NCLEX-PN Exam 2026/2027 – Complete Practical Nursing
Review and Study Guide for LPN/LVN Comprehensive
Assessment
2026-2027 | Total Questions: 150 | 100% VERIFIED
Introduction
This comprehensive assessment measures the knowledge and clinical judgment required
for licensure as an LPN under the NCLEX-PN framework. The assessment spans eight
domains: Safe and Effective Care Environment; Health Promotion and Maintenance;
Psychosocial Integrity; Physiological Integrity; Basic Care and Comfort; Pharmacological
Therapies; Reduction of Risk Potential; and Physiological Adaptation. Each question tests a
distinct sub-topic mapped to the official NCSBN NCLEX-PN blueprint, emphasizing
prioritization, safe scope of execution, and physiologic reasoning rather than isolated recall.
Mastery of this material is essential for state licensure and licensed nursing clinical
execution.
Question 1. The LPN/LVN working under RN supervision can appropriately:
A. Perform the initial comprehensive admission assessment
B. Administer scheduled oral medications to stable clients
C. Titrate an intravenous vasoactive medication
D. Establish the nursing diagnosis for the plan of care
Correct Answer: B — Administer scheduled oral medications to stable clients
Rationale: LPNs administer routine medications to stable clients within scope. Initial
assessment, titration, and care planning are RN responsibilities.
Question 2. A client tells the LPN he wants to leave the hospital against medical advice. The
best response is to:
A. Notify the supervising RN and provider, and ensure the client understands the risks
of leaving
B. Hide the client's clothes
C. Restrain the client until the provider arrives
D. Tell the client insurance will pay nothing so he must stay
Correct Answer: A — Notify the supervising RN and provider, and ensure the
client understands the risks of leaving
Rationale: Competent adults may leave AMA; the nurse informs the RN and provider
and documents teaching. Restraint, concealment, and pressure violate rights.
Question 3. Informed consent for surgery is obtained by the:
A. Night-shift nurse off duty
B. Unit secretary
C. Surgeon performing the procedure
, D. Dietary aide
Correct Answer: C — Surgeon performing the procedure
Rationale: The treating surgeon discloses risks, benefits, and alternatives. Nurses
witness signature and confirm understanding but do not obtain consent.
Question 4. When a competent elderly client with a signed advance directive refuses a
blood transfusion, the nurse should:
A. Transfuse anyway because the client is elderly
B. Ask the family to override the decision
C. Support the refusal and ensure the directive is followed and documented
D. Transfer the client to another hospital immediately
Correct Answer: C — Support the refusal and ensure the directive is followed and
documented
Rationale: Advance directives express autonomous treatment choices that staff must
honor. Override attempts and coercion violate client rights.
Question 5. The nurse finds a confused client climbing over raised bed rails. The safest
intervention is:
A. Apply a vest restraint immediately without an order
B. Provide close observation and consider bed placement near the station with frequent
checks
C. Sedate the client with PRN medication without assessment
D. Ignore the behavior to avoid escalation
Correct Answer: B — Provide close observation and consider bed placement near
the station with frequent checks
Rationale: Least-restrictive alternatives and monitoring precede restraints. Unordered
restraint, sedation, and inattention endanger the client and breach regulations.
Question 6. Which action demonstrates proper use of restraints?
A. Tying the restraint in a knot the family cannot undo
B. Applying wrist restraints to both wrists and ankles simultaneously PRN
C. Documenting restraint checks only at discharge
D. Securing the order with frequent circulation checks, skin assessment, and range of
motion
Correct Answer: D — Securing the order with frequent circulation checks, skin
assessment, and range of motion
Rationale: Restraints require orders, scheduled release, and monitoring. Knots must be
quick-release, PRN orders are prohibited, and checks are continuous documentation.
Question 7. A nurse reports a colleague's repeated medication errors affecting client safety.
This action reflects:
A. Disloyalty to the team
, B. Defamation of the colleague
C. Breach of confidentiality
D. The professional duty to protect clients through appropriate reporting
Correct Answer: D — The professional duty to protect clients through appropriate
reporting
Rationale: Client safety obligations supersede team loyalty, and factual reporting is
protected. The other labels mischaracterize a duty.
Question 8. Professional negligence requires proof of:
A. Intent to harm
B. Duty, breach of duty, causation, and damages
C. A signed confession
D. Prior complaints only
Correct Answer: B — Duty, breach of duty, causation, and damages
Rationale: The four elements of negligence apply regardless of intent. The remaining
options are not legal elements.
Question 9. When documenting in the medical record, the nurse should:
A. Chart care that has not yet been given
B. Use personal opinions about clients
C. Erase errors completely
D. Chart objectively, timely, and with factual observations and interventions
Correct Answer: D — Chart objectively, timely, and with factual observations and
interventions
Rationale: Documentation must be factual, contemporaneous, and complete. Pre-
charting, opinions, and obliterated errors are legal hazards.
