NEW YORK PRACTICAL NURSE READINESS TEST
PRACTICE EXAM – STUDY GUIDE QUESTIONS &
ACTUAL TESTBANK | 150 QUESTIONS & 100% CORRECT
ANSWERS | LATEST UPDATE 2026/2027
Table of Contents: 1. Safe and Effective Care Environment — Coordinated Care; Scope of
Practice; Delegation; Documentation; Ethics; 2. Safety and Infection Prevention —
Standard Precautions; Transmission-Based Precautions; Sterile Technique; Emergency
Safety; 3. Health Promotion and Maintenance — Growth and Development; Maternal-
Newborn; Pediatrics; Older Adults; Screening and Prevention; 4. Psychosocial Integrity —
Mental Health; Therapeutic Communication; Crisis Intervention; Substance Use; 5. Basic
Care and Comfort — Mobility; Nutrition; Elimination; Pain; Skin Integrity; 6.
Pharmacological and Parenteral Therapies — Medication Administration; IV Therapy;
Adverse Effects; Medication Safety; 7. Reduction of Risk Potential — Monitoring;
Laboratory Interpretation; Diagnostic Procedures; Complications; 8. Physiological
Adaptation — Acute and Chronic Illness; Cardiovascular; Respiratory; Neurologic;
Endocrine; Renal; Gastrointestinal; Emergency Care; 9. New York Professional Practice —
LPN Scope; Supervision; Professional Accountability; Legal and Regulatory Issues; 10.
Clinical Judgment — Recognition of Cues; Analysis; Prioritization; Intervention;
Evaluation.
INTRODUCTION
This 2026/2027 New York Practical Nurse Readiness Test practice examination is
designed as an advanced study resource for candidates preparing for practical-
nursing licensure and readiness assessments. The content emphasizes clinical
judgment, prioritization, safety, pharmacology, physiological adaptation, psychosocial
care, health promotion, delegation, documentation, and professional practice. The
2026 NCLEX-PN framework explicitly emphasizes clinical judgment and integrates
recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking
action, and evaluating outcomes. New York-specific items also reflect the state's
statutory framework for LPN practice, including practice under the direction of
authorized practitioners. Questions are intentionally application-heavy and use
realistic clinical situations rather than simple memorization.
QUESTIONS 1–150
Question 1
A practical nurse receives report on four clients. Which client should the nurse assess
first?
,A. A client with chronic heart failure who gained 1 kg over 48 hours
B. A client with pneumonia whose oxygen saturation decreased from 95% to 89%
C. A client with diabetes whose premeal glucose is 178 mg/dL
D. A postoperative client requesting assistance to the bathroom
Correct Answer: B.
Explanation: A new decline in oxygen saturation in a client with pneumonia
indicates worsening respiratory status and requires immediate assessment. Airway
and breathing concerns take priority over stable or less urgent findings.
Question 2
A client receiving IV morphine becomes difficult to arouse and has a respiratory rate
of 7/min. Which action is the priority?
A. Obtain a urine specimen
B. Administer the next scheduled dose later
C. Stimulate the client and initiate emergency respiratory support measures
D. Document the sedation level and reassess in 30 minutes
Correct Answer: C.
Explanation: Severe opioid-induced respiratory depression is an emergency.
Immediate airway and breathing support takes precedence over documentation or
routine reassessment.
Question 3
A client with suspected sepsis has a temperature of 39.2°C, heart rate 128/min,
respiratory rate 30/min, and blood pressure 84/48 mm Hg. Which finding is most
concerning?
A. Temperature elevation
B. Tachycardia
C. Tachypnea
D. Hypotension
Correct Answer: D.
Explanation: Severe hypotension suggests impaired tissue perfusion and possible
septic shock. Although all findings are significant, circulatory compromise represents
the most immediate threat.
,Question 4
A client receiving a blood transfusion develops chills, fever, and flank discomfort 15
minutes after initiation. What should the nurse do first?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Obtain a urine specimen
Correct Answer: B.
Explanation: Acute transfusion-reaction symptoms require immediate cessation of
the blood product. The nurse then maintains appropriate IV access according to
facility protocol and notifies the appropriate provider.
