NCLEX-PN COMPREHENSIVE EXAM PREP BUNDLE:
LICENSING EXAM REVIEW WITH PRACTICE QUESTIONS,
ANSWERS AND RATIONALES, COMPLETE STUDY GUIDE
FOR PRACTICAL NURSING CERTIFICATION — 2026–2027
EDITION
This comprehensive examination preparation document is designed for practical nursing
candidates preparing for the NCLEX-PN licensing examination in the United States. The
assessment covers the four major client needs categories: safe and effective care environment,
health promotion and maintenance, psychosocial integrity, and physiological integrity. Each
question has been developed to mirror the cognitive complexity and clinical judgment
expectations of the current NCLEX-PN test plan. The 2026–2027 edition incorporates updated
pharmacology, infection control standards, client safety protocols, and evidence-based nursing
interventions essential for entry-level practical nursing practice. Detailed rationales are
provided to reinforce clinical reasoning and highlight the safest, most effective nursing actions.
This resource is ideal for exam preparation, remediation, and identifying knowledge gaps across
all content areas of the practical nursing licensure examination.
Table of Contents
I. Safe and Effective Care Environment
II. Health Promotion and Maintenance
III. Psychosocial Integrity
IV. Basic Care and Comfort
V. Pharmacological and Parenteral Therapies
VI. Reduction of Risk Potential
VII. Physiological Adaptation
VIII. Coordinated Care and Delegation
IX. Infection Control and Safety
X. Legal and Ethical Nursing Practice
,1: The practical nurse is caring for a client who has returned from surgery with an indwelling
urinary catheter. Which action is most important to prevent catheter-associated urinary tract
infection?
A) Irrigate the catheter with normal saline every shift
B) Keep the drainage bag below the level of the bladder at all times
C) Clamp the catheter for 2 hours before removal
D) Cleanse the perineal area with alcohol daily
Correct Answer: B
Keeping the drainage bag below bladder level prevents backflow of urine into the bladder,
reducing infection risk. The bag should be emptied regularly and the catheter secured to the leg.
Irrigation and alcohol cleansing are unnecessary and may introduce pathogens.
2: A client is prescribed furosemide 40 mg PO daily. Which food should the practical nurse
encourage the client to increase in the diet?
A) Bananas and oranges
B) Cheese and yogurt
C) Pasta and rice
D) Bread and cereals
Correct Answer: A
Furosemide is a loop diuretic that causes potassium loss, increasing the risk of hypokalemia.
Bananas and oranges are rich in potassium and help maintain normal levels. Cheese and yogurt
provide calcium; grains provide carbohydrates but not potassium.
3: The practical nurse observes a client with a new tracheostomy who develops sudden
restlessness and decreased oxygen saturation. The nurse should first:
A) Suction the tracheostomy
B) Administer a bronchodilator
C) Increase the oxygen flow rate without assessing
D) Notify the healthcare provider immediately
,Correct Answer: A
Sudden restlessness and decreased oxygen saturation suggest a mucus plug or airway
obstruction. The first action is to suction the tracheostomy to clear the airway and restore
oxygenation. Increasing oxygen without clearing the obstruction is ineffective; notifying the
provider is secondary after attempting suction.
4: A client with diabetes mellitus reports feeling shaky, diaphoretic, and confused. The practical
nurse should first:
A) Administer insulin as prescribed
B) Check the client's blood glucose level
C) Give the client a glass of orange juice
D) Call the healthcare provider
Correct Answer: B
The client is displaying signs of hypoglycemia, but the nurse must validate the blood glucose
level before treatment. Administering insulin would worsen hypoglycemia; giving orange juice
without checking glucose may be inappropriate if the client is hyperglycemic. The provider is not
needed before a quick bedside glucose check.
5: The practical nurse is preparing to administer an intramuscular injection to a 6-month-old
infant. Which site is most appropriate?
A) Deltoid muscle
B) Ventrogluteal muscle
C) Dorsogluteal muscle
D) Vastus lateralis muscle
Correct Answer: D
The vastus lateralis is the preferred site for infants and young children because it is well
developed and free of major nerves and blood vessels. The deltoid is too small, the dorsogluteal
is contraindicated due to sciatic nerve risk, and the ventrogluteal is safe but may be more
difficult in infants.
, 6: A client has a prescription for digoxin 0.125 mg PO daily. Before administering the
medication, the practical nurse should assess:
A) Respiratory rate and temperature
B) Apical pulse for one full minute
C) Blood pressure in both arms
D) Pupillary response
Correct Answer: B
Digoxin can cause bradycardia and heart block. The nurse must count the apical pulse for one
minute and hold the medication if the pulse is below 60 beats/min in adults. Other vital signs do
not directly indicate digoxin toxicity or safe administration.
7: The practical nurse is caring for a client who is on contact precautions for Clostridioides
difficile infection. Which action is essential?
A) Wear a surgical mask when entering the room
B) Use soap and water for hand hygiene after care
C) Keep the door closed at all times
D) Wear sterile gloves for all client contact
Correct Answer: B
Alcohol-based hand sanitizers are not effective against C. difficile spores. Soap and water hand
hygiene is essential. Contact precautions require gloves and gown, not necessarily a mask unless
there is risk of splash. The door does not need to be closed; sterile gloves are unnecessary for
routine care.
8: A client is receiving a continuous tube feeding. The practical nurse should place the client in
which position?
