NCLEX-PN 2026 Practical Nurse Exam
with Rationales 2026/2027 – Complete
Exam-Style Questions | 100% Verified |
Detailed Rationales – Pass Guaranteed –
A+ Graded
1. A LPN is assisting with the care of a client prescribed warfarin. Which
laboratory value is most important to report to the RN?
A) INR 2.5
B) INR 4.2
C) Platelets 250,000
D) Hemoglobin 12 g/dL
Rationale: Therapeutic INR for most indications is 2–3. INR 4.2 increases bleeding
risk significantly. Report immediately.
2. A client falls in the hallway. What is the LPN’s priority action?
A) Fill out an incident report
B) Assess the client for injury
C) Call the nursing supervisor
D) Help the client back to bed
Rationale: Client safety first – assess for injury. Incident report is completed later.
3. Which assignment can the LPN accept?
A) Initial assessment of a new admission
B) Administration of routine oral meds to stable clients
C) IV push chemotherapy
D) Teaching a diabetic client insulin injection
,Rationale: LPN can give routine PO meds to stable clients. Initial assessments,
chemo, and teaching are RN scope in many states.
4. A client on contact precautions for C. diff. Which hand hygiene is correct?
A) Alcohol-based hand rub
B) Soap and water
C) Hand sanitizer twice
D) Gloves only
Rationale: C. diff spores are not killed by alcohol. Soap and water with friction
required.
5. Client with active TB is placed in which type of precautions?
A) Contact
B) Droplet
C) Airborne
D) Protective
Rationale: Airborne precautions – N95 mask, negative pressure room.
6. A confused client has a vest restraint. How often must restraint be released?
A) Every 30 minutes
B) Every 2 hours
C) Every 4 hours
D) Every shift
Rationale: CMS guidelines – restraint release and ROM q2h for adults.
7. A client refuses a prescribed enema. What should the LPN do?
A) Give it anyway
B) Respect refusal and notify RN
C) Ask family to convince them
D) Document as “refused” only
Rationale: Client has right to refuse. Notify RN for further assessment.
,8. Which finding indicates a fire in a trash can? RACE acronym – first
action?
A) Extinguish
B) Rescue
C) Alarm
D) Contain
Rationale: RACE – Rescue (move clients in immediate danger), Alarm, Contain,
Extinguish.
9. LPN observes RN preparing a med from a multidose vial with a
contaminated needle. What action?
A) Ignore it
B) Report to charge nurse
C) Tell the patient
D) Dispose of vial quietly
Rationale: Report immediately – patient safety and infection control breach.
10. A client’s IV site is red, swollen, warm. Likely complication?
A) Infiltration
B) Phlebitis
C) Air embolism
D) Extravasation
Rationale: Redness, warmth, swelling = phlebitis (vein inflammation).
11. Which task is appropriate for an LPN to delegate to a UAP?
A) Catheter care
B) Ambulation of a stable post-op client
C) Feeding a client with dysphagia
D) First dressing change
Rationale: UAP can ambulate stable clients. Dysphagia feeding requires skilled
assessment.
, 12. Client with a living will has cardiac arrest. What should staff do?
A) Withhold all care
B) Initiate CPR unless DNR is signed
C) Call family for decision
D) Only give oxygen
Rationale: Living will guides long-term care; CPR unless DNR order written.
13. Which client is most at risk for a fall?
A) 30-year-old with ankle sprain
B) 80-year-old on furosemide and lorazepam
C) 50-year-old post-op day 3
D) 20-year-old migraine
Rationale: Elderly, diuretics (orthostasis), and benzodiazepines (sedation)
increase fall risk.
14. Client with HIV – which personal item can be shared?
A) Toothbrush
B) Telephone
C) Razor
D) Nail clippers
Rationale: Telephone is safe – no blood or mucosa exposure. Toothbrushes/razors
can transmit blood.
15. LPN overhears two staff discussing a client in the elevator. Best action?
A) Join the conversation
B) Remind them of HIPAA and stop the discussion
C) Report to security
D) Walk away
Rationale: HIPAA violation – correct in private.