Question 5
An LPN is caring for a client under the direction of an RN. The client develops sudden
unilateral weakness and slurred speech. What is the most appropriate action?
A. Wait for the next scheduled assessment
B. Encourage oral fluids
C. Immediately report the acute neurological change
D. Document the findings after completing all routine medications
Correct Answer: C.
Explanation: Sudden focal neurological deficits may indicate an acute stroke. Rapid
recognition and escalation are essential because treatment eligibility can be time
dependent.
Question 6
Which assignment is most appropriate for an experienced nursing assistant?
A. Assessing a newly admitted client with chest pain
B. Teaching a client how to use an incentive spirometer
C. Obtaining routine vital signs on a stable client
D. Evaluating response to an analgesic
Correct Answer: C.
Explanation: Routine data collection on a stable client may be delegated when
, permitted by policy and when the assistant is competent. Assessment, teaching, and
evaluation require nursing judgment.
Question 7
A client refuses a prescribed medication because of religious beliefs. Which response
is most appropriate?
A. “You must take the medication because it was prescribed.”
B. “Your beliefs cannot interfere with necessary treatment.”
C. “Tell me what concerns you have about taking it.”
D. “I will document that you are noncompliant.”
Correct Answer: C.
Explanation: The response promotes therapeutic communication and respects
autonomy. The nurse should explore the client's concern and communicate the
refusal appropriately.
Question 8
A nurse discovers that a medication was administered to the wrong client. What is the
priority action?
A. Alter the medication record
B. Assess the client who received the medication
C. Wait for symptoms before notifying anyone
D. Ask another nurse to correct the documentation
Correct Answer: B.
Explanation: Client assessment and safety take priority after a medication error. The
error should then be reported and documented according to policy without falsifying
the record.
Question 9
A client with dysphagia begins coughing repeatedly during oral medication
administration. What should the nurse do?
A. Encourage the client to swallow faster
B. Give additional water
C. Stop the administration and assess swallowing and airway status
D. Crush all medications immediately
PRACTICE EXAM – STUDY GUIDE QUESTIONS &
ACTUAL TESTBANK | 150 QUESTIONS & 100% CORRECT
ANSWERS | LATEST UPDATE 2026/2027
Table of Contents: 1. Safe and Effective Care Environment — Coordinated Care; Scope of
Practice; Delegation; Documentation; Ethics; 2. Safety and Infection Prevention —
Standard Precautions; Transmission-Based Precautions; Sterile Technique; Emergency
Safety; 3. Health Promotion and Maintenance — Growth and Development; Maternal-
Newborn; Pediatrics; Older Adults; Screening and Prevention; 4. Psychosocial Integrity —
Mental Health; Therapeutic Communication; Crisis Intervention; Substance Use; 5. Basic
Care and Comfort — Mobility; Nutrition; Elimination; Pain; Skin Integrity; 6.
Pharmacological and Parenteral Therapies — Medication Administration; IV Therapy;
Adverse Effects; Medication Safety; 7. Reduction of Risk Potential — Monitoring;
Laboratory Interpretation; Diagnostic Procedures; Complications; 8. Physiological
Adaptation — Acute and Chronic Illness; Cardiovascular; Respiratory; Neurologic;
Endocrine; Renal; Gastrointestinal; Emergency Care; 9. New York Professional Practice —
LPN Scope; Supervision; Professional Accountability; Legal and Regulatory Issues; 10.
Clinical Judgment — Recognition of Cues; Analysis; Prioritization; Intervention;
Evaluation.
INTRODUCTION
This 2026/2027 New York Practical Nurse Readiness Test practice examination is
designed as an advanced study resource for candidates preparing for practical-
nursing licensure and readiness assessments. The content emphasizes clinical
judgment, prioritization, safety, pharmacology, physiological adaptation, psychosocial
care, health promotion, delegation, documentation, and professional practice. The
2026 NCLEX-PN framework explicitly emphasizes clinical judgment and integrates
recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking
action, and evaluating outcomes. New York-specific items also reflect the state's
statutory framework for LPN practice, including practice under the direction of
authorized practitioners. Questions are intentionally application-heavy and use
realistic clinical situations rather than simple memorization.
