NCLEX PN EXAM NEWEST 2026 ACTUAL EXAM TEST BANK | NGN NCLEX PN
EXAM WITH COMPLETE REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALES/ ALREADY GRADED A+
QUESTION 1
A practical nurse is caring for a client who was admitted with heart failure. The nurse notes that the
client has increased shortness of breath when lying flat, bilateral crackles in the lung bases, and a 2-kg
(4.4-lb) weight gain over the past 2 days. Which action should the practical nurse take first?
A. Encourage the client to increase oral fluid intake
B. Place the client in a high-Fowler's position
C. Administer a prescribed potassium supplement
D. Assist the client with ambulation in the hallway
Correct ANSWER: B
Rationale:
A. Encouraging oral fluid intake would worsen fluid overload and increase the client's symptoms. This
action is contraindicated in a client with heart failure who is already retaining fluid.
B. CORRECT: The client is showing signs of fluid overload and worsening heart failure, including
orthopnea, crackles, and rapid weight gain. Positioning the client upright decreases venous return and
improves lung expansion, reducing shortness of breath. This action should be taken first.
C. Administering a potassium supplement may be necessary if the client is on diuretic therapy, but it is
not the priority action. The immediate concern is respiratory distress from fluid overload.
D. Ambulation would increase oxygen demand and could worsen the client's respiratory status. This
action is not appropriate for a client experiencing acute shortness of breath.
,QUESTION 2
A practical nurse is preparing to administer digoxin to a client with heart failure. Which finding would
indicate that the medication should be withheld and the healthcare provider notified?
A. Apical pulse of 68 beats per minute
B. Serum potassium level of 3.2 mEq/L
C. Blood pressure of 118/76 mmHg
D. Respiratory rate of 18 breaths per minute
Correct ANSWER: B
Rationale:
A. An apical pulse of 68 beats per minute is within normal range (60-100 bpm) and would not be a
reason to withhold digoxin. The nurse should hold digoxin if the pulse is below 60 bpm in adults.
B. CORRECT: A serum potassium level of 3.2 mEq/L is below normal (3.5-5.0 mEq/L). Hypokalemia
increases the risk of digoxin toxicity and cardiac arrhythmias. The medication should be withheld and
the healthcare provider notified.
C. A blood pressure of 118/76 mmHg is within normal range and would not be a contraindication for
digoxin administration.
D. A respiratory rate of 18 breaths per minute is within normal range (12-20 breaths per minute) and
would not be a reason to withhold digoxin.
QUESTION 3
A client with type 2 diabetes mellitus is prescribed metformin. Which laboratory value should the
practical nurse monitor closely while the client is taking this medication?
A. Serum creatinine
B. Serum potassium
,C. Serum sodium
D. Serum calcium
Correct ANSWER: A
Rationale:
A. CORRECT: Metformin is excreted by the kidneys and can accumulate in clients with renal impairment,
increasing the risk of lactic acidosis. Serum creatinine and BUN should be monitored to assess renal
function.
B. Serum potassium is not specifically affected by metformin. Other diabetes medications or conditions
may affect potassium levels.
C. Serum sodium is not directly affected by metformin therapy. Sodium levels may be affected by other
factors such as fluid balance.
D. Serum calcium is not specifically affected by metformin. Calcium levels may be affected by other
medications or conditions.
QUESTION 4
A practical nurse is caring for a client who is receiving continuous enteral tube feedings. The nurse notes
that the client has developed diarrhea, abdominal distension, and decreased bowel sounds. Which
action should the nurse take?
A. Increase the rate of the tube feeding
B. Administer an anti-diarrheal medication
C. Check the client for lactose intolerance
D. Slow the rate of the tube feeding
Correct ANSWER: D
, Rationale:
A. Increasing the rate of the tube feeding would likely worsen the client's symptoms of diarrhea and
abdominal distension by delivering formula faster than the gastrointestinal tract can tolerate.
B. Administering an anti-diarrheal medication without identifying the cause could mask symptoms and
delay appropriate treatment. It is important to address the underlying cause first.
C. While lactose intolerance can cause diarrhea, the client's symptoms of abdominal distension and
decreased bowel sounds are more consistent with dumping syndrome or formula intolerance. This
assessment can be done but is not the priority action.
D. CORRECT: Slowing the rate of the tube feeding allows the gastrointestinal tract to process the
formula more gradually, reducing symptoms of dumping syndrome such as diarrhea and abdominal
distension.
QUESTION 5
A practical nurse is reinforcing teaching with a client who has been prescribed warfarin. Which
statement by the client indicates a need for further teaching?
A. "I will take my medication at the same time every day."
B. "I will avoid eating large amounts of green leafy vegetables."
C. "I can take ibuprofen if I have a headache."
D. "I will report any unusual bleeding to my healthcare provider."
Correct ANSWER: C
Rationale:
A. Taking warfarin at the same time every day is essential for maintaining therapeutic blood levels and
preventing fluctuations. This statement indicates correct understanding.
