E X A M P R E P A R AT I O N R E S O U R C E
NCLEX PN
2026
Practice Exam
100 multiple-choice questions with full rationales
covering Medical-Surgical Nursing, Pharmacology,
Fundamentals, Mental Health, Maternity, Pediatrics,
and Leadership.
100 Questions with Detailed Rationales
Full Exam Format Balanced Subject Distribution
Mixed Difficulty Recall, Application, and Analysis
PN EXAM 2026 EDITION
L AT E S T N C L E X P N T E S T P L A N A L I G N M E N T
,Question 1
A nurse is caring for a client with heart failure who is receiving furosemide 40 mg IV
twice daily. Which of the following findings should the nurse report to the provider
immediately?
A. Potassium level of 3.0 mEq/L
B. Blood pressure of 110/70 mm Hg
C. Urinary output of 80 mL/hr
D. Weight loss of 0.5 kg in 24 hours
Correct Answer: A
A potassium level of 3.0 mEq/L indicates hypokalemia, which is a critical finding in a
client receiving loop diuretics. Hypokalemia increases the risk of lethal cardiac
dysrhythmias and requires immediate intervention such as potassium supplementation. A
blood pressure of 110/70 mm Hg is within normal limits. Urinary output of 80 mL/hr is an
expected therapeutic response to diuretic therapy. Weight loss of 0.5 kg in 24 hours
suggests effective fluid reduction.
Question 2
A nurse is assessing a client who had a myocardial infarction 2 days ago. The client
reports new onset of sharp chest pain that worsens with deep inspiration and is
relieved by sitting forward. Which of the following actions should the nurse take first?
A. Administer prescribed nitroglycerin
B. Check the client's troponin level
C. Obtain a 12-lead electrocardiogram
D. Auscultate for a pericardial friction rub
Correct Answer: D
Sharp chest pain that worsens with inspiration and improves with sitting forward is
classic for pericarditis, a complication after myocardial infarction. The nurse should first
auscultate for a pericardial friction rub, the hallmark assessment finding. Nitroglycerin is
indicated for cardiac ischemia, not pericarditis. While an ECG and troponin may be
obtained, the initial assessment should focus on identifying the friction rub to confirm the
diagnosis.
,NCLEX PN 2026 Practice Exam 100 Questions with Full Rationales
Question 3
A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an understanding of
the teaching?
A. I will take an aspirin each day for headache prevention
B. I should eat a consistent amount of leafy green vegetables each day
C. I should increase my intake of vitamin K supplements
D. I will use a straight razor for shaving to prevent bleeding
Correct Answer: A
The client should maintain a consistent intake of vitamin K-rich foods such as leafy green
vegetables because warfarin works by antagonizing vitamin K-dependent clotting factors.
Sudden dietary changes in vitamin K can alter the INR and increase the risk of bleeding or
thrombosis. Aspirin with warfarin increases bleeding risk. Vitamin K supplements
counteract warfarin. A straight razor should be avoided; an electric razor should be used
instead.
Question 4
A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. The nurse observes that the client's affected leg is shorter than the other
leg and the client reports severe pain in the affected hip. Which of the following actions
should the nurse take first?
A. Administer prescribed analgesic medication
B. Reposition the client to the unaffected side
C. Notify the surgeon immediately
D. Apply an abduction pillow to the legs
Correct Answer: D
A shortened affected leg with severe hip pain following hip arthroplasty is a classic sign of
prosthesis dislocation, a surgical emergency requiring immediate notification of the
surgeon. Analgesics do not address the underlying problem. An abduction pillow prevents
but cannot correct dislocation. Repositioning could worsen the dislocation.
Page 2
, NCLEX PN 2026 Practice Exam 100 Questions with Full Rationales
Question 5
A nurse is reviewing the laboratory results of a client who has chronic kidney disease.
Which of the following findings should the nurse expect?
A. Increased hemoglobin level
B. Decreased blood urea nitrogen (BUN)
C. Decreased serum calcium
D. Increased serum sodium
Correct Answer: A
In chronic kidney disease, the kidneys cannot activate vitamin D or excrete phosphate
effectively, leading to hyperphosphatemia and hypocalcemia. BUN is expected to be
elevated. Hemoglobin is typically decreased due to reduced erythropoietin. Serum sodium
may be normal or decreased due to fluid retention.
Question 6
A nurse is assessing a client who has a deep vein thrombosis (DVT) of the left lower
extremity. Which of the following findings should the nurse expect?
A. Left calf that is cool and pale
B. Diminished popliteal pulse in the left leg
C. Bilateral pitting edema of the lower extremities
D. Left calf that is red, warm, and swollen
Correct Answer: D
DVT typically presents with unilateral warmth, redness, and edema due to inflammation
and venous obstruction. A cool and pale extremity is characteristic of arterial occlusion.
Bilateral edema suggests a systemic condition like heart failure. Popliteal pulse is
typically not diminished in DVT since arterial circulation remains intact.
Question 7
A nurse is caring for a client with type 2 diabetes mellitus who reports feeling shaky
and diaphoretic. The client's blood glucose level is 58 mg/dL. Which of the following
actions should the nurse take?
A. Give the client 4 oz of orange juice
B. Obtain a repeat blood glucose reading in 15 minutes
C. Provide a high-protein snack immediately
D. Administer 1 mg of glucagon intramuscularly
Correct Answer: D
A blood glucose of 58 mg/dL indicates mild to moderate hypoglycemia in an awake client.
The treatment is 15 to 20 grams of fast-acting carbohydrates, such as 4 oz of orange juice,
followed by rechecking in 15 minutes. Glucagon is for severe hypoglycemia when the
client is unconscious. Protein does not raise blood glucose quickly. Rechecking is done
after treatment, not before.
