KAPLAN NCLEX-PN READINESS EXAM PRACTICE | COMPREHENSIVE STUDY GUIDE |
TESTBANK | ADVANCED PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION |
LATEST UPDATE 2026/2027
I. Management of Care and Prioritization
II. Safety and Infection Prevention and Control
III. Pharmacological and Parenteral Therapies
IV. Physiological Adaptation and Clinical Judgment
V. Reduction of Risk Potential
VI. Psychosocial Integrity and Mental Health
VII. Health Promotion and Maintenance
VIII. Basic Care, Comfort, and Professional Practice
INTRODUCTION
This comprehensive Kaplan NCLEX-PN readiness practice set is designed to strengthen
clinical judgment, prioritization, safety, pharmacological reasoning, and application of
practical nursing principles. The questions emphasize realistic patient scenarios
requiring analysis rather than simple memorization. Coverage reflects major NCLEX-PN
client-needs areas, including management of care, safety and infection control,
pharmacological therapies, physiological adaptation, psychosocial integrity, health
promotion, and risk reduction. Students should expect increasingly complex situations
involving changes in patient status, competing priorities, delegation, medication safety,
therapeutic communication, and evidence-based nursing interventions. The material is
intended for advanced preparation and should be used to identify knowledge gaps,
improve decision-making under pressure, and reinforce principles needed for safe
entry-level practical nursing practice.
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 gained 1.5 kg (3.3 lb) over the past 24 hours and
reports increasing ankle edema
B. A client with pneumonia whose temperature is 38.3°C (100.9°F) and who requests
acetaminophen
C. A client with diabetes whose premeal blood glucose is 68 mg/dL (3.8 mmol/L) and
who is awake and able to swallow
,D. A client receiving chemotherapy who reports nausea 30 minutes after receiving an
antiemetic
🔴 Correct Answer: C. A client with diabetes whose premeal blood glucose is 68
mg/dL (3.8 mmol/L) and who is awake and able to swallow.
🔵 Explanation: A blood glucose below 70 mg/dL indicates hypoglycemia and requires
prompt treatment to prevent neurological deterioration. Because the client is awake and
can swallow, a rapidly absorbed carbohydrate should be provided according to facility
protocol. The other clients require attention but do not have the same immediate risk of
deterioration.
Question 2
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. The client becomes increasingly drowsy and difficult to arouse.
Respirations are 8/min and shallow. Which action should the practical nurse take first?
A. Increase the oxygen flow rate to 6 L/min
B. Assess the client's respiratory status and immediately notify the registered nurse
C. Place the client in a supine position
D. Administer the next prescribed bronchodilator
🔴 Correct Answer: B. Assess the client's respiratory status and immediately notify
the registered nurse.
🔵 Explanation: Bradypnea, shallow respirations, and decreased level of consciousness
indicate potentially life-threatening respiratory compromise. The nurse should rapidly
assess airway and breathing while obtaining appropriate assistance. Increasing oxygen
independently does not correct hypoventilation and may be inappropriate for some
clients with chronic carbon dioxide retention.
Question 3
A client receiving a continuous heparin infusion develops sudden severe headache,
vomiting, and decreased level of consciousness. Which action has the highest priority?
A. Stop the infusion and immediately notify the registered nurse and provider
according to protocol
B. Administer the next prescribed dose of warfarin
C. Place the client in Trendelenburg position
D. Reassure the family that headache is an expected adverse effect
,🔴 Correct Answer: A. Stop the infusion and immediately notify the registered nurse
and provider according to protocol.
🔵 Explanation: Sudden severe headache, vomiting, and neurological deterioration in a
client receiving anticoagulation may indicate intracranial bleeding. Heparin should be
stopped when serious bleeding is suspected, and emergency evaluation is required.
Continuing anticoagulation could worsen potentially life-threatening hemorrhage.
Question 4
A client with a new tracheostomy becomes restless and develops noisy respirations.
The pulse oximeter decreases from 96% to 86%. Which intervention should the
practical nurse perform first?
A. Remove the tracheostomy tube
B. Assess the tracheostomy for obstruction and suction as indicated
C. Give the client oral fluids
D. Place the client flat in bed
🔴 Correct Answer: B. Assess the tracheostomy for obstruction and suction as
indicated.
🔵 Explanation: Restlessness, noisy respirations, and declining oxygen saturation suggest
airway obstruction. A newly placed tracheostomy is particularly vulnerable to obstruction
from secretions. The nurse should assess airway patency and suction according to clinical
indications and facility procedure.
