NCLEX-PN PRACTICE EXAM • 2026–2027
NCLEX-PN
COMPREHENSIVE EXAM
• 180 Original Practice Questions
Exam focus Practical Nurse Licensure Preparation
Question format Multiple-choice clinical and safety scenarios
Included Answer key and concise rationales
Design update Soft lavender page theme with plum and teal accents
INTRODUCTION
This practice paper supports review of practical-nursing knowledge, clinical judgment, patient safety, communication, and
foundational care. These are original study questions—not actual, recalled, or officially verified NCLEX-PN examination
items.
HOW TO USE THIS PAPER
• Answer each question before checking the answer key.
• Review rationales for both correct and incorrect choices.
• Mark topics that need further study and revisit current course materials and official candidate guidance.
• Follow facility policy, scope-of-practice requirements, and current clinical guidance when applying concepts.
CONTENT AREAS
Safety and infection prevention • Pharmacology and medication safety • Basic care and comfort • Health promotion •
Psychosocial care • Physiological adaptation • Clinical judgment and communication
Original practice material | Page 1
, NCLEX-PN PRACTICE EXAM • 2026–2027
1. Which action should the practical nurse take first when a client suddenly reports shortness of breath?
A. Offer water
B. Assess respiratory status and oxygen saturation
C. Document the complaint
D. Help the client walk
2. A client has a new prescription for an opioid analgesic. Which assessment is most important before administration?
A. Bowel sounds only
B. Respiratory rate and level of alertness
C. Hair and skin texture
D. Last eye examination
3. Which finding should be reported promptly in a client receiving an anticoagulant?
A. Mild thirst
B. New black, tarry stool
C. Occasional sneezing
D. Dry elbows
4. A nurse is preparing to administer medication. The client says, 'That pill looks different.' What is the best response?
A. Tell the client it is probably fine
B. Recheck the medication order and medication package before giving it
C. Ask the client to take it and report problems
D. Skip documentation
5. Which action best reduces the risk of transmitting infection between clients?
A. Wearing the same gloves for the whole shift
B. Performing hand hygiene at the appropriate moments
C. Using antibiotics for every fever
D. Keeping room doors closed
6. A client with diabetes is shaky, sweaty, and confused. Which problem should the nurse suspect first?
A. Hypoglycemia
B. Hypercalcemia
C. Constipation
D. Fluid overload
7. Which position usually helps a client who is experiencing difficulty breathing?
A. Flat supine
B. High Fowler's, if tolerated
C. Trendelenburg
D. Prone with face down
8. A client has a temperature of 39.2°C (102.6°F). Which action is appropriate?
A. Assess the client and report according to facility protocol
B. Ignore the reading if the client is resting
C. Apply ice directly to the skin
D. Restrict all fluids automatically
9. Which finding is most concerning after a client returns from surgery?
A. Mild incisional discomfort
B. Urine output of 10 mL over the last hour
C. Request for a blanket
D. Sleepiness after prescribed analgesia
10. When transferring a weak client from bed to chair, what should the nurse do?
A. Pull the client by the arms
B. Use safe body mechanics and prescribed assistive devices
C. Twist at the waist
D. Ask the client to hold the nurse's neck
Original practice material | Page 2
, NCLEX-PN PRACTICE EXAM • 2026–2027
11. A client has difficulty swallowing tablets. What should the nurse do?
A. Crush every tablet
B. Check the medication formulation and consult the prescriber/pharmacist as needed
C. Hide the tablet in food without asking
D. Tell the client to swallow quickly
12. Which action is appropriate when obtaining a blood pressure?
A. Use a cuff that is too small
B. Support the arm at heart level and use the correct cuff size
C. Measure over thick clothing
D. Have the client talk continuously
13. A client on bed rest is at risk for pressure injury. Which intervention is most appropriate?
A. Reposition according to the care plan and inspect the skin
B. Massage reddened bony areas vigorously
C. Keep damp linens in place
D. Limit protein without an order
14. Which finding may indicate dehydration in an older adult?
A. Moist mucous membranes and stable weight
B. New confusion with reduced urine output
C. Increased tears
D. Frequent clear urine with no symptoms
15. A client reports chest pressure with nausea and sweating. What should the nurse do?
A. Encourage a brisk walk
B. Promptly assess and activate the facility's emergency response as indicated
C. Offer a large meal
D. Wait until the next routine round
16. Which statement by a client taking antibiotics indicates understanding?
A. I will stop as soon as I feel better
B. I will take the medication as prescribed and ask what to do if I miss a dose
C. I will share leftover tablets
D. I will double the next dose after a missed dose
17. A client is placed on contact precautions. Which practice is generally appropriate?
A. Use required gown and gloves according to policy
B. Share equipment without cleaning
C. Remove precautions when visitors arrive
D. Skip hand hygiene if gloves were worn
18. Which is the best way to confirm a client's identity before medication administration?
A. Ask the room number
B. Use two approved identifiers and compare them with the MAR
C. Ask another client
D. Recognize the client's face only
19. A client who has been vomiting is at risk for which imbalance?
A. Fluid and electrolyte imbalance
B. Excessive bone growth
C. Improved oxygenation
D. Reduced infection risk
20. Which action demonstrates therapeutic communication?
A. Interrupting to give advice
B. Using an open-ended question and listening attentively
C. Changing the subject when emotions arise
D. Making promises that everything will be fine
Original practice material | Page 3
NCLEX-PN
COMPREHENSIVE EXAM
• 180 Original Practice Questions
Exam focus Practical Nurse Licensure Preparation
Question format Multiple-choice clinical and safety scenarios
Included Answer key and concise rationales
Design update Soft lavender page theme with plum and teal accents
INTRODUCTION
This practice paper supports review of practical-nursing knowledge, clinical judgment, patient safety, communication, and
foundational care. These are original study questions—not actual, recalled, or officially verified NCLEX-PN examination
items.
