NCLEX PN
NCLEX PN Exam– Practice Questions With Answers
Build your test-taking confidence with Ulosca’s NCLEX PN Exam review. This guide is designed for practical nursing students preparing to demonstrate safe, effective, and client-centered care across medical-surgical, maternal-newborn, pediatric, and mental health settings.
Everything you need to answer with confidence:
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Covers all major NCLEX PN test plan categories including Coordinated Care, Safety and Infection Control, Health Promotion, Psychosocial Integrity, and Physiological Integrity.
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Features + 1500 Next Generation NCLEX (NGN)-style case studies with layered data, highlighting clinical judgment, delegation, prioritization, and anticipation of provider orders.
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Strengthens your ability to recognize early warning signs, implement safe interventions, and collaborate effectively within the LPN scope of practice.
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Fully aligned with the 2023 NCLEX PN test plan and client-centered care framework.
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Free NCLEX PN Questions
Which of the following are components of the definition of critical thinking
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Reasoned thinking
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Openness to alternatives
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Adherence to established guidelines
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Ability to reflect
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Loyalty to traditional approaches
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Desire to seek the truth
Explanation
Correct Answer:
A. Reasoned thinking
B. Openness to alternatives
D. Ability to reflect
F. Desire to seek the truth
Explanation:
A. Reasoned thinking is a core component of critical thinking. It involves the ability to analyze facts, assess different viewpoints, and draw logical conclusions based on evidence rather than emotion or assumption. Critical thinkers do not simply accept information at face value but engage in rational analysis.
Openness to alternatives reflects the flexibility required in critical thinking. Being willing to consider multiple perspectives or solutions helps ensure that decisions are not biased or narrowly focused. This openness enhances the quality of decision-making and problem-solving.
B. Ability to reflect is essential because it allows individuals to evaluate their own thoughts, assumptions, and conclusions. Reflection improves self-awareness and promotes learning from past experiences, both of which are necessary for strong critical reasoning.
F. Desire to seek the truth captures the foundational motivation behind critical thinking. It drives the thinker to move beyond superficial answers and to investigate the most accurate and reliable conclusions. This trait supports integrity and objectivity in decision-making.
Why Other Options Are Wrong:
C. Adherence to established guidelines
While following guidelines is important for clinical safety and standards of care, it is not a defining feature of critical thinking. Critical thinkers question and analyze whether guidelines apply appropriately in specific contexts rather than follow them blindly. Critical thinking often requires going beyond protocols when situations are complex or unusual.
E. Loyalty to traditional approaches
This is contrary to the nature of critical thinking. Being loyal to tradition may lead to inflexibility or resistance to new and possibly better solutions. Critical thinking encourages questioning the status quo, adopting evidence-based changes, and rejecting outdated methods when appropriate.
Laboratory reference ranges
Glucose (fasting)
Infant - Within 24 hours after birth
≥40 mg/dL (2.2 mmol/L)
The nurse is caring for assigned newborns. Which of the following newborns should the nurse check first
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a newborn who was delivered 30 minutes ago and has bilateral crackles
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a newborn who was delivered 45 minutes ago and has asymmetric arm movement when the Moro reflex is tested
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a newborn who was delivered 6 hours ago and has a respiratory rate of 52/min
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a newborn who was delivered 12 hours ago, is jittery, and has a serum glucose level of 38 mg/dL (2.1 mmol/L)
Explanation
Correct Answer D. A newborn who was delivered 12 hours ago, is jittery, and has a serum glucose level of 38 mg/dL (2.1 mmol/L)
Explanation of the Correct Answer:
A serum glucose level of 38 mg/dL is below the normal range (≥40 mg/dL) for newborns and is considered hypoglycemia, especially in a newborn who is now 12 hours old. Jitteriness is a classic sign of neonatal hypoglycemia, which can lead to seizures, apnea, or brain injury if not treated promptly. This newborn requires immediate intervention, making them the highest priority.
