NCLEX-PN COMPREHENSIVE ACTUAL EXAM
100 Questions with NGN Case Studies,
SATA, and Detailed Rationales ALREADY
GRADED A+
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-15)
1. A charge nurse is making assignments on a long-term care unit. Which patient should be
assigned to the LPN/LVN?
A. A patient with a new tracheostomy requiring frequent suctioning
B. A patient with stable diabetes mellitus requiring insulin administration
C. A patient with a new-onset seizure disorder
D. A patient with an unstable cardiac rhythm
Answer: B
Rationale: LPNs/LVNs can care for stable patients with predictable outcomes (B). Patients with
new tracheostomies (A), new-onset seizures (C), or unstable cardiac rhythms (D) require
assessment and care planning by an RN. The LPN can administer insulin to a stable diabetic
patient.
2. The LPN is caring for a patient with an indwelling Foley catheter. Which action is
appropriate for the LPN to perform independently?
A. Inserting the Foley catheter
B. Assessing the patient's need for catheter removal
C. Irrigating the catheter with a sterile solution per order
D. Changing the catheter based on the nurse's assessment
Answer: A
Rationale: LPNs can insert Foley catheters (A) within their scope of practice. Assessment for
removal (B) and determining the need for change (D) are RN responsibilities. Catheter irrigation
(C) may be done by LPNs in some states but typically requires a provider order and RN
delegation.
1
, 3. A patient with a history of falls is attempting to get out of bed without assistance. What is
the priority intervention?
A. Apply soft wrist restraints
B. Place the bed in the lowest position and use bed alarms
C. Assign a 1:1 sitter
D. Administer a sedative
Answer: B
Rationale: The least restrictive interventions should be used first. Placing the bed in the lowest
position and using bed alarms (B) are appropriate safety measures. Restraints (A) are a last
resort. Sedatives (D) are not appropriate for fall prevention.
4. The LPN is preparing to administer a medication via a nasogastric (NG) tube. Which action
is correct?
A. Crush all medications before administration
B. Flush the tube with 30-60 mL of water before and after each medication
C. Mix medications together in the same syringe
D. Administer medications with the patient in a supine position
Answer: B
Rationale: Flushing the NG tube with 30-60 mL of water before and after each medication (B)
prevents clogging and ensures medication delivery. Not all medications can be crushed (A)
(enteric-coated, sustained-release). Medications should be given separately (C). The patient
should be in semi-Fowler's position (D) to prevent aspiration.
5. A nurse is delegating a task to a UAP. Which task is appropriate to delegate?
A. Performing a sterile wound dressing change
B. Assisting a patient with a bed bath
C. Administering an oral medication
D. Assessing a patient's pain level
Answer: B
Rationale: UAPs can assist with activities of daily living (ADLs), including bed baths (B). Sterile
wound care (A), medication administration (C), and pain assessment (D) are within the LPN/RN
scope and cannot be delegated to UAPs.
6. The LPN is providing handoff report to the oncoming shift. Which information should be
included?
A. The patient's complete medical history
B. The patient's insurance information
2
, C. The patient's current condition, medications, and any changes
D. The patient's family history of illness
Answer: C
Rationale: Handoff reports should include the patient's current condition, medications
administered, and any changes in status (C). Complete medical history (A), insurance (B), and
family history (D) are not essential for routine shift handoff.
7. A patient is refusing a prescribed medication. What is the LPN's best initial response?
A. "You must take this medication."
B. "Tell me your concerns about this medication."
C. "I will notify the healthcare provider."
D. "You are making a mistake."
Answer: B
Rationale: The LPN should explore the patient's concerns (B) in a therapeutic manner. If the
patient still refuses, the LPN should document the refusal and notify the provider. Coercion (A)
and judgmental statements (D) are not appropriate.
8. The LPN is caring for a patient with a pressure injury. Which intervention is appropriate?
A. Massage the area around the pressure injury
B. Turn and reposition the patient every 2 hours
C. Use a donut cushion to relieve pressure
D. Keep the wound open to air
Answer: B
Rationale: Turning and repositioning every 2 hours (B) is the standard of care to prevent and
treat pressure injuries. Massage (A) is not recommended. Donut cushions (C) can impair
circulation. Wounds should be covered (D) to maintain a moist healing environment.
