KAPLAN NCLEX-PN DIAGNOSTIC EXAM PRACTICE | COMPREHENSIVE STUDY GUIDE
| TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION | LATEST
UPDATE 2026/2027
i. Management of Care and Prioritization — Questions 1–5
ii. Safety, Infection Prevention, and Control — Questions 6–9
iii. Pharmacological and Parenteral Therapies — Questions 10–14
iv. Physiological Adaptation and Clinical Judgment — Questions 15–20
v. Psychosocial Integrity and Basic Care — Questions 21–24
vi. Maternal-Newborn and Pediatric Nursing — Questions 25–27
vii. Reduction of Risk Potential and Integrated Clinical Judgment — Questions 28–30
INTRODUCTION
This Kaplan NCLEX-PN Diagnostic Exam Practice set is designed as an advanced study
resource for evaluating clinical judgment, prioritization, safety, pharmacology,
physiological adaptation, psychosocial care, maternal-newborn nursing, pediatrics, and
risk reduction. The questions emphasize application rather than simple recall and
require the learner to identify the most appropriate nursing action in realistic clinical
situations. Students should expect competing priorities, subtle changes in patient
condition, medication-safety decisions, delegation considerations, and situations
requiring recognition of deterioration. The difficulty is intentionally rigorous to support
advanced preparation while remaining aligned with practical nursing scope,
contemporary nursing principles, and the clinical-judgment emphasis of the current
NCLEX-PN framework.
QUESTION 1
A practical nurse is beginning a shift and receives report on four clients. Which client
should the nurse assess first?
A. A client with heart failure who has gained 2 lb (0.9 kg) since yesterday and reports
needing two pillows at night
B. A client with diabetes mellitus whose premeal glucose is 238 mg/dL (13.2 mmol/L)
and who requests correctional insulin
C. A client 24 hours after abdominal surgery who reports incisional pain rated 7/10
despite receiving prescribed analgesia
D. A client with chronic obstructive pulmonary disease whose oxygen saturation
decreased from 94% to 91% while ambulating
,🔴 Correct Answer: A. A client with heart failure who has gained 2 lb (0.9 kg) since
yesterday and reports needing two pillows at night.
🔵 Explanation: Rapid weight gain accompanied by orthopnea suggests worsening fluid
retention and possible acute heart-failure exacerbation. This client has the greatest
immediate risk for pulmonary edema and impaired oxygenation. The other findings
require attention but are less immediately concerning.
QUESTION 2
A practical nurse is caring for four clients. Which task is most appropriate to delegate
to unlicensed assistive personnel (UAP)?
A. Reinforce teaching about incentive-spirometer use for a postoperative client
B. Obtain routine vital signs for a stable client awaiting discharge
C. Evaluate whether a newly prescribed antihypertensive is controlling blood pressure
D. Assess a client who reports new-onset dizziness after receiving medication
🔴 Correct Answer: B. Obtain routine vital signs for a stable client awaiting
discharge.
🔵 Explanation: Routine data collection for a stable client is appropriate for UAP when
the task is within facility policy and the UAP is competent. Teaching, assessment,
evaluation, and clinical judgment remain nursing responsibilities.
QUESTION 3
A client with suspected sepsis has a temperature of 39.2°C (102.6°F), heart rate
128/min, respiratory rate 30/min, blood pressure 86/50 mm Hg, and new confusion.
Which intervention has the highest priority?
A. Administer the prescribed broad-spectrum antimicrobial therapy
B. Obtain a complete dietary history
C. Encourage oral fluids
D. Place the client in a quiet environment
🔴 Correct Answer: A. Administer the prescribed broad-spectrum antimicrobial
therapy.
🔵 Explanation: This client has findings consistent with severe systemic infection and
circulatory compromise. Timely antimicrobial therapy is a critical component of sepsis
management and should not be unnecessarily delayed. Hypotension and altered mental
status indicate significant physiological deterioration.
,QUESTION 4
A practical nurse is reviewing discharge instructions with a client prescribed warfarin.
Which statement by the client requires the most immediate follow-up?
A. “I will keep my intake of leafy green vegetables reasonably consistent.”
B. “I will use a soft toothbrush.”
C. “If my knee hurts, I will take ibuprofen before calling the clinic.”
D. “I will report black, tarry stools.”
🔴 Correct Answer: C. “If my knee hurts, I will take ibuprofen before calling the
clinic.”
🔵 Explanation: NSAIDs such as ibuprofen can increase bleeding risk when combined
with warfarin. The client should consult the healthcare team before taking medications
that may potentiate anticoagulation or gastrointestinal bleeding.
