New York NCLEX-PN State Board Simulator | Multi-
Version Exam Prep & Rationales | 2027–2028 Syllabus
Abstract
Purpose: This comprehensive examination guide is designed to prepare Licensed Practical
Nursing (LPN) candidates for the NCLEX-PN examination required for licensure in New
York State. The exam incorporates the 2026 NCLEX-PN Test Plan effective April 1, 2026,
which retains the Client Needs categories and percentage weights from the 2023 plan with
minor edits for currency and clarity .
Examination Framework: The NCLEX-PN employs a Computerized Adaptive Testing
(CAT) format, where questions adapt in real-time based on candidate responses. The test
plan is organized into four major Client Needs categories: Safe and Effective Care
Environment, Health Promotion and Maintenance, Psychosocial Integrity, and
Physiological Integrity . The examination integrates the NCSBN Clinical Judgment
Measurement Model (NCJMM) to evaluate clinical judgment through an iterative process .
New York Licensure Requirements: To qualify for LPN licensure in New York, applicants
must: file an application, complete an approved practical nursing program or equivalent,
pass the NCLEX-PN, be at least 17 years of age, demonstrate good moral character, and
pay the required fees ($115 for examination and initial license, $45 for each reexamination)
. New York does not participate in the Enhanced Nurse Licensure Compact (eNLC) .
New York Practice Requirements: New York requires LPNs to complete an approved
infection control course and a child abuse identification and reporting course for licensure .
LPNs may provide IV therapy services only if appropriately trained and clinically
competent, with annual competency assessments required . NYSED does not require
fingerprinting for LPN licensure .
Key Content Domains: This test bank addresses all Client Needs categories: Safe and
Effective Care Environment (Management of Care 18-24%, Safety and Infection Prevention
and Control 8-14%), Health Promotion and Maintenance (6-12%), Psychosocial Integrity (9-
15%), and Physiological Integrity (Basic Care and Comfort 7-13%, Pharmacological and
Parenteral Therapies 10-16%, Reduction of Risk Potential 9-15%, Physiological Adaptation
11-17%) .
Target Audience: This resource is suitable for nursing students preparing for the NCLEX-
PN examination, graduates seeking initial New York licensure, internationally educated
nurses preparing for U.S. licensure examination, and LPNs preparing for recertification or
continuing education.
Disclaimer: This study guide is for educational purposes only and should be used in
conjunction with official NCSBN, Pearson VUE, and New York State Education
Department resources. Candidates should consult the current NCLEX-PN Test Plan and
New York State Board for Nursing requirements for definitive guidance.
,SECTION I: SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (18-24%) - Questions 1-45
CASE STUDY 1: Delegation, Supervision, and Assignment
A charge nurse on a long-term care unit is making assignments for the shift. The unit has
two RNs, three LPNs, and four certified nursing assistants (CNAs). The following patients
are on the unit:
Patient A: 78-year-old with diabetes requiring insulin administration and blood glucose
monitoring
Patient B: 85-year-old with dementia requiring assistance with ADLs and redirection
Patient C: 72-year-old post-CVA with a PEG tube requiring tube feeding administration
Patient D: 90-year-old with stable vital signs requiring daily weights and vital signs
Patient E: 68-year-old with a new colostomy requiring ostomy care and teaching
1. Which patient assignment is most appropriate for the LPN?
A) Patients A, B, and D
B) Patients A, C, and D
C) Patients B, D, and E
D) Patients C and E only
Correct Answer: B
Rationale: LPNs may provide care for stable patients requiring insulin administration, tube
feedings, and routine monitoring. Patient A (insulin) and C (PEG tube) are within LPN
scope when stable. Patient D (vital signs) can be delegated to CNA. Patient B
(dementia/ADLs) is appropriate for CNA. Patient E (new ostomy teaching) requires RN-
level initial teaching and assessment. Answer B is correct because it assigns stable patients
requiring nursing interventions to LPNs. Answer A is incorrect because Patient E requires
RN assessment. Answer C is incorrect because Patient E requires RN-level teaching.
Answer D is incorrect because it underutilizes staff and omits stable patients the LPN
could manage .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
2. Which patient should the charge nurse assign to the RN?
,A) Patient A
B) Patient B
C) Patient C
D) Patient E
Correct Answer: D
Rationale: Patient E requires initial colostomy teaching and assessment, which falls within
the RN's scope of practice as it involves comprehensive patient education, assessment of
learning needs, and evaluation of understanding. Answer A is incorrect because insulin
administration in a stable patient can be assigned to an LPN. Answer B is incorrect
because Patient B can be assigned to a CNA with appropriate supervision. Answer C is
incorrect because PEG tube feeding in a stable patient can be assigned to an LPN. Initial
teaching, discharge planning, and complex patient assessments are RN responsibilities .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
3. Which task can the nurse safely delegate to a certified nursing assistant (CNA)?
A) Administering insulin
B) Obtaining daily weights
C) Administering tube feeding
D) Assessing a new ostomy
Correct Answer: B
Rationale: Obtaining daily weights is a routine, stable-task that can be safely delegated to
CNAs with appropriate training and supervision. Answer A is incorrect because medication
administration requires nursing scope. Answer C is incorrect because tube feeding
administration requires nursing judgment. Answer D is incorrect because assessment
requires professional nursing judgment. The RN/LPN retains accountability for delegated
tasks and must ensure the delegatee's competency .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
4. When assigning a patient to an LPN, which factor is most important for the charge nurse
to consider?
