NCLEX PN NGN REAL ACTUAL TEST WITH 250
QUESTIONS WITH ANSWERS
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT
QUESTION 1
Format: Multiple Choice
Question: An LPN is preparing to delegate a task to unlicensed assistive personnel (UAP).
Which task is appropriate for the LPN to delegate?
A. Performing an initial patient assessment
B. Administering oral medications
C. Assisting a patient with ambulation using a gait belt
D. Evaluating the effectiveness of patient education
Answer: C. Assisting a patient with ambulation using a gait belt.
Rationale: Assisting with ambulation is a routine, non-invasive task within the UAP scope of
practice. Assessment, medication administration, and evaluation require licensed nursing
judgment and cannot be delegated. The rights of delegation include right task, right
circumstances, right person, right direction/communication, and right
supervision/evaluation .
QUESTION 2
Format: Multiple Choice
Question: A client's daughter calls requesting information about her mother's condition. The
client's chart does not specify that information can be released. Which response by the
nurse is appropriate?
A. "Your mother had a restful night and is doing well."
B. "You will need to contact your mother directly about her condition."
C. "I can give you a brief update, but no specific details."
D. "Let me check with the provider first and call you back."
Answer: B. "You will need to contact your mother directly about her condition."
Rationale: The nurse must protect client confidentiality under HIPAA. Without explicit
consent, no health information can be disclosed. Directing the caller to speak with the client
is the appropriate response. Nurses must perform care to support unbiased treatment and
equal access to care, regardless of culture, ethnicity, sexual orientation, or gender identity .
,QUESTION 3
Format: Multiple Choice
Question: An LPN makes an error in a patient's medical record. Which action is correct?
A. Erase or white out the error and write the correction
B. Draw a single line through the error, write "error," initial, and date it
C. Rewrite the entire entry to avoid confusion
D. Ignore the error and document the correct information elsewhere
Answer: B. Draw a single line through the error, write "error," initial, and date it.
Rationale: The correct documentation correction method is to draw a single line through the
error (maintaining legibility), write "error" or "mistaken entry," and initial and date the
correction. The original entry must remain readable.
QUESTION 4
Format: Multiple Choice
Question: An LPN is assisting with a quality improvement initiative. Which action is
appropriate?
A. Ignoring the initiative and continuing routine care
B. Reporting observations about patient safety concerns to the RN
C. Making independent changes to unit policies
D. Delegating all quality improvement tasks to UAP
Answer: B. Reporting observations about patient safety concerns to the RN.
Rationale: LPNs can contribute to quality improvement by reporting observations and
concerns to the RN or charge nurse. They should not make independent policy changes.
LPNs also serve as a resource to other staff members .
QUESTION 5
Format: Multiple Choice
Question: A client expresses a desire to leave the hospital against medical advice. Which
action by the nurse is appropriate?
A. Physically prevent the client from leaving
B. Notify the provider and document the client's decision
C. Tell the client they cannot leave without a provider's order
D. Call security to detain the client
,Answer: B. Notify the provider and document the client's decision.
Rationale: Clients have the right to leave against medical advice if they are competent. The
nurse should notify the provider, document the client's decision, and ensure the client
understands the risks involved.
QUESTION 6
Format: Multiple Choice
Question: The nurse is caring for a client with an advance directive that states "do not
resuscitate." The client's family is requesting CPR. What should the nurse do?
A. Follow the family's wishes and initiate CPR if needed
B. Follow the patient's advance directive
C. Call an ethics consult without involving the RN
D. Ask the provider to override the advance directive
Answer: B. Follow the patient's advance directive.
Rationale: Advance directives reflect the patient's autonomous wishes and are legally
binding. The LPN should notify the RN of the family's concerns and follow the patient's
documented preferences.
QUESTION 7
Format: Multiple Choice
Question: Which action by the nurse demonstrates appropriate use of the chain of
command?