A nurse is caring for a 2-year-old with a new diagnosis of strabismus. Which intervention should the nurse anticipate
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Correction with laser surgery
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Eye drops in the affected eye
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Measurement of intraocular pressure
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Patching of the unaffected eye
Explanation
Correct Answer D. Patching of the unaffected eye
Explanation:
Patching the unaffected (stronger) eye is a common treatment for strabismus in young children. This forces the use of the weaker eye and helps strengthen the muscles responsible for proper alignment. Early treatment is essential to prevent amblyopia (lazy eye) and promote normal visual development. This intervention is non-invasive and often effective when implemented consistently during the critical period of visual development.
The nurse cares for a client six hours post-operative following a transurethral resection of a prostate (TURP)
Item 1 of 1
Nurse’s Notes
The client was alert, oriented to person, place, time, and situation. The client has a three-way indwelling urinary catheter and is continuously irrigated with isotonic saline. Urine output is ketchup-like with medium to large clots. The client reports the need to urinate and reported pressure in the pelvic region described as spasms.
Intake and Output
Intake – Continuous bladder irrigation: 550 mL
Output – Indwelling catheter: 975 mL
Vital Signs
Blood Pressure: 100/60 mm Hg
Temperature: 98° F (36.7° C)
Heart rate: 106/min
Respiratory rate: 19 breaths per minute
Oxygen saturation: 95% on room air
Drag words from the choices below to fill in the blank in the following sentence:
The client is demonstrating signs and symptoms of:
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urinary catheter obstruction
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hyponatremia
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urinary tract infection
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shock
Explanation
Correct Answer D. shock
Explanation:
The client is showing early signs of hypovolemic shock, which is a serious complication following TURP. The "ketchup-like" urine with clots indicates excessive bleeding, and the urinary output, though exceeding the irrigation input, may include significant blood loss. The low blood pressure (100/60 mm Hg) combined with a heart rate of 106/min suggests compensatory tachycardia—a hallmark of early shock. The client’s report of pelvic pressure and spasms, in combination with bleeding and hemodynamic changes, should prompt immediate evaluation for hemorrhage. TURP clients are at high risk of bleeding within the first 24 hours, making this a priority concern.
Why Other Options Are Wrong:
A. Urinary catheter obstruction
While the presence of clots could suggest an evolving obstruction, the total output (975 mL) still exceeds the irrigation input (550 mL), indicating that drainage is occurring. Additionally, obstruction does not explain the drop in blood pressure and rising heart rate—findings that more clearly align with hypovolemia and shock.
B. Hyponatremia
This is a potential complication of TURP syndrome, which can occur if large volumes of hypotonic fluids are absorbed. However, this client is receiving isotonic saline, and no neurological signs such as confusion, headache, or seizures are present. The signs here are more consistent with blood loss than electrolyte imbalance.
C. Urinary tract infection
Though UTIs are possible after catheterization, they typically present with fever, dysuria, or cloudy/foul-smelling urine—not hypotension, tachycardia, and significant hematuria. The clinical picture does not support an infectious process at this time.
While caring for a client who is suspected of having appendicitis, the nurse overhears his conversation with a loved one. Which of the following statements would prompt immediate intervention
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The pain doesn’t feel as bad now, I think it was just a stomach ache.
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Would you mind getting me an ice pack?
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I know I'm not supposed to eat anything right now, but I’m hungry.
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I wonder if I can play in the basketball game on Monday.
Explanation
Correct Answer A. The pain doesn’t feel as bad now, I think it was just a stomach ache.
Explanation:
In a client with suspected appendicitis, sudden relief of pain may signal a ruptured appendix. This is a surgical emergency, as it can lead to peritonitis, sepsis, and shock. The nurse must immediately intervene to reassess the client, notify the healthcare provider, and prepare for urgent intervention.
Why Other Options Are Wrong:
B. Would you mind getting me an ice pack?
Applying cold may offer comfort, and ice is acceptable in suspected appendicitis. The concern would arise if the client requested heat, which can increase inflammation and risk of ruptur
C. I know I'm not supposed to eat anything right now, but I’m hungry.
While eating is not advised preoperatively or during workup for appendicitis, this does not indicate clinical deterioration. The nurse should remind the client of NPO status, but it does not demand emergency response.
