NCLEX-PN Comprehensive Exam
2025/2026 – Verified Questions, Correct
Answers, and Explanations
Safe and Effective Care Environment: Coordinated Care
(18–24%)
1. A licensed practical nurse (LPN) is assisting with discharge planning for a client
with heart failure. What is the priority teaching point?
a. Increase sodium intake to maintain fluid balance
b. Weigh daily and report a gain of 2–3 pounds in 24 hours
c. Limit physical activity to prevent fatigue
d. Take diuretics at bedtime to reduce nocturia
Answer: b. Weigh daily and report a gain of 2–3 pounds in 24 hours
Rationale: Daily weight monitoring is critical for clients with heart failure to detect fluid
retention, which may indicate worsening heart failure. A gain of 2–3 pounds in 24 hours
warrants reporting, per ACC/AHA guidelines. Sodium should be restricted, physical
activity should be encouraged within limits, and diuretics are taken in the morning to
avoid nocturia.
2. A client refuses a prescribed blood transfusion due to religious beliefs. What is the
LPN’s most appropriate action?
a. Administer the transfusion anyway
b. Document the refusal and notify the healthcare provider
c. Convince the client to accept the transfusion
d. Request a psychiatric consult
Answer: b. Document the refusal and notify the healthcare provider
Rationale: Respecting client autonomy, the LPN must document the refusal and notify
the provider to discuss alternatives, per ANA ethical standards. Administering against the
client’s wishes or convincing them violates autonomy, and a psychiatric consult is not
indicated.
3. A client with diabetes is scheduled for surgery. Who should the LPN coordinate
with to adjust insulin doses?
a. Dietitian
b. Pharmacist
c. Primary healthcare provider
d. Case manager
Answer: c. Primary healthcare provider
Rationale: The primary healthcare provider is responsible for adjusting insulin doses
based on surgical needs and fasting status, per ADA guidelines. The LPN coordinates
with the provider to ensure safe perioperative management.
4. A client with a new colostomy asks about dietary restrictions. What should the LPN
recommend?
a. Avoid high-fiber foods initially
b. Increase dairy intake
, c. Limit protein intake
d. Avoid drinking water with meals
Answer: a. Avoid high-fiber foods initially
Rationale: High-fiber foods can cause gas or blockages in a new colostomy. The LPN
should advise avoiding them initially and gradually reintroducing them, per WOCN
guidelines.
5. An LPN is assigned to multiple clients. Which client should the LPN assess first?
a. A client with hypertension reporting a headache
b. A client with chest pain and diaphoresis
c. A client with diabetes requesting a snack
d. A client with a fever scheduled for antibiotics
Answer: b. A client with chest pain and diaphoresis
Rationale: Chest pain and diaphoresis suggest a potential myocardial infarction, a life-
threatening condition requiring immediate assessment, per ABC prioritization principles.
Safe and Effective Care Environment: Safety and Infection
Control (10–16%)
6. A client is prescribed contact precautions for MRSA. What should the LPN wear
when entering the room?
a. Mask and gloves
b. Gown and gloves
c. Face shield and gown
d. Mask and gown
Answer: b. Gown and gloves
Rationale: Contact precautions for MRSA require a gown and gloves to prevent skin and
clothing contamination, per CDC guidelines. A mask or face shield is not required unless
droplet or airborne precautions are indicated.
7. A client with a history of falls is admitted. What is the most appropriate safety
intervention?
a. Keep the bed in the highest position
b. Use a bed alarm
c. Restrain the client in bed
d. Place the call bell out of reach
Answer: b. Use a bed alarm
Rationale: A bed alarm alerts staff to potential falls, promoting safety without restricting
mobility, per AGS guidelines. Restraints are a last resort, and the bed should be low with
the call bell accessible.
8. A client is receiving IV fluids. What should the LPN check to prevent infection?
a. IV site for redness or swelling
b. Fluid bag for expiration date
c. Tubing for air bubbles
d. Infusion rate every hour
Answer: a. IV site for redness or swelling
Rationale: Checking the IV site for signs of infection (redness, swelling) is critical to
prevent complications like phlebitis or sepsis, per INS guidelines.
