NCLEX-PN EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS
| PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains:*
* *Safe and Effective Care Environment: Coordinated Care*
* *Safe and Effective Care Environment: Safety and Infection Control*
* *Health Promotion and Maintenance*
* *Psychosocial Integrity*
* *Physiological Integrity: Basic Care and Comfort*
* *Physiological Integrity: Pharmacological and Parenteral Therapies*
* *Physiological Integrity: Reduction of Risk Potential*
* *Physiological Integrity: Physiological Adaptation*
*Introduction:*
*The purpose of this comprehensive assessment is to evaluate the entry-level readiness,
knowledge, and clinical competence of practical and vocational nursing candidates. It
measures essential skills and judgment across the lifespan to ensure safe, ethical, and
effective client care. The exam utilizes multiple-choice and complex scenario-based
structures designed to mirror actual testing conditions. There is a strong emphasis on real-
world clinical application, critical thinking, regulatory compliance, and evidence-based
decision-making. Candidates are assessed on their ability to minimize risk, promote health,
and safely manage diverse physiological and psychological client needs within the practical
nursing scope of practice.*
SECTION ONE: QUESTIONS 1-100
Question 1
A licensed practical nurse (LPN) is assigned to care for a client who is 2 hours postoperative
following an abdominal hysterectomy. Which clinical finding should the nurse report to the
supervising registered nurse (RN) immediately?
A. Serosanguineous drainage on the abdominal dressing measuring 2 cm in diameter B.
Urinary output of 50 mL via indwelling catheter over the past 2 hours C. Complaints of
incisional pain rated as a 6 on a scale of 0 to 10 D. Apical pulse rate of 112 beats per minute
and blood pressure of 90/58 mmHg
D. Apical pulse rate of 112 beats per minute and blood pressure of 90/58 mmHg
, Explanation: Tachycardia combined with hypotension in a immediate postoperative
client strongly suggests hemorrhage or hypovolemic shock, requiring immediate medical
evaluation and intervention. The other findings are expected or do not represent an
immediate life-threatening emergency.
Question 2
The nurse is reviewing the laboratory results of a client receiving daily furosemide for the
management of congestive heart failure. Which result requires immediate notification to the
healthcare provider?
A. Serum potassium level of 2.8 mEq/L B. Serum sodium level of 136 mEq/L C. Blood urea
nitrogen (BUN) level of 22 mg/dL D. Fasting blood glucose level of 110 mg/dL
A. Serum potassium level of 2.8 mEq/L
Explanation: Furosemide is a loop diuretic that causes potassium excretion. A serum
potassium level of 2.8 mEq/L indicates severe hypokalemia, which places the client at a high
risk for life-threatening cardiac arrhythmias.
Question 3
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with an
acute exacerbation. The provider orders oxygen therapy. What is the most appropriate
action by the practical nurse regarding oxygen administration?
A. Administer oxygen at 6 L/min via simple face mask to maximize oxygenation B. Maintain
the oxygen flow rate between 1 and 2 L/min via nasal cannula C. Adjust the oxygen flow until
the client's pulse oximetry reads 100% D. Keep the client on room air to avoid suppressing
the respiratory drive completely
B. Maintain the oxygen flow rate between 1 and 2 L/min via nasal cannula
Explanation: Clients with COPD often rely on a hypoxic drive (low oxygen levels) to
stimulate breathing. Administering high concentrations of oxygen can abolish this drive,
leading to respiratory hypoventilation and carbon dioxide retention. A low flow rate via nasal
cannula is safe and standard.
Question 4
The nurse is preparing to administer an intramuscular (IM) injection of an antibiotic to an
adult client. Which muscle site is the preferred and safest choice for this injection?
A. Deltoid B. Dorsogluteal C. Ventrogluteal D. Vastus lateralis
C. Ventrogluteal
, Explanation: The ventrogluteal site is the preferred and safest site for deep
intramuscular injections in adults because it lacks major nerves and blood vessels, and has a
large muscle mass. The dorsogluteal site is avoided due to the proximity of the sciatic nerve.
