SAUNDERS COMPREHENSIVE REVIEW FOR THE
NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
TEST BANK
1️⃣ Reference
Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination: Computer Adaptive
Testing
2️⃣ NCLEX-PN Clinical Scenario
A practical nursing student is preparing to take the NCLEX-PN® examination and asks the clinical
instructor how the Computer Adaptive Testing (CAT) system selects questions. The student
expresses concern about receiving questions of varying difficulty throughout the exam. Which
response by the nurse instructor correctly explains the operational mechanism of CAT?
3️⃣ Options (A–D)
A. "The exam delivers a preset sequence of questions that becomes progressively easier as you
answer correctly."
B. "The computer continuously recalculates your ability level based on your performance on
previous questions."
,C. "Questions are selected at random from a large pool regardless of whether your previous
answer was right or wrong."
D. "The system presents harder questions only during the last 20 questions to determine your
final score."
4️⃣ Correct Answer
B. "The computer continuously recalculates your ability level based on your performance on
previous questions."
5️⃣ Rationales
Correct Answer
• Option B: Computer Adaptive Testing (CAT) re-estimates the candidate's ability level
after every answered question. The computer selects the next item that the candidate
should have a 50% chance of answering correctly based on previous performance. This
ensures that the examination is tailored specifically to the candidate's demonstrated
knowledge level.
Incorrect Answers
• Option A: CAT does not use a preset sequence, nor do items become easier when
answered correctly; correctly answered items lead to higher-difficulty items.
• Option C: CAT does not select questions randomly; selection is dynamically driven by
the candidate's ongoing performance and test plan requirements.
• Option D: CAT recalculates ability and adjusts item difficulty throughout the entire test,
not just during the final 20 questions.
6️⃣ Teaching Point
CAT re-estimates candidate ability after every answer, selecting subsequent items aligned with
the candidate's established difficulty level.
,7️⃣ Citation
Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-PN®
Examination (9th ed.). Clinical Judgment and the Next Generation NCLEX (NGN)-PN®
Examination.
1️⃣ Reference
Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination: Client Needs
Category
2️⃣ NCLEX-PN Clinical Scenario
A licensed practical nurse (LPN) working in an acute care unit is assigned to care for a client
requiring continuous vital sign monitoring, oral medication administration, and reinforcing
diabetic discharge teaching. The LPN recognizes that these responsibilities fall within specific
Client Needs categories on the NCLEX-PN® Test Plan. Which Client Needs category
encompasses hand hygiene, personal protective equipment usage, and safe client equipment
operation?
3️⃣ Options (A–D)
A. Physiological Integrity
B. Psychosocial Integrity
C. Safe and Effective Care Environment
D. Health Promotion and Maintenance
4️⃣ Correct Answer
C. Safe and Effective Care Environment
5️⃣ Rationales
Correct Answer
, • Option C: The Safe and Effective Care Environment category focuses on protecting
clients and healthcare personnel from hazards. It includes subcategories such as
Coordinated Care and Safety and Infection Control (e.g., standard precautions, PPE,
hand hygiene, and equipment safety).
Incorrect Answers
• Option A: Physiological Integrity covers physical care, comfort, risk reduction, and
pharmacological therapies.
• Option B: Psychosocial Integrity focuses on emotional, mental, and social well-being
throughout the lifespan.
• Option D: Health Promotion and Maintenance relates to growth and development, early
detection, and lifestyle choices.
6️⃣ Teaching Point
Infection prevention and standard precautions are core elements under the Safe and Effective
Care Environment Client Needs category.
7️⃣ Citation
Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-PN®
Examination (9th ed.). Clinical Judgment and the Next Generation NCLEX (NGN)-PN®
Examination.
