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NCLEX-PN Practice Questions — 100 Original Items
Safe and Effective Care Environment: Coordinated Care (1–15)
1. The charge nurse is making assignments for an 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
Answer: B. LPNs can administer medications and perform stable, routine treatments. Initial
assessment, care plan development, and initial teaching require RN-level judgment .
2. A nurse is caring for a patient with a do-not-resuscitate (DNR) order. The family asks 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."
Answer: B. DNR means CPR and ACLS will not be initiated if cardiac or respiratory arrest
occurs. It does not mean withholding other treatments such as pain relief or antibiotics .
3. A patient is to receive a blood transfusion. Which IV solution is compatible for priming the
tubing?
A) 5% dextrose in water (D5W)
B) Lactated Ringer's (LR)
C) 0.9% normal saline
D) 0.45% normal saline (half-strength)
Answer: C. Only 0.9% normal saline is compatible with blood products. Dextrose can cause
hemolysis; LR contains calcium, which can cause clotting .
4. A nurse is reviewing client rights with staff. Which statement indicates understanding?
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."
Answer: A. A competent adult has the right to refuse any treatment, even life-saving
treatment, at any time .
5. A charge nurse is observing a new 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
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C) Ignore the error because the patient is not at risk
D) Report the new nurse to the state board of nursing
Answer: B. Breaking sterile technique increases infection risk. The charge nurse must
intervene immediately. Reporting to the state board is not appropriate for a single
correctable error .
6. A nurse is preparing to administer insulin. Which action should the LPN take FIRST?
A) Verify the client's identity using two identifiers
B) Check the client's blood glucose level
C) Review the physician's order for insulin type and dose
D) Assess the client for signs of hypoglycemia
Answer: C. Before administering any medication, the LPN must first verify the physician's
order to ensure the five rights of medication administration .
7. An LPN is caring for a client who had abdominal surgery 12 hours ago. Which finding
should the LPN report to the RN IMMEDIATELY?
A) Temperature of 99.2°F (37.3°C)
B) Serous drainage on the dressing
C) Absence of bowel sounds
D) Rigid, board-like abdomen
Answer: D. A rigid, board-like abdomen may indicate peritonitis or hemorrhage and requires
immediate RN assessment .
8. A client refuses a blood transfusion due to religious beliefs. Which actions should the
nurse take? (Select all that apply.)
A) Verify the patient understands risks
B) Document the refusal
C) Administer the transfusion if Hgb is critical
D) Notify the provider
E) Ask the family to override the decision
Answer: A, B, D. Competent adults have autonomy. The nurse ensures informed refusal,
documents, and notifies the provider. Forcing treatment or family override is unethical.
9. A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to
delegate?
A) Teaching a client about insulin administration
B) Ambulating a stable client
C) Assessing a post-op client's incision
D) Administering oral medications
Answer: B. Ambulating a stable client is within AP scope. Teaching, assessing, and
medication administration require licensed nurses.
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10. A nurse is caring for a client with a DNR order who is experiencing respiratory distress.
Which action is appropriate?
A) Withhold all comfort measures
B) Administer prescribed oxygen and comfort measures
C) Begin CPR immediately
D) Withhold all medications
Answer: B. DNR does not mean withholding comfort care, oxygen, or symptom
management. It specifically means no CPR or ACLS .
11. A charge nurse is teaching about restraints. Which instruction should be included?
A) Place a belt restraint on a school-age child who has seizures
B) Secure wrist restraints to the bed rails for an adolescent
C) Apply elbow immobilizers for an infant receiving cleft lip repair
D) Keep the side rails of a toddler's crib elevated
Answer: C. Elbow immobilizers prevent infants from touching surgical sites. Restraints
should never be secured to bed rails; belt restraints are contraindicated for seizure clients.
12. A nurse is preparing to discharge a client with a new prescription for warfarin. Which
statement indicates understanding?
A) "I will avoid eating large amounts of green leafy vegetables."
B) "I can take aspirin for headaches while on this medication."
C) "I will stop taking the medication if I notice bruising."
D) "I will have my blood drawn monthly for PT/INR."
Answer: A. Green leafy vegetables are high in vitamin K, which can decrease warfarin's
effectiveness. Aspirin increases bleeding risk; bruising is expected and should be reported.
13. A nurse is caring for a client with a new tracheostomy. Which action should the nurse
take first?
A) Performing tracheostomy suctioning
B) Assessing breath sounds
C) Providing oral care
D) Monitoring oxygen saturation
Answer: B. Assessment is always the first step before intervention. Assess breath sounds to
determine the need for suctioning.
14. A nurse is preparing a client for surgery. Which action should the nurse take first?
A) Verify the client's identity and surgical site
B) Administer preoperative medications
C) Obtain informed consent
D) Start an IV line
Answer: C. Informed consent must be obtained before preoperative medications that may
alter the client's ability to consent.