Page 3
NCLEX PN
2026
Practice Exam
100 multiple-choice questions with full rationales
covering Medical-Surgical Nursing, Pharmacology,
Fundamentals, Mental Health, Maternity, Pediatrics,
and Leadership.
100 Questions with Detailed Rationales
Full Exam Format Balanced Subject Distribution
Mixed Difficulty Recall, Application, and Analysis
PN EXAM 2026 EDITION
L AT E S T N C L E X P N T E S T P L A N A L I G N M E N T
,Question 1
A nurse is caring for a client with heart failure who is receiving furosemide 40 mg IV
twice daily. Which of the following findings should the nurse report to the provider
immediately?
A. Potassium level of 3.0 mEq/L
B. Blood pressure of 110/70 mm Hg
C. Urinary output of 80 mL/hr
D. Weight loss of 0.5 kg in 24 hours
Correct Answer: A
A potassium level of 3.0 mEq/L indicates hypokalemia, which is a critical finding in a
client receiving loop diuretics. Hypokalemia increases the risk of lethal cardiac
dysrhythmias and requires immediate intervention such as potassium supplementation. A
blood pressure of 110/70 mm Hg is within normal limits. Urinary output of 80 mL/hr is an
expected therapeutic response to diuretic therapy. Weight loss of 0.5 kg in 24 hours
suggests effective fluid reduction.
Question 2
A nurse is assessing a client who had a myocardial infarction 2 days ago. The client
reports new onset of sharp chest pain that worsens with deep inspiration and is
relieved by sitting forward. Which of the following actions should the nurse take first?
A. Administer prescribed nitroglycerin
B. Check the client's troponin level
C. Obtain a 12-lead electrocardiogram
D. Auscultate for a pericardial friction rub
Correct Answer: D
Sharp chest pain that worsens with inspiration and improves with sitting forward is
classic for pericarditis, a complication after myocardial infarction. The nurse should first
auscultate for a pericardial friction rub, the hallmark assessment finding. Nitroglycerin is
indicated for cardiac ischemia, not pericarditis. While an ECG and troponin may be
obtained, the initial assessment should focus on identifying the friction rub to confirm the
diagnosis.
,NCLEX PN 2026 Practice Exam 100 Questions with Full Rationales
Question 3
A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an understanding of
the teaching?
A. I will take an aspirin each day for headache prevention
B. I should eat a consistent amount of leafy green vegetables each day
C. I should increase my intake of vitamin K supplements
D. I will use a straight razor for shaving to prevent bleeding
Correct Answer: A
The client should maintain a consistent intake of vitamin K-rich foods such as leafy green
vegetables because warfarin works by antagonizing vitamin K-dependent clotting factors.
Sudden dietary changes in vitamin K can alter the INR and increase the risk of bleeding or
thrombosis. Aspirin with warfarin increases bleeding risk. Vitamin K supplements
counteract warfarin. A straight razor should be avoided; an electric razor should be used
instead.
Question 4
A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. The nurse observes that the client's affected leg is shorter than the other
leg and the client reports severe pain in the affected hip. Which of the following actions
should the nurse take first?
A. Administer prescribed analgesic medication
B. Reposition the client to the unaffected side
C. Notify the surgeon immediately
D. Apply an abduction pillow to the legs
Correct Answer: D
A shortened affected leg with severe hip pain following hip arthroplasty is a classic sign of
prosthesis dislocation, a surgical emergency requiring immediate notification of the
surgeon. Analgesics do not address the underlying problem. An abduction pillow prevents
but cannot correct dislocation. Repositioning could worsen the dislocation.
Page 2
, NCLEX PN 2026 Practice Exam 100 Questions with Full Rationales
Question 5
A nurse is reviewing the laboratory results of a client who has chronic kidney disease.
Which of the following findings should the nurse expect?
A. Increased hemoglobin level
B. Decreased blood urea nitrogen (BUN)
C. Decreased serum calcium
D. Increased serum sodium
Correct Answer: A
In chronic kidney disease, the kidneys cannot activate vitamin D or excrete phosphate
effectively, leading to hyperphosphatemia and hypocalcemia. BUN is expected to be
elevated. Hemoglobin is typically decreased due to reduced erythropoietin. Serum sodium
may be normal or decreased due to fluid retention.
Question 6
A nurse is assessing a client who has a deep vein thrombosis (DVT) of the left lower
extremity. Which of the following findings should the nurse expect?
A. Left calf that is cool and pale
B. Diminished popliteal pulse in the left leg
C. Bilateral pitting edema of the lower extremities
D. Left calf that is red, warm, and swollen
Correct Answer: D
DVT typically presents with unilateral warmth, redness, and edema due to inflammation
and venous obstruction. A cool and pale extremity is characteristic of arterial occlusion.
Bilateral edema suggests a systemic condition like heart failure. Popliteal pulse is
typically not diminished in DVT since arterial circulation remains intact.
Question 7
A nurse is caring for a client with type 2 diabetes mellitus who reports feeling shaky
and diaphoretic. The client's blood glucose level is 58 mg/dL. Which of the following
actions should the nurse take?
A. Give the client 4 oz of orange juice
B. Obtain a repeat blood glucose reading in 15 minutes
C. Provide a high-protein snack immediately
D. Administer 1 mg of glucagon intramuscularly
Correct Answer: D
A blood glucose of 58 mg/dL indicates mild to moderate hypoglycemia in an awake client.
The treatment is 15 to 20 grams of fast-acting carbohydrates, such as 4 oz of orange juice,
followed by rechecking in 15 minutes. Glucagon is for severe hypoglycemia when the
client is unconscious. Protein does not raise blood glucose quickly. Rechecking is done
after treatment, not before.
Page 3