9. A patient is on a clear liquid diet. Which food is allowed?
A. Apple juice
B. Milk
C. Pudding
D. Orange juice with pulp
Answer: A
Rationale: A clear liquid diet includes liquids that are transparent at room temperature. Apple
juice (A) is allowed. Milk (B) and pudding (C) are full liquids. Orange juice with pulp (D) is not
clear.
3
, 10. The LPN is preparing to insert an NG tube. The patient is anxious and coughing. What
should the LPN do?
A. Advance the tube quickly to pass the gag reflex
B. Stop advancing and allow the patient to take deep breaths
C. Remove the tube and start over
D. Tell the patient to swallow
Answer: B
Rationale: If the patient is coughing or gagging, the LPN should stop advancing (B) and allow the
patient to take deep breaths. The tube should not be removed unless it is in the airway (C). The
patient should be encouraged to swallow when the tube is at the back of the throat.
11. A patient has a nasogastric (NG) tube to low intermittent suction. The LPN notes the tube
is not draining. What is the priority action?
A. Irrigate the tube with normal saline
B. Reposition the patient and check the tube connections
C. Increase the suction pressure
D. Remove and reinsert the tube
Answer: B
Rationale: The first action is to reposition the patient and check the tube connections (B) to
ensure the tube is not kinked or the suction is not working. Irrigation (A) should only be done
with a provider order. Increasing suction (C) can damage the gastric mucosa.
12. The LPN is assisting a patient with ambulation. The patient begins to fall. What should the
LPN do?
A. Grab the patient's arm and pull them upright
B. Widen the base of support and gently lower the patient to the floor
C. Step away from the patient to avoid injury
D. Call for help and leave the patient
Answer: B
Rationale: If a patient starts to fall, the LPN should widen their base of support and gently lower
the patient (B) to prevent injury to both. Grabbing (A) can cause injury. Stepping away (C) or
leaving the patient (D) is unsafe.
13. The LPN is collecting a urine specimen from a patient with a Foley catheter. Which action
is correct?
A. Collect urine from the drainage bag
B. Clamp the catheter tubing and aspirate urine from the port
4
100 Questions with NGN Case Studies,
SATA, and Detailed Rationales ALREADY
GRADED A+
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-15)
1. A charge nurse is making assignments on a long-term care unit. Which patient should be
assigned to the LPN/LVN?
A. A patient with a new tracheostomy requiring frequent suctioning
B. A patient with stable diabetes mellitus requiring insulin administration
C. A patient with a new-onset seizure disorder
D. A patient with an unstable cardiac rhythm
Answer: B
Rationale: LPNs/LVNs can care for stable patients with predictable outcomes (B). Patients with
new tracheostomies (A), new-onset seizures (C), or unstable cardiac rhythms (D) require
assessment and care planning by an RN. The LPN can administer insulin to a stable diabetic
patient.
2. The LPN is caring for a patient with an indwelling Foley catheter. Which action is
appropriate for the LPN to perform independently?
A. Inserting the Foley catheter
B. Assessing the patient's need for catheter removal
C. Irrigating the catheter with a sterile solution per order
D. Changing the catheter based on the nurse's assessment
Answer: A
Rationale: LPNs can insert Foley catheters (A) within their scope of practice. Assessment for
removal (B) and determining the need for change (D) are RN responsibilities. Catheter irrigation
(C) may be done by LPNs in some states but typically requires a provider order and RN
delegation.
1
, 3. A patient with a history of falls is attempting to get out of bed without assistance. What is
the priority intervention?
A. Apply soft wrist restraints
B. Place the bed in the lowest position and use bed alarms
C. Assign a 1:1 sitter
D. Administer a sedative
Answer: B
Rationale: The least restrictive interventions should be used first. Placing the bed in the lowest
position and using bed alarms (B) are appropriate safety measures. Restraints (A) are a last
resort. Sedatives (D) are not appropriate for fall prevention.
4. The LPN is preparing to administer a medication via a nasogastric (NG) tube. Which action
is correct?
