NLN NEX PN Comprehensive Exam Questions and
Answers with Rationales 2026/2027 Update
SECTION I — FUNDAMENTALS OF NURSING
1. A nurse is preparing to assess a newly admitted client. Which action
should the nurse take first?
A. Review the discharge plan
B. Perform hand hygiene
C. Administer prescribed medications
D. Ask the family to leave
Answer: B. Perform hand hygiene
Rationale: Hand hygiene is a fundamental infection-prevention
measure and should be performed before client contact.
2. Which position is generally appropriate for a client experiencing
difficulty breathing?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone
Answer: B. High-Fowler's
Rationale: Upright positioning promotes lung expansion and can
decrease the work of breathing.
3. Which finding should the nurse recognize as an early indication of
hypoxia?
,A. Restlessness
B. Cyanosis
C. Severe hypotension
D. Unresponsiveness
Answer: A. Restlessness
Rationale: Restlessness, anxiety, and changes in mental status can
occur early with inadequate oxygenation. Cyanosis is generally a later
finding.
4. Which intervention is most appropriate for preventing pressure
injuries in an immobile client?
A. Massage reddened bony areas
B. Reposition regularly and relieve pressure
C. Restrict fluids
D. Keep the head of bed elevated continuously
Answer: B. Reposition regularly and relieve pressure
Rationale: Regular repositioning, pressure redistribution, skin
assessment, nutrition, and moisture management reduce pressure-
injury risk.
5. Which finding indicates that a client's pain-management intervention
has been effective?
A. The client states the pain is reduced
B. The client has an increased respiratory rate
C. The client is guarding the affected area more
D. The client refuses to move
,Answer: A. The client states the pain is reduced
Rationale: The client's self-report is the primary indicator of pain
intensity and response to treatment.
6. A client has weakness on the left side. Which action is safest when
assisting the client to transfer?
A. Place the wheelchair on the client's weak side
B. Leave the wheelchair unlocked
C. Position the wheelchair on the client's stronger side when
appropriate
D. Pull the client by the arms
Answer: C. Position the wheelchair on the client's stronger side when
appropriate
Rationale: Positioning equipment to maximize the client's strength can
improve transfer safety.
7. Which intervention helps prevent falls?
A. Keep the bed in the highest position
B. Keep frequently used items within reach
C. Remove nonskid footwear
D. Turn off all room lighting at night
Answer: B. Keep frequently used items within reach
Rationale: Accessibility reduces unnecessary reaching and unassisted
ambulation.
8. A client has difficulty swallowing. Which intervention is appropriate?
A. Encourage rapid eating
, B. Position the client upright during meals
C. Give thin liquids automatically
D. Have the client lie flat after eating
Answer: B. Position the client upright during meals
Rationale: Upright positioning reduces aspiration risk.
9. Which assessment finding is most concerning in a client receiving
oxygen therapy?
A. Dry nasal passages
B. New confusion and increasing respiratory distress
C. Mild thirst
D. Warm hands
Answer: B. New confusion and increasing respiratory distress
Rationale: These findings may indicate worsening oxygenation and
require prompt assessment and intervention.
10. Which action is appropriate when measuring a client's blood
pressure?
A. Use a cuff that is too small
B. Place the cuff over thick clothing
C. Support the arm at approximately heart level
D. Ask the client to talk continuously
Answer: C. Support the arm at approximately heart level
Rationale: Proper positioning helps improve measurement accuracy.
11. Which finding should be documented as objective data?
A. "Client appears unpleasant."
Answers with Rationales 2026/2027 Update
SECTION I — FUNDAMENTALS OF NURSING
1. A nurse is preparing to assess a newly admitted client. Which action
should the nurse take first?
A. Review the discharge plan
B. Perform hand hygiene
C. Administer prescribed medications
D. Ask the family to leave
Answer: B. Perform hand hygiene
Rationale: Hand hygiene is a fundamental infection-prevention
measure and should be performed before client contact.
2. Which position is generally appropriate for a client experiencing
difficulty breathing?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone
Answer: B. High-Fowler's
Rationale: Upright positioning promotes lung expansion and can
decrease the work of breathing.
3. Which finding should the nurse recognize as an early indication of
hypoxia?
,A. Restlessness
B. Cyanosis
C. Severe hypotension
D. Unresponsiveness
Answer: A. Restlessness
Rationale: Restlessness, anxiety, and changes in mental status can
occur early with inadequate oxygenation. Cyanosis is generally a later
finding.
4. Which intervention is most appropriate for preventing pressure
injuries in an immobile client?
A. Massage reddened bony areas
B. Reposition regularly and relieve pressure
C. Restrict fluids
D. Keep the head of bed elevated continuously
Answer: B. Reposition regularly and relieve pressure
Rationale: Regular repositioning, pressure redistribution, skin
assessment, nutrition, and moisture management reduce pressure-
injury risk.
5. Which finding indicates that a client's pain-management intervention
has been effective?
A. The client states the pain is reduced
B. The client has an increased respiratory rate
C. The client is guarding the affected area more
D. The client refuses to move
,Answer: A. The client states the pain is reduced
Rationale: The client's self-report is the primary indicator of pain
intensity and response to treatment.
6. A client has weakness on the left side. Which action is safest when
assisting the client to transfer?
A. Place the wheelchair on the client's weak side
B. Leave the wheelchair unlocked
C. Position the wheelchair on the client's stronger side when
appropriate
D. Pull the client by the arms
Answer: C. Position the wheelchair on the client's stronger side when
appropriate
Rationale: Positioning equipment to maximize the client's strength can
improve transfer safety.
7. Which intervention helps prevent falls?
A. Keep the bed in the highest position
B. Keep frequently used items within reach
C. Remove nonskid footwear
D. Turn off all room lighting at night
Answer: B. Keep frequently used items within reach
Rationale: Accessibility reduces unnecessary reaching and unassisted
ambulation.
8. A client has difficulty swallowing. Which intervention is appropriate?
A. Encourage rapid eating
, B. Position the client upright during meals
C. Give thin liquids automatically
D. Have the client lie flat after eating
Answer: B. Position the client upright during meals
Rationale: Upright positioning reduces aspiration risk.
9. Which assessment finding is most concerning in a client receiving
oxygen therapy?
A. Dry nasal passages
B. New confusion and increasing respiratory distress
C. Mild thirst
D. Warm hands
Answer: B. New confusion and increasing respiratory distress
Rationale: These findings may indicate worsening oxygenation and
require prompt assessment and intervention.
10. Which action is appropriate when measuring a client's blood
pressure?
A. Use a cuff that is too small
B. Place the cuff over thick clothing
C. Support the arm at approximately heart level
D. Ask the client to talk continuously
Answer: C. Support the arm at approximately heart level
Rationale: Proper positioning helps improve measurement accuracy.
11. Which finding should be documented as objective data?
A. "Client appears unpleasant."
