NCLEX-PN QUESTIONS AND ANSWERS ALREADY GRADED A+| 100%
VERIFIED SOLUTIONS………...
CORE DOMAINS
• Safe and Effective Care Environment: Coordinated Care
• Safe and Effective Care Environment: Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity: Basic Care and Comfort
• Physiological Integrity: Pharmacological Therapies
• Physiological Integrity: Reduction of Risk Potential
• Physiological Integrity: Physiological Adaptation
INTRODUCTION
This comprehensive examination is designed for practical/vocational nursing students preparing
for the NCLEX-PN licensure examination. It assesses the knowledge, skills, and clinical judgment
required for safe, effective entry-level practical nursing practice. The examination employs
multiple-choice and scenario-based questions that mirror the actual NCLEX-PN test plan.
Emphasis is placed on prioritization, delegation, infection control, medication safety, and
patient-centered care across the lifespan. Each question is accompanied by a verified answer
and detailed rationale to support learning and exam readiness.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who is receiving a blood transfusion. The client develops fever,
chills, and flank pain. What is the priority action?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Document the findings
B. Stop the transfusion immediately
RATIONALE: Fever, chills, and flank pain during a blood transfusion indicate a hemolytic
transfusion reaction, which is life-threatening. The transfusion must be stopped immediately,
,and the provider notified. Slowing the rate does not address the emergency. Acetaminophen is
not the priority. Documentation follows intervention.
2. A nurse is preparing to administer a prescribed medication and notices the dosage seems
unusually high. What should the PN do?
A. Withhold the medication until the dosage can be confirmed
B. Administer the medication as prescribed
C. Give half the dose and document the discrepancy
D. Ask another nurse to verify the dosage and administer if they agree
A. Withhold the medication until the dosage can be confirmed
RATIONALE: If a prescribed dose appears unsafe or unusual, the PN must withhold the
medication and contact the prescribing provider to verify the order. Administering a potentially
unsafe dose violates patient safety.
3. A client with a diagnosis of schizophrenia is experiencing auditory hallucinations. Which
nursing intervention is most appropriate?
A. Tell the client the voices are not real
B. Encourage the client to participate in a distracting activity
C. Isolate the client until the hallucinations stop
D. Administer PRN antipsychotic medication immediately
B. Encourage the client to participate in a distracting activity
RATIONALE: Distraction is an effective non-pharmacological intervention for auditory
hallucinations. Telling the client the voices are not real is dismissive. Isolation can worsen
symptoms. PRN medication is used when other interventions fail and per order.
4. A postpartum client is receiving oxytocin (Pitocin) IV. Which finding requires immediate
intervention?
A. Contractions every 2 minutes lasting 60 seconds
B. Uterine hyperstimulation with fetal heart rate decelerations
C. Blood pressure of 120/80 mm Hg
D. Heart rate of 80 bpm
B. Uterine hyperstimulation with fetal heart rate decelerations
RATIONALE: Uterine hyperstimulation (contractions more frequent than every 2 minutes or
lasting longer than 90 seconds) with fetal heart rate decelerations indicates fetal distress. The
oxytocin must be stopped immediately.
,5. A client who is 38 weeks pregnant presents with painless vaginal bleeding. Which condition
should the nurse suspect?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Preterm labor
A. Placenta previa
RATIONALE: Painless vaginal bleeding in the third trimester is characteristic of placenta
previa. Placental abruption typically presents with painful bleeding and a rigid abdomen.
6. A nurse is assessing a newborn 1 hour after birth. Which finding requires immediate
intervention?
A. Respiratory rate of 70/min with nasal flaring
B. Heart rate of 130 bpm
C. Temperature of 36.8°C (98.2°F) axillary
D. Acrocyanosis of the hands and feet
A. Respiratory rate of 70/min with nasal flaring
RATIONALE: A respiratory rate greater than 60/min with nasal flaring indicates respiratory
distress in a newborn. This requires immediate intervention and provider notification.
7. A client with type 1 diabetes mellitus is found unresponsive with a blood glucose of 40
mg/dL. Which action should the PN take first?