D. I wonder if I can play in the basketball game on Monday.
This indicates the client is thinking ahead, and while unrealistic, it reflects normal conversation and coping—not an immediate medical concern.
While working on the pediatric floor, you are assigned a client with impetigo. Which of the following actions do you take to prevent the spread of this disease
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Initiate standard precautions
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Initiate contact precautions
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Initiate droplet precautions
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Initiate airborne precautions
Explanation
Correct Answer B. Initiate contact precautions
Explanation:
Impetigo is a highly contagious bacterial skin infection that spreads through direct contact with the lesions or with contaminated items such as towels, linens, and clothing. Contact precautions are required to prevent transmission. This includes the use of gloves and gown during any interaction with the patient or their environment, as well as dedicated equipment.
Why Other Options Are Wrong:
A. Initiate standard precautions
Standard precautions are necessary for all clients, but they are not sufficient alone for infections like impetigo. Contact precautions are needed due to the contagious nature of the lesions.
C. Initiate droplet precautions
Droplet precautions are used for pathogens spread through respiratory droplets, such as influenza or pertussis. Impetigo does not spread this way.
D. Initiate airborne precautions
Airborne precautions are used for diseases like tuberculosis and measles that can remain suspended in the air. Impetigo spreads through contact, not through airborne transmission.
The nurse caring for multiple clients on a medical-surgical unit should delegate which action to the nursing assistant
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Offer orange juice to client if bedside glucose reading is <70 mg/dL (3.9mmol/L)
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Assist client, post hip fracture repair, to the bathroom
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Check the appearance of client's wound
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Discontinue nasogastric tube if client tolerates oral liquids
Explanation
Correct Answer B. Assist client, post hip fracture repair, to the bathroom
Explanation:
A nursing assistant can safely assist a stable client who is post–hip fracture repair to the bathroom if the client is cleared for mobility and requires assistance. This task is within the scope of a nursing assistant and involves routine support for activities of daily living (ADLs), which includes toileting and ambulation with appropriate precautions to prevent falls or injury.
The nurse is supervising a student nurse administer prescribed medications via a double-lumen nasogastric tube (NGT) with an air vent. Which action by the student requires follow-up? The student
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Irrigates the air vent before medication administration with water
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Contacts the pharmacy to obtain available medications in liquid form
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Flushes the NGT between medications with water
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Administers each medication separately through the NGT
Explanation
Correct Answer A. Irrigates the air vent before medication administration with water
Explanation:
A double-lumen NGT (such as a Salem sump tube) has one lumen for suction or feeding and a second air vent to prevent gastric mucosa from adhering to the tube. The air vent should never be irrigated with water, as this can disrupt its function and lead to complications such as aspiration or blocked venting. An air vent should remain dry and open to air, or only flushed with a small amount of air, not fluid.
Why Other Options Are Incorrect:
B. Contacts the pharmacy to obtain available medications in liquid form
Correct action. Liquid medications are preferred for NGT administration as they reduce the risk of tube blockage.
C. Flushes the NGT between medications with water
Correct action. Flushing with water helps prevent drug interactions and clogs in the tube.
D. Administers each medication separately through the NGT
Correct action. Giving medications one at a time allows for proper absorption and prevents mixing, which could clog the tube or cause interactions.
The nurse is caring for a 75-year-old client who is admitted to the hospital with pneumonia. What assessment finding is most consistent with the diagnosis of delirium
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Family reports a gradual inability to remember recent events
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Client is experiencing muscle stiffness and resting hand tremors
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Client is inattentive and disoriented
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Client reports decreased enjoyment in hobbies
Explanation
Correct Answer C. Client is inattentive and disoriented
Explanation of the Correct Answer:
Delirium is an acute confusional state that is often triggered by an underlying medical condition, such as infection (e.g., pneumonia). Inattention and disorientation are hallmark signs of delirium. Clients with delirium may have fluctuating levels of consciousness, be easily distracted, and have difficulty focusing or following conversations. Disorientation regarding time, place, and person is common, and these symptoms often develop suddenly.