QUESTION 5
A client with chronic kidney disease has a potassium level of 6.4 mEq/L (6.4 mmol/L).
Which finding requires the nurse's immediate attention?
A. Generalized muscle weakness
B. Anorexia
C. Pruritus
D. Fatigue
🔴 Correct Answer: A. Generalized muscle weakness.
🔵 Explanation: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias
and neuromuscular abnormalities. Muscle weakness may accompany significant
potassium elevation and requires immediate assessment and intervention, including
cardiac monitoring as indicated.
QUESTION 6
A client with suspected pulmonary tuberculosis is admitted to the unit. Which
infection-control intervention is most appropriate?
A. Place the client in a negative-pressure airborne infection isolation room
B. Place the client in a private room and use contact precautions
C. Require only a surgical mask for healthcare personnel entering the room
D. Keep the room door open to improve ventilation
, 🔴 Correct Answer: A. Place the client in a negative-pressure airborne infection
isolation room.
🔵 Explanation: Suspected pulmonary tuberculosis requires airborne precautions. A
negative-pressure room and appropriate respiratory protection help prevent transmission
of infectious airborne particles.
QUESTION 7
A practical nurse sustains a needlestick injury while administering an injection. What
should the nurse do first?
A. Complete an incident report
B. Wash the affected area with soap and water
C. Notify the client that an exposure occurred
D. Wait until the end of the shift for occupational-health evaluation
🔴 Correct Answer: B. Wash the affected area with soap and water.
🔵 Explanation: Immediate cleansing of the exposure site is the first action following a
needlestick. The exposure should then be promptly reported and evaluated according to
occupational-exposure protocols.
QUESTION 8
A client receiving chemotherapy has an absolute neutrophil count of 400/mm³. Which
nursing action is most appropriate?
A. Encourage visitors with mild respiratory symptoms to wear masks
B. Avoid fresh flowers and plants in the client's environment
C. Serve raw fruits and vegetables without additional precautions
D. Encourage the client to attend crowded communal activities
🔴 Correct Answer: B. Avoid fresh flowers and plants in the client's environment.
🔵 Explanation: Severe neutropenia creates a high risk for infection. Soil, standing water,
flowers, and plants can harbor microorganisms and may be restricted according to
institutional neutropenic-care practices.
QUESTION 9
A client develops profuse diarrhea after several days of antibiotic therapy. The
healthcare provider suspects Clostridioides difficile infection. Which action is most
appropriate?
| TESTBANK | PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION | LATEST
UPDATE 2026/2027
i. Management of Care and Prioritization — Questions 1–5
ii. Safety, Infection Prevention, and Control — Questions 6–9
iii. Pharmacological and Parenteral Therapies — Questions 10–14
iv. Physiological Adaptation and Clinical Judgment — Questions 15–20
v. Psychosocial Integrity and Basic Care — Questions 21–24
vi. Maternal-Newborn and Pediatric Nursing — Questions 25–27
vii. Reduction of Risk Potential and Integrated Clinical Judgment — Questions 28–30
INTRODUCTION
This Kaplan NCLEX-PN Diagnostic Exam Practice set is designed as an advanced study
resource for evaluating clinical judgment, prioritization, safety, pharmacology,
physiological adaptation, psychosocial care, maternal-newborn nursing, pediatrics, and
risk reduction. The questions emphasize application rather than simple recall and
require the learner to identify the most appropriate nursing action in realistic clinical
situations. Students should expect competing priorities, subtle changes in patient
condition, medication-safety decisions, delegation considerations, and situations
requiring recognition of deterioration. The difficulty is intentionally rigorous to support
advanced preparation while remaining aligned with practical nursing scope,
contemporary nursing principles, and the clinical-judgment emphasis of the current
NCLEX-PN framework.
QUESTION 1
A practical nurse is beginning a shift and receives report on four clients. Which client
should the nurse assess first?
A. A client with heart failure who has gained 2 lb (0.9 kg) since yesterday and reports
needing two pillows at night
B. A client with diabetes mellitus whose premeal glucose is 238 mg/dL (13.2 mmol/L)
and who requests correctional insulin
C. A client 24 hours after abdominal surgery who reports incisional pain rated 7/10
despite receiving prescribed analgesia
D. A client with chronic obstructive pulmonary disease whose oxygen saturation
decreased from 94% to 91% while ambulating
,🔴 Correct Answer: A. A client with heart failure who has gained 2 lb (0.9 kg) since
yesterday and reports needing two pillows at night.
🔵 Explanation: Rapid weight gain accompanied by orthopnea suggests worsening fluid
retention and possible acute heart-failure exacerbation. This client has the greatest
immediate risk for pulmonary edema and impaired oxygenation. The other findings
require attention but are less immediately concerning.
