Illinois NCLEX-PN
Practice
Examination
Section 1: Safe and Effective Care Environment –
Management of Care
1. The practical nurse (PN) is caring for a client who is scheduled for surgery. The
client asks the PN to explain the surgical procedure in detail. Which action should
the PN take?
A. Explain the procedure in detail
B. Notify the registered nurse (RN) or health care provider, as this is part of informed
consent
C. Give the client a pamphlet and tell them to read it
D. Tell the client it is not important to know
Correct Answer: B
Rationale: The PN's scope of practice does not include obtaining informed consent or
explaining surgical procedures; that responsibility belongs to the health care provider.
The PN should alert the RN or provider so the client can receive accurate information .
2. The charge nurse on a medical-surgical unit is making assignments for a
licensed practical nurse (LPN). Which task is appropriate to delegate to the LPN?
,A. Perform the initial admission assessment on a patient with pneumonia
B. Administer a PRN enema to a constipated patient
C. Develop the nursing care plan for a patient with heart failure
D. Teach a patient how to self-administer insulin
Correct Answer: B
Rationale: LPNs can administer medications (including PRN enemas) and perform
stable, routine treatments. Initial assessment and care plan development require RN-
level critical thinking. Initial patient teaching is typically performed by the RN .
3. A nurse is caring for a patient who has a do-not-resuscitate (DNR) order. The
family asks the nurse to explain what DNR means. The nurse should respond:
A. "It means we will not provide any treatment to keep the patient alive."
B. "It means that if the patient stops breathing or the heart stops, we will not perform
CPR or advanced cardiac life support."
C. "I cannot discuss that; you need to talk to the doctor."
D. "It means the patient will be allowed to die naturally without any medical care."
Correct Answer: B
Rationale: DNR means that if the patient experiences cardiac or respiratory arrest, CPR
and ACLS will not be initiated. It does NOT mean withholding other treatments such as
pain relief, antibiotics, or hydration .
4. A nurse manager is reviewing client rights with the nursing staff. Which
statement indicates an understanding of client rights?
A. "A client can refuse a treatment even if it is life-saving."
B. "A client cannot refuse a treatment once it has been started."
C. "A client's family can override the client's refusal."
D. "Only physicians can determine if a client is competent to refuse."
Correct Answer: A
,Rationale: A competent adult has the right to refuse any treatment, even life-saving
treatment, at any time. This is a fundamental patient right. Family cannot override the
client's refusal .
5. A charge nurse is observing a new graduate nurse insert a urinary catheter. The
new nurse touches the inner surface of the sterile drape without sterile gloves. The
charge nurse should:
A. Praise the new nurse for completing the procedure quickly
B. Stop the procedure immediately and remind the new nurse about sterile technique
C. Ignore the error because the patient is not at risk
D. Report the new nurse to the state board of nursing
Correct Answer: B
Rationale: Breaking sterile technique increases the risk of infection. The charge nurse
must intervene immediately to correct the error and prevent contamination. Reporting
to the state board is not appropriate for a single correctable error .
6. A PN is delegating tasks to unlicensed assistive personnel (UAP). Which task is
most appropriate for the PN to delegate?
A. Measuring and recording intake and output for a stable client
B. Performing a focused respiratory assessment
C. Administering oral medications
D. Evaluating the effectiveness of patient teaching
Correct Answer: A
Rationale: Measuring and recording intake and output is a routine, non-invasive task
within the UAP scope. Assessment, medication administration, and evaluation require
licensed nursing judgment and cannot be delegated.
, 7. A PN is caring for a client who is 1 day postoperative following a total hip
replacement and reports pain rated 4/10. Which client should the PN assess first?
A. The client with hip pain rated 4/10
B. A client who has type 2 diabetes and a fasting glucose of 142 mg/dL
C. A client who has heart failure and reports increasing dyspnea over the past 2 hours
D. A client who has a new colostomy and requests assistance with appliance change
Correct Answer: C
Rationale: Increasing dyspnea in a heart failure client may indicate worsening fluid
overload, pulmonary edema, or cardiac decompensation. The ABC prioritization
framework directs the nurse to address breathing difficulties first.
8. A PN is reviewing a client's advance directive. The client has a living will stating
"no heroic measures." The surgeon asks the PN to witness the client signing a
consent form for a high-risk procedure. What is the PN's priority action?
A. Witness the consent as requested
B. Verify the client understands the procedure and its risks
C. Refuse to witness because of the living will
D. Contact the ethics committee immediately
Correct Answer: B
Rationale: The nurse's role in informed consent is to verify that the client understands
the procedure, risks, benefits, and alternatives. A living will does not prohibit surgery; it
guides end-of-life care.
9. A PN observes a coworker diverting a narcotic pain medication for personal use.
What is the priority action?