A. Crush all medications before administration
B. Flush the tube with 30-60 mL of water before and after each medication
C. Mix medications together in the same syringe
D. Administer medications with the patient in a supine position
Answer: B
Rationale: Flushing the NG tube with 30-60 mL of water before and after each medication (B)
prevents clogging and ensures medication delivery. Not all medications can be crushed (A)
(enteric-coated, sustained-release). Medications should be given separately (C). The patient
should be in semi-Fowler's position (D) to prevent aspiration.
5. A nurse is delegating a task to a UAP. Which task is appropriate to delegate?
A. Performing a sterile wound dressing change
B. Assisting a patient with a bed bath
C. Administering an oral medication
D. Assessing a patient's pain level
Answer: B
Rationale: UAPs can assist with activities of daily living (ADLs), including bed baths (B). Sterile
wound care (A), medication administration (C), and pain assessment (D) are within the LPN/RN
scope and cannot be delegated to UAPs.
6. The LPN is providing handoff report to the oncoming shift. Which information should be
included?
A. The patient's complete medical history
B. The patient's insurance information
2
, C. The patient's current condition, medications, and any changes
D. The patient's family history of illness
Answer: C
Rationale: Handoff reports should include the patient's current condition, medications
administered, and any changes in status (C). Complete medical history (A), insurance (B), and
family history (D) are not essential for routine shift handoff.
7. A patient is refusing a prescribed medication. What is the LPN's best initial response?
A. "You must take this medication."
B. "Tell me your concerns about this medication."
C. "I will notify the healthcare provider."
D. "You are making a mistake."
Answer: B
Rationale: The LPN should explore the patient's concerns (B) in a therapeutic manner. If the
patient still refuses, the LPN should document the refusal and notify the provider. Coercion (A)
and judgmental statements (D) are not appropriate.
8. The LPN is caring for a patient with a pressure injury. Which intervention is appropriate?
A. Massage the area around the pressure injury
B. Turn and reposition the patient every 2 hours
C. Use a donut cushion to relieve pressure
D. Keep the wound open to air
Answer: B
Rationale: Turning and repositioning every 2 hours (B) is the standard of care to prevent and
treat pressure injuries. Massage (A) is not recommended. Donut cushions (C) can impair
circulation. Wounds should be covered (D) to maintain a moist healing environment.
9. A patient is on a clear liquid diet. Which food is allowed?
A. Apple juice
B. Milk
C. Pudding
D. Orange juice with pulp
Answer: A
Rationale: A clear liquid diet includes liquids that are transparent at room temperature. Apple
juice (A) is allowed. Milk (B) and pudding (C) are full liquids. Orange juice with pulp (D) is not
clear.
3
, 10. The LPN is preparing to insert an NG tube. The patient is anxious and coughing. What
should the LPN do?
A. Advance the tube quickly to pass the gag reflex
B. Stop advancing and allow the patient to take deep breaths
C. Remove the tube and start over
D. Tell the patient to swallow
Answer: B
Rationale: If the patient is coughing or gagging, the LPN should stop advancing (B) and allow the
patient to take deep breaths. The tube should not be removed unless it is in the airway (C). The
patient should be encouraged to swallow when the tube is at the back of the throat.
11. A patient has a nasogastric (NG) tube to low intermittent suction. The LPN notes the tube
is not draining. What is the priority action?
A. Irrigate the tube with normal saline
B. Reposition the patient and check the tube connections
C. Increase the suction pressure
D. Remove and reinsert the tube
Answer: B
Rationale: The first action is to reposition the patient and check the tube connections (B) to
ensure the tube is not kinked or the suction is not working. Irrigation (A) should only be done
with a provider order. Increasing suction (C) can damage the gastric mucosa.
12. The LPN is assisting a patient with ambulation. The patient begins to fall. What should the
LPN do?
A. Grab the patient's arm and pull them upright
B. Widen the base of support and gently lower the patient to the floor
C. Step away from the patient to avoid injury
D. Call for help and leave the patient
Answer: B
Rationale: If a patient starts to fall, the LPN should widen their base of support and gently lower
the patient (B) to prevent injury to both. Grabbing (A) can cause injury. Stepping away (C) or
leaving the patient (D) is unsafe.
13. The LPN is collecting a urine specimen from a patient with a Foley catheter. Which action
is correct?
A. Collect urine from the drainage bag
B. Clamp the catheter tubing and aspirate urine from the port
4
