NCLEX Exam NCLEX-PN NCLEX
NCLEX-PN Practice Test
QUESTIONS 2026
Question 1
A client has been diagnosed with gonorrhea. Teaching the client how to prevent
reinfection and further spread is an example of which type of prevention?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primary health care prevention
Correct Answer: B. Secondary prevention
Explanation: Secondary prevention focuses on early diagnosis and prompt
treatment to reduce disease prevalence and morbidity. Teaching a client with an
existing infection how to prevent its spread falls under this category.
Question 2
A client is admitted to the hospital following an acetaminophen (Tylenol) overdose.
Overdoses of this medication can precipitate life-threatening abnormalities in which
organ?
A. Lungs
B. Liver
C. Kidneys
D. Adrenal glands
Correct Answer: B. Liver
Explanation: Acetaminophen is extensively metabolized in the liver. A large
overdose can overwhelm this metabolic pathway, leading to severe and life-
threatening hepatotoxicity.
Question 3
A client’s arterial blood gas (ABG) results are: pH 7.38, PO2 78 mmHg, PCO2 36
mmHg, and HCO3 24 mEq/L. What do these values indicate?
A. Metabolic alkalosis
B. Homeostasis
,C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B. Homeostasis
Explanation: These ABG values are all within normal limits (pH: 7.35-7.45; PCO2: 35-
45 mmHg; HCO3: 21-28 mEq/L), indicating a state of acid-base balance
Question 4
A practical nurse is caring for a client with chronic obstructive pulmonary disease
(COPD) who has a new prescription for oxygen at 2 L/min via nasal cannula. Which
assessment finding indicates the oxygen therapy is having the desired effect?
A. Respiratory rate decreases from 26 to 18 breaths/min
B. Pulse oximetry increases from 88% to 92%
C. Client reports less dyspnea on exertion
D. Arterial PCO2 decreases from 52 to 48 mmHg
Correct Answer: B. Pulse oximetry increases from 88% to 92%
Rationale: The primary goal of oxygen therapy in COPD is to maintain SpO2 ≥ 90%
to prevent hypoxemia while avoiding oxygen-induced hypercapnia. While improved
respiratory rate and less dyspnea are positive signs, the most objective indicator of
desired effect is the rise in SpO2.
Question 5
A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which
instruction should the PN include in the teaching plan?
A. "Take this medication with food to reduce gastrointestinal upset."
B. "Check your blood glucose only once per week while on this drug."
C. "This medication may cause your urine to turn orange."
D. "You may experience weight gain as a side effect."
Correct Answer: A. "Take this medication with food to reduce gastrointestinal
upset."
Rationale: Metformin commonly causes GI distress (nausea, diarrhea). Taking it with
meals minimizes these effects. It does not cause orange urine (that's
phenazopyridine) and is weight-neutral or may cause mild weight loss, not gain.
,Question 6
(NGN - Case Study)
A 72-year-old client is admitted with confusion, dry mucous membranes, and
decreased skin turgor. Serum sodium is 158 mEq/L.
Which two interventions should the PN anticipate implementing? (Select all that
apply)
A. Restrict oral fluids to 800 mL/day
B. Administer 0.45% sodium chloride IV as prescribed
C. Encourage intake of broth and crackers
D. Monitor serum sodium levels daily
E. Place the client in restraints to prevent falls
Correct Answers: B and D
Rationale: This client has hypernatremia (high sodium) due to dehydration.
Treatment includes hypotonic IV fluids (0.45% NaCl) and monitoring serum sodium.
Restricting fluids worsens hypernatremia; broth and crackers add sodium; restraints
are a last resort and not appropriate here.
Question 7
A client is 2 days post-operative following a total hip replacement. Which position is
contraindicated for this client?
A. Supine with a pillow between the legs
B. Side-lying on the non-operative side with a pillow between the knees
C. Semi-Fowler's with knees slightly flexed
D. Crossing the legs at the ankles while sitting
Correct Answer: D. Crossing the legs at the ankles while sitting
Rationale: After hip replacement, crossing the legs (even at the ankles) can cause hip
dislocation. The client should avoid adduction and internal rotation. A pillow
between the legs maintains abduction and is safe.
, Question 8
The PN is reinforcing teaching for a client prescribed warfarin (Coumadin). Which
statement by the client indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I can take ibuprofen for headaches instead of acetaminophen."
C. "I will avoid eating large amounts of leafy green vegetables."
D. "I should report any unusual bruising or bleeding to my provider."
Correct Answer: B. "I can take ibuprofen for headaches instead of
acetaminophen."
Rationale: NSAIDs like ibuprofen increase bleeding risk when taken with warfarin.
Acetaminophen is the safer choice for pain/headache, though even that should be
limited. This statement shows misunderstanding and requires correction.
Question 9
A client with heart failure has crackles in the lung bases, jugular vein distension, and
3+ pitting edema in the lower extremities. Which dietary restriction is most important
for the PN to reinforce?
A. Restrict protein intake to 40 g/day
B. Restrict sodium intake to 2 g/day
C. Restrict potassium-rich foods
D. Restrict carbohydrate intake to 150 g/day
Correct Answer: B. Restrict sodium intake to 2 g/day
Rationale: These are signs of fluid volume excess from heart failure. Sodium
restriction helps reduce fluid retention. Protein and carbohydrate restrictions are not
standard for HF; potassium may be needed if the client is on diuretics.
