NCLEX-PN 2026/2027 – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
CORE DOMAINS
• Coordinated Care and Care Management
• Safety and Infection Prevention and Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Basic Care and Comfort
• Pharmacological Therapies
• Reduction of Risk Potential
• Physiological Adaptation
• Clinical Judgment and Prioritization
INTRODUCTION
The NCLEX-PN evaluates whether practical/vocational nursing candidates can apply nursing
knowledge safely and effectively in patient-care situations. Success requires more than recalling
isolated facts; candidates must recognize priorities, interpret clinical findings, identify risks,
communicate appropriately, and choose interventions that support safe outcomes. This practice
test provides NCLEX-PN-style questions covering essential nursing concepts and realistic
clinical situations. Scenario-based items emphasize clinical judgment, prioritization, delegation,
safety, pharmacology, psychosocial care, and physiological adaptation. The questions are
designed to support structured exam preparation by helping candidates identify knowledge gaps
and strengthen the reasoning skills needed to apply nursing concepts in practice.
SECTION ONE
QUESTIONS 1–50
1. A practical nurse is receiving change-of-shift report on four clients. Which client should
the nurse assess first?
A. A client with osteoarthritis who reports pain of 6/10
B. A client with pneumonia who has a temperature of 38.1°C (100.6°F)
C. A client with heart failure who suddenly reports severe shortness of breath
D. A client with diabetes who requests assistance selecting a bedtime snack
Rationale: Sudden severe dyspnea in a client with heart failure may indicate acute pulmonary
edema or another life-threatening deterioration. Airway and breathing take priority over stable
pain, fever, or dietary concerns.
, 2. A client is prescribed digoxin. Which assessment finding should cause the practical nurse
to withhold the medication and notify the appropriate provider?
A. Blood pressure of 128/76 mm Hg
B. Respiratory rate of 18/min
C. Potassium level of 4.2 mEq/L
D. Apical pulse of 52 beats/min
Rationale: Digoxin can decrease the heart rate. A significantly low apical pulse increases the
risk of clinically important bradycardia and warrants withholding the medication and further
evaluation.
3. A client with type 1 diabetes is experiencing diaphoresis, tremors, and confusion. The
client is awake and able to swallow. What is the priority intervention?
A. Administer the prescribed rapid-acting insulin
B. Encourage the client to ambulate
C. Provide approximately 15 g of a rapid-acting carbohydrate
D. Restrict oral fluids until the symptoms resolve
Rationale: Diaphoresis, tremors, and confusion are common manifestations of hypoglycemia. An
alert client who can swallow should receive a rapid-acting carbohydrate, followed by
reassessment of blood glucose.
4. A practical nurse is teaching a client how to use a metered-dose inhaler with a prescribed
bronchodilator. Which instruction is most appropriate?
A. Inhale rapidly immediately after spraying the medication
B. Exhale into the inhaler before activating it
C. Exhale fully, seal the lips around the mouthpiece, and inhale slowly while activating the
inhaler
D. Hold the breath for only one second after inhaling the medication
Rationale: A slow, deep inhalation coordinated with medication release improves deposition of
the drug in the lower airways. The client should also hold the breath briefly afterward to
enhance delivery.
, 5. A hospitalized client has confirmed Clostridioides difficile infection. Which action is
most important when the practical nurse provides care?
A. Use alcohol-based hand sanitizer after removing gloves
B. Place the client in a positive-pressure room
C. Wash hands with soap and water after removing gloves
D. Wear an N95 respirator for every interaction
Rationale: C. difficile spores are not reliably eliminated by alcohol-based hand sanitizers. Soap-
and-water hand hygiene and appropriate contact precautions are essential.
6. A client taking warfarin asks which food should be consumed consistently rather than
avoided completely. Which response is appropriate?
