ATI NCLEX-PN EXAM 2026 — REAL
QUESTIONS AND ANSWERS WITH FULL
RATIONALES TO GUARANTEE YOUR FIRST
ATTEMPT SUCCESS IN NCLEX-PN EXAMS.
Core Domains
1. Safe and Effective Care Environment – Management of Care (15-21%)
2. Safe and Effective Care Environment – Safety and Infection Control
(10-16%)
3. Health Promotion and Maintenance (6-12%)
4. Psychosocial Integrity (9-15%)
5. Basic Care and Comfort (7-13%)
6. Pharmacological and Parenteral Therapies (10-16%)
7. Reduction of Risk Potential (9-15%)
8. Physiological Adaptation (7-13%)
9. Clinical Judgment – NGN Case Studies and Prioritization
Introduction
This comprehensive practice examination is designed to simulate the
NCLEX-PN exam experience with 180 questions covering all client needs
categories as outlined in the NCSBN 2026 Test Plan. The examination
includes multiple-choice, Select-All-That-Apply (SATA), ordered
response, and Next Generation NCLEX (NGN) case study questions.
Each question includes a detailed rationale to reinforce understanding of
key concepts. The 2026 NCLEX-PN test plan, effective April 1, 2026,
,continues to emphasize clinical judgment and the NGN format. Mastery
of these topics is essential for success on the NCLEX-PN examination.
SECTION ONE: QUESTIONS 1 – 100
1. A licensed practical nurse (LPN) is caring for a client who has a
prescription for a continuous IV infusion of heparin. Which of the
following laboratory values should the nurse monitor to evaluate the
effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
A. Activated partial thromboplastin time (aPTT)
RATIONALE: Heparin therapy is monitored using the aPTT, which
measures the intrinsic pathway of the coagulation cascade. The
therapeutic goal is typically 1.5 to 2.5 times the normal control value. INR
and PT are used to monitor warfarin therapy. Platelet count is monitored
to assess for heparin-induced thrombocytopenia (HIT).
2. A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
A. Check the client's vital signs
B. Verify the blood product with another licensed nurse
,C. Prime the IV tubing with normal saline
D. Obtain informed consent from the client
B. Verify the blood product with another licensed nurse
RATIONALE: Two-nurse verification of the blood product is the
priority action to ensure the correct blood product is being administered
to the correct client. This is a critical safety step to prevent transfusion
errors. Vital signs (A) should be checked before and during the
transfusion, but verification takes priority.
3. A client with a diagnosis of heart failure is prescribed furosemide.
The nurse should monitor the client for which of the following
adverse effects?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
B. Hypokalemia
RATIONALE: Furosemide is a loop diuretic that causes potassium
excretion, leading to hypokalemia. Hypokalemia can precipitate life-
threatening cardiac dysrhythmias. Serum potassium levels should be
monitored closely.
4. A nurse is providing teaching to a client who has a new prescription
for warfarin. Which of the following statements by the client
indicates an understanding of the teaching?
, A. "I will take ibuprofen for headaches instead of acetaminophen."
B. "I will increase my intake of green leafy vegetables."
C. "I will notify my dentist that I am taking this medication."
D. "I will check my blood glucose level daily."
C. "I will notify my dentist that I am taking this medication."
RATIONALE: Warfarin is an anticoagulant that increases bleeding
risk. Clients should notify all healthcare providers, including dentists, of
warfarin use to prevent excessive bleeding during procedures.
5. A nurse is caring for a client who is 2 hours post-operative after a
total hip arthroplasty. The client reports sudden onset of chest pain
and shortness of breath. Which of the following actions should the
nurse take first?
A. Administer oxygen
B. Assess the client's vital signs
C. Notify the provider
D. Position the client in high Fowler's position
A. Administer oxygen
RATIONALE: The client is exhibiting signs of a pulmonary embolism
(sudden chest pain, dyspnea, post-operative). The priority action is to
administer oxygen to support oxygenation. ABCs (Airway, Breathing,
Circulation) take precedence.
