KAPLAN NCLEX-PN EXAM PRACTICE | COMPREHENSIVE STUDY GUIDE | ADVANCED
TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION | LATEST
UPDATE 2026/2027
I. Clinical Judgment and Prioritization
II. Pharmacology and Medication Safety
III. Adult Medical-Surgical Nursing
IV. Maternal-Newborn and Pediatric Nursing
V. Mental Health and Therapeutic Communication
VI. Infection Prevention and Safety
VII. Delegation, Ethics, Documentation, and Professional Practice
VIII. Emergency and Complex-Care Decision Making
INTRODUCTION
This advanced Kaplan NCLEX-PN practice set is designed to strengthen clinical
judgment, prioritization, pharmacology, safety, communication, and application of
nursing principles at the practical/vocational nursing level. The questions emphasize
realistic patient situations requiring the learner to identify immediate risks, interpret
clinical findings, recognize deterioration, select appropriate nursing actions, and
distinguish expected findings from complications. Students should expect challenging
scenarios involving medication administration, delegation, infection control, maternal-
child nursing, mental health, chronic disease management, and emergency care. The
emphasis is on applying nursing knowledge rather than recalling isolated facts. These
questions are intended for study and preparation and are not actual NCLEX-PN
examination questions.
QUESTION 1
A practical nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with heart failure who has 2+ bilateral ankle edema and reports a 1-kg
weight gain over 3 days.
B. A client with pneumonia whose temperature is 38.1°C (100.6°F) and who requests
acetaminophen.
C. A client who received morphine 30 minutes ago and is difficult to arouse with a
respiratory rate of 8/min.
D. A client with diabetes whose premeal glucose is 14 mmol/L (252 mg/dL).
,🔴 Correct Answer: C. A client who received morphine 30 minutes ago and is
difficult to arouse with a respiratory rate of 8/min.
🔵 Explanation: The client has signs of opioid-induced respiratory depression, which is an
immediate airway and breathing threat. The nurse should rapidly assess respiratory
status and initiate appropriate emergency interventions according to protocol. The other
findings require attention but are not as immediately life-threatening.
QUESTION 2
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. The client becomes increasingly somnolent, and the respiratory rate
decreases from 18/min to 10/min. Which action should the practical nurse take first?
A. Increase the oxygen flow rate.
B. Assess respiratory status and notify the registered nurse/provider promptly.
C. Place the client in a supine position.
D. Encourage the client to drink fluids.
🔴 Correct Answer: B. Assess respiratory status and notify the registered
nurse/provider promptly.
🔵 Explanation: New somnolence and decreasing respiratory rate indicate possible
respiratory deterioration. The nurse should immediately assess airway, breathing,
oxygenation, and level of consciousness and escalate care. Increasing oxygen without
assessing the cause may worsen hypercapnia in susceptible clients and does not address
hypoventilation.
QUESTION 3
A client taking warfarin reports several new findings. Which finding requires the most
immediate follow-up?
A. Occasional mild bruising on the forearms.
B. INR within the prescribed therapeutic range.
C. Black, tarry stools for the past day.
D. Mild gum bleeding after vigorous tooth brushing.
🔴 Correct Answer: C. Black, tarry stools for the past day.
🔵 Explanation: Black, tarry stools may indicate gastrointestinal bleeding and require
prompt evaluation in a client receiving anticoagulation therapy. Although minor bruising
or gum bleeding may occur, melena can indicate significant internal bleeding and
requires immediate assessment.
,QUESTION 4
A practical nurse is preparing to administer insulin to a client with diabetes. The client is
awake but reports shakiness, diaphoresis, and weakness. The blood glucose level is 3.0
mmol/L (54 mg/dL). What should the nurse do first?
A. Administer the scheduled rapid-acting insulin.
B. Give an appropriate rapid-acting source of glucose.
C. Administer the client's long-acting insulin.
D. Encourage the client to ambulate.
🔴 Correct Answer: B. Give an appropriate rapid-acting source of glucose.
🔵 Explanation: The client is symptomatic with hypoglycemia. An alert client who can
safely swallow should receive a rapidly absorbed carbohydrate, followed by reassessment
according to protocol. Insulin would further lower the blood glucose and could cause
severe neurologic complications.
QUESTION 5
A client with a suspected stroke suddenly develops facial drooping and difficulty
speaking. The client's symptoms began approximately 30 minutes ago. Which
information is most important for the nurse to obtain?
A. The client's usual dietary pattern.
B. The client's last known well time.
C. The client's history of seasonal allergies.
D. The client's preferred method of communication.
🔴 Correct Answer: B. The client's last known well time.