A. Grapefruit
B. Spinach
C. Bananas
D. White rice
Rationale: Spinach contains substantial vitamin K, which can affect warfarin therapy. Clients do
not necessarily need to eliminate vitamin K-containing foods but should maintain a consistent
intake and follow monitoring instructions.
7. A client with a newly applied cast reports increasing pain that is not relieved by
prescribed analgesics. The toes are cool and pale. What should the practical nurse do
first?
A. Elevate the extremity above the level of the heart
B. Apply a heating pad over the cast
C. Encourage active range-of-motion exercises
D. Notify the healthcare provider promptly about possible neurovascular compromise
Rationale: Increasing pain accompanied by cool, pale extremities can indicate impaired
circulation or compartment syndrome. Prompt evaluation is necessary to prevent permanent
tissue injury.
, 8. A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. Which finding requires immediate attention?
A. Oxygen saturation of 91%
B. Productive cough with clear sputum
C. Respiratory rate of 20/min
D. Increasing drowsiness with a respiratory rate of 8/min
Rationale: Increasing somnolence and marked respiratory depression may indicate worsening
ventilation and carbon dioxide retention. The change requires immediate assessment and
intervention.
9. A practical nurse is caring for a client who has dysphagia following a stroke. Which
intervention best reduces the risk of aspiration during meals?
A. Offer thin liquids frequently
B. Encourage the client to eat while lying in bed
C. Position the client upright during meals and for a period afterward
D. Use a straw for all liquids
Rationale: Upright positioning promotes safer swallowing and reduces the likelihood that food
or liquid will enter the airway. Thin liquids and straws may increase aspiration risk for some
clients with dysphagia.
10. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What is the nurse's priority action?
A. Slow the transfusion rate
B. Administer the prescribed antipyretic
C. Obtain another set of vital signs in 30 minutes
D. Stop the transfusion immediately
Rationale: Fever, chills, and back pain shortly after starting a transfusion may indicate an acute
transfusion reaction. The transfusion must be stopped immediately while maintaining
appropriate intravenous access according to facility protocol.
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
CORE DOMAINS
• Coordinated Care and Care Management
• Safety and Infection Prevention and Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Basic Care and Comfort
• Pharmacological Therapies
• Reduction of Risk Potential
• Physiological Adaptation
• Clinical Judgment and Prioritization
INTRODUCTION
The NCLEX-PN evaluates whether practical/vocational nursing candidates can apply nursing
knowledge safely and effectively in patient-care situations. Success requires more than recalling
isolated facts; candidates must recognize priorities, interpret clinical findings, identify risks,
communicate appropriately, and choose interventions that support safe outcomes. This practice
test provides NCLEX-PN-style questions covering essential nursing concepts and realistic
clinical situations. Scenario-based items emphasize clinical judgment, prioritization, delegation,
safety, pharmacology, psychosocial care, and physiological adaptation. The questions are
designed to support structured exam preparation by helping candidates identify knowledge gaps
and strengthen the reasoning skills needed to apply nursing concepts in practice.
SECTION ONE
QUESTIONS 1–50
1. A practical nurse is receiving change-of-shift report on four clients. Which client should
the nurse assess first?
A. A client with osteoarthritis who reports pain of 6/10
B. A client with pneumonia who has a temperature of 38.1°C (100.6°F)
C. A client with heart failure who suddenly reports severe shortness of breath
D. A client with diabetes who requests assistance selecting a bedtime snack
Rationale: Sudden severe dyspnea in a client with heart failure may indicate acute pulmonary
edema or another life-threatening deterioration. Airway and breathing take priority over stable
pain, fever, or dietary concerns.
, 2. A client is prescribed digoxin. Which assessment finding should cause the practical nurse
to withhold the medication and notify the appropriate provider?
A. Blood pressure of 128/76 mm Hg
B. Respiratory rate of 18/min
C. Potassium level of 4.2 mEq/L
D. Apical pulse of 52 beats/min
Rationale: Digoxin can decrease the heart rate. A significantly low apical pulse increases the
risk of clinically important bradycardia and warrants withholding the medication and further
evaluation.
