SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — Clinical Judgment and the NGN-PN®
Examination — Recognizing Cues & Prioritization
Stem: During an NGN practice case, a PN candidate notes a
client’s increased respiratory rate, decreased SpO₂, and new
restlessness. Which action best demonstrates the PN’s priority
clinical judgment in the scenario as assessed by NGN-style
items?
A. Document findings and continue routine monitoring every 4
hours.
B. Elevate the head of the bed and apply oxygen per standing
,protocol while preparing to notify the RN.
C. Call the provider immediately to request an arterial blood gas
(ABG).
D. Offer the client a drink and encourage deep breathing
exercises.
Correct Answer: B
Rationale — Correct: Elevating the head of the bed and
initiating oxygen per standing protocol are immediate, safety-
focused nursing actions that address hypoxia and are within PN
responsibilities; notifying the RN follows appropriately. This
aligns with NGN emphasis on recognizing cues and initiating
timely interventions.
Rationale — A (incorrect): Waiting to document and only
monitor is unsafe given signs of respiratory compromise.
Rationale — C (incorrect): Requesting an ABG is a provider
action and not the immediate priority over basic oxygenation
measures.
Rationale — D (incorrect): Encouraging fluids and breathing
exercises alone are inadequate for hypoxia and delay necessary
interventions.
Teaching Point: Prioritize airway/oxygenation interventions
first; escalate after immediate measures.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
,2
Reference: Ch. 1 — Pyramid to Success — Preparation & Test-
Day Routine
Stem: A PN candidate has an early morning exam and reports
poor sleep the night before. Which action from the Pyramid to
Success best supports performance and aligns with
recommended pre-test behavior?
A. Skip breakfast to avoid nausea and save time.
B. Arrive at the testing center 15–30 minutes early with
required identification.
C. Bring study notes to review in the waiting area immediately
before testing.
D. Request to reschedule only if feeling physically ill.
Correct Answer: B
Rationale — Correct: Arriving early with proper identification
reduces pre-test stress and allows time for check-in
procedures—practical test-day preparation recommended in
exam guidance.
Rationale — A (incorrect): Skipping breakfast can impair
concentration; light nutrition is advised.
Rationale — C (incorrect): Testing centers prohibit study
materials; reviewing in waiting area is typically not allowed and
increases anxiety.
Rationale — D (incorrect): Rescheduling is an option but
, unnecessary for a single poor night of sleep; following routine
arrival procedures is appropriate.
Teaching Point: Arrive early with required ID; avoid last-minute
studying at the center.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
3
Reference: Ch. 1 — Clinical Judgment and NGN Items —
Prioritizing Responses
Stem: An NGN case presents four cues: hypotension, confusion,
decreased urine output, and cool extremities. Which
observation should the PN report first to the supervising RN?
A. Confusion.
B. Cool extremities.
C. Decreased urine output.
D. Hypotension.
Correct Answer: D
Rationale — Correct: Hypotension indicates immediate
perfusion compromise and is the highest priority cue to report;
reporting it allows prompt collaborative intervention.
Rationale — A (incorrect): Confusion is important but may be
secondary to perfusion changes caused by hypotension.
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — Clinical Judgment and the NGN-PN®
Examination — Recognizing Cues & Prioritization
Stem: During an NGN practice case, a PN candidate notes a
client’s increased respiratory rate, decreased SpO₂, and new
restlessness. Which action best demonstrates the PN’s priority
clinical judgment in the scenario as assessed by NGN-style
items?
A. Document findings and continue routine monitoring every 4
hours.
B. Elevate the head of the bed and apply oxygen per standing
,protocol while preparing to notify the RN.
C. Call the provider immediately to request an arterial blood gas
(ABG).
D. Offer the client a drink and encourage deep breathing
exercises.
Correct Answer: B
Rationale — Correct: Elevating the head of the bed and
initiating oxygen per standing protocol are immediate, safety-
focused nursing actions that address hypoxia and are within PN
responsibilities; notifying the RN follows appropriately. This
aligns with NGN emphasis on recognizing cues and initiating
timely interventions.
Rationale — A (incorrect): Waiting to document and only
monitor is unsafe given signs of respiratory compromise.
Rationale — C (incorrect): Requesting an ABG is a provider
action and not the immediate priority over basic oxygenation
measures.
Rationale — D (incorrect): Encouraging fluids and breathing
exercises alone are inadequate for hypoxia and delay necessary
interventions.
Teaching Point: Prioritize airway/oxygenation interventions
first; escalate after immediate measures.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
,2
Reference: Ch. 1 — Pyramid to Success — Preparation & Test-
Day Routine
Stem: A PN candidate has an early morning exam and reports
poor sleep the night before. Which action from the Pyramid to
Success best supports performance and aligns with
recommended pre-test behavior?
A. Skip breakfast to avoid nausea and save time.
B. Arrive at the testing center 15–30 minutes early with
required identification.
C. Bring study notes to review in the waiting area immediately
before testing.
D. Request to reschedule only if feeling physically ill.
Correct Answer: B
Rationale — Correct: Arriving early with proper identification
reduces pre-test stress and allows time for check-in
procedures—practical test-day preparation recommended in
exam guidance.
Rationale — A (incorrect): Skipping breakfast can impair
concentration; light nutrition is advised.
Rationale — C (incorrect): Testing centers prohibit study
materials; reviewing in waiting area is typically not allowed and
increases anxiety.
Rationale — D (incorrect): Rescheduling is an option but
, unnecessary for a single poor night of sleep; following routine
arrival procedures is appropriate.
Teaching Point: Arrive early with required ID; avoid last-minute
studying at the center.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
3
Reference: Ch. 1 — Clinical Judgment and NGN Items —
Prioritizing Responses
Stem: An NGN case presents four cues: hypotension, confusion,
decreased urine output, and cool extremities. Which
observation should the PN report first to the supervising RN?
A. Confusion.
B. Cool extremities.
C. Decreased urine output.
D. Hypotension.
Correct Answer: D
Rationale — Correct: Hypotension indicates immediate
perfusion compromise and is the highest priority cue to report;
reporting it allows prompt collaborative intervention.
Rationale — A (incorrect): Confusion is important but may be
secondary to perfusion changes caused by hypotension.