🔵 Explanation: Determining the last known well time is critical when evaluating a
possible acute stroke because eligibility for time-sensitive interventions depends partly on
when symptoms began or when the client was last known to be neurologically normal.
QUESTION 6
A client receiving furosemide reports muscle weakness and palpitations. Which
laboratory result should concern the practical nurse most?
A. Sodium 138 mEq/L.
B. Potassium 2.8 mEq/L.
C. Calcium 9.2 mg/dL.
D. Glucose 98 mg/dL.
, 🔴 Correct Answer: B. Potassium 2.8 mEq/L.
🔵 Explanation: Furosemide can cause potassium loss. A potassium level of 2.8 mEq/L
represents significant hypokalemia and, combined with weakness and palpitations,
increases the risk for potentially dangerous cardiac dysrhythmias.
QUESTION 7
A client receiving a blood transfusion develops chills, low back pain, dyspnea, and fever
shortly after the transfusion begins. Which action should the practical nurse take first?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer the next prescribed dose of an antipyretic.
D. Flush the blood tubing with the remaining blood product.
🔴 Correct Answer: B. Stop the transfusion immediately.
🔵 Explanation: The symptoms may indicate an acute transfusion reaction. The blood
product must be stopped immediately, and the nurse should maintain appropriate
intravenous access using compatible solution according to institutional protocol while
notifying the appropriate personnel and following the transfusion-reaction procedure.
QUESTION 8
A client with heart failure suddenly develops severe dyspnea, pink frothy sputum, and
diffuse crackles. Which intervention is the priority?
A. Place the client in a high-Fowler position and initiate urgent respiratory assessment.
B. Encourage the client to drink additional fluids.
C. Place the client flat and elevate the legs.
D. Provide a high-sodium snack.
🔴 Correct Answer: A. Place the client in a high-Fowler position and initiate urgent
respiratory assessment.
🔵 Explanation: Pink frothy sputum and severe dyspnea are classic warning signs of
acute pulmonary edema. Positioning upright promotes lung expansion and decreases
venous return, while immediate assessment and escalation of care are necessary because
respiratory failure can develop rapidly.
QUESTION 9
A client prescribed digoxin has an apical pulse of 52/min before medication
administration. What should the practical nurse do?
TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION | LATEST
UPDATE 2026/2027
I. Clinical Judgment and Prioritization
II. Pharmacology and Medication Safety
III. Adult Medical-Surgical Nursing
IV. Maternal-Newborn and Pediatric Nursing
V. Mental Health and Therapeutic Communication
VI. Infection Prevention and Safety
VII. Delegation, Ethics, Documentation, and Professional Practice
VIII. Emergency and Complex-Care Decision Making
INTRODUCTION
This advanced Kaplan NCLEX-PN practice set is designed to strengthen clinical
judgment, prioritization, pharmacology, safety, communication, and application of
nursing principles at the practical/vocational nursing level. The questions emphasize
realistic patient situations requiring the learner to identify immediate risks, interpret
clinical findings, recognize deterioration, select appropriate nursing actions, and
distinguish expected findings from complications. Students should expect challenging
scenarios involving medication administration, delegation, infection control, maternal-
child nursing, mental health, chronic disease management, and emergency care. The
emphasis is on applying nursing knowledge rather than recalling isolated facts. These
questions are intended for study and preparation and are not actual NCLEX-PN
examination questions.
QUESTION 1
A practical nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with heart failure who has 2+ bilateral ankle edema and reports a 1-kg
weight gain over 3 days.
B. A client with pneumonia whose temperature is 38.1°C (100.6°F) and who requests
acetaminophen.
C. A client who received morphine 30 minutes ago and is difficult to arouse with a
respiratory rate of 8/min.
D. A client with diabetes whose premeal glucose is 14 mmol/L (252 mg/dL).
,🔴 Correct Answer: C. A client who received morphine 30 minutes ago and is
difficult to arouse with a respiratory rate of 8/min.
🔵 Explanation: The client has signs of opioid-induced respiratory depression, which is an
immediate airway and breathing threat. The nurse should rapidly assess respiratory
status and initiate appropriate emergency interventions according to protocol. The other
findings require attention but are not as immediately life-threatening.
QUESTION 2
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. The client becomes increasingly somnolent, and the respiratory rate
decreases from 18/min to 10/min. Which action should the practical nurse take first?