A) The LPN's personal preference
B) The LPN's educational preparation and demonstrated competency
C) The patient's insurance coverage
D) The availability of CNAs
Correct Answer: B
Rationale: The most important factor in assignment is the LPN's educational preparation
and demonstrated competency to perform the required tasks safely. Answer A is incorrect
, because personal preference does not determine competency. Answer C is incorrect because
insurance does not affect assignment decisions. Answer D is incorrect because staffing
availability should not override competency considerations. LPNs must only accept
assignments they are competent to carry out safely .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
5. What is the RN's responsibility when delegating tasks to an LPN?
A) Delegating all tasks to reduce workload
B) Verifying competency and providing appropriate supervision
C) Delegating tasks without follow-up
D) Delegating tasks to anyone available regardless of competency
Correct Answer: B
Rationale: The RN must verify competency and provide supervision when delegating tasks.
Answer A is incorrect because delegation must be appropriate and within scope. Answer C
is incorrect because supervision and follow-up are required. Answer D is incorrect because
competency verification is essential. The RN retains accountability for delegated tasks and
must ensure the delegatee can perform the task safely .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
6. In New York State, an LPN may administer IV therapy only if:
A) They have completed an IV therapy training program and demonstrated competency
B) They have worked as an LPN for at least one year
C) They are supervised by a physician
D) They have completed a BSN program
Correct Answer: A
Rationale: New York law requires LPNs to complete IV Therapy Training and demonstrate
clinical competency before providing IV Therapy services. Answer B is incorrect because
years of experience do not substitute for formal training. Answer C is incorrect because
supervision by an RN, NP, CNS, physician, dentist, or podiatrist is required in health
facilities, but training is also required. Answer D is incorrect because BSN is not required
for LPN IV therapy .
Reference: NYSED LPN IV Therapy Guidance; 10 NYCRR §400.15 and §700.4
7. In a health care facility, LPNs providing IV therapy must practice under the onsite
supervision of:
Version Exam Prep & Rationales | 2027–2028 Syllabus
Abstract
Purpose: This comprehensive examination guide is designed to prepare Licensed Practical
Nursing (LPN) candidates for the NCLEX-PN examination required for licensure in New
York State. The exam incorporates the 2026 NCLEX-PN Test Plan effective April 1, 2026,
which retains the Client Needs categories and percentage weights from the 2023 plan with
minor edits for currency and clarity .
Examination Framework: The NCLEX-PN employs a Computerized Adaptive Testing
(CAT) format, where questions adapt in real-time based on candidate responses. The test
plan is organized into four major Client Needs categories: Safe and Effective Care
Environment, Health Promotion and Maintenance, Psychosocial Integrity, and
Physiological Integrity . The examination integrates the NCSBN Clinical Judgment
Measurement Model (NCJMM) to evaluate clinical judgment through an iterative process .
New York Licensure Requirements: To qualify for LPN licensure in New York, applicants
must: file an application, complete an approved practical nursing program or equivalent,
pass the NCLEX-PN, be at least 17 years of age, demonstrate good moral character, and
pay the required fees ($115 for examination and initial license, $45 for each reexamination)
. New York does not participate in the Enhanced Nurse Licensure Compact (eNLC) .
New York Practice Requirements: New York requires LPNs to complete an approved
infection control course and a child abuse identification and reporting course for licensure .
LPNs may provide IV therapy services only if appropriately trained and clinically
competent, with annual competency assessments required . NYSED does not require
fingerprinting for LPN licensure .
Key Content Domains: This test bank addresses all Client Needs categories: Safe and
Effective Care Environment (Management of Care 18-24%, Safety and Infection Prevention
and Control 8-14%), Health Promotion and Maintenance (6-12%), Psychosocial Integrity (9-
15%), and Physiological Integrity (Basic Care and Comfort 7-13%, Pharmacological and
Parenteral Therapies 10-16%, Reduction of Risk Potential 9-15%, Physiological Adaptation
11-17%) .
Target Audience: This resource is suitable for nursing students preparing for the NCLEX-
PN examination, graduates seeking initial New York licensure, internationally educated
nurses preparing for U.S. licensure examination, and LPNs preparing for recertification or
continuing education.
Disclaimer: This study guide is for educational purposes only and should be used in
conjunction with official NCSBN, Pearson VUE, and New York State Education
Department resources. Candidates should consult the current NCLEX-PN Test Plan and
New York State Board for Nursing requirements for definitive guidance.