QUESTIONS AND ANSWERS WITH FULL
RATIONALES TO GUARANTEE YOUR FIRST
ATTEMPT SUCCESS IN NCLEX-PN EXAMS.
Core Domains
1. Safe and Effective Care Environment – Management of Care (15-21%)
2. Safe and Effective Care Environment – Safety and Infection Control
(10-16%)
3. Health Promotion and Maintenance (6-12%)
4. Psychosocial Integrity (9-15%)
5. Basic Care and Comfort (7-13%)
6. Pharmacological and Parenteral Therapies (10-16%)
7. Reduction of Risk Potential (9-15%)
8. Physiological Adaptation (7-13%)
9. Clinical Judgment – NGN Case Studies and Prioritization
Introduction
This comprehensive practice examination is designed to simulate the
NCLEX-PN exam experience with 180 questions covering all client needs
categories as outlined in the NCSBN 2026 Test Plan. The examination
includes multiple-choice, Select-All-That-Apply (SATA), ordered
response, and Next Generation NCLEX (NGN) case study questions.
Each question includes a detailed rationale to reinforce understanding of
key concepts. The 2026 NCLEX-PN test plan, effective April 1, 2026,
,continues to emphasize clinical judgment and the NGN format. Mastery
of these topics is essential for success on the NCLEX-PN examination.
SECTION ONE: QUESTIONS 1 – 100
1. A licensed practical nurse (LPN) is caring for a client who has a
prescription for a continuous IV infusion of heparin. Which of the
following laboratory values should the nurse monitor to evaluate the
effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
A. Activated partial thromboplastin time (aPTT)
RATIONALE: Heparin therapy is monitored using the aPTT, which
measures the intrinsic pathway of the coagulation cascade. The
therapeutic goal is typically 1.5 to 2.5 times the normal control value. INR
and PT are used to monitor warfarin therapy. Platelet count is monitored
to assess for heparin-induced thrombocytopenia (HIT).
2. A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
A. Check the client's vital signs
B. Verify the blood product with another licensed nurse
,C. Prime the IV tubing with normal saline
D. Obtain informed consent from the client
B. Verify the blood product with another licensed nurse
RATIONALE: Two-nurse verification of the blood product is the
priority action to ensure the correct blood product is being administered
to the correct client. This is a critical safety step to prevent transfusion
errors. Vital signs (A) should be checked before and during the
transfusion, but verification takes priority.
3. A client with a diagnosis of heart failure is prescribed furosemide.
The nurse should monitor the client for which of the following
adverse effects?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
B. Hypokalemia
RATIONALE: Furosemide is a loop diuretic that causes potassium
excretion, leading to hypokalemia. Hypokalemia can precipitate life-
threatening cardiac dysrhythmias. Serum potassium levels should be
monitored closely.
4. A nurse is providing teaching to a client who has a new prescription
for warfarin. Which of the following statements by the client
indicates an understanding of the teaching?
, A. "I will take ibuprofen for headaches instead of acetaminophen."
B. "I will increase my intake of green leafy vegetables."
C. "I will notify my dentist that I am taking this medication."
D. "I will check my blood glucose level daily."
C. "I will notify my dentist that I am taking this medication."
RATIONALE: Warfarin is an anticoagulant that increases bleeding
risk. Clients should notify all healthcare providers, including dentists, of
warfarin use to prevent excessive bleeding during procedures.
5. A nurse is caring for a client who is 2 hours post-operative after a
total hip arthroplasty. The client reports sudden onset of chest pain
and shortness of breath. Which of the following actions should the
nurse take first?
A. Administer oxygen
B. Assess the client's vital signs
C. Notify the provider
D. Position the client in high Fowler's position
A. Administer oxygen
RATIONALE: The client is exhibiting signs of a pulmonary embolism
(sudden chest pain, dyspnea, post-operative). The priority action is to
administer oxygen to support oxygenation. ABCs (Airway, Breathing,
Circulation) take precedence.