A. Performing a procedure without proper training
B. Reporting a patient safety concern to the charge nurse
C. Ignoring an unsafe practice to avoid conflict
D. Making a decision outside the LPN's scope of practice
Answer: B. Reporting a patient safety concern to the charge nurse.
Rationale: The chain of command provides a structured communication pathway. Reporting
safety concerns to the charge nurse is an appropriate use of this system.
QUESTION 8
Format: Multiple Choice
, Question: A client is being transferred to another facility. Which information should the
nurse include in the transfer report?
A. Only the client's diagnosis
B. A complete nursing assessment and current treatment plan
C. The client's insurance information
D. The names of all family members
Answer: B. A complete nursing assessment and current treatment plan.
Rationale: Transfer reports should include relevant clinical information to ensure continuity
of care, including assessment findings, treatment plans, and current status.
QUESTION 9
Format: Multiple Choice
Question: The nurse is caring for a client from a different cultural background. Which action
demonstrates cultural competence?
A. Ignoring the patient's cultural beliefs to provide standardized care
B. Assessing the patient's cultural beliefs and incorporating them into the care plan
C. Insisting the patient follow Western medical practices
D. Requesting the patient be transferred to another nurse
Answer: B. Assessing the patient's cultural beliefs and incorporating them into the care plan.
Rationale: Cultural competence involves assessing and respecting the patient's cultural
beliefs and incorporating them into the care plan. This promotes patient-centered care and
improves outcomes. Nurses must respect client's self-reported religious/spiritual beliefs .
QUESTION 10
Format: Multiple Choice
Question: Which action demonstrates the LPN's role as a patient advocate?
A. Making decisions for the patient without input
B. Ensuring the patient has access to resources and their rights are protected
C. Avoiding discussing difficult topics to prevent distress
D. Following hospital policies regardless of patient preference
Answer: B. Ensuring the patient has access to resources and their rights are protected.
Rationale: Advocacy involves speaking and acting on behalf of patients, ensuring they have
access to resources, information, and protection of their rights. It empowers patients rather
than making decisions for them.
QUESTIONS WITH ANSWERS
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT
QUESTION 1
Format: Multiple Choice
Question: An LPN is preparing to delegate a task to unlicensed assistive personnel (UAP).
Which task is appropriate for the LPN to delegate?
A. Performing an initial patient assessment
B. Administering oral medications
C. Assisting a patient with ambulation using a gait belt
D. Evaluating the effectiveness of patient education
Answer: C. Assisting a patient with ambulation using a gait belt.
Rationale: Assisting with ambulation is a routine, non-invasive task within the UAP scope of
practice. Assessment, medication administration, and evaluation require licensed nursing
judgment and cannot be delegated. The rights of delegation include right task, right
circumstances, right person, right direction/communication, and right
supervision/evaluation .
QUESTION 2
Format: Multiple Choice
Question: A client's daughter calls requesting information about her mother's condition. The
client's chart does not specify that information can be released. Which response by the
nurse is appropriate?
A. "Your mother had a restful night and is doing well."
B. "You will need to contact your mother directly about her condition."
C. "I can give you a brief update, but no specific details."
D. "Let me check with the provider first and call you back."
Answer: B. "You will need to contact your mother directly about her condition."
Rationale: The nurse must protect client confidentiality under HIPAA. Without explicit
consent, no health information can be disclosed. Directing the caller to speak with the client
is the appropriate response. Nurses must perform care to support unbiased treatment and
equal access to care, regardless of culture, ethnicity, sexual orientation, or gender identity .
,QUESTION 3
Format: Multiple Choice
Question: An LPN makes an error in a patient's medical record. Which action is correct?
A. Erase or white out the error and write the correction
B. Draw a single line through the error, write "error," initial, and date it
C. Rewrite the entire entry to avoid confusion
D. Ignore the error and document the correct information elsewhere
Answer: B. Draw a single line through the error, write "error," initial, and date it.