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 most immediate intervention?
A. Generalized muscle weakness
B. Dependent edema
C. Peaked T waves on the electrocardiogram
D. Decreased appetite
🔴 Correct Answer: C. Peaked T waves on the electrocardiogram.
🔵 Explanation: Severe hyperkalemia can cause dangerous cardiac conduction
abnormalities and dysrhythmias. Peaked T waves are a classic electrocardiographic
manifestation and indicate an immediate risk to cardiac stability. Muscle weakness is also
concerning, but the ECG change signals potentially imminent cardiovascular compromise.
, Question 6
A client taking warfarin has an international normalized ratio (INR) of 5.8. The client has
no active bleeding. Which action should the practical nurse anticipate?
A. Administer the scheduled warfarin dose
B. Hold the medication and notify the registered nurse or provider
C. Administer aspirin to prevent thrombosis
D. Encourage foods high in vitamin K immediately
🔴 Correct Answer: B. Hold the medication and notify the registered nurse or
provider.
🔵 Explanation: An INR of 5.8 represents excessive anticoagulation and substantially
increases bleeding risk. The scheduled warfarin dose should not be administered until the
treatment plan is clarified. Vitamin K therapy may be considered depending on the INR,
bleeding status, and provider orders.
Question 7
A client with suspected sepsis has a temperature of 39.4°C (102.9°F), heart rate
128/min, respiratory rate 30/min, blood pressure 84/48 mm Hg, and altered mental
status. Which finding is the strongest indication that the client's condition has
progressed to a life-threatening state?
A. Temperature of 39.4°C
B. Heart rate of 128/min
C. Blood pressure of 84/48 mm Hg with altered mental status
D. Respiratory rate of 30/min
🔴 Correct Answer: C. Blood pressure of 84/48 mm Hg with altered mental status.
🔵 Explanation: Hypotension accompanied by altered mental status indicates inadequate
tissue perfusion and possible septic shock. Although fever, tachycardia, and tachypnea are
important manifestations of infection and systemic response, circulatory failure with
neurological changes represents a more immediate threat to life.
Question 8
A practical nurse is reinforcing discharge teaching for a client prescribed prednisone for
several weeks. Which statement by the client indicates a need for further teaching?
TESTBANK | ADVANCED PRACTICE QUESTIONS & ANSWERS | EXAM PREPARATION |
LATEST UPDATE 2026/2027
I. Management of Care and Prioritization
II. Safety and Infection Prevention and Control
III. Pharmacological and Parenteral Therapies
IV. Physiological Adaptation and Clinical Judgment
V. Reduction of Risk Potential
VI. Psychosocial Integrity and Mental Health
VII. Health Promotion and Maintenance
VIII. Basic Care, Comfort, and Professional Practice
INTRODUCTION
This comprehensive Kaplan NCLEX-PN readiness practice set is designed to strengthen
clinical judgment, prioritization, safety, pharmacological reasoning, and application of
practical nursing principles. The questions emphasize realistic patient scenarios
requiring analysis rather than simple memorization. Coverage reflects major NCLEX-PN
client-needs areas, including management of care, safety and infection control,
pharmacological therapies, physiological adaptation, psychosocial integrity, health
promotion, and risk reduction. Students should expect increasingly complex situations
involving changes in patient status, competing priorities, delegation, medication safety,
therapeutic communication, and evidence-based nursing interventions. The material is
intended for advanced preparation and should be used to identify knowledge gaps,
improve decision-making under pressure, and reinforce principles needed for safe
entry-level practical nursing practice.
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 gained 1.5 kg (3.3 lb) over the past 24 hours and
reports increasing ankle edema
B. A client with pneumonia whose temperature is 38.3°C (100.9°F) and who requests
acetaminophen
C. A client with diabetes whose premeal blood glucose is 68 mg/dL (3.8 mmol/L) and
who is awake and able to swallow
,D. A client receiving chemotherapy who reports nausea 30 minutes after receiving an
antiemetic
🔴 Correct Answer: C. A client with diabetes whose premeal blood glucose is 68
mg/dL (3.8 mmol/L) and who is awake and able to swallow.
🔵 Explanation: A blood glucose below 70 mg/dL indicates hypoglycemia and requires
prompt treatment to prevent neurological deterioration. Because the client is awake and
can swallow, a rapidly absorbed carbohydrate should be provided according to facility
protocol. The other clients require attention but do not have the same immediate risk of
deterioration.