EXAM WITH COMPLETE REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS WITH RATIONALES/ ALREADY GRADED A+
QUESTION 1
A practical nurse is caring for a client who was admitted with heart failure. The nurse notes that the
client has increased shortness of breath when lying flat, bilateral crackles in the lung bases, and a 2-kg
(4.4-lb) weight gain over the past 2 days. Which action should the practical nurse take first?
A. Encourage the client to increase oral fluid intake
B. Place the client in a high-Fowler's position
C. Administer a prescribed potassium supplement
D. Assist the client with ambulation in the hallway
Correct ANSWER: B
Rationale:
A. Encouraging oral fluid intake would worsen fluid overload and increase the client's symptoms. This
action is contraindicated in a client with heart failure who is already retaining fluid.
B. CORRECT: The client is showing signs of fluid overload and worsening heart failure, including
orthopnea, crackles, and rapid weight gain. Positioning the client upright decreases venous return and
improves lung expansion, reducing shortness of breath. This action should be taken first.
C. Administering a potassium supplement may be necessary if the client is on diuretic therapy, but it is
not the priority action. The immediate concern is respiratory distress from fluid overload.
D. Ambulation would increase oxygen demand and could worsen the client's respiratory status. This
action is not appropriate for a client experiencing acute shortness of breath.
,QUESTION 2
A practical nurse is preparing to administer digoxin to a client with heart failure. Which finding would
indicate that the medication should be withheld and the healthcare provider notified?
A. Apical pulse of 68 beats per minute
B. Serum potassium level of 3.2 mEq/L
C. Blood pressure of 118/76 mmHg
D. Respiratory rate of 18 breaths per minute
Correct ANSWER: B
Rationale:
A. An apical pulse of 68 beats per minute is within normal range (60-100 bpm) and would not be a
reason to withhold digoxin. The nurse should hold digoxin if the pulse is below 60 bpm in adults.
B. CORRECT: A serum potassium level of 3.2 mEq/L is below normal (3.5-5.0 mEq/L). Hypokalemia
increases the risk of digoxin toxicity and cardiac arrhythmias. The medication should be withheld and
the healthcare provider notified.
C. A blood pressure of 118/76 mmHg is within normal range and would not be a contraindication for
digoxin administration.
D. A respiratory rate of 18 breaths per minute is within normal range (12-20 breaths per minute) and
would not be a reason to withhold digoxin.
QUESTION 3
A client with type 2 diabetes mellitus is prescribed metformin. Which laboratory value should the
practical nurse monitor closely while the client is taking this medication?
A. Serum creatinine
B. Serum potassium
,C. Serum sodium
D. Serum calcium
Correct ANSWER: A
Rationale:
A. CORRECT: Metformin is excreted by the kidneys and can accumulate in clients with renal impairment,
increasing the risk of lactic acidosis. Serum creatinine and BUN should be monitored to assess renal
function.
B. Serum potassium is not specifically affected by metformin. Other diabetes medications or conditions
may affect potassium levels.
C. Serum sodium is not directly affected by metformin therapy. Sodium levels may be affected by other
factors such as fluid balance.
D. Serum calcium is not specifically affected by metformin. Calcium levels may be affected by other
medications or conditions.
QUESTION 4
A practical nurse is caring for a client who is receiving continuous enteral tube feedings. The nurse notes
that the client has developed diarrhea, abdominal distension, and decreased bowel sounds. Which
action should the nurse take?
A. Increase the rate of the tube feeding
B. Administer an anti-diarrheal medication
C. Check the client for lactose intolerance
D. Slow the rate of the tube feeding
Correct ANSWER: D
, Rationale:
A. Increasing the rate of the tube feeding would likely worsen the client's symptoms of diarrhea and
abdominal distension by delivering formula faster than the gastrointestinal tract can tolerate.
B. Administering an anti-diarrheal medication without identifying the cause could mask symptoms and
delay appropriate treatment. It is important to address the underlying cause first.
C. While lactose intolerance can cause diarrhea, the client's symptoms of abdominal distension and
decreased bowel sounds are more consistent with dumping syndrome or formula intolerance. This
assessment can be done but is not the priority action.
D. CORRECT: Slowing the rate of the tube feeding allows the gastrointestinal tract to process the
formula more gradually, reducing symptoms of dumping syndrome such as diarrhea and abdominal
distension.
QUESTION 5
A practical nurse is reinforcing teaching with a client who has been prescribed warfarin. Which
statement by the client indicates a need for further teaching?
A. "I will take my medication at the same time every day."
B. "I will avoid eating large amounts of green leafy vegetables."
C. "I can take ibuprofen if I have a headache."
D. "I will report any unusual bleeding to my healthcare provider."
Correct ANSWER: C
Rationale:
A. Taking warfarin at the same time every day is essential for maintaining therapeutic blood levels and
preventing fluctuations. This statement indicates correct understanding.