A) Supine
B) Trendelenburg
C) Head of bed elevated 30 to 45 degrees
D) Left side-lying flat
LICENSING EXAM REVIEW WITH PRACTICE QUESTIONS,
ANSWERS AND RATIONALES, COMPLETE STUDY GUIDE
FOR PRACTICAL NURSING CERTIFICATION — 2026–2027
EDITION
This comprehensive examination preparation document is designed for practical nursing
candidates preparing for the NCLEX-PN licensing examination in the United States. The
assessment covers the four major client needs categories: safe and effective care environment,
health promotion and maintenance, psychosocial integrity, and physiological integrity. Each
question has been developed to mirror the cognitive complexity and clinical judgment
expectations of the current NCLEX-PN test plan. The 2026–2027 edition incorporates updated
pharmacology, infection control standards, client safety protocols, and evidence-based nursing
interventions essential for entry-level practical nursing practice. Detailed rationales are
provided to reinforce clinical reasoning and highlight the safest, most effective nursing actions.
This resource is ideal for exam preparation, remediation, and identifying knowledge gaps across
all content areas of the practical nursing licensure examination.
Table of Contents
I. Safe and Effective Care Environment
II. Health Promotion and Maintenance
III. Psychosocial Integrity
IV. Basic Care and Comfort
V. Pharmacological and Parenteral Therapies
VI. Reduction of Risk Potential
VII. Physiological Adaptation
VIII. Coordinated Care and Delegation
IX. Infection Control and Safety
X. Legal and Ethical Nursing Practice
,1: The practical nurse is caring for a client who has returned from surgery with an indwelling
urinary catheter. Which action is most important to prevent catheter-associated urinary tract
infection?
A) Irrigate the catheter with normal saline every shift
B) Keep the drainage bag below the level of the bladder at all times
C) Clamp the catheter for 2 hours before removal
D) Cleanse the perineal area with alcohol daily
Correct Answer: B
Keeping the drainage bag below bladder level prevents backflow of urine into the bladder,
reducing infection risk. The bag should be emptied regularly and the catheter secured to the leg.
Irrigation and alcohol cleansing are unnecessary and may introduce pathogens.
2: A client is prescribed furosemide 40 mg PO daily. Which food should the practical nurse
encourage the client to increase in the diet?
A) Bananas and oranges
B) Cheese and yogurt
C) Pasta and rice
D) Bread and cereals
Correct Answer: A
Furosemide is a loop diuretic that causes potassium loss, increasing the risk of hypokalemia.
Bananas and oranges are rich in potassium and help maintain normal levels. Cheese and yogurt
provide calcium; grains provide carbohydrates but not potassium.
3: The practical nurse observes a client with a new tracheostomy who develops sudden
restlessness and decreased oxygen saturation. The nurse should first:
A) Suction the tracheostomy
B) Administer a bronchodilator
C) Increase the oxygen flow rate without assessing
D) Notify the healthcare provider immediately
,Correct Answer: A
Sudden restlessness and decreased oxygen saturation suggest a mucus plug or airway
obstruction. The first action is to suction the tracheostomy to clear the airway and restore
oxygenation. Increasing oxygen without clearing the obstruction is ineffective; notifying the
provider is secondary after attempting suction.
4: A client with diabetes mellitus reports feeling shaky, diaphoretic, and confused. The practical
nurse should first:
A) Administer insulin as prescribed
B) Check the client's blood glucose level
C) Give the client a glass of orange juice
D) Call the healthcare provider
Correct Answer: B
The client is displaying signs of hypoglycemia, but the nurse must validate the blood glucose
level before treatment. Administering insulin would worsen hypoglycemia; giving orange juice
without checking glucose may be inappropriate if the client is hyperglycemic. The provider is not
needed before a quick bedside glucose check.
5: The practical nurse is preparing to administer an intramuscular injection to a 6-month-old
infant. Which site is most appropriate?
A) Deltoid muscle
B) Ventrogluteal muscle
C) Dorsogluteal muscle
D) Vastus lateralis muscle
Correct Answer: D
The vastus lateralis is the preferred site for infants and young children because it is well
developed and free of major nerves and blood vessels. The deltoid is too small, the dorsogluteal
is contraindicated due to sciatic nerve risk, and the ventrogluteal is safe but may be more
difficult in infants.
, 6: A client has a prescription for digoxin 0.125 mg PO daily. Before administering the
medication, the practical nurse should assess:
A) Respiratory rate and temperature
B) Apical pulse for one full minute
C) Blood pressure in both arms
D) Pupillary response
Correct Answer: B
Digoxin can cause bradycardia and heart block. The nurse must count the apical pulse for one
minute and hold the medication if the pulse is below 60 beats/min in adults. Other vital signs do
not directly indicate digoxin toxicity or safe administration.
7: The practical nurse is caring for a client who is on contact precautions for Clostridioides
difficile infection. Which action is essential?
A) Wear a surgical mask when entering the room
B) Use soap and water for hand hygiene after care
C) Keep the door closed at all times
D) Wear sterile gloves for all client contact
Correct Answer: B
Alcohol-based hand sanitizers are not effective against C. difficile spores. Soap and water hand
hygiene is essential. Contact precautions require gloves and gown, not necessarily a mask unless
there is risk of splash. The door does not need to be closed; sterile gloves are unnecessary for
routine care.
8: A client is receiving a continuous tube feeding. The practical nurse should place the client in
which position?
A) Supine
B) Trendelenburg
C) Head of bed elevated 30 to 45 degrees
D) Left side-lying flat
