number of questions is not adjusted based on the
speed of completion. The examination has a minimum and
maximum number of questions determined by the test
plan and candidate performance.
• D: The computer does not use nursing program
performance or clinical evaluations to select questions.
Question selection is based solely on responses to items
during the examination.
Teaching Point: Computer Adaptive Testing (CAT) tailors
question difficulty to each candidate's ability level based on
real-time performance.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
,Question 2
Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing graduate is preparing for
the NCLEX-PN® examination and is reviewing the test plan. The
graduate correctly identifies that the examination is organized
around which two major frameworks that form the basis for
safe and effective nursing practice?
Options:
A. Client Needs categories and Integrated Processes
B. Nursing Process and Maslow's Hierarchy of Needs
C. Health Promotion and Physiological Adaptation
D. Pharmacological Therapies and Reduction of Risk Potential
Correct Answer: A
Rationale for Correct Answer: The correct answer is A. The
NCLEX-PN® test plan is organized around two major
frameworks: Client Needs categories and Integrated Processes.
The Client Needs categories include Safe and Effective Care
Environment, Health Promotion and Maintenance, and
Psychosocial Integrity, as well as Physiological Integrity.
,Integrated Processes include caring, communication and
documentation, nursing process, and teaching and learning.
Rationale for Incorrect Answers:
• B: Although the Nursing Process and Maslow's Hierarchy
are important frameworks in nursing, they are not the two
major organizing frameworks of the NCLEX-PN® test plan.
• C: Health Promotion and Physiological Adaptation are
subcategories within the Client Needs framework but do
not represent the two major frameworks of the test plan.
• D: Pharmacological Therapies and Reduction of Risk
Potential are subcategories of Physiological Integrity, not
the major test plan frameworks.
Teaching Point: The NCLEX-PN® test plan is organized by Client
Needs categories and Integrated Processes, which guide 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: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing student is reviewing the
Client Needs categories in the NCLEX-PN® test plan. The
student is studying the "Safe and Effective Care Environment"
category. Which of the following nursing actions would be
classified under this Client Needs category?
Options:
A. Teaching a patient about the adverse effects of a prescribed
medication
B. Monitoring a patient's blood pressure for changes indicating
hypovolemia
C. Using proper hand hygiene before providing wound care to a
surgical patient
D. Encouraging a patient to express feelings about a new
diagnosis of diabetes
Correct Answer: C
Rationale for Correct Answer: The correct answer is C. Safe and
Effective Care Environment includes nursing actions that
promote safety and infection control. Using proper hand
hygiene before providing wound care is a fundamental
,infection prevention measure that ensures a safe care
environment for the patient, which directly aligns with this
Client Needs category.
Rationale for Incorrect Answers:
• A: Teaching about medication adverse effects falls under
the Client Needs category of Physiological Integrity,
specifically Pharmacological and Parenteral Therapies.
• B: Monitoring blood pressure for changes indicating
hypovolemia is classified under Physiological Integrity,
specifically Reduction of Risk Potential.
• D: Encouraging expression of feelings about a new
diagnosis falls under Psychosocial Integrity, which focuses
on emotional and mental health needs.
Teaching Point: Safe and Effective Care Environment includes
infection control, safety, and management of care
responsibilities.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 4
,Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing student is preparing for
the NCLEX-PN® examination and encounters a question
requiring the student to analyze assessment data to determine
the priority nursing intervention. At which level of cognitive
ability is this question written?
Options:
A. Knowledge
B. Comprehension
C. Application
D. Analysis
Correct Answer: D
Rationale for Correct Answer: The correct answer is D. Analysis
involves breaking down information and examining
relationships, including identifying priorities based on
assessment data. When a question requires the candidate to
analyze assessment findings to determine the priority nursing
intervention, it is testing at the analysis level of cognitive
ability.
Rationale for Incorrect Answers:
, • A: Knowledge involves recall of facts and information, not
the analysis of data to determine priorities.
• B: Comprehension involves understanding the meaning of
information but does not require breaking down data or
determining priorities.
• C: Application involves using knowledge in a specific
situation but may not require the higher-level thinking of
analyzing and prioritizing data.
Teaching Point: Analysis-level questions require breaking down
assessment data and identifying priority nursing actions based
on clinical judgment.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Chapter 1.
Question 5
Reference: Clinical Judgment and the Next Generation NCLEX
(NGN)-PN® Examination
Clinical Scenario: A practical nursing candidate is taking the
NCLEX-PN® examination and encounters a question format that
includes a scenario with an exhibit that can be opened to reveal
, additional information. The candidate must review the scenario
and the exhibit to answer the question correctly. Which type of
question format is the candidate experiencing?
Options:
A. Multiple-Response Question
B. Ordered-Response Question
C. Scenario/Exhibit Question
D. Figure or Hot Spot Question
Correct Answer: C
Rationale for Correct Answer: The correct answer is C. A
Scenario/Exhibit Question presents a clinical scenario along
with an exhibit that the candidate can open to view additional
information. The exhibit may contain laboratory values, vital
signs, or other relevant clinical data. The candidate must review
both the scenario and the exhibit to answer the question,
which tests the ability to gather and interpret data.
Rationale for Incorrect Answers:
• A: A Multiple-Response Question requires the candidate to
select more than one correct answer from a list of options,
not to review an exhibit.