, 9. A client with a tracheostomy requires suctioning. What is the most important safety
precaution?
a. Use sterile technique
b. Suction for 20 seconds
c. Apply suction while inserting the catheter
d. Use a large-bore catheter
Answer: a. Use sterile technique
Rationale: Sterile technique prevents infection during tracheostomy suctioning, per ATS
guidelines. Suctioning should be limited to 10–15 seconds, applied during withdrawal,
and a small-bore catheter is preferred.
10. A client is at risk for aspiration. What should the LPN do when assisting with
feeding?
a. Place the client in a supine position
b. Elevate the head of the bed to 45 degrees
c. Offer thin liquids first
d. Feed the client quickly
Answer: b. Elevate the head of the bed to 45 degrees
Rationale: Elevating the head of the bed to 45–90 degrees reduces aspiration risk by
promoting proper swallowing, per ASPEN guidelines.
Health Promotion and Maintenance (6–12%)
11. A 45-year-old client asks about colorectal cancer screening. What should the LPN
recommend?
a. Begin screening at age 50
b. Begin screening at age 45
c. No screening unless symptomatic
d. Annual fecal occult blood test
Answer: b. Begin screening at age 45
Rationale: USPSTF recommends colorectal cancer screening starting at age 45 for
average-risk individuals, typically with a colonoscopy every 10 years.
12. A client is taught about self-monitoring blood glucose. What is the most important
teaching point?
a. Check glucose only when symptomatic
b. Record results and report patterns to the provider
c. Use the same finger for each test
d. Test after meals only
Answer: b. Record results and report patterns to the provider
Rationale: Recording and reporting glucose patterns helps the provider adjust treatment,
per ADA guidelines. Testing frequency varies, and rotating fingers prevents tissue
damage.
13. A 60-year-old client asks about vaccinations. Which vaccine should the LPN
recommend?
a. MMR
b. Tdap
c. Zoster
d. HPV
Answer: c. Zoster
2025/2026 – Verified Questions, Correct
Answers, and Explanations
Safe and Effective Care Environment: Coordinated Care
(18–24%)
1. A licensed practical nurse (LPN) is assisting with discharge planning for a client
with heart failure. What is the priority teaching point?
a. Increase sodium intake to maintain fluid balance
b. Weigh daily and report a gain of 2–3 pounds in 24 hours
c. Limit physical activity to prevent fatigue
d. Take diuretics at bedtime to reduce nocturia
Answer: b. Weigh daily and report a gain of 2–3 pounds in 24 hours
Rationale: Daily weight monitoring is critical for clients with heart failure to detect fluid
retention, which may indicate worsening heart failure. A gain of 2–3 pounds in 24 hours
warrants reporting, per ACC/AHA guidelines. Sodium should be restricted, physical
activity should be encouraged within limits, and diuretics are taken in the morning to
avoid nocturia.
2. A client refuses a prescribed blood transfusion due to religious beliefs. What is the
LPN’s most appropriate action?
a. Administer the transfusion anyway
b. Document the refusal and notify the healthcare provider
c. Convince the client to accept the transfusion
d. Request a psychiatric consult
Answer: b. Document the refusal and notify the healthcare provider
Rationale: Respecting client autonomy, the LPN must document the refusal and notify
the provider to discuss alternatives, per ANA ethical standards. Administering against the
client’s wishes or convincing them violates autonomy, and a psychiatric consult is not
indicated.
3. A client with diabetes is scheduled for surgery. Who should the LPN coordinate
with to adjust insulin doses?
a. Dietitian
b. Pharmacist
c. Primary healthcare provider
d. Case manager
Answer: c. Primary healthcare provider
Rationale: The primary healthcare provider is responsible for adjusting insulin doses
based on surgical needs and fasting status, per ADA guidelines. The LPN coordinates
with the provider to ensure safe perioperative management.