1️⃣ Reference
Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination: Registration and
Appointment Scheduling
2️⃣ NCLEX-PN Clinical Scenario
A practical nursing graduate receives an Authorization to Test (ATT) letter via email after
registering for the NCLEX-PN® examination. The graduate plans to schedule an examination
NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
TEST BANK
1️⃣ Reference
Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination: Computer Adaptive
Testing
2️⃣ NCLEX-PN Clinical Scenario
A practical nursing student is preparing to take the NCLEX-PN® examination and asks the clinical
instructor how the Computer Adaptive Testing (CAT) system selects questions. The student
expresses concern about receiving questions of varying difficulty throughout the exam. Which
response by the nurse instructor correctly explains the operational mechanism of CAT?
3️⃣ Options (A–D)
A. "The exam delivers a preset sequence of questions that becomes progressively easier as you
answer correctly."
B. "The computer continuously recalculates your ability level based on your performance on
previous questions."
,C. "Questions are selected at random from a large pool regardless of whether your previous
answer was right or wrong."
D. "The system presents harder questions only during the last 20 questions to determine your
final score."
4️⃣ Correct Answer
B. "The computer continuously recalculates your ability level based on your performance on
previous questions."
5️⃣ Rationales
Correct Answer
• Option B: Computer Adaptive Testing (CAT) re-estimates the candidate's ability level
after every answered question. The computer selects the next item that the candidate
should have a 50% chance of answering correctly based on previous performance. This
ensures that the examination is tailored specifically to the candidate's demonstrated
knowledge level.
Incorrect Answers
• Option A: CAT does not use a preset sequence, nor do items become easier when
answered correctly; correctly answered items lead to higher-difficulty items.
• Option C: CAT does not select questions randomly; selection is dynamically driven by
the candidate's ongoing performance and test plan requirements.
• Option D: CAT recalculates ability and adjusts item difficulty throughout the entire test,
not just during the final 20 questions.
6️⃣ Teaching Point
CAT re-estimates candidate ability after every answer, selecting subsequent items aligned with
the candidate's established difficulty level.
,7️⃣ Citation
Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-PN®
Examination (9th ed.). Clinical Judgment and the Next Generation NCLEX (NGN)-PN®
Examination.
1️⃣ Reference
Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination: Client Needs
Category
2️⃣ NCLEX-PN Clinical Scenario
A licensed practical nurse (LPN) working in an acute care unit is assigned to care for a client
requiring continuous vital sign monitoring, oral medication administration, and reinforcing
diabetic discharge teaching. The LPN recognizes that these responsibilities fall within specific
Client Needs categories on the NCLEX-PN® Test Plan. Which Client Needs category
encompasses hand hygiene, personal protective equipment usage, and safe client equipment
operation?
3️⃣ Options (A–D)
A. Physiological Integrity
B. Psychosocial Integrity
C. Safe and Effective Care Environment
D. Health Promotion and Maintenance
4️⃣ Correct Answer
C. Safe and Effective Care Environment
5️⃣ Rationales
Correct Answer
, • Option C: The Safe and Effective Care Environment category focuses on protecting
clients and healthcare personnel from hazards. It includes subcategories such as
Coordinated Care and Safety and Infection Control (e.g., standard precautions, PPE,
hand hygiene, and equipment safety).
Incorrect Answers
• Option A: Physiological Integrity covers physical care, comfort, risk reduction, and
pharmacological therapies.
• Option B: Psychosocial Integrity focuses on emotional, mental, and social well-being
throughout the lifespan.
• Option D: Health Promotion and Maintenance relates to growth and development, early
detection, and lifestyle choices.
6️⃣ Teaching Point
Infection prevention and standard precautions are core elements under the Safe and Effective
Care Environment Client Needs category.
7️⃣ Citation
Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-PN®
Examination (9th ed.). Clinical Judgment and the Next Generation NCLEX (NGN)-PN®
Examination.
1️⃣ Reference
Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination: Registration and
Appointment Scheduling
2️⃣ NCLEX-PN Clinical Scenario
A practical nursing graduate receives an Authorization to Test (ATT) letter via email after
registering for the NCLEX-PN® examination. The graduate plans to schedule an examination