Question 5
An older adult client residing in a long-term care facility is prescribed warfarin for atrial
fibrillation. Which dietary modification should the nurse reinforce during client teaching?
A. Completely eliminate all green leafy vegetables from the diet B. Maintain a consistent
intake of foods high in vitamin K C. Increase the intake of citrus fruits and juices daily D.
Restrict fluids to less than 1,000 mL per day
B. Maintain a consistent intake of foods high in vitamin K
Explanation: Warfarin is a vitamin K antagonist. Drastic changes in vitamin K intake can
alter the effectiveness of warfarin and affect the International Normalized Ratio (INR).
Consistency in the diet is key; eliminating it entirely or fluctuating intake introduces safety
risks.
Question 6
A nurse is caring for a client who is in skeletal traction for a fractured femur. Which nursing
action is appropriate when caring for this client?
A. Remove the traction weights for 10 minutes every shift to assess skin integrity B. Ensure
that the traction weights hang freely and do not touch the floor C. Keep the client in a high-
Fowler's position at all times D. Adjust the traction knots so they rest tightly against the
pulley mechanism
B. Ensure that the traction weights hang freely and do not touch the floor
Explanation: For skeletal traction to be effective and maintain proper alignment, the
weights must hang freely at all times and never touch the floor or bed frame. Weights
should never be removed without a specific healthcare provider order.
Question 7
The nurse is reinforcing discharge instructions for a client who has been newly prescribed
sublingual nitroglycerin for stable angina. Which instruction must be included?
A. Swallow the tablet with a full glass of water if chest pain occurs B. Take one tablet every
15 minutes for up to an hour if pain persists C. Store the medication in its original dark glass
bottle away from heat and light D. Expect the medication to cause immediate bradycardia
and hypertension
C. Store the medication in its original dark glass bottle away from heat and light
, Explanation: Sublingual nitroglycerin is highly sensitive to light, moisture, and heat, and
will lose its potency quickly if not stored in its original amber glass bottle. It should not be
swallowed, and the protocol is up to 3 doses spaced 5 minutes apart.
Question 8
A client on a psychiatric unit is pacing the hallway, raising their voice, and exhibiting
increasingly agitated behavior. Which initial action should the practical nurse take?
A. Request an immediate order for mechanical restraints from the provider B. Tell the client
in a loud, firm voice that they must go to their room immediately C. Approach the client
calmly, maintain a safe physical distance, and speak in a low voice D. Ignore the behavior
until the client makes a direct physical threat to someone
C. Approach the client calmly, maintain a safe physical distance, and speak in a low voice
Explanation: De-escalation techniques should always be the first intervention for an
agitated client. Speaking calmly and maintaining a safe distance helps lower the client's
anxiety and prevents escalation while ensuring the nurse's safety. Restraints are a last resort.
Question 9
The nurse is assisting with the care of a client receiving a blood transfusion. Fifteen minutes
after the transfusion starts, the client develops chills, lower back pain, and a fever. Which
action must the nurse take first?
A. Slow the infusion rate down to a keep-vein-open status B. Administer an ordered
antipyretic medication immediately C. Stop the blood transfusion completely and notify the
registered nurse D. Document the vital signs and continue to monitor for another 15
minutes
C. Stop the blood transfusion completely and notify the registered nurse
Explanation: Chills, fever, and lower back pain are classic indicators of an acute hemolytic
transfusion reaction. The immediate priority is to stop the transfusion to prevent further
exposure to the incompatible blood, then alert the RN and provider.
Question 10
A nurse is reinforcing teaching regarding an incentive spirometer to a preoperative client.
Which statement by the client indicates a correct understanding of the procedure?
