SAUNDERS COMPREHENSIVE REVIEW FOR THE
NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
TEST BANK
QUESTION 1
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination — Test
Plan / Client Needs
Scenario: A practical nursing student is reviewing the NCLEX-PN® test plan and notes that the
examination measures competencies in four major categories. The student understands
that Client Needs categories are used to organize the test plan. Which Client Needs category
would a question about preoperative teaching for a patient undergoing surgery most likely
address?
Options:
A. Health Promotion and Maintenance
B. Psychosocial Integrity
C. Reduction of Risk Potential
D. Management of Care
Correct Answer: A
,Rationale:
Correct: Health Promotion and Maintenance includes content related to the nurse's role in
health screening, disease prevention, and patient education . Preoperative teaching provides
the patient with information to promote a positive outcome and prevent complications,
aligning with this category.
Option B (Incorrect): Psychosocial Integrity addresses emotional, social, and mental health
needs. While surgery may cause anxiety, preoperative teaching primarily focuses on physical
preparation and knowledge.
Option C (Incorrect): Reduction of Risk Potential involves preventing complications related
to diagnostic tests or treatments. While related, this is not the primary focus of general
preoperative education.
Option D (Incorrect): Management of Care addresses delegation, supervision, and care
coordination. This category focuses on the nurse's role in managing patient care delivery rather
than direct patient teaching.
Teaching Point: Preoperative teaching promotes health and prevents complications; identify
this as a Health Promotion and Maintenance focus on the NCLEX-PN®.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Chapter 1: Clinical Judgment and the Next Generation NCLEX (NGN)-
PN® Examination.
QUESTION 2
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination —
Computer Adaptive Testing
Scenario: A candidate is taking the NCLEX-PN® examination and notices that the questions
change in difficulty based on previous answers. The candidate recalls that the exam uses
,computer adaptive testing (CAT). The candidate has correctly answered several consecutive
questions above the passing standard. What should the candidate expect next?
Options:
A. The test will end immediately because the candidate has demonstrated competency.
B. The computer will begin selecting more difficult questions.
C. The computer will revert to easier questions to confirm baseline knowledge.
D. The test will stop at exactly 85 questions regardless of performance.
Correct Answer: B
Rationale:
Correct: In computer adaptive testing (CAT), when a candidate consistently answers
questions correctly at or above the passing standard, the computer selects increasingly difficult
questions to confirm the candidate's ability level and determine if the passing standard has
been met .
Option A (Incorrect): The test does not end immediately upon correct answers. CAT
requires enough questions to determine with statistical confidence whether the candidate
meets or exceeds the passing standard.
Option C (Incorrect): The computer does not revert to easier questions after a series of
correct answers. CAT is designed to move toward the candidate's ability level—progressively
more difficult items for higher-performing candidates.
Option D (Incorrect): The NCLEX-PN® has a minimum of 85 questions and a maximum of
150 questions. The test length is determined by CAT algorithm, not a fixed number.
Teaching Point: CAT increases question difficulty after correct answers above the passing
standard to confirm competency level .
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Chapter 1: Clinical Judgment and the Next Generation NCLEX (NGN)-
PN® Examination.
, QUESTION 3
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination — Levels
of Cognitive Ability
Scenario: An NCLEX-PN® question presents a practical nurse with a scenario describing a
patient with shortness of breath and decreased oxygen saturation. The question asks the nurse
to identify the priority intervention and then evaluate the effectiveness of that intervention.
The question is assessing the candidate's ability to apply the nursing process at which cognitive
level?
Options:
A. Recall
B. Application
C. Analysis
D. Clinical Judgment
Correct Answer: D
Rationale:
Correct: Clinical Judgment is the highest cognitive level on the NCLEX-PN® and requires
synthesizing assessment data, prioritizing interventions, implementing care, and evaluating
outcomes. This question requires multiple steps of the nursing process and clinical decision-
making .
Option A (Incorrect): Recall involves simple memory of facts. This question requires far
more than remembering information—it requires applying and evaluating nursing actions.
Option B (Incorrect): Application requires using knowledge in a specific situation. However,
this question goes further by requiring evaluation of the intervention's effectiveness, which is a
component of clinical judgment.
NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
TEST BANK
QUESTION 1
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination — Test
Plan / Client Needs
Scenario: A practical nursing student is reviewing the NCLEX-PN® test plan and notes that the
examination measures competencies in four major categories. The student understands
that Client Needs categories are used to organize the test plan. Which Client Needs category
would a question about preoperative teaching for a patient undergoing surgery most likely
address?
Options:
A. Health Promotion and Maintenance
B. Psychosocial Integrity
C. Reduction of Risk Potential
D. Management of Care
Correct Answer: A
,Rationale:
Correct: Health Promotion and Maintenance includes content related to the nurse's role in
health screening, disease prevention, and patient education . Preoperative teaching provides
the patient with information to promote a positive outcome and prevent complications,
aligning with this category.
Option B (Incorrect): Psychosocial Integrity addresses emotional, social, and mental health
needs. While surgery may cause anxiety, preoperative teaching primarily focuses on physical
preparation and knowledge.
Option C (Incorrect): Reduction of Risk Potential involves preventing complications related
to diagnostic tests or treatments. While related, this is not the primary focus of general
preoperative education.
Option D (Incorrect): Management of Care addresses delegation, supervision, and care
coordination. This category focuses on the nurse's role in managing patient care delivery rather
than direct patient teaching.
Teaching Point: Preoperative teaching promotes health and prevents complications; identify
this as a Health Promotion and Maintenance focus on the NCLEX-PN®.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Chapter 1: Clinical Judgment and the Next Generation NCLEX (NGN)-
PN® Examination.
QUESTION 2
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination —
Computer Adaptive Testing
Scenario: A candidate is taking the NCLEX-PN® examination and notices that the questions
change in difficulty based on previous answers. The candidate recalls that the exam uses
,computer adaptive testing (CAT). The candidate has correctly answered several consecutive
questions above the passing standard. What should the candidate expect next?
Options:
A. The test will end immediately because the candidate has demonstrated competency.
B. The computer will begin selecting more difficult questions.
C. The computer will revert to easier questions to confirm baseline knowledge.
D. The test will stop at exactly 85 questions regardless of performance.
Correct Answer: B
Rationale:
Correct: In computer adaptive testing (CAT), when a candidate consistently answers
questions correctly at or above the passing standard, the computer selects increasingly difficult
questions to confirm the candidate's ability level and determine if the passing standard has
been met .
Option A (Incorrect): The test does not end immediately upon correct answers. CAT
requires enough questions to determine with statistical confidence whether the candidate
meets or exceeds the passing standard.
Option C (Incorrect): The computer does not revert to easier questions after a series of
correct answers. CAT is designed to move toward the candidate's ability level—progressively
more difficult items for higher-performing candidates.
Option D (Incorrect): The NCLEX-PN® has a minimum of 85 questions and a maximum of
150 questions. The test length is determined by CAT algorithm, not a fixed number.
Teaching Point: CAT increases question difficulty after correct answers above the passing
standard to confirm competency level .
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Chapter 1: Clinical Judgment and the Next Generation NCLEX (NGN)-
PN® Examination.
, QUESTION 3
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination — Levels
of Cognitive Ability
Scenario: An NCLEX-PN® question presents a practical nurse with a scenario describing a
patient with shortness of breath and decreased oxygen saturation. The question asks the nurse
to identify the priority intervention and then evaluate the effectiveness of that intervention.
The question is assessing the candidate's ability to apply the nursing process at which cognitive
level?
Options:
A. Recall
B. Application
C. Analysis
D. Clinical Judgment
Correct Answer: D
Rationale:
Correct: Clinical Judgment is the highest cognitive level on the NCLEX-PN® and requires
synthesizing assessment data, prioritizing interventions, implementing care, and evaluating
outcomes. This question requires multiple steps of the nursing process and clinical decision-
making .
Option A (Incorrect): Recall involves simple memory of facts. This question requires far
more than remembering information—it requires applying and evaluating nursing actions.
Option B (Incorrect): Application requires using knowledge in a specific situation. However,
this question goes further by requiring evaluation of the intervention's effectiveness, which is a
component of clinical judgment.
