Latest NCLEX PN Exam 2026 — Real Questions
and Answers with Full Rationales to Guarantee
Your First Attempt Success in NCLEX PN
Exams.
1. The LPN is caring for a client with a new diagnosis of type 1 diabetes. Which morning blood
glucose level indicates to the nurse that the client's insulin regimen is effectively managing
their blood sugar?
• A. 180 mg/dL
• B. 145 mg/dL
• C. 95 mg/dL
• D. 62 mg/dL
Answer: C (95 mg/dL)
Rationale: A normal fasting blood glucose range is 70–100 mg/dL. 180 (A) and 145 (B)
are hyperglycemic. 62 (D) is hypoglycemic and dangerous.
2. A client is prescribed Digoxin. Which finding should prompt the LPN to withhold the
medication and notify the RN?
• A. Apical pulse of 52 bpm
• B. Blood pressure of 140/90
• C. Respiratory rate of 18
• D. Serum potassium of 4.0 mEq/L
Answer: A (Apical pulse of 52 bpm)
Rationale: Digoxin slows the heart rate. The general rule is to hold the medication if the
apical pulse is below 60 bpm (or per facility policy) and notify the provider. The other
options are within normal limits.
3. An elderly client is recovering from hip surgery. What is the LPN’s priority intervention to
prevent complications?
• A. Keep the client on strict bed rest to prevent falls.
• B. Encourage the client to use an incentive spirometer every hour while awake.
, • C. Restrict fluid intake to prevent edema.
• D. Place the client in a high-Fowler's position for meals.
Answer: B (Encourage the use of an incentive spirometer)
Rationale: Post-operative clients (especially elderly) are at high risk for atelectasis and
pneumonia. Incentive spirometry promotes lung expansion. Bed rest (A) increases DVT
risk; fluids (C) should be encouraged, not restricted; High-Fowler's (D) is good for
swallowing but not the priority complication.
4. The LPN is preparing to administer an intramuscular (IM) injection in the ventrogluteal site.
The nurse identifies this site by locating which anatomical landmarks?
• A. Acromion process and axilla
• B. Greater trochanter and iliac crest
• C. Anterior superior iliac spine and iliac crest
• D. Xiphoid process and costal margin
Answer: C (Anterior superior iliac spine and iliac crest)
Rationale: To locate the ventrogluteal site, the nurse places the palm on the greater
trochanter, the index finger on the anterior superior iliac spine, and the middle finger
toward the iliac crest. A is for the deltoid; B are landmarks for the dorsogluteal (which is
no longer recommended).
5. A client on a psychiatric unit begins pacing aggressively and speaking loudly. What is the
most appropriate initial nursing intervention?
• A. Place the client in seclusion immediately.
• B. Administer a PRN sedative.
• C. Approach the client calmly and offer to talk in a quiet area.
• D. Call security for physical restraints.
Answer: C (Approach calmly and offer a quiet area)
Rationale: The least restrictive intervention should always be attempted first. Verbal de-
escalation and changing the environment are prioritized before chemical (B) or physical
(A, D) restraints.
6. A client with heart failure is prescribed furosemide (Lasix). Which breakfast selection
indicates the client needs further dietary teaching?
• A. Oatmeal and a banana
, • B. Scrambled eggs and toast
• C. Canned tomato soup and a saltine crackers
• D. Yogurt and berries
Answer: C (Canned tomato soup and crackers)
Rationale: Furosemide is a diuretic that depletes potassium. Clients should eat
potassium-rich foods (bananas, OJ). However, heart failure clients must restrict sodium.
Canned soup and crackers are extremely high in sodium, which causes fluid retention
and counteracts the medication.
7. The LPN is caring for a client with a tracheostomy. Which action is essential for maintaining
a patent airway?
• A. Suction the tracheostomy every 15 minutes routinely.
• B. Deflate the tracheostomy cuff for 5 minutes every hour.
• C. Keep an obturator and a spare tracheostomy tube at the bedside.
• D. Clean the inner cannula with sterile water only.
Answer: C (Keep an obturator and spare tube at bedside)
Rationale: If the tracheostomy tube becomes dislodged or obstructed, the obturator is
used to reinsert a new tube. Routine suctioning (A) is PRN, not every 15 min. Cuff
deflation (B) is typically done per protocol, but the airway is the priority. Inner cannula
cleaning requires sterile technique, but the equipment at the bedside is the priority
safety net.