HOW TO USE THIS PAPER
• Answer each question before checking the answer key.
• Review rationales for both correct and incorrect choices.
• Mark topics that need further study and revisit current course materials and official candidate guidance.
• Follow facility policy, scope-of-practice requirements, and current clinical guidance when applying concepts.
CONTENT AREAS
Safety and infection prevention • Pharmacology and medication safety • Basic care and comfort • Health promotion •
Psychosocial care • Physiological adaptation • Clinical judgment and communication
Original practice material | Page 1
, NCLEX-PN PRACTICE EXAM • 2026–2027
1. Which action should the practical nurse take first when a client suddenly reports shortness of breath?
A. Offer water
B. Assess respiratory status and oxygen saturation
C. Document the complaint
D. Help the client walk
2. A client has a new prescription for an opioid analgesic. Which assessment is most important before administration?
A. Bowel sounds only
B. Respiratory rate and level of alertness
C. Hair and skin texture
D. Last eye examination
3. Which finding should be reported promptly in a client receiving an anticoagulant?
A. Mild thirst
B. New black, tarry stool
C. Occasional sneezing
D. Dry elbows
4. A nurse is preparing to administer medication. The client says, 'That pill looks different.' What is the best response?
A. Tell the client it is probably fine
B. Recheck the medication order and medication package before giving it
C. Ask the client to take it and report problems
D. Skip documentation
5. Which action best reduces the risk of transmitting infection between clients?
A. Wearing the same gloves for the whole shift
B. Performing hand hygiene at the appropriate moments
C. Using antibiotics for every fever
D. Keeping room doors closed
6. A client with diabetes is shaky, sweaty, and confused. Which problem should the nurse suspect first?
A. Hypoglycemia
B. Hypercalcemia
C. Constipation
D. Fluid overload
7. Which position usually helps a client who is experiencing difficulty breathing?
A. Flat supine
B. High Fowler's, if tolerated
C. Trendelenburg
D. Prone with face down
8. A client has a temperature of 39.2°C (102.6°F). Which action is appropriate?
A. Assess the client and report according to facility protocol
B. Ignore the reading if the client is resting
C. Apply ice directly to the skin
D. Restrict all fluids automatically
9. Which finding is most concerning after a client returns from surgery?
A. Mild incisional discomfort
B. Urine output of 10 mL over the last hour
C. Request for a blanket
D. Sleepiness after prescribed analgesia
10. When transferring a weak client from bed to chair, what should the nurse do?
A. Pull the client by the arms
B. Use safe body mechanics and prescribed assistive devices
C. Twist at the waist
D. Ask the client to hold the nurse's neck
Original practice material | Page 2
, NCLEX-PN PRACTICE EXAM • 2026–2027
11. A client has difficulty swallowing tablets. What should the nurse do?
A. Crush every tablet
B. Check the medication formulation and consult the prescriber/pharmacist as needed
C. Hide the tablet in food without asking
D. Tell the client to swallow quickly
12. Which action is appropriate when obtaining a blood pressure?
A. Use a cuff that is too small
B. Support the arm at heart level and use the correct cuff size
C. Measure over thick clothing
D. Have the client talk continuously
13. A client on bed rest is at risk for pressure injury. Which intervention is most appropriate?
A. Reposition according to the care plan and inspect the skin
B. Massage reddened bony areas vigorously
C. Keep damp linens in place
D. Limit protein without an order
14. Which finding may indicate dehydration in an older adult?
A. Moist mucous membranes and stable weight
B. New confusion with reduced urine output
C. Increased tears
D. Frequent clear urine with no symptoms
15. A client reports chest pressure with nausea and sweating. What should the nurse do?
A. Encourage a brisk walk
B. Promptly assess and activate the facility's emergency response as indicated
C. Offer a large meal
D. Wait until the next routine round
16. Which statement by a client taking antibiotics indicates understanding?
A. I will stop as soon as I feel better
B. I will take the medication as prescribed and ask what to do if I miss a dose
C. I will share leftover tablets
D. I will double the next dose after a missed dose
17. A client is placed on contact precautions. Which practice is generally appropriate?
A. Use required gown and gloves according to policy
B. Share equipment without cleaning
C. Remove precautions when visitors arrive
D. Skip hand hygiene if gloves were worn
18. Which is the best way to confirm a client's identity before medication administration?
A. Ask the room number
B. Use two approved identifiers and compare them with the MAR
C. Ask another client
D. Recognize the client's face only
19. A client who has been vomiting is at risk for which imbalance?
A. Fluid and electrolyte imbalance
B. Excessive bone growth
C. Improved oxygenation
D. Reduced infection risk
20. Which action demonstrates therapeutic communication?
A. Interrupting to give advice
B. Using an open-ended question and listening attentively
C. Changing the subject when emotions arise
D. Making promises that everything will be fine
Original practice material | Page 3