A. Administer glucagon IM
B. Administer orange juice PO
C. Start an IV line
D. Notify the healthcare provider
A. Administer glucagon IM
RATIONALE: For an unresponsive client with hypoglycemia, oral intake is contraindicated
due to aspiration risk. Glucagon IM or IV dextrose is the appropriate emergency treatment.
8. A client is prescribed warfarin. Which laboratory value should the PN monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
, A. INR
RATIONALE: Warfarin therapy is monitored with the INR (International Normalized Ratio).
Therapeutic INR for most indications is 2.0-3.0.
9. A client with a new colostomy is being taught about ostomy care. Which statement
indicates understanding?
A. "I should change the pouch every day."
B. "I should cut the wafer to fit snugly around the stoma."
C. "I should use alcohol to clean the stoma."
D. "I should avoid eating any foods with fiber."
B. "I should cut the wafer to fit snugly around the stoma."
RATIONALE: The wafer must be cut to fit snugly around the stoma to prevent skin irritation
and leakage. Pouches are typically changed every 3-7 days. Alcohol should not be used on the
stoma. Fiber is gradually reintroduced.
10. A nurse is caring for a client with a suspected pulmonary embolism. Which finding is most
consistent with this diagnosis?
A. Sudden onset of dyspnea and pleuritic chest pain
B. Productive cough with green sputum
C. Bradycardia and hypertension
D. Gradual onset of fatigue
A. Sudden onset of dyspnea and pleuritic chest pain
RATIONALE: Pulmonary embolism typically presents with sudden dyspnea, pleuritic chest
pain, tachycardia, and hypoxemia.
11. A client with bipolar disorder is experiencing a manic episode. Which intervention should
the PN prioritize?
A. Provide a stimulating environment to redirect energy
B. Ensure a safe, low-stimulation environment
C. Encourage the client to take on leadership roles in group therapy
D. Allow the client to skip meals to reduce caloric intake
B. Ensure a safe, low-stimulation environment
RATIONALE: During mania, the priority is safety. A low-stimulation environment reduces
anxiety and prevents overstimulation. The client needs adequate nutrition and rest.
VERIFIED SOLUTIONS………...
CORE DOMAINS
• Safe and Effective Care Environment: Coordinated Care
• Safe and Effective Care Environment: Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity: Basic Care and Comfort
• Physiological Integrity: Pharmacological Therapies
• Physiological Integrity: Reduction of Risk Potential
• Physiological Integrity: Physiological Adaptation
INTRODUCTION
This comprehensive examination is designed for practical/vocational nursing students preparing
for the NCLEX-PN licensure examination. It assesses the knowledge, skills, and clinical judgment
required for safe, effective entry-level practical nursing practice. The examination employs
multiple-choice and scenario-based questions that mirror the actual NCLEX-PN test plan.
Emphasis is placed on prioritization, delegation, infection control, medication safety, and
patient-centered care across the lifespan. Each question is accompanied by a verified answer
and detailed rationale to support learning and exam readiness.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who is receiving a blood transfusion. The client develops fever,
chills, and flank pain. What is the priority action?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Document the findings
B. Stop the transfusion immediately
RATIONALE: Fever, chills, and flank pain during a blood transfusion indicate a hemolytic
transfusion reaction, which is life-threatening. The transfusion must be stopped immediately,
,and the provider notified. Slowing the rate does not address the emergency. Acetaminophen is
not the priority. Documentation follows intervention.
2. A nurse is preparing to administer a prescribed medication and notices the dosage seems
unusually high. What should the PN do?
A. Withhold the medication until the dosage can be confirmed
B. Administer the medication as prescribed
C. Give half the dose and document the discrepancy
D. Ask another nurse to verify the dosage and administer if they agree
A. Withhold the medication until the dosage can be confirmed
RATIONALE: If a prescribed dose appears unsafe or unusual, the PN must withhold the
medication and contact the prescribing provider to verify the order. Administering a potentially
unsafe dose violates patient safety.
3. A client with a diagnosis of schizophrenia is experiencing auditory hallucinations. Which
nursing intervention is most appropriate?