4. A client with a new colostomy asks about dietary restrictions. What should the LPN
recommend?
a. Avoid high-fiber foods initially
b. Increase dairy intake
, c. Limit protein intake
d. Avoid drinking water with meals
Answer: a. Avoid high-fiber foods initially
Rationale: High-fiber foods can cause gas or blockages in a new colostomy. The LPN
should advise avoiding them initially and gradually reintroducing them, per WOCN
guidelines.
5. An LPN is assigned to multiple clients. Which client should the LPN assess first?
a. A client with hypertension reporting a headache
b. A client with chest pain and diaphoresis
c. A client with diabetes requesting a snack
d. A client with a fever scheduled for antibiotics
Answer: b. A client with chest pain and diaphoresis
Rationale: Chest pain and diaphoresis suggest a potential myocardial infarction, a life-
threatening condition requiring immediate assessment, per ABC prioritization principles.
Safe and Effective Care Environment: Safety and Infection
Control (10–16%)
6. A client is prescribed contact precautions for MRSA. What should the LPN wear
when entering the room?
a. Mask and gloves
b. Gown and gloves
c. Face shield and gown
d. Mask and gown
Answer: b. Gown and gloves
Rationale: Contact precautions for MRSA require a gown and gloves to prevent skin and
clothing contamination, per CDC guidelines. A mask or face shield is not required unless
droplet or airborne precautions are indicated.
7. A client with a history of falls is admitted. What is the most appropriate safety
intervention?
a. Keep the bed in the highest position
b. Use a bed alarm
c. Restrain the client in bed
d. Place the call bell out of reach
Answer: b. Use a bed alarm
Rationale: A bed alarm alerts staff to potential falls, promoting safety without restricting
mobility, per AGS guidelines. Restraints are a last resort, and the bed should be low with
the call bell accessible.
8. A client is receiving IV fluids. What should the LPN check to prevent infection?
a. IV site for redness or swelling
b. Fluid bag for expiration date
c. Tubing for air bubbles
d. Infusion rate every hour
Answer: a. IV site for redness or swelling
Rationale: Checking the IV site for signs of infection (redness, swelling) is critical to
prevent complications like phlebitis or sepsis, per INS guidelines.
, 9. A client with a tracheostomy requires suctioning. What is the most important safety
precaution?
a. Use sterile technique
b. Suction for 20 seconds
c. Apply suction while inserting the catheter
d. Use a large-bore catheter
Answer: a. Use sterile technique
Rationale: Sterile technique prevents infection during tracheostomy suctioning, per ATS
guidelines. Suctioning should be limited to 10–15 seconds, applied during withdrawal,
and a small-bore catheter is preferred.
10. A client is at risk for aspiration. What should the LPN do when assisting with
feeding?
a. Place the client in a supine position
b. Elevate the head of the bed to 45 degrees
c. Offer thin liquids first
d. Feed the client quickly
Answer: b. Elevate the head of the bed to 45 degrees
Rationale: Elevating the head of the bed to 45–90 degrees reduces aspiration risk by
promoting proper swallowing, per ASPEN guidelines.
Health Promotion and Maintenance (6–12%)
11. A 45-year-old client asks about colorectal cancer screening. What should the LPN
recommend?
a. Begin screening at age 50
b. Begin screening at age 45
c. No screening unless symptomatic
d. Annual fecal occult blood test
Answer: b. Begin screening at age 45
Rationale: USPSTF recommends colorectal cancer screening starting at age 45 for
average-risk individuals, typically with a colonoscopy every 10 years.
12. A client is taught about self-monitoring blood glucose. What is the most important
teaching point?
a. Check glucose only when symptomatic
b. Record results and report patterns to the provider
c. Use the same finger for each test
d. Test after meals only
Answer: b. Record results and report patterns to the provider
Rationale: Recording and reporting glucose patterns helps the provider adjust treatment,
per ADA guidelines. Testing frequency varies, and rotating fingers prevents tissue
damage.
13. A 60-year-old client asks about vaccinations. Which vaccine should the LPN
recommend?
a. MMR
b. Tdap
c. Zoster
d. HPV
Answer: c. Zoster
