PN4001 NURSING CONCEPTS: FINAL EXAM
REVIEW 2026/2027 UPDATED EDITION -
Complete Solutions & NCLEX-Style Rationales for
Practical Nursing Students
🏥 SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT – 19 Items
1A: Management of Care (10 items) | 1B: Safety & Infection Control (9 items)
Q1: A practical nurse (PN) is assigned to care for a group of clients on a
medical-surgical unit. Which of the following tasks should the PN prioritize FIRST?
A. Reinforce teaching about insulin self-administration for a client newly diagnosed with
diabetes
B. Collect a routine urine specimen from a client scheduled for discharge in 2 hours
C. Check the blood glucose level of a client who reports feeling shaky and diaphoretic
D. Document intake and output for a client who received IV fluids throughout the shift
Correct Answer: C
Rationale: The PN uses clinical judgment to prioritize based on ABCs and acute
physiologic instability. Shakiness and diaphoresis are manifestations of hypoglycemia,
which can rapidly progress to loss of consciousness or seizure. Data collection
(glucose check) is within PN scope and must occur immediately.
,❌ A: Teaching reinforcement is important but not emergent; this is appropriate to
delegate to PN but not the priority.
❌ B: Routine specimen collection can be delegated to assistive personnel or
completed later.
❌ D: Documentation is an important nursing responsibility but is a low-priority task that
can be delayed.
Q2: A practical nurse is reinforcing teaching with a client about fall prevention
strategies. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I should wear my reading glasses when I get up to use the bathroom at night."
B. "I will put non-slip socks on before walking in the hallway."
C. "I should keep my walker next to my bed so I can reach it easily."
D. "I will call for help if I need to get up during the night."
Correct Answer: D
Rationale: The safest fall prevention strategy for hospitalized or high-risk clients is to
ask for assistance when getting out of bed, particularly during night hours when
visibility is reduced and the client may be groggy or unsteady.
❌ A: Wearing reading glasses for ambulation is unsafe; they are not designed for
distance vision and may distort depth perception.
❌ B: Non-slip socks reduce risk but do not eliminate the need for assistance; the client
should still call for help.
,❌ C: Placing the walker next to the bed is appropriate, but the priority safety behavior is
requesting assistance.
Q3: A PN is delegating tasks to an unlicensed assistive personnel (UAP). Which of the
following tasks is MOST appropriate to delegate?
A. Feeding a client who had a stroke and has dysphagia
B. Obtaining vital signs on a client receiving blood transfusion
C. Assisting with ambulation of a client 1 day post-op hip replacement
D. Providing perineal care for a client with an indwelling catheter
Correct Answer: D
Rationale: Perineal care for a client with an indwelling catheter is a standard, stable
procedure that does not require ongoing assessment or judgment. The PN retains
responsibility for catheter insertion/removal and assessment of urinary output
characteristics.
❌ A: Dysphagia requires specialized feeding techniques and aspiration precautions; PN
must supervise or perform.
❌ B: Vital signs during blood transfusion require assessment for acute hemolytic
reactions; PN scope only, cannot delegate.
❌ C: Post-op day 1 hip replacement requires assessment for orthostatic hypotension
and pain; PN should assist.
Q4: A PN receives report that a client has a new order for contact precautions. Which of
the following PPE items is REQUIRED when entering the room?
, A. N95 respirator
B. Gown and gloves
C. Face shield
D. Powered air-purifying respirator (PAPR)
Correct Answer: B
Rationale: Contact precautions require a gown and gloves for room entry. The gown
prevents contamination of clothing; gloves prevent hand contamination.
❌ A: N95 is for airborne precautions (TB, measles, varicella).
❌ C: Face shield is for droplet or splash precautions.
❌ D: PAPR is for airborne precautions when N95 fit testing fails or high-risk
procedures.
Q5: A PN is caring for a client who has a living will stating "no heroic measures." The
client becomes unresponsive and pulseless. The family demands that CPR be started.
Which action should the PN take FIRST?