,SECTION I: SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (18-24%) - Questions 1-45
CASE STUDY 1: Delegation, Supervision, and Assignment
A charge nurse on a long-term care unit is making assignments for the shift. The unit has
two RNs, three LPNs, and four certified nursing assistants (CNAs). The following patients
are on the unit:
Patient A: 78-year-old with diabetes requiring insulin administration and blood glucose
monitoring
Patient B: 85-year-old with dementia requiring assistance with ADLs and redirection
Patient C: 72-year-old post-CVA with a PEG tube requiring tube feeding administration
Patient D: 90-year-old with stable vital signs requiring daily weights and vital signs
Patient E: 68-year-old with a new colostomy requiring ostomy care and teaching
1. Which patient assignment is most appropriate for the LPN?
A) Patients A, B, and D
B) Patients A, C, and D
C) Patients B, D, and E
D) Patients C and E only
Correct Answer: B
Rationale: LPNs may provide care for stable patients requiring insulin administration, tube
feedings, and routine monitoring. Patient A (insulin) and C (PEG tube) are within LPN
scope when stable. Patient D (vital signs) can be delegated to CNA. Patient B
(dementia/ADLs) is appropriate for CNA. Patient E (new ostomy teaching) requires RN-
level initial teaching and assessment. Answer B is correct because it assigns stable patients
requiring nursing interventions to LPNs. Answer A is incorrect because Patient E requires
RN assessment. Answer C is incorrect because Patient E requires RN-level teaching.
Answer D is incorrect because it underutilizes staff and omits stable patients the LPN
could manage .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
2. Which patient should the charge nurse assign to the RN?
,A) Patient A
B) Patient B
C) Patient C
D) Patient E
Correct Answer: D
Rationale: Patient E requires initial colostomy teaching and assessment, which falls within
the RN's scope of practice as it involves comprehensive patient education, assessment of
learning needs, and evaluation of understanding. Answer A is incorrect because insulin
administration in a stable patient can be assigned to an LPN. Answer B is incorrect
because Patient B can be assigned to a CNA with appropriate supervision. Answer C is
incorrect because PEG tube feeding in a stable patient can be assigned to an LPN. Initial
teaching, discharge planning, and complex patient assessments are RN responsibilities .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
3. Which task can the nurse safely delegate to a certified nursing assistant (CNA)?
A) Administering insulin
B) Obtaining daily weights
C) Administering tube feeding
D) Assessing a new ostomy
Correct Answer: B
Rationale: Obtaining daily weights is a routine, stable-task that can be safely delegated to
CNAs with appropriate training and supervision. Answer A is incorrect because medication
administration requires nursing scope. Answer C is incorrect because tube feeding
administration requires nursing judgment. Answer D is incorrect because assessment
requires professional nursing judgment. The RN/LPN retains accountability for delegated
tasks and must ensure the delegatee's competency .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
4. When assigning a patient to an LPN, which factor is most important for the charge nurse
to consider?
A) The LPN's personal preference
B) The LPN's educational preparation and demonstrated competency
C) The patient's insurance coverage
D) The availability of CNAs
Correct Answer: B
Rationale: The most important factor in assignment is the LPN's educational preparation
and demonstrated competency to perform the required tasks safely. Answer A is incorrect
, because personal preference does not determine competency. Answer C is incorrect because
insurance does not affect assignment decisions. Answer D is incorrect because staffing
availability should not override competency considerations. LPNs must only accept
assignments they are competent to carry out safely .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
5. What is the RN's responsibility when delegating tasks to an LPN?
A) Delegating all tasks to reduce workload
B) Verifying competency and providing appropriate supervision
C) Delegating tasks without follow-up
D) Delegating tasks to anyone available regardless of competency
Correct Answer: B
Rationale: The RN must verify competency and provide supervision when delegating tasks.
Answer A is incorrect because delegation must be appropriate and within scope. Answer C
is incorrect because supervision and follow-up are required. Answer D is incorrect because
competency verification is essential. The RN retains accountability for delegated tasks and
must ensure the delegatee can perform the task safely .
Reference: NYSED LPN Scope of Practice; NCSBN Delegation Guidelines
6. In New York State, an LPN may administer IV therapy only if:
A) They have completed an IV therapy training program and demonstrated competency
B) They have worked as an LPN for at least one year
C) They are supervised by a physician
D) They have completed a BSN program
Correct Answer: A
Rationale: New York law requires LPNs to complete IV Therapy Training and demonstrate
clinical competency before providing IV Therapy services. Answer B is incorrect because
years of experience do not substitute for formal training. Answer C is incorrect because
supervision by an RN, NP, CNS, physician, dentist, or podiatrist is required in health
facilities, but training is also required. Answer D is incorrect because BSN is not required
for LPN IV therapy .
Reference: NYSED LPN IV Therapy Guidance; 10 NYCRR §400.15 and §700.4
7. In a health care facility, LPNs providing IV therapy must practice under the onsite
supervision of:
