PN Comprehensive Predictor
2026 with NGN
180 Questions and Answers
Actual Retake Edition
Next Generation NCLEX (NGN) Integrated
180
Verified Questions
9
Client Need Domains
6
NGN Cognitive Operations
Exam Format: Single-best-answer multiple choice (A-D) with NGN case studies
Cognitive Mix: 30% recall, 50% application, 20% analysis
Style: 80% scenario-based clinical judgment; 20% direct recall with calculation
integration
NGN Integration: Six clinical judgment operations: Recognize Cues, Analyze Cues, Prioritize
Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes
Blueprint: Management of Care, Safety, Health Promotion, Psychosocial Integrity, Basic
Care, Pharmacology, Risk Reduction, Physiological Adaptation, NGN Case
Studies
This examination booklet contains 180 verified questions and detailed rationales aligned with the
2026 PN Comprehensive Predictor blueprint, integrating Next Generation NCLEX (NGN) clinical
judgment measurement model items. Content covers practical nursing scope of practice,
delegation, prioritization (ABC, Maslow, Safety, Least Restrictive), infection control, medication
administration with dosage calculations, maternal-newborn and pediatric nursing, mental health,
,medical-surgical nursing across all body systems, fluid and electrolyte balance, laboratory value
interpretation, and NGN case studies requiring multi-step clinical reasoning. Distractors reflect
common PN Predictor candidate errors: incorrect prioritization, hyper/hypokalemia confusion,
isolation precaution misapplication, improper delegation, and selecting "call the provider" when
independent nursing action is required.
,PN Comprehensive Predictor 2026 with NGN - 180 Questions and Answers Page 3
Table of Contents
Section 1: Management of Care | Advocacy, Delegation, Prioritization, Continuity of
Care, & Legal/Ethical Issues | Q1-Q25 (25 questions)
Section 2: Safety and Infection Control | Precautions, Injury Prevention, Emergency
Response, & Safe Practice | Q26-Q45 (20 questions)
Section 3: Health Promotion and Maintenance | Developmental Stages,
Maternal-Newborn, & Health Screening | Q46-Q65 (20 questions)
Section 4: Psychosocial Integrity | Therapeutic Communication, Coping, Grief, Mental
Health, & Crisis Intervention | Q66-Q85 (20 questions)
Section 5: Basic Care and Comfort | Mobility, Nutrition, Elimination, Hygiene,
Rest/Sleep, & Pain Management | Q86-Q105 (20 questions)
Section 6: Pharmacological and Parenteral Therapies | Medication Administration,
Dosage Calculation, IV Therapy, & Adverse Effects | Q106-Q130 (25 questions)
Section 7: Reduction of Risk Potential | Diagnostic Tests, Lab Values, Vital Signs, &
Complication Prevention | Q131-Q150 (20 questions)
Section 8: Physiological Adaptation | Medical-Surgical, Fluid/Electrolytes, & Medical
Emergencies | Q151-Q168 (18 questions)
Section 9: NGN Case Studies and Clinical Judgment | Recognizing Cues, Analyzing Cues,
Prioritizing Hypotheses, Generating Solutions, Taking Action, & Evaluating Outcomes |
Q169-Q180 (12 questions)
How to use this booklet: Attempt each question before reading the rationale. Rationales explain
why the correct answer is right and why each distractor is wrong, with NGN clinical judgment
reasoning, safety considerations, prioritization frameworks, and test-taking strategy. Section 9
(Q169-180) contains NGN case studies integrating the six cognitive operations of the NGN Clinical
Judgment Measurement Model.
Practical Nursing | Next Generation NCLEX (NGN) Integrated 180 Questions - Complete Exam
, PN Comprehensive Predictor 2026 with NGN - 180 Questions and Answers Page 4
Section 1: Management of Care
Advocacy, Delegation, Prioritization, Continuity of Care, & Legal/Ethical Issues
Q1. An LPN/LVN on a med-surg unit is caring for four clients. Which client should the LPN
assess FIRST after receiving handoff report?
