NCLEX-PN Comprehensive Practice
Examination: Questions with Answers and
Rationales
**1. A client with a new diagnosis of type 1 diabetes is being discharged. Which statement by the client indicates a need for further teaching
regarding the disposal of sharps?**
A. "I will throw the used syringes in a sealed coffee can."
B. "I should use a heavy-duty plastic container for my needles."
C. "It is best to place the container in a designated biohazard area."
D. "I must not recap the needles before disposal."
,**Answer: A**
**Rationale:** Used syringes and needles should be placed in a puncture-resistant, leak-proof container (e.g., a heavy-duty plastic detergent
bottle). It is unsafe to use a container that needles can easily puncture, like a coffee can. Options B, C, and D are correct safety measures.
**2. The PN is caring for four clients. Which client should the PN assess first?**
A. A client with a new colostomy who is anxious about stoma care.
B. A client with a hip fracture who is in balanced traction and complaining of severe pain in the operative leg.
C. A client with pneumonia who has an oxygen saturation of 92% on room air.
D. A client scheduled for discharge who needs to review medication instructions.
**Answer: B**
**Rationale:** The client in traction with severe pain in the operative leg may be experiencing compartment syndrome or neurovascular
compromise. This is a potential emergency and must be assessed first. The other clients have stable needs that can be addressed later.
**3. A client is being admitted to a medical-surgical unit. The PN is delegating tasks to the unlicensed assistive personnel (UAP). Which task is
appropriate to delegate to the UAP?**
A. Assess the client's skin condition for breakdown.
B. Teach the client about the new medication they will be starting.
C. Assist the client with ambulation using a gait belt.
,D. Evaluate the effectiveness of the client's pain medication.
**Answer: C**
**Rationale:** UAPs are trained to perform tasks of daily living, including ambulation with a gait belt. Assessment, teaching, and evaluation
are nursing responsibilities that cannot be delegated.
**4. The client has a prescription for a continuous enteral feeding. The PN notes that the feeding bag is empty and the next bag is not
available. Which action is most appropriate?**
A. Flush the feeding tube with water and hold the feeding until the next bag arrives.
B. Fill the bag with a different formula that is available on the unit.
C. Administer the feeding via a syringe bolus to prevent a delay in nutrition.
D. Call the pharmacy or dietary department to request the correct formula immediately.
**Answer: D**
**Rationale:** The nurse should ensure continuity of care by contacting the appropriate department to obtain the prescribed formula. Using a
different formula (B) is unsafe. Holding the feeding (A) for a long period could cause hypoglycemia. A bolus (C) is not appropriate unless
prescribed.
**5. The PN is providing a shift report to the oncoming nurse. Which client information is most important to communicate?**
A. The client in room 208 who is requesting a sleeping pill.
, B. The client in room 210 who has a family member at the bedside.
C. The client in room 212 whose chest tube drainage has suddenly increased to 200 mL in the last hour.
D. The client in room 214 who needs a breakfast tray ordered for the morning.
**Answer: C**
**Rationale:** A sudden increase in chest tube drainage is a significant clinical change that may indicate hemorrhage. This is an urgent finding
that must be communicated clearly during the handoff report. The other options are routine or non-urgent.
**6. A client is scheduled for an intravenous pyelogram (IVP). Which finding is most important to report to the healthcare provider before the
procedure?**
A. The client reports a history of hives after eating shellfish.
B. The client's blood pressure is 132/84 mmHg.
C. The client reports a mild headache.
D. The client's pulse is 88 bpm.
**Answer: A**
**Rationale:** An IVP uses a contrast dye that contains iodine. A history of allergy to shellfish increases the risk of an anaphylactic reaction to
the dye. This is a critical finding that requires immediate reporting. The other vital signs are within normal limits.
**7. The PN observes a UAP applying a dry gauze dressing to a client's stage 2 pressure injury. What should the PN do?**
Examination: Questions with Answers and
Rationales
**1. A client with a new diagnosis of type 1 diabetes is being discharged. Which statement by the client indicates a need for further teaching
regarding the disposal of sharps?**
A. "I will throw the used syringes in a sealed coffee can."
B. "I should use a heavy-duty plastic container for my needles."
C. "It is best to place the container in a designated biohazard area."
D. "I must not recap the needles before disposal."
,**Answer: A**
**Rationale:** Used syringes and needles should be placed in a puncture-resistant, leak-proof container (e.g., a heavy-duty plastic detergent
bottle). It is unsafe to use a container that needles can easily puncture, like a coffee can. Options B, C, and D are correct safety measures.
**2. The PN is caring for four clients. Which client should the PN assess first?**
A. A client with a new colostomy who is anxious about stoma care.
B. A client with a hip fracture who is in balanced traction and complaining of severe pain in the operative leg.
C. A client with pneumonia who has an oxygen saturation of 92% on room air.
D. A client scheduled for discharge who needs to review medication instructions.
**Answer: B**
**Rationale:** The client in traction with severe pain in the operative leg may be experiencing compartment syndrome or neurovascular
compromise. This is a potential emergency and must be assessed first. The other clients have stable needs that can be addressed later.
**3. A client is being admitted to a medical-surgical unit. The PN is delegating tasks to the unlicensed assistive personnel (UAP). Which task is
appropriate to delegate to the UAP?**
A. Assess the client's skin condition for breakdown.
B. Teach the client about the new medication they will be starting.
C. Assist the client with ambulation using a gait belt.
,D. Evaluate the effectiveness of the client's pain medication.
**Answer: C**
**Rationale:** UAPs are trained to perform tasks of daily living, including ambulation with a gait belt. Assessment, teaching, and evaluation
are nursing responsibilities that cannot be delegated.
**4. The client has a prescription for a continuous enteral feeding. The PN notes that the feeding bag is empty and the next bag is not
available. Which action is most appropriate?**
A. Flush the feeding tube with water and hold the feeding until the next bag arrives.
B. Fill the bag with a different formula that is available on the unit.
C. Administer the feeding via a syringe bolus to prevent a delay in nutrition.
D. Call the pharmacy or dietary department to request the correct formula immediately.
**Answer: D**
**Rationale:** The nurse should ensure continuity of care by contacting the appropriate department to obtain the prescribed formula. Using a
different formula (B) is unsafe. Holding the feeding (A) for a long period could cause hypoglycemia. A bolus (C) is not appropriate unless
prescribed.
**5. The PN is providing a shift report to the oncoming nurse. Which client information is most important to communicate?**
A. The client in room 208 who is requesting a sleeping pill.
, B. The client in room 210 who has a family member at the bedside.
C. The client in room 212 whose chest tube drainage has suddenly increased to 200 mL in the last hour.
D. The client in room 214 who needs a breakfast tray ordered for the morning.
**Answer: C**
**Rationale:** A sudden increase in chest tube drainage is a significant clinical change that may indicate hemorrhage. This is an urgent finding
that must be communicated clearly during the handoff report. The other options are routine or non-urgent.
**6. A client is scheduled for an intravenous pyelogram (IVP). Which finding is most important to report to the healthcare provider before the
procedure?**
A. The client reports a history of hives after eating shellfish.
B. The client's blood pressure is 132/84 mmHg.
C. The client reports a mild headache.
D. The client's pulse is 88 bpm.
**Answer: A**
**Rationale:** An IVP uses a contrast dye that contains iodine. A history of allergy to shellfish increases the risk of an anaphylactic reaction to
the dye. This is a critical finding that requires immediate reporting. The other vital signs are within normal limits.
**7. The PN observes a UAP applying a dry gauze dressing to a client's stage 2 pressure injury. What should the PN do?**