A. I should blow forcefully into the mouthpiece to push the cylinder as high as possible B. I
will take a deep, slow breath in through the mouthpiece to raise the ball or cylinder C. I
should use the incentive spirometer once every 8 hours while awake D. I will hold my breath
for 30 seconds after inhaling through the device
B. I will take a deep, slow breath in through the mouthpiece to raise the ball or cylinder
| PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains:*
* *Safe and Effective Care Environment: Coordinated Care*
* *Safe and Effective Care Environment: Safety and Infection Control*
* *Health Promotion and Maintenance*
* *Psychosocial Integrity*
* *Physiological Integrity: Basic Care and Comfort*
* *Physiological Integrity: Pharmacological and Parenteral Therapies*
* *Physiological Integrity: Reduction of Risk Potential*
* *Physiological Integrity: Physiological Adaptation*
*Introduction:*
*The purpose of this comprehensive assessment is to evaluate the entry-level readiness,
knowledge, and clinical competence of practical and vocational nursing candidates. It
measures essential skills and judgment across the lifespan to ensure safe, ethical, and
effective client care. The exam utilizes multiple-choice and complex scenario-based
structures designed to mirror actual testing conditions. There is a strong emphasis on real-
world clinical application, critical thinking, regulatory compliance, and evidence-based
decision-making. Candidates are assessed on their ability to minimize risk, promote health,
and safely manage diverse physiological and psychological client needs within the practical
nursing scope of practice.*
SECTION ONE: QUESTIONS 1-100
Question 1
A licensed practical nurse (LPN) is assigned to care for a client who is 2 hours postoperative
following an abdominal hysterectomy. Which clinical finding should the nurse report to the
supervising registered nurse (RN) immediately?
A. Serosanguineous drainage on the abdominal dressing measuring 2 cm in diameter B.
Urinary output of 50 mL via indwelling catheter over the past 2 hours C. Complaints of
incisional pain rated as a 6 on a scale of 0 to 10 D. Apical pulse rate of 112 beats per minute
and blood pressure of 90/58 mmHg
D. Apical pulse rate of 112 beats per minute and blood pressure of 90/58 mmHg
, Explanation: Tachycardia combined with hypotension in a immediate postoperative
client strongly suggests hemorrhage or hypovolemic shock, requiring immediate medical
evaluation and intervention. The other findings are expected or do not represent an
immediate life-threatening emergency.
Question 2
The nurse is reviewing the laboratory results of a client receiving daily furosemide for the
management of congestive heart failure. Which result requires immediate notification to the
healthcare provider?
A. Serum potassium level of 2.8 mEq/L B. Serum sodium level of 136 mEq/L C. Blood urea
nitrogen (BUN) level of 22 mg/dL D. Fasting blood glucose level of 110 mg/dL
A. Serum potassium level of 2.8 mEq/L
Explanation: Furosemide is a loop diuretic that causes potassium excretion. A serum
potassium level of 2.8 mEq/L indicates severe hypokalemia, which places the client at a high
risk for life-threatening cardiac arrhythmias.
Question 3
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with an
acute exacerbation. The provider orders oxygen therapy. What is the most appropriate
action by the practical nurse regarding oxygen administration?
A. Administer oxygen at 6 L/min via simple face mask to maximize oxygenation B. Maintain
the oxygen flow rate between 1 and 2 L/min via nasal cannula C. Adjust the oxygen flow until
the client's pulse oximetry reads 100% D. Keep the client on room air to avoid suppressing
the respiratory drive completely
B. Maintain the oxygen flow rate between 1 and 2 L/min via nasal cannula
Explanation: Clients with COPD often rely on a hypoxic drive (low oxygen levels) to
stimulate breathing. Administering high concentrations of oxygen can abolish this drive,
leading to respiratory hypoventilation and carbon dioxide retention. A low flow rate via nasal
cannula is safe and standard.
Question 4
The nurse is preparing to administer an intramuscular (IM) injection of an antibiotic to an
adult client. Which muscle site is the preferred and safest choice for this injection?
A. Deltoid B. Dorsogluteal C. Ventrogluteal D. Vastus lateralis
C. Ventrogluteal
, Explanation: The ventrogluteal site is the preferred and safest site for deep
intramuscular injections in adults because it lacks major nerves and blood vessels, and has a
large muscle mass. The dorsogluteal site is avoided due to the proximity of the sciatic nerve.