Question 10. Confidentiality is maintained by:
A. Discussing cases in elevators
B. Posting client photos online without identifiers
C. Faxing records to unknown numbers
D. Sharing client information only with those involved in care or as legally required
Correct Answer: D — Sharing client information only with those involved in care
or as legally required
Rationale: Privacy limits disclosure to care-related, authorized recipients. Public,
casual, and unverified sharing breach confidentiality.
Question 11. The nurse assigned to four clients should assess first:
A. A client requesting a snack
B. A client with new shortness of breath and chest pain
C. A client due for a scheduled bath
D. A client asking about discharge time
, Correct Answer: B — A client with new shortness of breath and chest pain
Rationale: Airway and breathing concerns take priority over routine and
administrative needs.
Question 12. Health care-associated infection prevention in the hospital setting relies most
on:
A. Weekly unit deep cleaning alone
B. Restricting all visitors completely
C. Hand hygiene before and after every client contact
D. Antibiotics for every staff member
Correct Answer: C — Hand hygiene before and after every client contact
Rationale: Hand hygiene is the single most effective transmission interrupter. Cleaning,
visitor limits, and prophylaxis are supplementary.
Question 13. A client who speaks a different language requires discharge teaching. The
nurse should:
A. Speak louder in English
B. Ask the client's young child to interpret
C. Use a qualified medical interpreter for the teaching session
D. Provide only English pamphlets
Correct Answer: C — Use a qualified medical interpreter for the teaching session
Rationale: Trained interpreters ensure accurate, unbiased teaching. Volume, children,
and monolingual materials compromise comprehension.
Question 14. Advocacy by the licensed nurse is best demonstrated by:
A. Communicating the client's wishes to the team even when they conflict with staff
convenience
B. Making decisions for the client
C. Avoiding difficult conversations
D. Supporting the provider regardless of client wishes
Correct Answer: A — Communicating the client's wishes to the team even when
they conflict with staff convenience
Rationale: Advocacy gives clients voice and protects their interests. Substituting
judgment, avoidance, and provider-first loyalty fail the client.
Question 15. The disaster triage system sorts clients primarily by:
A. Age of the client
B. Likelihood of survival with immediate intervention
C. Order of arrival
D. Insurance status
Correct Answer: B — Likelihood of survival with immediate intervention
Review and Study Guide for LPN/LVN Comprehensive
Assessment
2026-2027 | Total Questions: 150 | 100% VERIFIED
Introduction
This comprehensive assessment measures the knowledge and clinical judgment required
for licensure as an LPN under the NCLEX-PN framework. The assessment spans eight
domains: Safe and Effective Care Environment; Health Promotion and Maintenance;
Psychosocial Integrity; Physiological Integrity; Basic Care and Comfort; Pharmacological
Therapies; Reduction of Risk Potential; and Physiological Adaptation. Each question tests a
distinct sub-topic mapped to the official NCSBN NCLEX-PN blueprint, emphasizing
prioritization, safe scope of execution, and physiologic reasoning rather than isolated recall.
Mastery of this material is essential for state licensure and licensed nursing clinical
execution.
Question 1. The LPN/LVN working under RN supervision can appropriately:
A. Perform the initial comprehensive admission assessment
B. Administer scheduled oral medications to stable clients
C. Titrate an intravenous vasoactive medication
D. Establish the nursing diagnosis for the plan of care
Correct Answer: B — Administer scheduled oral medications to stable clients
Rationale: LPNs administer routine medications to stable clients within scope. Initial
assessment, titration, and care planning are RN responsibilities.
Question 2. A client tells the LPN he wants to leave the hospital against medical advice. The
best response is to:
A. Notify the supervising RN and provider, and ensure the client understands the risks
of leaving
B. Hide the client's clothes
C. Restrain the client until the provider arrives
D. Tell the client insurance will pay nothing so he must stay
Correct Answer: A — Notify the supervising RN and provider, and ensure the
client understands the risks of leaving
Rationale: Competent adults may leave AMA; the nurse informs the RN and provider
and documents teaching. Restraint, concealment, and pressure violate rights.
Question 3. Informed consent for surgery is obtained by the:
A. Night-shift nurse off duty
B. Unit secretary
C. Surgeon performing the procedure
, D. Dietary aide
Correct Answer: C — Surgeon performing the procedure
Rationale: The treating surgeon discloses risks, benefits, and alternatives. Nurses
witness signature and confirm understanding but do not obtain consent.
