NCSBN ALIGNED | NGN CLINICAL JUDGMENT INTEGRATED
NGN NCLEX PN
ACTUAL FINAL EXAM
Complete Questions with Expert Solutions
2026 Latest Updated | GET A+
Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
with Next Generation NCLEX (NGN) Components
150 Questions Total
Sections 1-8: Traditional NCLEX-PN Format with NGN Integration (Q1-140)
Section 9: NGN Clinical Judgment - SATA, Bowtie, and Extended Case Studies (Q141-150)
Cognitive Levels: 20% Recall | 50% Application | 30% Analysis
Includes: Comprehensive rationales with clinical judgment model application
Comprehensive Preparation for NCLEX-PN Success
EXPert Solutions Provided | 150 Questions | NCSBN NCLEX-PN Test Plan
,NGN NCLEX PN ACTUAL FINAL EXAM | EXPERT SOLUTIONS Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
Table of Contents
Section 1: Safe and Effective Care Environment - Coordinated Care
Questions Q1-25
Section 2: Safe and Effective Care Environment - Safety and Infection Control
Questions Q26-40
Section 3: Health Promotion and Maintenance
Questions Q41-55
Section 4: Psychosocial Integrity
Questions Q56-70
Section 5: Basic Care and Comfort
Questions Q71-85
Section 6: Pharmacological and Parenteral Therapies
Questions Q86-105
Section 7: Reduction of Risk Potential
Questions Q106-120
Section 8: Physiological Adaptation
Questions Q121-140
Section 9: Next Generation NCLEX (NGN) Clinical Judgment
Questions Q141-150
All questions include comprehensive Expert Solutions with NGN clinical judgment model integration, PN
scope of practice considerations, and evidence-based practice rationales.
NGN NCLEX PN Actual Final Exam | 2026 Latest Updated | Page 2
,NGN NCLEX PN ACTUAL FINAL EXAM | EXPERT SOLUTIONS Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
SECTION 1
Safe and Effective Care Environment - Coordinated Care
Advocacy, Client Rights, Delegation, Supervision, Assignment, Ethics, Legal Issues, Advance Directives, HIPAA,
Continuity of Care, Interdisciplinary Collaboration, Case Management, & Resource Management
Questions 1-25
Q1. An LPN/LVN is caring for a 78-year-old client with advanced dementia who has a documented
advance directive specifying no artificial nutrition or hydration. The client's adult daughter
demands the LPN start IV fluids, stating, "My mother would want to live." Which action by the LPN
best demonstrates advocacy within PN scope?
A. Start a peripheral IV and begin normal saline at 75 mL/hr as the daughter requests
B. Refuse to start the IV, explain the advance directive to the daughter, and notify the RN [CORRECT]
C. Document the daughter's request in the chart and wait for the next shift to handle it
D. Call the provider for an order to start IV fluids without discussing the directive
Correct Answer: B
Rationale: The LPN functions as a client advocate by honoring the legally executed advance directive, which takes precedence
over family member requests when the client lacks capacity. The PN scope includes reinforcing education about the directive,
but conflict resolution and ethical consultation require RN/provider involvement. Starting the IV would violate the client's
autonomous decision documented in the directive. The LPN must promptly escalate to the supervising RN and document the
encounter thoroughly, applying the ethical principles of autonomy and beneficence.
Q2. Which task is most appropriate for the LPN to delegate to an experienced unlicensed assistive
personnel (UAP) on a medical-surgical unit?
A. Measuring intake and output for a client with acute kidney injury receiving IV diuretics
B. Ambulating a client two days post-op abdominal surgery whose hemoglobin dropped from 11.2 to 8.9 g/dL
C. Obtaining vital signs on a stable client three days after appendectomy [CORRECT]
D. Reinforcing teaching about a newly prescribed anticoagulant medication
Correct Answer: C
Rationale: The five rights of delegation require the right task be assigned to the right person under the right circumstances with
the right direction and communication, and the right supervision. UAP scope includes routine vital signs on stable clients,
ambulation of stable postoperative clients, and basic ADLs. Measuring I&O; on an unstable AKI client requires nursing
judgment about fluid balance interpretation. The post-op client with a significant hemoglobin drop may be hemodynamically
unstable and requires nurse assessment. Reinforcing medication teaching is the LPN's responsibility, not the UAP's, as it
requires nursing knowledge.
