SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — The Pyramid to Success — Test-taking
strategies and preparation
Stem: A PN student has three weeks before the NGN-PN® exam.
She reports feeling overwhelmed and is spending 8 hours
nightly rereading every chapter. Which strategy should the
practical nurse educator recommend to maximize exam
readiness and reduce anxiety?
A. Continue rereading all chapters nightly until exam day.
B. Focus on practice NGN-style items and analysis of rationales
with scheduled breaks.
C. Only study high-yield facts and memorize key definitions.
,D. Study in one 8-hour block each day to mimic testing
endurance.
Correct Answer: B
Rationales:
• Correct (B): Practicing NGN-style items with review of
rationales builds clinical judgment and test-taking skills;
scheduled breaks reduce cognitive fatigue—aligns with the
Pyramid to Success emphasis on active practice.
• A: Passive rereading is low-yield and increases burnout
rather than improving application.
• C: Memorization of facts neglects clinical judgement and
NGN item formats that require analysis.
• D: Marathon study without spacing reduces retention and
increases fatigue; distributed practice is superior.
Teaching Point: Practice NGN items and review rationales;
space study to improve clinical judgment.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
2
Reference: Ch. 1 — Clinical Judgment and Next Generation
NCLEX® Items — Recognizing cues
,Stem: A licensed practical nurse observes morning vital signs:
HR 110, RR 22, BP 100/60, O₂ 94% on room air. The client
reports mild shortness of breath and new confusion. Which
action should the PN take first?
A. Administer PRN acetaminophen for possible infection.
B. Reassess oxygen saturation and place patient in Fowler’s
position.
C. Notify the provider to obtain a stat chest x-ray.
D. Document the findings and continue routine care.
Correct Answer: B
Rationales:
• Correct (B): Reassessing and promoting
airway/oxygenation (Fowler’s) are immediate nursing
actions to address respiratory compromise and confusion;
aligns with NGN cue recognition and immediate
interventions within PN scope.
• A: Antipyretic is not first-line for respiratory compromise
and does not address oxygenation or confusion.
• C: Provider notification may be necessary, but immediate
bedside reassessment/intervention takes priority before
diagnostic orders.
• D: Documenting without intervention neglects
deteriorating cues and is unsafe.
Teaching Point: Prioritize immediate assessment and basic
interventions for respiratory/cognitive change.
, Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
3
Reference: Ch. 1 — NGN Test Design — Case-based item
reasoning
Stem: On a practice NGN case, a PN candidate must sequence
four nursing actions for a postoperative client with acute
shortness of breath. Which rationale explains why sequencing
items test clinical judgment rather than recall?
A. Sequencing items assess memory of procedures in order.
B. Sequencing items require evaluating and prioritizing
interventions based on client cues.
C. Sequencing items measure speed and test-taking endurance
only.
D. Sequencing items focus on provider tasks rather than nursing
decisions.
Correct Answer: B
Rationales:
• Correct (B): Sequencing requires analysis of cues and
prioritization—core to NGN’s focus on clinical judgment.
• A: Sequencing is not merely rote memory; it depends on
clinical context and priorities.
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — The Pyramid to Success — Test-taking
strategies and preparation
Stem: A PN student has three weeks before the NGN-PN® exam.
She reports feeling overwhelmed and is spending 8 hours
nightly rereading every chapter. Which strategy should the
practical nurse educator recommend to maximize exam
readiness and reduce anxiety?
A. Continue rereading all chapters nightly until exam day.
B. Focus on practice NGN-style items and analysis of rationales
with scheduled breaks.
C. Only study high-yield facts and memorize key definitions.
,D. Study in one 8-hour block each day to mimic testing
endurance.
Correct Answer: B
Rationales:
• Correct (B): Practicing NGN-style items with review of
rationales builds clinical judgment and test-taking skills;
scheduled breaks reduce cognitive fatigue—aligns with the
Pyramid to Success emphasis on active practice.
• A: Passive rereading is low-yield and increases burnout
rather than improving application.
• C: Memorization of facts neglects clinical judgement and
NGN item formats that require analysis.
• D: Marathon study without spacing reduces retention and
increases fatigue; distributed practice is superior.
Teaching Point: Practice NGN items and review rationales;
space study to improve clinical judgment.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
2
Reference: Ch. 1 — Clinical Judgment and Next Generation
NCLEX® Items — Recognizing cues
,Stem: A licensed practical nurse observes morning vital signs:
HR 110, RR 22, BP 100/60, O₂ 94% on room air. The client
reports mild shortness of breath and new confusion. Which
action should the PN take first?
A. Administer PRN acetaminophen for possible infection.
B. Reassess oxygen saturation and place patient in Fowler’s
position.
C. Notify the provider to obtain a stat chest x-ray.
D. Document the findings and continue routine care.
Correct Answer: B
Rationales:
• Correct (B): Reassessing and promoting
airway/oxygenation (Fowler’s) are immediate nursing
actions to address respiratory compromise and confusion;
aligns with NGN cue recognition and immediate
interventions within PN scope.
• A: Antipyretic is not first-line for respiratory compromise
and does not address oxygenation or confusion.
• C: Provider notification may be necessary, but immediate
bedside reassessment/intervention takes priority before
diagnostic orders.
• D: Documenting without intervention neglects
deteriorating cues and is unsafe.
Teaching Point: Prioritize immediate assessment and basic
interventions for respiratory/cognitive change.
, Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
3
Reference: Ch. 1 — NGN Test Design — Case-based item
reasoning
Stem: On a practice NGN case, a PN candidate must sequence
four nursing actions for a postoperative client with acute
shortness of breath. Which rationale explains why sequencing
items test clinical judgment rather than recall?
A. Sequencing items assess memory of procedures in order.
B. Sequencing items require evaluating and prioritizing
interventions based on client cues.
C. Sequencing items measure speed and test-taking endurance
only.
D. Sequencing items focus on provider tasks rather than nursing
decisions.
Correct Answer: B
Rationales:
• Correct (B): Sequencing requires analysis of cues and
prioritization—core to NGN’s focus on clinical judgment.
• A: Sequencing is not merely rote memory; it depends on
clinical context and priorities.
