NCLEX-PN COMPREHENSIVE LICENSURE
EXAM/ ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. A client with heart failure is receiving furosemide. Which finding requires
the PN to notify the RN or provider immediately?
A. Dry mouth
B. Leg cramps
C. Mild fatigue
D. Increased urination
Correct Answer: B. Leg cramps
Rationale: Leg cramps may indicate hypokalemia, a serious adverse effect of
loop diuretics that can lead to arrhythmias. Requires rapid reporting.
2. A postoperative client reports sharp pain at the surgical site when
coughing. What is the priority PN action?
A. Encourage deep breathing
B. Offer an opioid
C. Splint the incision with a pillow
D. Call the surgeon
Correct Answer: C. Splint the incision
Rationale: Splinting reduces strain on the incision and prevents dehiscence while
still promoting airway clearance.
,3. Which task is appropriate for the PN to delegate to an unlicensed assistive
personnel (UAP)?
A. Administering oral medications
B. Teaching incentive spirometry
C. Ambulating a stable postoperative client
D. Assessing pain level
Correct Answer: C. Ambulating a stable client
Rationale: UAP can perform non-invasive, routine tasks. Medication
administration, assessment, and teaching are outside UAP scope.
4. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The
PN notes increasing somnolence. What should the PN do first?
A. Increase oxygen flow
B. Notify the RN/provider
C. Encourage deep breathing
D. Turn the client to the side
Correct Answer: B. Notify the RN/provider
Rationale: COPD clients can retain CO₂ at higher O₂ flow rates → increasing
somnolence is a sign of CO₂ narcosis. Requires immediate reporting.
5. A client with diabetes has a blood glucose of 58 mg/dL and is awake but
shaky. What should the PN give first?
A. 4 oz orange juice
B. 50% dextrose IV
C. Glucagon IM
D. A high-protein snack
Correct Answer: A. 4 oz orange juice
Rationale: Conscious hypoglycemia → give fast-acting oral carbohydrate.
,6. The PN is reinforcing teaching about digoxin. Which statement indicates
understanding?
A. “I will take it if my pulse is above 50.”
B. “I will check my apical pulse for 1 minute.”
C. “I can take an antacid at the same time.”
D. “Blurred vision is normal.”
Correct Answer: B. Check apical pulse
Rationale: Digoxin is held if the pulse is <60 bpm. Antacids decrease absorption.
Blurred vision is a toxicity sign.
7. A client with pneumonia has thick secretions. What should the PN
encourage?
A. Increased fluid intake
B. Restrict fluids
C. Deep breathing only
D. Use of anticholinergic medications
Correct Answer: A. Increase fluids
Rationale: Hydration thins secretions → easier airway clearance.
8. The PN receives four clients. Which should be assessed first?
A. Post-op appendectomy reporting 6/10 pain
B. COPD client with O₂ sat of 88%
C. Client needing morning meds
D. Diabetic client due for fasting blood glucose
Correct Answer: B. COPD client
Rationale: Oxygen saturation <90% is an immediate threat.
, 9. Which action is appropriate when collecting a sterile urine specimen from a
Foley catheter?
A. Drain specimen from the bag
B. Clamp the tubing and use port
C. Remove catheter and collect midstream
D. Wipe port with water
Correct Answer: B. Clamp and collect from port
Rationale: Bag urine is contaminated; port sampling maintains sterility.
10. A client taking warfarin has an INR of 4.8. What is the PN’s priority?
A. Encourage more leafy vegetables
B. Hold the next dose and notify provider
C. Give aspirin
D. Document and continue therapy
Correct Answer: B. Hold and notify
Rationale: INR 4.8 is high → risk for bleeding → provider notification needed.
11. A client receiving morphine IV reports itching. What is the PN’s best
action?
A. Stop the infusion immediately
B. Notify the RN/provider
C. Give diphenhydramine as ordered
D. Document the finding only
Correct Answer: C. Give diphenhydramine
Rationale: Mild itching is a common histamine-release side effect, not an
allergy. Treat with antihistamine if ordered.
