National Council Licensure Examination
– Practical Nurse (NCLEX-PN) Practice
Exam Question And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A |Instant Download Pdf
1. A client with chronic obstructive pulmonary disease (COPD) reports
increased shortness of breath and a productive cough with green sputum.
Which action should the practical nurse take first?
A. Administer albuterol inhaler.
B. Encourage pursed-lip breathing.
C. Assess oxygen saturation and respiratory status.
D. Obtain a sputum specimen for culture.
Rationale: Assessing oxygenation and respiratory status is the immediate
priority to determine need for oxygen or other interventions.
2. A client receiving heparin therapy has an aPTT result of 110 seconds
(therapeutic range 60–80 sec). The nurse should:
A. Continue current infusion rate.
B. Hold the heparin infusion and notify the provider.
C. Administer protamine sulfate immediately.
D. Draw an INR.
Rationale: An aPTT this high indicates excessive anticoagulation; hold
heparin and notify the provider. Protamine is given only when reversal is
ordered or with active bleeding.
3. A postpartum client on oxytocin has uterine fundus firm at umbilicus and
bleeding saturated one peripad in 15 minutes. The nurse should:
A. Massage the fundus gently and re-evaluate.
B. Continue to massage the fundus and call the provider if bleeding
, continues.
C. Start infusion of intravenous fluids.
D. Prepare for immediate surgical intervention.
Rationale: Uterine massage is first-line for uterine atony; if bleeding
persists, escalate per protocol.
4. A client with type 1 diabetes is unconscious and has no IV access. The nurse
should administer:
A. Regular insulin subcutaneously.
B. Glucagon intramuscularly.
C. Orange juice via oral route.
D. D50 via oral syringe.
Rationale: Glucagon IM is appropriate when the patient is unconscious
and IV access is not available to raise blood glucose.
5. A client with heart failure is prescribed furosemide. Which electrolyte
should the nurse closely monitor?
A. Calcium.
B. Potassium.
C. Phosphate.
D. Magnesium.
Rationale: Loop diuretics like furosemide cause potassium loss; monitor
for hypokalemia.
6. A client admitted with suspected bacterial meningitis has a new
prescription for droplet precautions. Which action is appropriate?
A. Place the client in a negative-pressure room.
B. Wear a mask when within 3 feet of the client.
C. Use airborne isolation mask only during procedures.
D. No special precautions are needed.
Rationale: Bacterial meningitis requires droplet precautions; masks should
be worn when within close proximity.
7. A nurse is caring for an elderly client with a new indwelling urinary
catheter. Which intervention reduces risk of catheter-associated urinary
tract infection (CAUTI)?
A. Change catheter every 3 days.
, B. Maintain a closed drainage system and keep the bag below bladder
level.
C. Irrigate catheter daily.
D. Disconnect tubing to measure residual frequently.
Rationale: Maintaining a closed system and proper positioning prevents
ascending infection.
8. A client with asthma uses a metered-dose inhaler with spacer. Which
statement indicates correct use?
A. Inhale forcefully and quickly without holding breath.
B. Exhale fully, actuate the inhaler, inhale slowly, and hold breath for 10
seconds.
C. Shake inhaler after each puff and exhale through the nose.
D. Use spacer only for steroids.
Rationale: Slow inhalation and breath-hold improve deposition; spacers
facilitate this.
9. A client reports severe crushing chest pain, diaphoresis, and nausea. The
nurse should:
A. Obtain a chest X-ray.
B. Administer oxygen, prepare for ECG and notify provider immediately.
C. Give sublingual nitroglycerin without assessment.
D. Place the client in Trendelenburg position.
Rationale: Immediate assessment with ECG and oxygen and notifying
provider are priorities for possible MI; nitroglycerin may be given after
assessment and contraindications checked.
10.A client with a sodium level of 126 mEq/L is confused and lethargic. Which
intervention is most appropriate?
A. Encourage salt intake by mouth.
B. Implement seizure precautions and restrict free water.
C. Start rapid IV hypotonic fluids.
D. Give oral diuretics.
Rationale: Hyponatremia can cause neurologic symptoms; protect the
patient and manage fluids per provider orders.