A. Begin CPR immediately
B. Honor the living will and do not resuscitate
C. Call the RN and provider to the bedside immediately
D. Ask the family to produce the original living will document
Correct Answer: C
REVIEW 2026/2027 UPDATED EDITION -
Complete Solutions & NCLEX-Style Rationales for
Practical Nursing Students
🏥 SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT – 19 Items
1A: Management of Care (10 items) | 1B: Safety & Infection Control (9 items)
Q1: A practical nurse (PN) is assigned to care for a group of clients on a
medical-surgical unit. Which of the following tasks should the PN prioritize FIRST?
A. Reinforce teaching about insulin self-administration for a client newly diagnosed with
diabetes
B. Collect a routine urine specimen from a client scheduled for discharge in 2 hours
C. Check the blood glucose level of a client who reports feeling shaky and diaphoretic
D. Document intake and output for a client who received IV fluids throughout the shift
Correct Answer: C
Rationale: The PN uses clinical judgment to prioritize based on ABCs and acute
physiologic instability. Shakiness and diaphoresis are manifestations of hypoglycemia,
which can rapidly progress to loss of consciousness or seizure. Data collection
(glucose check) is within PN scope and must occur immediately.
,❌ A: Teaching reinforcement is important but not emergent; this is appropriate to
delegate to PN but not the priority.
❌ B: Routine specimen collection can be delegated to assistive personnel or
completed later.
❌ D: Documentation is an important nursing responsibility but is a low-priority task that
can be delayed.
Q2: A practical nurse is reinforcing teaching with a client about fall prevention
strategies. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I should wear my reading glasses when I get up to use the bathroom at night."
B. "I will put non-slip socks on before walking in the hallway."
C. "I should keep my walker next to my bed so I can reach it easily."
D. "I will call for help if I need to get up during the night."
Correct Answer: D
Rationale: The safest fall prevention strategy for hospitalized or high-risk clients is to
ask for assistance when getting out of bed, particularly during night hours when
visibility is reduced and the client may be groggy or unsteady.
❌ A: Wearing reading glasses for ambulation is unsafe; they are not designed for
distance vision and may distort depth perception.
❌ B: Non-slip socks reduce risk but do not eliminate the need for assistance; the client
should still call for help.
,❌ C: Placing the walker next to the bed is appropriate, but the priority safety behavior is
requesting assistance.
Q3: A PN is delegating tasks to an unlicensed assistive personnel (UAP). Which of the
following tasks is MOST appropriate to delegate?
A. Feeding a client who had a stroke and has dysphagia
B. Obtaining vital signs on a client receiving blood transfusion
C. Assisting with ambulation of a client 1 day post-op hip replacement
D. Providing perineal care for a client with an indwelling catheter
Correct Answer: D
Rationale: Perineal care for a client with an indwelling catheter is a standard, stable
procedure that does not require ongoing assessment or judgment. The PN retains
responsibility for catheter insertion/removal and assessment of urinary output
characteristics.
❌ A: Dysphagia requires specialized feeding techniques and aspiration precautions; PN
must supervise or perform.
❌ B: Vital signs during blood transfusion require assessment for acute hemolytic
reactions; PN scope only, cannot delegate.
❌ C: Post-op day 1 hip replacement requires assessment for orthostatic hypotension
and pain; PN should assist.
Q4: A PN receives report that a client has a new order for contact precautions. Which of
the following PPE items is REQUIRED when entering the room?
, A. N95 respirator
B. Gown and gloves
C. Face shield
D. Powered air-purifying respirator (PAPR)
Correct Answer: B
Rationale: Contact precautions require a gown and gloves for room entry. The gown
prevents contamination of clothing; gloves prevent hand contamination.
❌ A: N95 is for airborne precautions (TB, measles, varicella).
❌ C: Face shield is for droplet or splash precautions.
❌ D: PAPR is for airborne precautions when N95 fit testing fails or high-risk
procedures.
Q5: A PN is caring for a client who has a living will stating "no heroic measures." The
client becomes unresponsive and pulseless. The family demands that CPR be started.
Which action should the PN take FIRST?
A. Begin CPR immediately
B. Honor the living will and do not resuscitate
C. Call the RN and provider to the bedside immediately
D. Ask the family to produce the original living will document
Correct Answer: C