A. A client 2 days post-op hip replacement who is requesting pain medication
B. A client with chronic heart failure reporting new onset dyspnea and a hacky cough
[CORRECT]
C. A client with type 2 diabetes scheduled for a fasting blood glucose in 2 hours
D. A client receiving IV antibiotics for cellulitis with a temperature of 99.2F
Correct Answer: B
Rationale:
Using the ABC priority framework, the client with new-onset dyspnea is the highest priority because
respiratory distress may signal pulmonary edema or fluid overload in heart failure and could rapidly
progress to respiratory failure. The LPN must assess this client first and notify the RN. Pain medication
(Q1A) is important but not life-threatening; the fasting glucose (Q1C) is a scheduled task; the low-grade
fever (Q1D) is expected with cellulitis and not urgent.
Q2. An LPN is working with an experienced unlicensed assistive personnel (UAP). Which
task is MOST appropriate to delegate to the UAP?
A. Reinforcing teaching about a low-sodium diet for a client with heart failure
B. Measuring and recording intake and output for a client with kidney injury
[CORRECT]
C. Assessing a surgical wound for signs of infection
D. Administering an oral analgesic to a stable postoperative client
Correct Answer: B
Rationale:
Measuring intake and output is a routine, non-invasive task within the UAP scope; the LPN remains
responsible for interpreting the data and reporting abnormalities. Reinforcing teaching (Q2A) requires
nursing knowledge and is an LPN task, not UAP; wound assessment (Q2C) is a nursing assessment that
cannot be delegated; medication administration (Q2D) is outside the UAP scope and requires nursing
judgment. The Five Rights of Delegation: right task, right circumstance, right person, right
communication, right supervision.
Q3. A client with terminal cancer refuses a prescribed blood transfusion, stating 'I want to
die naturally.' The LPN's BEST action is to:
A. Administer the transfusion because the provider ordered it
B. Document the refusal, notify the RN/provider, and explore the client's reasons and
beliefs [CORRECT]
C. Have the family convince the client to accept the transfusion
D. Administer half the transfusion to honor the order partially
Practical Nursing | Next Generation NCLEX (NGN) Integrated 180 Questions - Complete Exam
2026 with NGN
180 Questions and Answers
Actual Retake Edition
Next Generation NCLEX (NGN) Integrated
180
Verified Questions
9
Client Need Domains
6
NGN Cognitive Operations
Exam Format: Single-best-answer multiple choice (A-D) with NGN case studies
Cognitive Mix: 30% recall, 50% application, 20% analysis
Style: 80% scenario-based clinical judgment; 20% direct recall with calculation
integration
NGN Integration: Six clinical judgment operations: Recognize Cues, Analyze Cues, Prioritize
Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes
Blueprint: Management of Care, Safety, Health Promotion, Psychosocial Integrity, Basic
Care, Pharmacology, Risk Reduction, Physiological Adaptation, NGN Case
Studies
This examination booklet contains 180 verified questions and detailed rationales aligned with the
2026 PN Comprehensive Predictor blueprint, integrating Next Generation NCLEX (NGN) clinical
judgment measurement model items. Content covers practical nursing scope of practice,
delegation, prioritization (ABC, Maslow, Safety, Least Restrictive), infection control, medication
administration with dosage calculations, maternal-newborn and pediatric nursing, mental health,
,medical-surgical nursing across all body systems, fluid and electrolyte balance, laboratory value
interpretation, and NGN case studies requiring multi-step clinical reasoning. Distractors reflect
common PN Predictor candidate errors: incorrect prioritization, hyper/hypokalemia confusion,
isolation precaution misapplication, improper delegation, and selecting "call the provider" when
independent nursing action is required.