8. A 4-year-old child is admitted with dehydration. Which assessment finding would indicate
severe dehydration requiring immediate intervention?
• A. Dry mucous membranes
• B. Sunken fontanels
• C. Capillary refill of 2 seconds
• D. Blood pressure of 100/60
Answer: B (Sunken fontanels)
Rationale: In an infant/toddler, sunken fontanels, absent tears, and poor skin turgor
indicate severe dehydration. Capillary refill of >3 seconds is concerning; 2 seconds is
normal. Hypotension (D) is a late sign but less specific to severe dehydration than
fontanels.
, 9. A client is discharged with a prescription for warfarin (Coumadin). Which statement by the
client indicates effective teaching?
• A. "I will take ibuprofen if I get a headache."
• B. "I will avoid eating large amounts of green leafy vegetables."
• C. "I will use an electric razor instead of a straight razor."
• D. "I will check my blood sugar daily."
Answer: C (I will use an electric razor)
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Electric razors
prevent nicks/cuts that cause bleeding. Vitamin K (found in green leafy veggies) reverses
warfarin, so they should eat consistent amounts, not avoid entirely (B). NSAIDs (A)
increase bleeding risk.
10. The LPN notes a client has a PRN order for haloperidol (Haldol) for agitation. Before
administering, what is the priority nursing assessment?
• A. Blood glucose level
• B. Temperature and WBC count
• C. Heart rate and blood pressure
• D. Respiratory rate and oxygen saturation
Answer: C (Heart rate and blood pressure)
Rationale: Haloperidol (an antipsychotic) can cause significant hypotension, tachycardia,
and QT prolongation. The nurse must check vitals before administration to ensure safety.
Temperature/WBC (B) are for infection; glucose (A) is unrelated.
11. When caring for a client in isolation for Clostridium difficile (C. diff), which infection
control measure is most important?
• A. Wear a fit-tested N95 respirator.
• B. Use alcohol-based hand sanitizer after removing gloves.
• C. Wash hands with soap and water after removing gloves.
• D. Place the client in a negative pressure room.
Answer: C (Wash hands with soap and water)
Rationale: C. diff spores are not killed by alcohol-based sanitizers (B). The nurse must
and Answers with Full Rationales to Guarantee
Your First Attempt Success in NCLEX PN
Exams.
1. The LPN is caring for a client with a new diagnosis of type 1 diabetes. Which morning blood
glucose level indicates to the nurse that the client's insulin regimen is effectively managing
their blood sugar?
• A. 180 mg/dL
• B. 145 mg/dL
• C. 95 mg/dL
• D. 62 mg/dL
Answer: C (95 mg/dL)
Rationale: A normal fasting blood glucose range is 70–100 mg/dL. 180 (A) and 145 (B)
are hyperglycemic. 62 (D) is hypoglycemic and dangerous.
2. A client is prescribed Digoxin. Which finding should prompt the LPN to withhold the
medication and notify the RN?
• A. Apical pulse of 52 bpm
• B. Blood pressure of 140/90
• C. Respiratory rate of 18
• D. Serum potassium of 4.0 mEq/L
Answer: A (Apical pulse of 52 bpm)
Rationale: Digoxin slows the heart rate. The general rule is to hold the medication if the
apical pulse is below 60 bpm (or per facility policy) and notify the provider. The other
options are within normal limits.
3. An elderly client is recovering from hip surgery. What is the LPN’s priority intervention to
prevent complications?
• A. Keep the client on strict bed rest to prevent falls.
• B. Encourage the client to use an incentive spirometer every hour while awake.
, • C. Restrict fluid intake to prevent edema.
• D. Place the client in a high-Fowler's position for meals.
Answer: B (Encourage the use of an incentive spirometer)
Rationale: Post-operative clients (especially elderly) are at high risk for atelectasis and
pneumonia. Incentive spirometry promotes lung expansion. Bed rest (A) increases DVT
risk; fluids (C) should be encouraged, not restricted; High-Fowler's (D) is good for
swallowing but not the priority complication.
4. The LPN is preparing to administer an intramuscular (IM) injection in the ventrogluteal site.
The nurse identifies this site by locating which anatomical landmarks?