Question 5
An older adult client residing in a long-term care facility is prescribed warfarin for atrial
fibrillation. Which dietary modification should the nurse reinforce during client teaching?
A. Completely eliminate all green leafy vegetables from the diet B. Maintain a consistent
intake of foods high in vitamin K C. Increase the intake of citrus fruits and juices daily D.
Restrict fluids to less than 1,000 mL per day
B. Maintain a consistent intake of foods high in vitamin K
Explanation: Warfarin is a vitamin K antagonist. Drastic changes in vitamin K intake can
alter the effectiveness of warfarin and affect the International Normalized Ratio (INR).
Consistency in the diet is key; eliminating it entirely or fluctuating intake introduces safety
risks.
Question 6
A nurse is caring for a client who is in skeletal traction for a fractured femur. Which nursing
action is appropriate when caring for this client?
A. Remove the traction weights for 10 minutes every shift to assess skin integrity B. Ensure
that the traction weights hang freely and do not touch the floor C. Keep the client in a high-
Fowler's position at all times D. Adjust the traction knots so they rest tightly against the
pulley mechanism
B. Ensure that the traction weights hang freely and do not touch the floor
Explanation: For skeletal traction to be effective and maintain proper alignment, the
weights must hang freely at all times and never touch the floor or bed frame. Weights
should never be removed without a specific healthcare provider order.
Question 7
The nurse is reinforcing discharge instructions for a client who has been newly prescribed
sublingual nitroglycerin for stable angina. Which instruction must be included?
A. Swallow the tablet with a full glass of water if chest pain occurs B. Take one tablet every
15 minutes for up to an hour if pain persists C. Store the medication in its original dark glass
bottle away from heat and light D. Expect the medication to cause immediate bradycardia
and hypertension
C. Store the medication in its original dark glass bottle away from heat and light
, Explanation: Sublingual nitroglycerin is highly sensitive to light, moisture, and heat, and
will lose its potency quickly if not stored in its original amber glass bottle. It should not be
swallowed, and the protocol is up to 3 doses spaced 5 minutes apart.
Question 8
A client on a psychiatric unit is pacing the hallway, raising their voice, and exhibiting
increasingly agitated behavior. Which initial action should the practical nurse take?
A. Request an immediate order for mechanical restraints from the provider B. Tell the client
in a loud, firm voice that they must go to their room immediately C. Approach the client
calmly, maintain a safe physical distance, and speak in a low voice D. Ignore the behavior
until the client makes a direct physical threat to someone
C. Approach the client calmly, maintain a safe physical distance, and speak in a low voice
Explanation: De-escalation techniques should always be the first intervention for an
agitated client. Speaking calmly and maintaining a safe distance helps lower the client's
anxiety and prevents escalation while ensuring the nurse's safety. Restraints are a last resort.
Question 9
The nurse is assisting with the care of a client receiving a blood transfusion. Fifteen minutes
after the transfusion starts, the client develops chills, lower back pain, and a fever. Which
action must the nurse take first?
A. Slow the infusion rate down to a keep-vein-open status B. Administer an ordered
antipyretic medication immediately C. Stop the blood transfusion completely and notify the
registered nurse D. Document the vital signs and continue to monitor for another 15
minutes
C. Stop the blood transfusion completely and notify the registered nurse
Explanation: Chills, fever, and lower back pain are classic indicators of an acute hemolytic
transfusion reaction. The immediate priority is to stop the transfusion to prevent further
exposure to the incompatible blood, then alert the RN and provider.
Question 10
A nurse is reinforcing teaching regarding an incentive spirometer to a preoperative client.
Which statement by the client indicates a correct understanding of the procedure?
A. I should blow forcefully into the mouthpiece to push the cylinder as high as possible B. I
will take a deep, slow breath in through the mouthpiece to raise the ball or cylinder C. I
should use the incentive spirometer once every 8 hours while awake D. I will hold my breath
for 30 seconds after inhaling through the device
B. I will take a deep, slow breath in through the mouthpiece to raise the ball or cylinder