QUESTIONS 1–150
Question 1
A practical nurse receives report on four clients. Which client should the nurse assess
first?
,A. A client with chronic heart failure who gained 1 kg over 48 hours
B. A client with pneumonia whose oxygen saturation decreased from 95% to 89%
C. A client with diabetes whose premeal glucose is 178 mg/dL
D. A postoperative client requesting assistance to the bathroom
Correct Answer: B.
Explanation: A new decline in oxygen saturation in a client with pneumonia
indicates worsening respiratory status and requires immediate assessment. Airway
and breathing concerns take priority over stable or less urgent findings.
Question 2
A client receiving IV morphine becomes difficult to arouse and has a respiratory rate
of 7/min. Which action is the priority?
A. Obtain a urine specimen
B. Administer the next scheduled dose later
C. Stimulate the client and initiate emergency respiratory support measures
D. Document the sedation level and reassess in 30 minutes
Correct Answer: C.
Explanation: Severe opioid-induced respiratory depression is an emergency.
Immediate airway and breathing support takes precedence over documentation or
routine reassessment.
Question 3
A client with suspected sepsis has a temperature of 39.2°C, heart rate 128/min,
respiratory rate 30/min, and blood pressure 84/48 mm Hg. Which finding is most
concerning?
A. Temperature elevation
B. Tachycardia
C. Tachypnea
D. Hypotension
Correct Answer: D.
Explanation: Severe hypotension suggests impaired tissue perfusion and possible
septic shock. Although all findings are significant, circulatory compromise represents
the most immediate threat.
,Question 4
A client receiving a blood transfusion develops chills, fever, and flank discomfort 15
minutes after initiation. What should the nurse do first?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Obtain a urine specimen
Correct Answer: B.
Explanation: Acute transfusion-reaction symptoms require immediate cessation of
the blood product. The nurse then maintains appropriate IV access according to
facility protocol and notifies the appropriate provider.
Question 5
An LPN is caring for a client under the direction of an RN. The client develops sudden
unilateral weakness and slurred speech. What is the most appropriate action?
A. Wait for the next scheduled assessment
B. Encourage oral fluids
C. Immediately report the acute neurological change
D. Document the findings after completing all routine medications
Correct Answer: C.
Explanation: Sudden focal neurological deficits may indicate an acute stroke. Rapid
recognition and escalation are essential because treatment eligibility can be time
dependent.
Question 6
Which assignment is most appropriate for an experienced nursing assistant?
A. Assessing a newly admitted client with chest pain
B. Teaching a client how to use an incentive spirometer
C. Obtaining routine vital signs on a stable client
D. Evaluating response to an analgesic
Correct Answer: C.
Explanation: Routine data collection on a stable client may be delegated when
, permitted by policy and when the assistant is competent. Assessment, teaching, and
evaluation require nursing judgment.
Question 7
A client refuses a prescribed medication because of religious beliefs. Which response
is most appropriate?
A. “You must take the medication because it was prescribed.”
B. “Your beliefs cannot interfere with necessary treatment.”
C. “Tell me what concerns you have about taking it.”
D. “I will document that you are noncompliant.”
Correct Answer: C.
Explanation: The response promotes therapeutic communication and respects
autonomy. The nurse should explore the client's concern and communicate the
refusal appropriately.
Question 8
A nurse discovers that a medication was administered to the wrong client. What is the
priority action?
A. Alter the medication record
B. Assess the client who received the medication
C. Wait for symptoms before notifying anyone
D. Ask another nurse to correct the documentation
Correct Answer: B.
Explanation: Client assessment and safety take priority after a medication error. The
error should then be reported and documented according to policy without falsifying
the record.
Question 9
A client with dysphagia begins coughing repeatedly during oral medication
administration. What should the nurse do?
A. Encourage the client to swallow faster
B. Give additional water
C. Stop the administration and assess swallowing and airway status
D. Crush all medications immediately