3. A client with type 1 diabetes is experiencing diaphoresis, tremors, and confusion. The
client is awake and able to swallow. What is the priority intervention?
A. Administer the prescribed rapid-acting insulin
B. Encourage the client to ambulate
C. Provide approximately 15 g of a rapid-acting carbohydrate
D. Restrict oral fluids until the symptoms resolve
Rationale: Diaphoresis, tremors, and confusion are common manifestations of hypoglycemia. An
alert client who can swallow should receive a rapid-acting carbohydrate, followed by
reassessment of blood glucose.
4. A practical nurse is teaching a client how to use a metered-dose inhaler with a prescribed
bronchodilator. Which instruction is most appropriate?
A. Inhale rapidly immediately after spraying the medication
B. Exhale into the inhaler before activating it
C. Exhale fully, seal the lips around the mouthpiece, and inhale slowly while activating the
inhaler
D. Hold the breath for only one second after inhaling the medication
Rationale: A slow, deep inhalation coordinated with medication release improves deposition of
the drug in the lower airways. The client should also hold the breath briefly afterward to
enhance delivery.
, 5. A hospitalized client has confirmed Clostridioides difficile infection. Which action is
most important when the practical nurse provides care?
A. Use alcohol-based hand sanitizer after removing gloves
B. Place the client in a positive-pressure room
C. Wash hands with soap and water after removing gloves
D. Wear an N95 respirator for every interaction
Rationale: C. difficile spores are not reliably eliminated by alcohol-based hand sanitizers. Soap-
and-water hand hygiene and appropriate contact precautions are essential.
6. A client taking warfarin asks which food should be consumed consistently rather than
avoided completely. Which response is appropriate?
A. Grapefruit
B. Spinach
C. Bananas
D. White rice
Rationale: Spinach contains substantial vitamin K, which can affect warfarin therapy. Clients do
not necessarily need to eliminate vitamin K-containing foods but should maintain a consistent
intake and follow monitoring instructions.
7. A client with a newly applied cast reports increasing pain that is not relieved by
prescribed analgesics. The toes are cool and pale. What should the practical nurse do
first?
A. Elevate the extremity above the level of the heart
B. Apply a heating pad over the cast
C. Encourage active range-of-motion exercises
D. Notify the healthcare provider promptly about possible neurovascular compromise
Rationale: Increasing pain accompanied by cool, pale extremities can indicate impaired
circulation or compartment syndrome. Prompt evaluation is necessary to prevent permanent
tissue injury.
, 8. A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. Which finding requires immediate attention?
A. Oxygen saturation of 91%
B. Productive cough with clear sputum
C. Respiratory rate of 20/min
D. Increasing drowsiness with a respiratory rate of 8/min
Rationale: Increasing somnolence and marked respiratory depression may indicate worsening
ventilation and carbon dioxide retention. The change requires immediate assessment and
intervention.
9. A practical nurse is caring for a client who has dysphagia following a stroke. Which
intervention best reduces the risk of aspiration during meals?
A. Offer thin liquids frequently
B. Encourage the client to eat while lying in bed
C. Position the client upright during meals and for a period afterward
D. Use a straw for all liquids
Rationale: Upright positioning promotes safer swallowing and reduces the likelihood that food
or liquid will enter the airway. Thin liquids and straws may increase aspiration risk for some
clients with dysphagia.
10. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What is the nurse's priority action?
A. Slow the transfusion rate
B. Administer the prescribed antipyretic
C. Obtain another set of vital signs in 30 minutes
D. Stop the transfusion immediately
Rationale: Fever, chills, and back pain shortly after starting a transfusion may indicate an acute
transfusion reaction. The transfusion must be stopped immediately while maintaining
appropriate intravenous access according to facility protocol.