Question 4. When a competent elderly client with a signed advance directive refuses a
blood transfusion, the nurse should:
A. Transfuse anyway because the client is elderly
B. Ask the family to override the decision
C. Support the refusal and ensure the directive is followed and documented
D. Transfer the client to another hospital immediately
Correct Answer: C — Support the refusal and ensure the directive is followed and
documented
Rationale: Advance directives express autonomous treatment choices that staff must
honor. Override attempts and coercion violate client rights.
Question 5. The nurse finds a confused client climbing over raised bed rails. The safest
intervention is:
A. Apply a vest restraint immediately without an order
B. Provide close observation and consider bed placement near the station with frequent
checks
C. Sedate the client with PRN medication without assessment
D. Ignore the behavior to avoid escalation
Correct Answer: B — Provide close observation and consider bed placement near
the station with frequent checks
Rationale: Least-restrictive alternatives and monitoring precede restraints. Unordered
restraint, sedation, and inattention endanger the client and breach regulations.
Question 6. Which action demonstrates proper use of restraints?
A. Tying the restraint in a knot the family cannot undo
B. Applying wrist restraints to both wrists and ankles simultaneously PRN
C. Documenting restraint checks only at discharge
D. Securing the order with frequent circulation checks, skin assessment, and range of
motion
Correct Answer: D — Securing the order with frequent circulation checks, skin
assessment, and range of motion
Rationale: Restraints require orders, scheduled release, and monitoring. Knots must be
quick-release, PRN orders are prohibited, and checks are continuous documentation.
Question 7. A nurse reports a colleague's repeated medication errors affecting client safety.
This action reflects:
A. Disloyalty to the team
, B. Defamation of the colleague
C. Breach of confidentiality
D. The professional duty to protect clients through appropriate reporting
Correct Answer: D — The professional duty to protect clients through appropriate
reporting
Rationale: Client safety obligations supersede team loyalty, and factual reporting is
protected. The other labels mischaracterize a duty.
Question 8. Professional negligence requires proof of:
A. Intent to harm
B. Duty, breach of duty, causation, and damages
C. A signed confession
D. Prior complaints only
Correct Answer: B — Duty, breach of duty, causation, and damages
Rationale: The four elements of negligence apply regardless of intent. The remaining
options are not legal elements.
Question 9. When documenting in the medical record, the nurse should:
A. Chart care that has not yet been given
B. Use personal opinions about clients
C. Erase errors completely
D. Chart objectively, timely, and with factual observations and interventions
Correct Answer: D — Chart objectively, timely, and with factual observations and
interventions
Rationale: Documentation must be factual, contemporaneous, and complete. Pre-
charting, opinions, and obliterated errors are legal hazards.
Question 10. Confidentiality is maintained by:
A. Discussing cases in elevators
B. Posting client photos online without identifiers
C. Faxing records to unknown numbers
D. Sharing client information only with those involved in care or as legally required
Correct Answer: D — Sharing client information only with those involved in care
or as legally required
Rationale: Privacy limits disclosure to care-related, authorized recipients. Public,
casual, and unverified sharing breach confidentiality.
Question 11. The nurse assigned to four clients should assess first:
A. A client requesting a snack
B. A client with new shortness of breath and chest pain
C. A client due for a scheduled bath
D. A client asking about discharge time
, Correct Answer: B — A client with new shortness of breath and chest pain
Rationale: Airway and breathing concerns take priority over routine and
administrative needs.
Question 12. Health care-associated infection prevention in the hospital setting relies most
on:
A. Weekly unit deep cleaning alone
B. Restricting all visitors completely
C. Hand hygiene before and after every client contact
D. Antibiotics for every staff member
Correct Answer: C — Hand hygiene before and after every client contact
Rationale: Hand hygiene is the single most effective transmission interrupter. Cleaning,
visitor limits, and prophylaxis are supplementary.
Question 13. A client who speaks a different language requires discharge teaching. The
nurse should:
A. Speak louder in English
B. Ask the client's young child to interpret
C. Use a qualified medical interpreter for the teaching session
D. Provide only English pamphlets
Correct Answer: C — Use a qualified medical interpreter for the teaching session
Rationale: Trained interpreters ensure accurate, unbiased teaching. Volume, children,
and monolingual materials compromise comprehension.
Question 14. Advocacy by the licensed nurse is best demonstrated by:
A. Communicating the client's wishes to the team even when they conflict with staff
convenience
B. Making decisions for the client
C. Avoiding difficult conversations
D. Supporting the provider regardless of client wishes
Correct Answer: A — Communicating the client's wishes to the team even when
they conflict with staff convenience
Rationale: Advocacy gives clients voice and protects their interests. Substituting
judgment, avoidance, and provider-first loyalty fail the client.
Question 15. The disaster triage system sorts clients primarily by:
A. Age of the client
B. Likelihood of survival with immediate intervention
C. Order of arrival
D. Insurance status
Correct Answer: B — Likelihood of survival with immediate intervention