,PN Comprehensive Predictor 2026 with NGN - 180 Questions and Answers Page 3
Table of Contents
Section 1: Management of Care | Advocacy, Delegation, Prioritization, Continuity of
Care, & Legal/Ethical Issues | Q1-Q25 (25 questions)
Section 2: Safety and Infection Control | Precautions, Injury Prevention, Emergency
Response, & Safe Practice | Q26-Q45 (20 questions)
Section 3: Health Promotion and Maintenance | Developmental Stages,
Maternal-Newborn, & Health Screening | Q46-Q65 (20 questions)
Section 4: Psychosocial Integrity | Therapeutic Communication, Coping, Grief, Mental
Health, & Crisis Intervention | Q66-Q85 (20 questions)
Section 5: Basic Care and Comfort | Mobility, Nutrition, Elimination, Hygiene,
Rest/Sleep, & Pain Management | Q86-Q105 (20 questions)
Section 6: Pharmacological and Parenteral Therapies | Medication Administration,
Dosage Calculation, IV Therapy, & Adverse Effects | Q106-Q130 (25 questions)
Section 7: Reduction of Risk Potential | Diagnostic Tests, Lab Values, Vital Signs, &
Complication Prevention | Q131-Q150 (20 questions)
Section 8: Physiological Adaptation | Medical-Surgical, Fluid/Electrolytes, & Medical
Emergencies | Q151-Q168 (18 questions)
Section 9: NGN Case Studies and Clinical Judgment | Recognizing Cues, Analyzing Cues,
Prioritizing Hypotheses, Generating Solutions, Taking Action, & Evaluating Outcomes |
Q169-Q180 (12 questions)
How to use this booklet: Attempt each question before reading the rationale. Rationales explain
why the correct answer is right and why each distractor is wrong, with NGN clinical judgment
reasoning, safety considerations, prioritization frameworks, and test-taking strategy. Section 9
(Q169-180) contains NGN case studies integrating the six cognitive operations of the NGN Clinical
Judgment Measurement Model.
Practical Nursing | Next Generation NCLEX (NGN) Integrated 180 Questions - Complete Exam
, PN Comprehensive Predictor 2026 with NGN - 180 Questions and Answers Page 4
Section 1: Management of Care
Advocacy, Delegation, Prioritization, Continuity of Care, & Legal/Ethical Issues
Q1. An LPN/LVN on a med-surg unit is caring for four clients. Which client should the LPN
assess FIRST after receiving handoff report?
A. A client 2 days post-op hip replacement who is requesting pain medication
B. A client with chronic heart failure reporting new onset dyspnea and a hacky cough
[CORRECT]
C. A client with type 2 diabetes scheduled for a fasting blood glucose in 2 hours
D. A client receiving IV antibiotics for cellulitis with a temperature of 99.2F
Correct Answer: B
Rationale:
Using the ABC priority framework, the client with new-onset dyspnea is the highest priority because
respiratory distress may signal pulmonary edema or fluid overload in heart failure and could rapidly
progress to respiratory failure. The LPN must assess this client first and notify the RN. Pain medication
(Q1A) is important but not life-threatening; the fasting glucose (Q1C) is a scheduled task; the low-grade
fever (Q1D) is expected with cellulitis and not urgent.
Q2. An LPN is working with an experienced unlicensed assistive personnel (UAP). Which
task is MOST appropriate to delegate to the UAP?
A. Reinforcing teaching about a low-sodium diet for a client with heart failure
B. Measuring and recording intake and output for a client with kidney injury
[CORRECT]
C. Assessing a surgical wound for signs of infection
D. Administering an oral analgesic to a stable postoperative client
Correct Answer: B
Rationale:
Measuring intake and output is a routine, non-invasive task within the UAP scope; the LPN remains
responsible for interpreting the data and reporting abnormalities. Reinforcing teaching (Q2A) requires
nursing knowledge and is an LPN task, not UAP; wound assessment (Q2C) is a nursing assessment that
cannot be delegated; medication administration (Q2D) is outside the UAP scope and requires nursing
judgment. The Five Rights of Delegation: right task, right circumstance, right person, right
communication, right supervision.
Q3. A client with terminal cancer refuses a prescribed blood transfusion, stating 'I want to
die naturally.' The LPN's BEST action is to:
A. Administer the transfusion because the provider ordered it
B. Document the refusal, notify the RN/provider, and explore the client's reasons and
beliefs [CORRECT]
C. Have the family convince the client to accept the transfusion
D. Administer half the transfusion to honor the order partially
Practical Nursing | Next Generation NCLEX (NGN) Integrated 180 Questions - Complete Exam