• A. Acromion process and axilla
• B. Greater trochanter and iliac crest
• C. Anterior superior iliac spine and iliac crest
• D. Xiphoid process and costal margin
Answer: C (Anterior superior iliac spine and iliac crest)
Rationale: To locate the ventrogluteal site, the nurse places the palm on the greater
trochanter, the index finger on the anterior superior iliac spine, and the middle finger
toward the iliac crest. A is for the deltoid; B are landmarks for the dorsogluteal (which is
no longer recommended).
5. A client on a psychiatric unit begins pacing aggressively and speaking loudly. What is the
most appropriate initial nursing intervention?
• A. Place the client in seclusion immediately.
• B. Administer a PRN sedative.
• C. Approach the client calmly and offer to talk in a quiet area.
• D. Call security for physical restraints.
Answer: C (Approach calmly and offer a quiet area)
Rationale: The least restrictive intervention should always be attempted first. Verbal de-
escalation and changing the environment are prioritized before chemical (B) or physical
(A, D) restraints.
6. A client with heart failure is prescribed furosemide (Lasix). Which breakfast selection
indicates the client needs further dietary teaching?
• A. Oatmeal and a banana
, • B. Scrambled eggs and toast
• C. Canned tomato soup and a saltine crackers
• D. Yogurt and berries
Answer: C (Canned tomato soup and crackers)
Rationale: Furosemide is a diuretic that depletes potassium. Clients should eat
potassium-rich foods (bananas, OJ). However, heart failure clients must restrict sodium.
Canned soup and crackers are extremely high in sodium, which causes fluid retention
and counteracts the medication.
7. The LPN is caring for a client with a tracheostomy. Which action is essential for maintaining
a patent airway?
• A. Suction the tracheostomy every 15 minutes routinely.
• B. Deflate the tracheostomy cuff for 5 minutes every hour.
• C. Keep an obturator and a spare tracheostomy tube at the bedside.
• D. Clean the inner cannula with sterile water only.
Answer: C (Keep an obturator and spare tube at bedside)
Rationale: If the tracheostomy tube becomes dislodged or obstructed, the obturator is
used to reinsert a new tube. Routine suctioning (A) is PRN, not every 15 min. Cuff
deflation (B) is typically done per protocol, but the airway is the priority. Inner cannula
cleaning requires sterile technique, but the equipment at the bedside is the priority
safety net.
8. A 4-year-old child is admitted with dehydration. Which assessment finding would indicate
severe dehydration requiring immediate intervention?
• A. Dry mucous membranes
• B. Sunken fontanels
• C. Capillary refill of 2 seconds
• D. Blood pressure of 100/60
Answer: B (Sunken fontanels)
Rationale: In an infant/toddler, sunken fontanels, absent tears, and poor skin turgor
indicate severe dehydration. Capillary refill of >3 seconds is concerning; 2 seconds is
normal. Hypotension (D) is a late sign but less specific to severe dehydration than
fontanels.
, 9. A client is discharged with a prescription for warfarin (Coumadin). Which statement by the
client indicates effective teaching?
• A. "I will take ibuprofen if I get a headache."
• B. "I will avoid eating large amounts of green leafy vegetables."
• C. "I will use an electric razor instead of a straight razor."
• D. "I will check my blood sugar daily."
Answer: C (I will use an electric razor)
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Electric razors
prevent nicks/cuts that cause bleeding. Vitamin K (found in green leafy veggies) reverses
warfarin, so they should eat consistent amounts, not avoid entirely (B). NSAIDs (A)
increase bleeding risk.
10. The LPN notes a client has a PRN order for haloperidol (Haldol) for agitation. Before
administering, what is the priority nursing assessment?
• A. Blood glucose level
• B. Temperature and WBC count
• C. Heart rate and blood pressure
• D. Respiratory rate and oxygen saturation
Answer: C (Heart rate and blood pressure)
Rationale: Haloperidol (an antipsychotic) can cause significant hypotension, tachycardia,
and QT prolongation. The nurse must check vitals before administration to ensure safety.
Temperature/WBC (B) are for infection; glucose (A) is unrelated.
11. When caring for a client in isolation for Clostridium difficile (C. diff), which infection
control measure is most important?
• A. Wear a fit-tested N95 respirator.
• B. Use alcohol-based hand sanitizer after removing gloves.
• C. Wash hands with soap and water after removing gloves.
• D. Place the client in a negative pressure room.
Answer: C (Wash hands with soap and water)
Rationale: C. diff spores are not killed by alcohol-based sanitizers (B). The nurse must