NCLEX-PN Practice Questions — 100 Original Items
Safe and Effective Care Environment: Coordinated Care (1–15)
1. The charge nurse is making assignments for an 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
Answer: B. LPNs can administer medications and perform stable, routine treatments. Initial
assessment, care plan development, and initial teaching require RN-level judgment .
2. A nurse is caring for a patient with a do-not-resuscitate (DNR) order. The family asks 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."
Answer: B. DNR means CPR and ACLS will not be initiated if cardiac or respiratory arrest
occurs. It does not mean withholding other treatments such as pain relief or antibiotics .
3. A patient is to receive a blood transfusion. Which IV solution is compatible for priming the
tubing?
A) 5% dextrose in water (D5W)
B) Lactated Ringer's (LR)
C) 0.9% normal saline
D) 0.45% normal saline (half-strength)
Answer: C. Only 0.9% normal saline is compatible with blood products. Dextrose can cause
hemolysis; LR contains calcium, which can cause clotting .
4. A nurse is reviewing client rights with staff. Which statement indicates understanding?
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."
Answer: A. A competent adult has the right to refuse any treatment, even life-saving
treatment, at any time .
5. A charge nurse is observing a new 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
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C) Ignore the error because the patient is not at risk
D) Report the new nurse to the state board of nursing
Answer: B. Breaking sterile technique increases infection risk. The charge nurse must
intervene immediately. Reporting to the state board is not appropriate for a single
correctable error .
6. A nurse is preparing to administer insulin. Which action should the LPN take FIRST?
A) Verify the client's identity using two identifiers
B) Check the client's blood glucose level
C) Review the physician's order for insulin type and dose
D) Assess the client for signs of hypoglycemia
Answer: C. Before administering any medication, the LPN must first verify the physician's
order to ensure the five rights of medication administration .
7. An LPN is caring for a client who had abdominal surgery 12 hours ago. Which finding
should the LPN report to the RN IMMEDIATELY?
A) Temperature of 99.2°F (37.3°C)
B) Serous drainage on the dressing
C) Absence of bowel sounds
D) Rigid, board-like abdomen
Answer: D. A rigid, board-like abdomen may indicate peritonitis or hemorrhage and requires
immediate RN assessment .
8. A client refuses a blood transfusion due to religious beliefs. Which actions should the
nurse take? (Select all that apply.)
A) Verify the patient understands risks
B) Document the refusal
C) Administer the transfusion if Hgb is critical
D) Notify the provider
E) Ask the family to override the decision
Answer: A, B, D. Competent adults have autonomy. The nurse ensures informed refusal,
documents, and notifies the provider. Forcing treatment or family override is unethical.
9. A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to
delegate?
A) Teaching a client about insulin administration
B) Ambulating a stable client
C) Assessing a post-op client's incision
D) Administering oral medications
Answer: B. Ambulating a stable client is within AP scope. Teaching, assessing, and
medication administration require licensed nurses.
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10. A nurse is caring for a client with a DNR order who is experiencing respiratory distress.
Which action is appropriate?
A) Withhold all comfort measures
B) Administer prescribed oxygen and comfort measures
C) Begin CPR immediately
D) Withhold all medications
Answer: B. DNR does not mean withholding comfort care, oxygen, or symptom
management. It specifically means no CPR or ACLS .
11. A charge nurse is teaching about restraints. Which instruction should be included?
A) Place a belt restraint on a school-age child who has seizures
B) Secure wrist restraints to the bed rails for an adolescent
C) Apply elbow immobilizers for an infant receiving cleft lip repair
D) Keep the side rails of a toddler's crib elevated
Answer: C. Elbow immobilizers prevent infants from touching surgical sites. Restraints
should never be secured to bed rails; belt restraints are contraindicated for seizure clients.
12. A nurse is preparing to discharge a client with a new prescription for warfarin. Which
statement indicates understanding?
A) "I will avoid eating large amounts of green leafy vegetables."
B) "I can take aspirin for headaches while on this medication."
C) "I will stop taking the medication if I notice bruising."
D) "I will have my blood drawn monthly for PT/INR."
Answer: A. Green leafy vegetables are high in vitamin K, which can decrease warfarin's
effectiveness. Aspirin increases bleeding risk; bruising is expected and should be reported.
13. A nurse is caring for a client with a new tracheostomy. Which action should the nurse
take first?
A) Performing tracheostomy suctioning
B) Assessing breath sounds
C) Providing oral care
D) Monitoring oxygen saturation
Answer: B. Assessment is always the first step before intervention. Assess breath sounds to
determine the need for suctioning.
14. A nurse is preparing a client for surgery. Which action should the nurse take first?
A) Verify the client's identity and surgical site
B) Administer preoperative medications
C) Obtain informed consent
D) Start an IV line
Answer: C. Informed consent must be obtained before preoperative medications that may
alter the client's ability to consent.