16. Which is an example of battery in nursing?
A) Telling a client they cannot leave
with Rationales 2026/2027 – Complete
Exam-Style Questions | 100% Verified |
Detailed Rationales – Pass Guaranteed –
A+ Graded
1. A LPN is assisting with the care of a client prescribed warfarin. Which
laboratory value is most important to report to the RN?
A) INR 2.5
B) INR 4.2
C) Platelets 250,000
D) Hemoglobin 12 g/dL
Rationale: Therapeutic INR for most indications is 2–3. INR 4.2 increases bleeding
risk significantly. Report immediately.
2. A client falls in the hallway. What is the LPN’s priority action?
A) Fill out an incident report
B) Assess the client for injury
C) Call the nursing supervisor
D) Help the client back to bed
Rationale: Client safety first – assess for injury. Incident report is completed later.
3. Which assignment can the LPN accept?
A) Initial assessment of a new admission
B) Administration of routine oral meds to stable clients
C) IV push chemotherapy
D) Teaching a diabetic client insulin injection
,Rationale: LPN can give routine PO meds to stable clients. Initial assessments,
chemo, and teaching are RN scope in many states.
4. A client on contact precautions for C. diff. Which hand hygiene is correct?
A) Alcohol-based hand rub
B) Soap and water
C) Hand sanitizer twice
D) Gloves only
Rationale: C. diff spores are not killed by alcohol. Soap and water with friction
required.
5. Client with active TB is placed in which type of precautions?
A) Contact
B) Droplet
C) Airborne
D) Protective
Rationale: Airborne precautions – N95 mask, negative pressure room.
6. A confused client has a vest restraint. How often must restraint be released?
A) Every 30 minutes
B) Every 2 hours
C) Every 4 hours
D) Every shift
Rationale: CMS guidelines – restraint release and ROM q2h for adults.
7. A client refuses a prescribed enema. What should the LPN do?
A) Give it anyway
B) Respect refusal and notify RN
C) Ask family to convince them
D) Document as “refused” only
Rationale: Client has right to refuse. Notify RN for further assessment.
,8. Which finding indicates a fire in a trash can? RACE acronym – first
action?
A) Extinguish
B) Rescue
C) Alarm
D) Contain
Rationale: RACE – Rescue (move clients in immediate danger), Alarm, Contain,
Extinguish.
9. LPN observes RN preparing a med from a multidose vial with a
contaminated needle. What action?
A) Ignore it
B) Report to charge nurse
C) Tell the patient
D) Dispose of vial quietly
Rationale: Report immediately – patient safety and infection control breach.
10. A client’s IV site is red, swollen, warm. Likely complication?
A) Infiltration
B) Phlebitis
C) Air embolism
D) Extravasation
Rationale: Redness, warmth, swelling = phlebitis (vein inflammation).
11. Which task is appropriate for an LPN to delegate to a UAP?
A) Catheter care
B) Ambulation of a stable post-op client
C) Feeding a client with dysphagia
D) First dressing change
Rationale: UAP can ambulate stable clients. Dysphagia feeding requires skilled
assessment.
, 12. Client with a living will has cardiac arrest. What should staff do?
A) Withhold all care
B) Initiate CPR unless DNR is signed
C) Call family for decision
D) Only give oxygen
Rationale: Living will guides long-term care; CPR unless DNR order written.
13. Which client is most at risk for a fall?
A) 30-year-old with ankle sprain
B) 80-year-old on furosemide and lorazepam
C) 50-year-old post-op day 3
D) 20-year-old migraine
Rationale: Elderly, diuretics (orthostasis), and benzodiazepines (sedation)
increase fall risk.
14. Client with HIV – which personal item can be shared?
A) Toothbrush
B) Telephone
C) Razor
D) Nail clippers
Rationale: Telephone is safe – no blood or mucosa exposure. Toothbrushes/razors
can transmit blood.
15. LPN overhears two staff discussing a client in the elevator. Best action?
A) Join the conversation
B) Remind them of HIPAA and stop the discussion
C) Report to security
D) Walk away
Rationale: HIPAA violation – correct in private.
16. Which is an example of battery in nursing?
A) Telling a client they cannot leave