QUESTION 2
A practical nurse is caring for four clients. Which task is most appropriate to delegate
to unlicensed assistive personnel (UAP)?
A. Reinforce teaching about incentive-spirometer use for a postoperative client
B. Obtain routine vital signs for a stable client awaiting discharge
C. Evaluate whether a newly prescribed antihypertensive is controlling blood pressure
D. Assess a client who reports new-onset dizziness after receiving medication
🔴 Correct Answer: B. Obtain routine vital signs for a stable client awaiting
discharge.
🔵 Explanation: Routine data collection for a stable client is appropriate for UAP when
the task is within facility policy and the UAP is competent. Teaching, assessment,
evaluation, and clinical judgment remain nursing responsibilities.
QUESTION 3
A client with suspected sepsis has a temperature of 39.2°C (102.6°F), heart rate
128/min, respiratory rate 30/min, blood pressure 86/50 mm Hg, and new confusion.
Which intervention has the highest priority?
A. Administer the prescribed broad-spectrum antimicrobial therapy
B. Obtain a complete dietary history
C. Encourage oral fluids
D. Place the client in a quiet environment
🔴 Correct Answer: A. Administer the prescribed broad-spectrum antimicrobial
therapy.
🔵 Explanation: This client has findings consistent with severe systemic infection and
circulatory compromise. Timely antimicrobial therapy is a critical component of sepsis
management and should not be unnecessarily delayed. Hypotension and altered mental
status indicate significant physiological deterioration.
,QUESTION 4
A practical nurse is reviewing discharge instructions with a client prescribed warfarin.
Which statement by the client requires the most immediate follow-up?
A. “I will keep my intake of leafy green vegetables reasonably consistent.”
B. “I will use a soft toothbrush.”
C. “If my knee hurts, I will take ibuprofen before calling the clinic.”
D. “I will report black, tarry stools.”
🔴 Correct Answer: C. “If my knee hurts, I will take ibuprofen before calling the
clinic.”
🔵 Explanation: NSAIDs such as ibuprofen can increase bleeding risk when combined
with warfarin. The client should consult the healthcare team before taking medications
that may potentiate anticoagulation or gastrointestinal bleeding.
QUESTION 5
A client with chronic kidney disease has a potassium level of 6.4 mEq/L (6.4 mmol/L).
Which finding requires the nurse's immediate attention?
A. Generalized muscle weakness
B. Anorexia
C. Pruritus
D. Fatigue
🔴 Correct Answer: A. Generalized muscle weakness.
🔵 Explanation: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias
and neuromuscular abnormalities. Muscle weakness may accompany significant
potassium elevation and requires immediate assessment and intervention, including
cardiac monitoring as indicated.
QUESTION 6
A client with suspected pulmonary tuberculosis is admitted to the unit. Which
infection-control intervention is most appropriate?
A. Place the client in a negative-pressure airborne infection isolation room
B. Place the client in a private room and use contact precautions
C. Require only a surgical mask for healthcare personnel entering the room
D. Keep the room door open to improve ventilation
, 🔴 Correct Answer: A. Place the client in a negative-pressure airborne infection
isolation room.
🔵 Explanation: Suspected pulmonary tuberculosis requires airborne precautions. A
negative-pressure room and appropriate respiratory protection help prevent transmission
of infectious airborne particles.
QUESTION 7
A practical nurse sustains a needlestick injury while administering an injection. What
should the nurse do first?
A. Complete an incident report
B. Wash the affected area with soap and water
C. Notify the client that an exposure occurred
D. Wait until the end of the shift for occupational-health evaluation
🔴 Correct Answer: B. Wash the affected area with soap and water.
🔵 Explanation: Immediate cleansing of the exposure site is the first action following a
needlestick. The exposure should then be promptly reported and evaluated according to
occupational-exposure protocols.
QUESTION 8
A client receiving chemotherapy has an absolute neutrophil count of 400/mm³. Which
nursing action is most appropriate?
A. Encourage visitors with mild respiratory symptoms to wear masks
B. Avoid fresh flowers and plants in the client's environment
C. Serve raw fruits and vegetables without additional precautions
D. Encourage the client to attend crowded communal activities
🔴 Correct Answer: B. Avoid fresh flowers and plants in the client's environment.
🔵 Explanation: Severe neutropenia creates a high risk for infection. Soil, standing water,
flowers, and plants can harbor microorganisms and may be restricted according to
institutional neutropenic-care practices.
QUESTION 9
A client develops profuse diarrhea after several days of antibiotic therapy. The
healthcare provider suspects Clostridioides difficile infection. Which action is most
appropriate?