A. Tell the client the voices are not real
B. Encourage the client to participate in a distracting activity
C. Isolate the client until the hallucinations stop
D. Administer PRN antipsychotic medication immediately
B. Encourage the client to participate in a distracting activity
RATIONALE: Distraction is an effective non-pharmacological intervention for auditory
hallucinations. Telling the client the voices are not real is dismissive. Isolation can worsen
symptoms. PRN medication is used when other interventions fail and per order.
4. A postpartum client is receiving oxytocin (Pitocin) IV. Which finding requires immediate
intervention?
A. Contractions every 2 minutes lasting 60 seconds
B. Uterine hyperstimulation with fetal heart rate decelerations
C. Blood pressure of 120/80 mm Hg
D. Heart rate of 80 bpm
B. Uterine hyperstimulation with fetal heart rate decelerations
RATIONALE: Uterine hyperstimulation (contractions more frequent than every 2 minutes or
lasting longer than 90 seconds) with fetal heart rate decelerations indicates fetal distress. The
oxytocin must be stopped immediately.
,5. A client who is 38 weeks pregnant presents with painless vaginal bleeding. Which condition
should the nurse suspect?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Preterm labor
A. Placenta previa
RATIONALE: Painless vaginal bleeding in the third trimester is characteristic of placenta
previa. Placental abruption typically presents with painful bleeding and a rigid abdomen.
6. A nurse is assessing a newborn 1 hour after birth. Which finding requires immediate
intervention?
A. Respiratory rate of 70/min with nasal flaring
B. Heart rate of 130 bpm
C. Temperature of 36.8°C (98.2°F) axillary
D. Acrocyanosis of the hands and feet
A. Respiratory rate of 70/min with nasal flaring
RATIONALE: A respiratory rate greater than 60/min with nasal flaring indicates respiratory
distress in a newborn. This requires immediate intervention and provider notification.
7. A client with type 1 diabetes mellitus is found unresponsive with a blood glucose of 40
mg/dL. Which action should the PN take first?
A. Administer glucagon IM
B. Administer orange juice PO
C. Start an IV line
D. Notify the healthcare provider
A. Administer glucagon IM
RATIONALE: For an unresponsive client with hypoglycemia, oral intake is contraindicated
due to aspiration risk. Glucagon IM or IV dextrose is the appropriate emergency treatment.
8. A client is prescribed warfarin. Which laboratory value should the PN monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
, A. INR
RATIONALE: Warfarin therapy is monitored with the INR (International Normalized Ratio).
Therapeutic INR for most indications is 2.0-3.0.
9. A client with a new colostomy is being taught about ostomy care. Which statement
indicates understanding?
A. "I should change the pouch every day."
B. "I should cut the wafer to fit snugly around the stoma."
C. "I should use alcohol to clean the stoma."
D. "I should avoid eating any foods with fiber."
B. "I should cut the wafer to fit snugly around the stoma."
RATIONALE: The wafer must be cut to fit snugly around the stoma to prevent skin irritation
and leakage. Pouches are typically changed every 3-7 days. Alcohol should not be used on the
stoma. Fiber is gradually reintroduced.
10. A nurse is caring for a client with a suspected pulmonary embolism. Which finding is most
consistent with this diagnosis?
A. Sudden onset of dyspnea and pleuritic chest pain
B. Productive cough with green sputum
C. Bradycardia and hypertension
D. Gradual onset of fatigue
A. Sudden onset of dyspnea and pleuritic chest pain
RATIONALE: Pulmonary embolism typically presents with sudden dyspnea, pleuritic chest
pain, tachycardia, and hypoxemia.
11. A client with bipolar disorder is experiencing a manic episode. Which intervention should
the PN prioritize?
A. Provide a stimulating environment to redirect energy
B. Ensure a safe, low-stimulation environment
C. Encourage the client to take on leadership roles in group therapy
D. Allow the client to skip meals to reduce caloric intake
B. Ensure a safe, low-stimulation environment
RATIONALE: During mania, the priority is safety. A low-stimulation environment reduces
anxiety and prevents overstimulation. The client needs adequate nutrition and rest.