EXAM/ ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. A client with heart failure is receiving furosemide. Which finding requires
the PN to notify the RN or provider immediately?
A. Dry mouth
B. Leg cramps
C. Mild fatigue
D. Increased urination
Correct Answer: B. Leg cramps
Rationale: Leg cramps may indicate hypokalemia, a serious adverse effect of
loop diuretics that can lead to arrhythmias. Requires rapid reporting.
2. A postoperative client reports sharp pain at the surgical site when
coughing. What is the priority PN action?
A. Encourage deep breathing
B. Offer an opioid
C. Splint the incision with a pillow
D. Call the surgeon
Correct Answer: C. Splint the incision
Rationale: Splinting reduces strain on the incision and prevents dehiscence while
still promoting airway clearance.
,3. Which task is appropriate for the PN to delegate to an unlicensed assistive
personnel (UAP)?
A. Administering oral medications
B. Teaching incentive spirometry
C. Ambulating a stable postoperative client
D. Assessing pain level
Correct Answer: C. Ambulating a stable client
Rationale: UAP can perform non-invasive, routine tasks. Medication
administration, assessment, and teaching are outside UAP scope.
4. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The
PN notes increasing somnolence. What should the PN do first?
A. Increase oxygen flow
B. Notify the RN/provider
C. Encourage deep breathing
D. Turn the client to the side
Correct Answer: B. Notify the RN/provider
Rationale: COPD clients can retain CO₂ at higher O₂ flow rates → increasing
somnolence is a sign of CO₂ narcosis. Requires immediate reporting.
5. A client with diabetes has a blood glucose of 58 mg/dL and is awake but
shaky. What should the PN give first?
A. 4 oz orange juice
B. 50% dextrose IV
C. Glucagon IM
D. A high-protein snack
Correct Answer: A. 4 oz orange juice
Rationale: Conscious hypoglycemia → give fast-acting oral carbohydrate.
,6. The PN is reinforcing teaching about digoxin. Which statement indicates
understanding?
A. “I will take it if my pulse is above 50.”
B. “I will check my apical pulse for 1 minute.”
C. “I can take an antacid at the same time.”
D. “Blurred vision is normal.”
Correct Answer: B. Check apical pulse
Rationale: Digoxin is held if the pulse is <60 bpm. Antacids decrease absorption.
Blurred vision is a toxicity sign.
7. A client with pneumonia has thick secretions. What should the PN
encourage?
A. Increased fluid intake
B. Restrict fluids
C. Deep breathing only
D. Use of anticholinergic medications
Correct Answer: A. Increase fluids
Rationale: Hydration thins secretions → easier airway clearance.
8. The PN receives four clients. Which should be assessed first?
A. Post-op appendectomy reporting 6/10 pain
B. COPD client with O₂ sat of 88%
C. Client needing morning meds
D. Diabetic client due for fasting blood glucose
Correct Answer: B. COPD client
Rationale: Oxygen saturation <90% is an immediate threat.
, 9. Which action is appropriate when collecting a sterile urine specimen from a
Foley catheter?
A. Drain specimen from the bag
B. Clamp the tubing and use port
C. Remove catheter and collect midstream
D. Wipe port with water
Correct Answer: B. Clamp and collect from port
Rationale: Bag urine is contaminated; port sampling maintains sterility.
10. A client taking warfarin has an INR of 4.8. What is the PN’s priority?
A. Encourage more leafy vegetables
B. Hold the next dose and notify provider
C. Give aspirin
D. Document and continue therapy
Correct Answer: B. Hold and notify
Rationale: INR 4.8 is high → risk for bleeding → provider notification needed.
11. A client receiving morphine IV reports itching. What is the PN’s best
action?
A. Stop the infusion immediately
B. Notify the RN/provider
C. Give diphenhydramine as ordered
D. Document the finding only
Correct Answer: C. Give diphenhydramine
Rationale: Mild itching is a common histamine-release side effect, not an
allergy. Treat with antihistamine if ordered.