A. Increase the oxygen flow rate.
B. Assess respiratory status and notify the registered nurse/provider promptly.
C. Place the client in a supine position.
D. Encourage the client to drink fluids.
🔴 Correct Answer: B. Assess respiratory status and notify the registered
nurse/provider promptly.
🔵 Explanation: New somnolence and decreasing respiratory rate indicate possible
respiratory deterioration. The nurse should immediately assess airway, breathing,
oxygenation, and level of consciousness and escalate care. Increasing oxygen without
assessing the cause may worsen hypercapnia in susceptible clients and does not address
hypoventilation.
QUESTION 3
A client taking warfarin reports several new findings. Which finding requires the most
immediate follow-up?
A. Occasional mild bruising on the forearms.
B. INR within the prescribed therapeutic range.
C. Black, tarry stools for the past day.
D. Mild gum bleeding after vigorous tooth brushing.
🔴 Correct Answer: C. Black, tarry stools for the past day.
🔵 Explanation: Black, tarry stools may indicate gastrointestinal bleeding and require
prompt evaluation in a client receiving anticoagulation therapy. Although minor bruising
or gum bleeding may occur, melena can indicate significant internal bleeding and
requires immediate assessment.
,QUESTION 4
A practical nurse is preparing to administer insulin to a client with diabetes. The client is
awake but reports shakiness, diaphoresis, and weakness. The blood glucose level is 3.0
mmol/L (54 mg/dL). What should the nurse do first?
A. Administer the scheduled rapid-acting insulin.
B. Give an appropriate rapid-acting source of glucose.
C. Administer the client's long-acting insulin.
D. Encourage the client to ambulate.
🔴 Correct Answer: B. Give an appropriate rapid-acting source of glucose.
🔵 Explanation: The client is symptomatic with hypoglycemia. An alert client who can
safely swallow should receive a rapidly absorbed carbohydrate, followed by reassessment
according to protocol. Insulin would further lower the blood glucose and could cause
severe neurologic complications.
QUESTION 5
A client with a suspected stroke suddenly develops facial drooping and difficulty
speaking. The client's symptoms began approximately 30 minutes ago. Which
information is most important for the nurse to obtain?
A. The client's usual dietary pattern.
B. The client's last known well time.
C. The client's history of seasonal allergies.
D. The client's preferred method of communication.
🔴 Correct Answer: B. The client's last known well time.
🔵 Explanation: Determining the last known well time is critical when evaluating a
possible acute stroke because eligibility for time-sensitive interventions depends partly on
when symptoms began or when the client was last known to be neurologically normal.
QUESTION 6
A client receiving furosemide reports muscle weakness and palpitations. Which
laboratory result should concern the practical nurse most?
A. Sodium 138 mEq/L.
B. Potassium 2.8 mEq/L.
C. Calcium 9.2 mg/dL.
D. Glucose 98 mg/dL.
, 🔴 Correct Answer: B. Potassium 2.8 mEq/L.
🔵 Explanation: Furosemide can cause potassium loss. A potassium level of 2.8 mEq/L
represents significant hypokalemia and, combined with weakness and palpitations,
increases the risk for potentially dangerous cardiac dysrhythmias.
QUESTION 7
A client receiving a blood transfusion develops chills, low back pain, dyspnea, and fever
shortly after the transfusion begins. Which action should the practical nurse take first?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer the next prescribed dose of an antipyretic.
D. Flush the blood tubing with the remaining blood product.
🔴 Correct Answer: B. Stop the transfusion immediately.
🔵 Explanation: The symptoms may indicate an acute transfusion reaction. The blood
product must be stopped immediately, and the nurse should maintain appropriate
intravenous access using compatible solution according to institutional protocol while
notifying the appropriate personnel and following the transfusion-reaction procedure.
QUESTION 8
A client with heart failure suddenly develops severe dyspnea, pink frothy sputum, and
diffuse crackles. Which intervention is the priority?
A. Place the client in a high-Fowler position and initiate urgent respiratory assessment.
B. Encourage the client to drink additional fluids.
C. Place the client flat and elevate the legs.
D. Provide a high-sodium snack.
🔴 Correct Answer: A. Place the client in a high-Fowler position and initiate urgent
respiratory assessment.
🔵 Explanation: Pink frothy sputum and severe dyspnea are classic warning signs of
acute pulmonary edema. Positioning upright promotes lung expansion and decreases
venous return, while immediate assessment and escalation of care are necessary because
respiratory failure can develop rapidly.
QUESTION 9
A client prescribed digoxin has an apical pulse of 52/min before medication
administration. What should the practical nurse do?
