PNLE EXAM 2026-2027: COMPLETE
PREMIUM PRACTICE QUESTION BANK
SUCCESSFUL A+ SOLUTIONS
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# NURSING PRACTICE I – FOUNDATIONS OF NURSING PRACTICE
## A. Nursing Process and Critical Thinking
**Question 1**
A 72-year-old client with heart failure is admitted with shortness of breath and peripheral edema.
The nurse auscultates crackles in the lung bases and notes a 2+ pitting edema in the lower
extremities. Which step of the nursing process is the nurse performing?
A. Assessment
B. Diagnosis
C. Planning
D. Implementation
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**Correct Answer: A. Assessment**
**Rationale:** Assessment is the first step of the nursing process, involving the systematic
collection, organization, validation, and documentation of patient data. The nurse is gathering
objective data (auscultating crackles, assessing edema) and subjective data (shortness of breath),
which constitutes the assessment phase. Diagnosis involves analyzing the data to formulate
nursing diagnoses; Planning involves setting goals and interventions; Implementation involves
carrying out the planned interventions.
**Distractor Analysis:**
- **B. Diagnosis:** Incorrect because the nurse is collecting data, not analyzing it to formulate a
nursing diagnosis yet.
- **C. Planning:** Incorrect because planning occurs after diagnoses are established, involving
goal setting and intervention selection.
- **D. Implementation:** Incorrect because implementation is the execution phase, which
occurs after planning is complete.
---
**Question 2**
A nurse is caring for a postoperative client who reports pain rated 8/10. The nurse administers the
prescribed analgesic and returns 30 minutes later to reassess the pain level. This action represents
which phase of the nursing process?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
**Correct Answer: D. Evaluation**
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**Rationale:** Evaluation is the final step of the nursing process where the nurse determines
whether the goals and outcomes have been achieved. By reassessing the pain level after
administering the analgesic, the nurse is evaluating the effectiveness of the intervention. This
step is crucial because it determines whether the plan of care should be continued, modified, or
terminated. The 2026 TOS emphasizes application and evaluation-level questions, with
approximately 10% of items targeting evaluation skills.
**Distractor Analysis:**
- **A. Assessment:** Incorrect; while reassessment involves data collection, the primary
purpose here is to evaluate the effectiveness of the intervention, not initial data gathering.
- **B. Planning:** Incorrect; planning involves establishing goals and interventions before
implementation.
- **C. Implementation:** Incorrect; implementation is the action of carrying out the
intervention, which has already occurred when the analgesic was administered.
---
**Question 3**
A client with diabetes mellitus has a blood glucose level of 45 mg/dL and is experiencing
diaphoresis and confusion. Which nursing diagnosis should the nurse prioritize?
A. Risk for Injury related to altered sensorium
B. Imbalanced Nutrition: Less than Body Requirements
C. Deficient Knowledge regarding disease management
D. Risk for Infection related to altered glucose metabolism
**Correct Answer: A. Risk for Injury related to altered sensorium**
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**Rationale:** According to Maslow's hierarchy of needs and the ABCs (Airway, Breathing,
Circulation) prioritization framework, safety is a priority. The client's confusion and
hypoglycemia place them at immediate risk for injury (falls, accidents). While Imbalanced
Nutrition is a related problem and Deficient Knowledge is a long-term concern, the immediate
threat to safety must be addressed first. The 2026 PNLE TOS emphasizes prioritization questions
that require application of Maslow's hierarchy and ABCs logic.
**Distractor Analysis:**
- **B. Imbalanced Nutrition:** Incorrect; while hypoglycemia reflects nutritional imbalance,
this diagnosis addresses the metabolic issue but not the immediate safety concern.
- **C. Deficient Knowledge:** Incorrect; this is a long-term diagnosis that does not address the
acute safety threat.
- **D. Risk for Infection:** Incorrect; though diabetes increases infection risk, this is not the
immediate priority in this scenario.
---
**Question 4**
A nurse is writing a care plan for a client with impaired physical mobility. Which outcome
statement is correctly written and measurable?
A. "Client will ambulate better by discharge"
B. "Client will demonstrate improved mobility"
C. "Client will walk 50 feet with a walker by day 3"
D. "Client will be able to walk eventually"
**Correct Answer: C. Client will walk 50 feet with a walker by day 3**
**Rationale:** A well-written outcome statement must be specific, measurable, achievable,
realistic, and time-bound (SMART). Option C includes a specific activity (walk 50 feet), a
specific assistive device (walker), and a specific timeframe (by day 3). This aligns with the