NCLEX-PN Practice Test
QUESTIONS 2026
Question 1
A client has been diagnosed with gonorrhea. Teaching the client how to prevent
reinfection and further spread is an example of which type of prevention?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primary health care prevention
Correct Answer: B. Secondary prevention
Explanation: Secondary prevention focuses on early diagnosis and prompt
treatment to reduce disease prevalence and morbidity. Teaching a client with an
existing infection how to prevent its spread falls under this category.
Question 2
A client is admitted to the hospital following an acetaminophen (Tylenol) overdose.
Overdoses of this medication can precipitate life-threatening abnormalities in which
organ?
A. Lungs
B. Liver
C. Kidneys
D. Adrenal glands
Correct Answer: B. Liver
Explanation: Acetaminophen is extensively metabolized in the liver. A large
overdose can overwhelm this metabolic pathway, leading to severe and life-
threatening hepatotoxicity.
Question 3
A client’s arterial blood gas (ABG) results are: pH 7.38, PO2 78 mmHg, PCO2 36
mmHg, and HCO3 24 mEq/L. What do these values indicate?
A. Metabolic alkalosis
B. Homeostasis
,C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B. Homeostasis
Explanation: These ABG values are all within normal limits (pH: 7.35-7.45; PCO2: 35-
45 mmHg; HCO3: 21-28 mEq/L), indicating a state of acid-base balance
Question 4
A practical nurse is caring for a client with chronic obstructive pulmonary disease
(COPD) who has a new prescription for oxygen at 2 L/min via nasal cannula. Which
assessment finding indicates the oxygen therapy is having the desired effect?
A. Respiratory rate decreases from 26 to 18 breaths/min
B. Pulse oximetry increases from 88% to 92%
C. Client reports less dyspnea on exertion
D. Arterial PCO2 decreases from 52 to 48 mmHg
Correct Answer: B. Pulse oximetry increases from 88% to 92%
Rationale: The primary goal of oxygen therapy in COPD is to maintain SpO2 ≥ 90%
to prevent hypoxemia while avoiding oxygen-induced hypercapnia. While improved
respiratory rate and less dyspnea are positive signs, the most objective indicator of
desired effect is the rise in SpO2.
Question 5
A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which
instruction should the PN include in the teaching plan?
A. "Take this medication with food to reduce gastrointestinal upset."
B. "Check your blood glucose only once per week while on this drug."
C. "This medication may cause your urine to turn orange."
D. "You may experience weight gain as a side effect."
Correct Answer: A. "Take this medication with food to reduce gastrointestinal
upset."
Rationale: Metformin commonly causes GI distress (nausea, diarrhea). Taking it with
meals minimizes these effects. It does not cause orange urine (that's
phenazopyridine) and is weight-neutral or may cause mild weight loss, not gain.
,Question 6
(NGN - Case Study)
A 72-year-old client is admitted with confusion, dry mucous membranes, and
decreased skin turgor. Serum sodium is 158 mEq/L.
Which two interventions should the PN anticipate implementing? (Select all that
apply)
A. Restrict oral fluids to 800 mL/day
B. Administer 0.45% sodium chloride IV as prescribed
C. Encourage intake of broth and crackers
D. Monitor serum sodium levels daily
E. Place the client in restraints to prevent falls
Correct Answers: B and D
Rationale: This client has hypernatremia (high sodium) due to dehydration.
Treatment includes hypotonic IV fluids (0.45% NaCl) and monitoring serum sodium.
Restricting fluids worsens hypernatremia; broth and crackers add sodium; restraints
are a last resort and not appropriate here.
Question 7
A client is 2 days post-operative following a total hip replacement. Which position is
contraindicated for this client?
A. Supine with a pillow between the legs
B. Side-lying on the non-operative side with a pillow between the knees
C. Semi-Fowler's with knees slightly flexed
D. Crossing the legs at the ankles while sitting
Correct Answer: D. Crossing the legs at the ankles while sitting
Rationale: After hip replacement, crossing the legs (even at the ankles) can cause hip
dislocation. The client should avoid adduction and internal rotation. A pillow
between the legs maintains abduction and is safe.
, Question 8
The PN is reinforcing teaching for a client prescribed warfarin (Coumadin). Which
statement by the client indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I can take ibuprofen for headaches instead of acetaminophen."
C. "I will avoid eating large amounts of leafy green vegetables."
D. "I should report any unusual bruising or bleeding to my provider."
Correct Answer: B. "I can take ibuprofen for headaches instead of
acetaminophen."
Rationale: NSAIDs like ibuprofen increase bleeding risk when taken with warfarin.
Acetaminophen is the safer choice for pain/headache, though even that should be
limited. This statement shows misunderstanding and requires correction.
Question 9
A client with heart failure has crackles in the lung bases, jugular vein distension, and
3+ pitting edema in the lower extremities. Which dietary restriction is most important
for the PN to reinforce?
A. Restrict protein intake to 40 g/day
B. Restrict sodium intake to 2 g/day
C. Restrict potassium-rich foods
D. Restrict carbohydrate intake to 150 g/day
Correct Answer: B. Restrict sodium intake to 2 g/day
Rationale: These are signs of fluid volume excess from heart failure. Sodium
restriction helps reduce fluid retention. Protein and carbohydrate restrictions are not
standard for HF; potassium may be needed if the client is on diuretics.