Question 2
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. The client becomes increasingly drowsy and difficult to arouse.
Respirations are 8/min and shallow. Which action should the practical nurse take first?
A. Increase the oxygen flow rate to 6 L/min
B. Assess the client's respiratory status and immediately notify the registered nurse
C. Place the client in a supine position
D. Administer the next prescribed bronchodilator
🔴 Correct Answer: B. Assess the client's respiratory status and immediately notify
the registered nurse.
🔵 Explanation: Bradypnea, shallow respirations, and decreased level of consciousness
indicate potentially life-threatening respiratory compromise. The nurse should rapidly
assess airway and breathing while obtaining appropriate assistance. Increasing oxygen
independently does not correct hypoventilation and may be inappropriate for some
clients with chronic carbon dioxide retention.
Question 3
A client receiving a continuous heparin infusion develops sudden severe headache,
vomiting, and decreased level of consciousness. Which action has the highest priority?
A. Stop the infusion and immediately notify the registered nurse and provider
according to protocol
B. Administer the next prescribed dose of warfarin
C. Place the client in Trendelenburg position
D. Reassure the family that headache is an expected adverse effect
,🔴 Correct Answer: A. Stop the infusion and immediately notify the registered nurse
and provider according to protocol.
🔵 Explanation: Sudden severe headache, vomiting, and neurological deterioration in a
client receiving anticoagulation may indicate intracranial bleeding. Heparin should be
stopped when serious bleeding is suspected, and emergency evaluation is required.
Continuing anticoagulation could worsen potentially life-threatening hemorrhage.
Question 4
A client with a new tracheostomy becomes restless and develops noisy respirations.
The pulse oximeter decreases from 96% to 86%. Which intervention should the
practical nurse perform first?
A. Remove the tracheostomy tube
B. Assess the tracheostomy for obstruction and suction as indicated
C. Give the client oral fluids
D. Place the client flat in bed
🔴 Correct Answer: B. Assess the tracheostomy for obstruction and suction as
indicated.
🔵 Explanation: Restlessness, noisy respirations, and declining oxygen saturation suggest
airway obstruction. A newly placed tracheostomy is particularly vulnerable to obstruction
from secretions. The nurse should assess airway patency and suction according to clinical
indications and facility procedure.
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 most immediate intervention?
A. Generalized muscle weakness
B. Dependent edema
C. Peaked T waves on the electrocardiogram
D. Decreased appetite
🔴 Correct Answer: C. Peaked T waves on the electrocardiogram.
🔵 Explanation: Severe hyperkalemia can cause dangerous cardiac conduction
abnormalities and dysrhythmias. Peaked T waves are a classic electrocardiographic
manifestation and indicate an immediate risk to cardiac stability. Muscle weakness is also
concerning, but the ECG change signals potentially imminent cardiovascular compromise.
, Question 6
A client taking warfarin has an international normalized ratio (INR) of 5.8. The client has
no active bleeding. Which action should the practical nurse anticipate?
A. Administer the scheduled warfarin dose
B. Hold the medication and notify the registered nurse or provider
C. Administer aspirin to prevent thrombosis
D. Encourage foods high in vitamin K immediately
🔴 Correct Answer: B. Hold the medication and notify the registered nurse or
provider.
🔵 Explanation: An INR of 5.8 represents excessive anticoagulation and substantially
increases bleeding risk. The scheduled warfarin dose should not be administered until the
treatment plan is clarified. Vitamin K therapy may be considered depending on the INR,
bleeding status, and provider orders.
Question 7
A client with suspected sepsis has a temperature of 39.4°C (102.9°F), heart rate
128/min, respiratory rate 30/min, blood pressure 84/48 mm Hg, and altered mental
status. Which finding is the strongest indication that the client's condition has
progressed to a life-threatening state?
A. Temperature of 39.4°C
B. Heart rate of 128/min
C. Blood pressure of 84/48 mm Hg with altered mental status
D. Respiratory rate of 30/min
🔴 Correct Answer: C. Blood pressure of 84/48 mm Hg with altered mental status.
🔵 Explanation: Hypotension accompanied by altered mental status indicates inadequate
tissue perfusion and possible septic shock. Although fever, tachycardia, and tachypnea are
important manifestations of infection and systemic response, circulatory failure with
neurological changes represents a more immediate threat to life.
Question 8
A practical nurse is reinforcing discharge teaching for a client prescribed prednisone for
several weeks. Which statement by the client indicates a need for further teaching?