– Practical Nurse (NCLEX-PN) Practice
Exam Question And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A |Instant Download Pdf
1. A client with chronic obstructive pulmonary disease (COPD) reports
increased shortness of breath and a productive cough with green sputum.
Which action should the practical nurse take first?
A. Administer albuterol inhaler.
B. Encourage pursed-lip breathing.
C. Assess oxygen saturation and respiratory status.
D. Obtain a sputum specimen for culture.
Rationale: Assessing oxygenation and respiratory status is the immediate
priority to determine need for oxygen or other interventions.
2. A client receiving heparin therapy has an aPTT result of 110 seconds
(therapeutic range 60–80 sec). The nurse should:
A. Continue current infusion rate.
B. Hold the heparin infusion and notify the provider.
C. Administer protamine sulfate immediately.
D. Draw an INR.
Rationale: An aPTT this high indicates excessive anticoagulation; hold
heparin and notify the provider. Protamine is given only when reversal is
ordered or with active bleeding.
3. A postpartum client on oxytocin has uterine fundus firm at umbilicus and
bleeding saturated one peripad in 15 minutes. The nurse should:
A. Massage the fundus gently and re-evaluate.
B. Continue to massage the fundus and call the provider if bleeding
, continues.
C. Start infusion of intravenous fluids.
D. Prepare for immediate surgical intervention.
Rationale: Uterine massage is first-line for uterine atony; if bleeding
persists, escalate per protocol.
4. A client with type 1 diabetes is unconscious and has no IV access. The nurse
should administer:
A. Regular insulin subcutaneously.
B. Glucagon intramuscularly.
C. Orange juice via oral route.
D. D50 via oral syringe.
Rationale: Glucagon IM is appropriate when the patient is unconscious
and IV access is not available to raise blood glucose.
5. A client with heart failure is prescribed furosemide. Which electrolyte
should the nurse closely monitor?
A. Calcium.
B. Potassium.
C. Phosphate.
D. Magnesium.
Rationale: Loop diuretics like furosemide cause potassium loss; monitor
for hypokalemia.
6. A client admitted with suspected bacterial meningitis has a new
prescription for droplet precautions. Which action is appropriate?
A. Place the client in a negative-pressure room.
B. Wear a mask when within 3 feet of the client.
C. Use airborne isolation mask only during procedures.
D. No special precautions are needed.
Rationale: Bacterial meningitis requires droplet precautions; masks should
be worn when within close proximity.
7. A nurse is caring for an elderly client with a new indwelling urinary
catheter. Which intervention reduces risk of catheter-associated urinary
tract infection (CAUTI)?
A. Change catheter every 3 days.
, B. Maintain a closed drainage system and keep the bag below bladder
level.
C. Irrigate catheter daily.
D. Disconnect tubing to measure residual frequently.
Rationale: Maintaining a closed system and proper positioning prevents
ascending infection.
8. A client with asthma uses a metered-dose inhaler with spacer. Which
statement indicates correct use?
A. Inhale forcefully and quickly without holding breath.
B. Exhale fully, actuate the inhaler, inhale slowly, and hold breath for 10
seconds.
C. Shake inhaler after each puff and exhale through the nose.
D. Use spacer only for steroids.
Rationale: Slow inhalation and breath-hold improve deposition; spacers
facilitate this.
9. A client reports severe crushing chest pain, diaphoresis, and nausea. The
nurse should:
A. Obtain a chest X-ray.
B. Administer oxygen, prepare for ECG and notify provider immediately.
C. Give sublingual nitroglycerin without assessment.
D. Place the client in Trendelenburg position.
Rationale: Immediate assessment with ECG and oxygen and notifying
provider are priorities for possible MI; nitroglycerin may be given after
assessment and contraindications checked.
10.A client with a sodium level of 126 mEq/L is confused and lethargic. Which
intervention is most appropriate?
A. Encourage salt intake by mouth.
B. Implement seizure precautions and restrict free water.
C. Start rapid IV hypotonic fluids.
D. Give oral diuretics.
Rationale: Hyponatremia can cause neurologic symptoms; protect the
patient and manage fluids per provider orders.