A. Confront the coworker directly about the behavior
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police department
Practice
Examination
Section 1: Safe and Effective Care Environment –
Management of Care
1. The practical nurse (PN) is caring for a client who is scheduled for surgery. The
client asks the PN to explain the surgical procedure in detail. Which action should
the PN take?
A. Explain the procedure in detail
B. Notify the registered nurse (RN) or health care provider, as this is part of informed
consent
C. Give the client a pamphlet and tell them to read it
D. Tell the client it is not important to know
Correct Answer: B
Rationale: The PN's scope of practice does not include obtaining informed consent or
explaining surgical procedures; that responsibility belongs to the health care provider.
The PN should alert the RN or provider so the client can receive accurate information .
2. The charge nurse on a medical-surgical unit is making assignments for a
licensed practical nurse (LPN). Which task is appropriate to delegate to the LPN?
,A. Perform the initial admission assessment on a patient with pneumonia
B. Administer a PRN enema to a constipated patient
C. Develop the nursing care plan for a patient with heart failure
D. Teach a patient how to self-administer insulin
Correct Answer: B
Rationale: LPNs can administer medications (including PRN enemas) and perform
stable, routine treatments. Initial assessment and care plan development require RN-
level critical thinking. Initial patient teaching is typically performed by the RN .
3. A nurse is caring for a patient who has a do-not-resuscitate (DNR) order. The
family asks the nurse to explain what DNR means. The nurse should respond:
A. "It means we will not provide any treatment to keep the patient alive."
B. "It means that if the patient stops breathing or the heart stops, we will not perform
CPR or advanced cardiac life support."
C. "I cannot discuss that; you need to talk to the doctor."
D. "It means the patient will be allowed to die naturally without any medical care."
Correct Answer: B
Rationale: DNR means that if the patient experiences cardiac or respiratory arrest, CPR
and ACLS will not be initiated. It does NOT mean withholding other treatments such as
pain relief, antibiotics, or hydration .
4. A nurse manager is reviewing client rights with the nursing staff. Which
statement indicates an understanding of client rights?
A. "A client can refuse a treatment even if it is life-saving."
B. "A client cannot refuse a treatment once it has been started."
C. "A client's family can override the client's refusal."
D. "Only physicians can determine if a client is competent to refuse."
Correct Answer: A
,Rationale: A competent adult has the right to refuse any treatment, even life-saving
treatment, at any time. This is a fundamental patient right. Family cannot override the
client's refusal .
5. A charge nurse is observing a new graduate nurse insert a urinary catheter. The
new nurse touches the inner surface of the sterile drape without sterile gloves. The
charge nurse should:
A. Praise the new nurse for completing the procedure quickly
B. Stop the procedure immediately and remind the new nurse about sterile technique
C. Ignore the error because the patient is not at risk
D. Report the new nurse to the state board of nursing
Correct Answer: B
Rationale: Breaking sterile technique increases the risk of infection. The charge nurse
must intervene immediately to correct the error and prevent contamination. Reporting
to the state board is not appropriate for a single correctable error .
6. A PN is delegating tasks to unlicensed assistive personnel (UAP). Which task is
most appropriate for the PN to delegate?
A. Measuring and recording intake and output for a stable client
B. Performing a focused respiratory assessment
C. Administering oral medications
D. Evaluating the effectiveness of patient teaching
Correct Answer: A
Rationale: Measuring and recording intake and output is a routine, non-invasive task
within the UAP scope. Assessment, medication administration, and evaluation require
licensed nursing judgment and cannot be delegated.
, 7. A PN is caring for a client who is 1 day postoperative following a total hip
replacement and reports pain rated 4/10. Which client should the PN assess first?
A. The client with hip pain rated 4/10
B. A client who has type 2 diabetes and a fasting glucose of 142 mg/dL
C. A client who has heart failure and reports increasing dyspnea over the past 2 hours
D. A client who has a new colostomy and requests assistance with appliance change
Correct Answer: C
Rationale: Increasing dyspnea in a heart failure client may indicate worsening fluid
overload, pulmonary edema, or cardiac decompensation. The ABC prioritization
framework directs the nurse to address breathing difficulties first.
8. A PN is reviewing a client's advance directive. The client has a living will stating
"no heroic measures." The surgeon asks the PN to witness the client signing a
consent form for a high-risk procedure. What is the PN's priority action?
A. Witness the consent as requested
B. Verify the client understands the procedure and its risks
C. Refuse to witness because of the living will
D. Contact the ethics committee immediately
Correct Answer: B
Rationale: The nurse's role in informed consent is to verify that the client understands
the procedure, risks, benefits, and alternatives. A living will does not prohibit surgery; it
guides end-of-life care.
9. A PN observes a coworker diverting a narcotic pain medication for personal use.
What is the priority action?
A. Confront the coworker directly about the behavior
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police department