Q3. A client tells the LPN, "I don't want my diagnosis shared with my family." The next day, the
client's spouse calls the unit and asks for the client's diagnosis. Which response by the LPN best
complies with HIPAA regulations?
A. "Your spouse has requested that we not share that information, so I cannot provide it." [CORRECT]
B. "I'll have the doctor call you back with the test results later today."
C. "Your spouse is doing well; you'll need to ask them directly about the diagnosis."
D. "The diagnosis is confidential under HIPAA, but family members are always allowed access."
Correct Answer: A
NGN NCLEX PN Actual Final Exam | 2026 Latest Updated | Page 3
, NGN NCLEX PN ACTUAL FINAL EXAM | EXPERT SOLUTIONS Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
Rationale: Under HIPAA, clients have the right to control disclosure of their protected health information (PHI), including to
family members. The LPN must honor the client's explicit request not to share information. Option B implies disclosure without
consent, violating HIPAA. Option C avoids the question without addressing the privacy directive the client established. Option
D misrepresents HIPAA, which does not grant automatic family access. The LPN should also notify the RN and document the
call, reinforcing that the PN scope includes protecting client privacy and confidentiality.
Q4. An LPN is preparing to witness a consent signature for a client scheduled for a
cholecystectomy. The client says, "The doctor explained it, but I'm not really sure what they're
going to do." Which action by the LPN is most appropriate?
A. Witness the signature since the provider already spoke with the client
B. Notify the RN and request the provider return to clarify the procedure [CORRECT]
C. Explain the surgical procedure to the client using a teaching brochure
D. Have the client sign the consent and inform them they can ask questions later
Correct Answer: B
Rationale: Informed consent requires the client understand the procedure, risks, benefits, alternatives, and consequences of
refusal. The LPN's role is to witness the signature, NOT to obtain consent or explain the procedure. If the client expresses
uncertainty or lack of understanding, the LPN must notify the RN and request the provider return for clarification. Forcing or
coercing the client to sign constitutes battery and violates the ethical principle of autonomy. Documenting the client's statement
and the provider notification is essential for legal protection.
Q5. Which assignment by the RN best matches the LPN/LVN scope of practice on a telemetry
unit?
A. A client admitted 2 hours ago with acute decompensated heart failure receiving IV nitroglycerin
B. A client one day post-cardiac catheterization requiring vital signs q15min and groin site checks
C. A client with chronic atrial fibrillation on oral warfarin requiring daily education [CORRECT]
D. A client with new-onset third-degree heart block awaiting pacemaker insertion
Correct Answer: C
Rationale: LPN/LVN scope includes caring for stable clients with predictable outcomes. The client with chronic atrial
fibrillation on oral warfarin has a stable, chronic condition requiring routine monitoring and reinforcement of teaching, which
falls within PN scope. Acute decompensated heart failure on IV nitroglycerin requires continuous hemodynamic monitoring and
titration beyond PN scope. The immediate post-cardiac catheterization client requires frequent assessment for hemorrhage and
is RN-appropriate. New-onset third-degree heart block is a critical, unstable condition requiring RN-level care and potential
emergency intervention.
Q6. A client with a terminal illness has a DNR (Do Not Resuscitate) order. The client goes into
cardiac arrest while the LPN is in the room. The family at the bedside begins screaming, "Do
something! Save them!" Which nursing action is appropriate?
A. Begin CPR immediately to honor the family's request
B. Call a code blue and initiate resuscitation per facility protocol
C. Confirm the DNR status with the charge nurse, do not initiate CPR, and provide comfort to the family
[CORRECT]
D. Ask the family to leave the room until the physician arrives
Correct Answer: C
Rationale: A valid DNR order must be honored regardless of family wishes. The LPN must verify the DNR is current and
properly documented, then refrain from initiating resuscitation. Initiating CPR would violate the client's autonomy and the
physician's order. Calling a code blue contradicts the DNR. Asking the family to leave without explanation is non-therapeutic.
The LPN should remain with the family, offer emotional support, and notify the RN and provider. This integrates the ethical
principles of autonomy and beneficence within PN scope.
NGN NCLEX PN Actual Final Exam | 2026 Latest Updated | Page 4
NGN NCLEX PN
ACTUAL FINAL EXAM
Complete Questions with Expert Solutions
2026 Latest Updated | GET A+
Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
with Next Generation NCLEX (NGN) Components
150 Questions Total
Sections 1-8: Traditional NCLEX-PN Format with NGN Integration (Q1-140)
Section 9: NGN Clinical Judgment - SATA, Bowtie, and Extended Case Studies (Q141-150)
Cognitive Levels: 20% Recall | 50% Application | 30% Analysis
Includes: Comprehensive rationales with clinical judgment model application
Comprehensive Preparation for NCLEX-PN Success
EXPert Solutions Provided | 150 Questions | NCSBN NCLEX-PN Test Plan
,NGN NCLEX PN ACTUAL FINAL EXAM | EXPERT SOLUTIONS Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
Table of Contents
Section 1: Safe and Effective Care Environment - Coordinated Care
Questions Q1-25
Section 2: Safe and Effective Care Environment - Safety and Infection Control
Questions Q26-40
Section 3: Health Promotion and Maintenance
Questions Q41-55
Section 4: Psychosocial Integrity
Questions Q56-70
Section 5: Basic Care and Comfort
Questions Q71-85
Section 6: Pharmacological and Parenteral Therapies
Questions Q86-105
Section 7: Reduction of Risk Potential
Questions Q106-120
Section 8: Physiological Adaptation
Questions Q121-140
Section 9: Next Generation NCLEX (NGN) Clinical Judgment
Questions Q141-150
All questions include comprehensive Expert Solutions with NGN clinical judgment model integration, PN
scope of practice considerations, and evidence-based practice rationales.
NGN NCLEX PN Actual Final Exam | 2026 Latest Updated | Page 2
,NGN NCLEX PN ACTUAL FINAL EXAM | EXPERT SOLUTIONS Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
SECTION 1
Safe and Effective Care Environment - Coordinated Care
Advocacy, Client Rights, Delegation, Supervision, Assignment, Ethics, Legal Issues, Advance Directives, HIPAA,
Continuity of Care, Interdisciplinary Collaboration, Case Management, & Resource Management
Questions 1-25
Q1. An LPN/LVN is caring for a 78-year-old client with advanced dementia who has a documented
advance directive specifying no artificial nutrition or hydration. The client's adult daughter
demands the LPN start IV fluids, stating, "My mother would want to live." Which action by the LPN
best demonstrates advocacy within PN scope?
A. Start a peripheral IV and begin normal saline at 75 mL/hr as the daughter requests
B. Refuse to start the IV, explain the advance directive to the daughter, and notify the RN [CORRECT]
C. Document the daughter's request in the chart and wait for the next shift to handle it
D. Call the provider for an order to start IV fluids without discussing the directive
Correct Answer: B
Rationale: The LPN functions as a client advocate by honoring the legally executed advance directive, which takes precedence
over family member requests when the client lacks capacity. The PN scope includes reinforcing education about the directive,
but conflict resolution and ethical consultation require RN/provider involvement. Starting the IV would violate the client's
autonomous decision documented in the directive. The LPN must promptly escalate to the supervising RN and document the
encounter thoroughly, applying the ethical principles of autonomy and beneficence.
Q2. Which task is most appropriate for the LPN to delegate to an experienced unlicensed assistive
personnel (UAP) on a medical-surgical unit?
A. Measuring intake and output for a client with acute kidney injury receiving IV diuretics
B. Ambulating a client two days post-op abdominal surgery whose hemoglobin dropped from 11.2 to 8.9 g/dL
C. Obtaining vital signs on a stable client three days after appendectomy [CORRECT]
D. Reinforcing teaching about a newly prescribed anticoagulant medication
Correct Answer: C
Rationale: The five rights of delegation require the right task be assigned to the right person under the right circumstances with
the right direction and communication, and the right supervision. UAP scope includes routine vital signs on stable clients,
ambulation of stable postoperative clients, and basic ADLs. Measuring I&O; on an unstable AKI client requires nursing
judgment about fluid balance interpretation. The post-op client with a significant hemoglobin drop may be hemodynamically
unstable and requires nurse assessment. Reinforcing medication teaching is the LPN's responsibility, not the UAP's, as it
requires nursing knowledge.