Rationale: The correct documentation correction method is to draw a single line through the
error (maintaining legibility), write "error" or "mistaken entry," and initial and date the
correction. The original entry must remain readable.
QUESTION 4
Format: Multiple Choice
Question: An LPN is assisting with a quality improvement initiative. Which action is
appropriate?
A. Ignoring the initiative and continuing routine care
B. Reporting observations about patient safety concerns to the RN
C. Making independent changes to unit policies
D. Delegating all quality improvement tasks to UAP
Answer: B. Reporting observations about patient safety concerns to the RN.
Rationale: LPNs can contribute to quality improvement by reporting observations and
concerns to the RN or charge nurse. They should not make independent policy changes.
LPNs also serve as a resource to other staff members .
QUESTION 5
Format: Multiple Choice
Question: A client expresses a desire to leave the hospital against medical advice. Which
action by the nurse is appropriate?
A. Physically prevent the client from leaving
B. Notify the provider and document the client's decision
C. Tell the client they cannot leave without a provider's order
D. Call security to detain the client
,Answer: B. Notify the provider and document the client's decision.
Rationale: Clients have the right to leave against medical advice if they are competent. The
nurse should notify the provider, document the client's decision, and ensure the client
understands the risks involved.
QUESTION 6
Format: Multiple Choice
Question: The nurse is caring for a client with an advance directive that states "do not
resuscitate." The client's family is requesting CPR. What should the nurse do?
A. Follow the family's wishes and initiate CPR if needed
B. Follow the patient's advance directive
C. Call an ethics consult without involving the RN
D. Ask the provider to override the advance directive
Answer: B. Follow the patient's advance directive.
Rationale: Advance directives reflect the patient's autonomous wishes and are legally
binding. The LPN should notify the RN of the family's concerns and follow the patient's
documented preferences.
QUESTION 7
Format: Multiple Choice
Question: Which action by the nurse demonstrates appropriate use of the chain of
command?
A. Performing a procedure without proper training
B. Reporting a patient safety concern to the charge nurse
C. Ignoring an unsafe practice to avoid conflict
D. Making a decision outside the LPN's scope of practice
Answer: B. Reporting a patient safety concern to the charge nurse.
Rationale: The chain of command provides a structured communication pathway. Reporting
safety concerns to the charge nurse is an appropriate use of this system.
QUESTION 8
Format: Multiple Choice
, Question: A client is being transferred to another facility. Which information should the
nurse include in the transfer report?
A. Only the client's diagnosis
B. A complete nursing assessment and current treatment plan
C. The client's insurance information
D. The names of all family members
Answer: B. A complete nursing assessment and current treatment plan.
Rationale: Transfer reports should include relevant clinical information to ensure continuity
of care, including assessment findings, treatment plans, and current status.
QUESTION 9
Format: Multiple Choice
Question: The nurse is caring for a client from a different cultural background. Which action
demonstrates cultural competence?
A. Ignoring the patient's cultural beliefs to provide standardized care
B. Assessing the patient's cultural beliefs and incorporating them into the care plan
C. Insisting the patient follow Western medical practices
D. Requesting the patient be transferred to another nurse
Answer: B. Assessing the patient's cultural beliefs and incorporating them into the care plan.
Rationale: Cultural competence involves assessing and respecting the patient's cultural
beliefs and incorporating them into the care plan. This promotes patient-centered care and
improves outcomes. Nurses must respect client's self-reported religious/spiritual beliefs .
QUESTION 10
Format: Multiple Choice
Question: Which action demonstrates the LPN's role as a patient advocate?
A. Making decisions for the patient without input
B. Ensuring the patient has access to resources and their rights are protected
C. Avoiding discussing difficult topics to prevent distress
D. Following hospital policies regardless of patient preference
Answer: B. Ensuring the patient has access to resources and their rights are protected.
Rationale: Advocacy involves speaking and acting on behalf of patients, ensuring they have
access to resources, information, and protection of their rights. It empowers patients rather
than making decisions for them.