Q3. A client tells the LPN, "I don't want my diagnosis shared with my family." The next day, the
client's spouse calls the unit and asks for the client's diagnosis. Which response by the LPN best
complies with HIPAA regulations?
A. "Your spouse has requested that we not share that information, so I cannot provide it." [CORRECT]
B. "I'll have the doctor call you back with the test results later today."
C. "Your spouse is doing well; you'll need to ask them directly about the diagnosis."
D. "The diagnosis is confidential under HIPAA, but family members are always allowed access."
Correct Answer: A
NGN NCLEX PN Actual Final Exam | 2026 Latest Updated | Page 3
, NGN NCLEX PN ACTUAL FINAL EXAM | EXPERT SOLUTIONS Aligned with 2026-2027 NCSBN NCLEX-PN Test Plan
Rationale: Under HIPAA, clients have the right to control disclosure of their protected health information (PHI), including to
family members. The LPN must honor the client's explicit request not to share information. Option B implies disclosure without
consent, violating HIPAA. Option C avoids the question without addressing the privacy directive the client established. Option
D misrepresents HIPAA, which does not grant automatic family access. The LPN should also notify the RN and document the
call, reinforcing that the PN scope includes protecting client privacy and confidentiality.
Q4. An LPN is preparing to witness a consent signature for a client scheduled for a
cholecystectomy. The client says, "The doctor explained it, but I'm not really sure what they're
going to do." Which action by the LPN is most appropriate?
A. Witness the signature since the provider already spoke with the client
B. Notify the RN and request the provider return to clarify the procedure [CORRECT]
C. Explain the surgical procedure to the client using a teaching brochure
D. Have the client sign the consent and inform them they can ask questions later
Correct Answer: B
Rationale: Informed consent requires the client understand the procedure, risks, benefits, alternatives, and consequences of
refusal. The LPN's role is to witness the signature, NOT to obtain consent or explain the procedure. If the client expresses
uncertainty or lack of understanding, the LPN must notify the RN and request the provider return for clarification. Forcing or
coercing the client to sign constitutes battery and violates the ethical principle of autonomy. Documenting the client's statement
and the provider notification is essential for legal protection.
Q5. Which assignment by the RN best matches the LPN/LVN scope of practice on a telemetry
unit?
A. A client admitted 2 hours ago with acute decompensated heart failure receiving IV nitroglycerin
B. A client one day post-cardiac catheterization requiring vital signs q15min and groin site checks
C. A client with chronic atrial fibrillation on oral warfarin requiring daily education [CORRECT]
D. A client with new-onset third-degree heart block awaiting pacemaker insertion
Correct Answer: C
Rationale: LPN/LVN scope includes caring for stable clients with predictable outcomes. The client with chronic atrial
fibrillation on oral warfarin has a stable, chronic condition requiring routine monitoring and reinforcement of teaching, which
falls within PN scope. Acute decompensated heart failure on IV nitroglycerin requires continuous hemodynamic monitoring and
titration beyond PN scope. The immediate post-cardiac catheterization client requires frequent assessment for hemorrhage and
is RN-appropriate. New-onset third-degree heart block is a critical, unstable condition requiring RN-level care and potential
emergency intervention.
Q6. A client with a terminal illness has a DNR (Do Not Resuscitate) order. The client goes into
cardiac arrest while the LPN is in the room. The family at the bedside begins screaming, "Do
something! Save them!" Which nursing action is appropriate?
A. Begin CPR immediately to honor the family's request
B. Call a code blue and initiate resuscitation per facility protocol
C. Confirm the DNR status with the charge nurse, do not initiate CPR, and provide comfort to the family
[CORRECT]
D. Ask the family to leave the room until the physician arrives
Correct Answer: C
Rationale: A valid DNR order must be honored regardless of family wishes. The LPN must verify the DNR is current and
properly documented, then refrain from initiating resuscitation. Initiating CPR would violate the client's autonomy and the
physician's order. Calling a code blue contradicts the DNR. Asking the family to leave without explanation is non-therapeutic.
The LPN should remain with the family, offer emotional support, and notify the RN and provider. This integrates the ethical
principles of autonomy and beneficence within PN scope.
NGN NCLEX PN Actual Final Exam | 2026 Latest Updated | Page 4