The nurse is caring for a client who is confused and is in soft wrist restraints. Which tasks can the nurse safely assign to unlicensed assistive personnel
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Assist the client with using a bedpan
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Check circulation and sensation of the extremities
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Perform range-of-motion exercises
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Report changes in skin integrity
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Turn and reposition the client in bed
Explanation
Correct Answers:
A. Assist the client with using a bedpan
D. Report changes in skin integrity
E. Turn and reposition the client in bed
Explanation of the Correct Answers:
A. Assist the client with using a bedpan:
Unlicensed assistive personnel (UAP) can safely assist the client with using a bedpan, as this is a routine activity that does not require specialized medical knowledge or assessment.
D. Report changes in skin integrity:
UAP can observe and report changes in skin integrity to the nurse, but they should not perform assessments or make decisions about treatment. Changes in skin integrity, such as redness or signs of breakdown, should be communicated to the nurse for further action.
E. Turn and reposition the client in bed:
UAP can assist with turning and repositioning the client in bed to help prevent pressure ulcers and promote comfort, as long as the client is stable and the procedure is within their scope of practice.
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Exam Description
NCLEX PN Exam – Comprehensive Practice Questions With Answers
This NCLEX PN exam focuses on essential areas of practical nursing care, including recognition of clinical deterioration, safe delegation within the PN scope, prioritization, infection control, pharmacology, maternal-newborn care, pediatrics, and psychosocial nursing. Students will be expected to apply clinical judgment, identify urgent findings, and collaborate effectively with the healthcare team to provide safe, client-centered care.
1. Recognition of Clinical Deterioration
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Alcohol withdrawal syndrome: tremors, diaphoresis, hallucinations, hypertension, and seizure risk.
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Sepsis and cellulitis: recognizing purulent drainage, wound changes, and loss of IV access.
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Delirium vs. dementia: acute confusion, agitation, and fluctuating cognition.
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Emergency recognition: autonomic dysreflexia, tension pneumothorax, GI bleeding.
2. Medication Safety and Pharmacology
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Safe insulin practices: NPH and regular insulin, avoiding sliding scale errors.
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Lithium toxicity monitoring: reporting polyuria and polydipsia.
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Benzodiazepine use in withdrawal: anticipating lorazepam orders.
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Vitamin supplementation: thiamine to prevent Wernicke’s encephalopathy.
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Medication administration safety: 5 rights, damaged labels, gloves with transdermals.
3. Delegation and Scope of Practice
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Tasks for UAPs: vital signs, ambulation, repositioning, urine output measurement, specimen collection.
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Tasks for LPNs: wound care, catheter irrigation, oral medication administration, stable post-op care.
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Tasks retained by RNs: initial assessments, complex admissions, IV push meds, client teaching.
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Delegation errors: venipuncture by unlicensed staff, unsafe feeding assignments, inappropriate assessment delegation.
4. Prioritization of Care
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Using ABCs and Maslow’s hierarchy in client assignment.
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Prioritizing unstable post-op or PACU clients over teaching and discharges.
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Recognizing life-threatening emergencies (seizures, respiratory distress, hemorrhage).
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Managing multiple trauma clients: airway and circulation first.
5. Infection Control and Safety
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MRSA wound precautions: gown and gloves.
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Contact and droplet isolation principles.
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Medication safety: clarifying unsafe orders (NPH IV push).
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Preventing hospital-acquired infections through delegation and monitoring.
6. Maternal-Newborn and Pediatric Care
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Obstetric emergencies: prolapsed cord management with knee-chest position.
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Gestational diabetes: complications including macrosomia, shoulder dystocia, polyhydramnios, preeclampsia.
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Hemophilia A teaching: safe activities, medical alert, avoiding aspirin.
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Pediatric safety: epistaxis management, therapeutic communication for injections.
7. Psychosocial and Mental Health Nursing
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Therapeutic communication: avoiding “why” questions and judgmental language.
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Conversion disorder: validating symptoms as real without stigma.
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Behavioral emergencies: client violence, priority to remove others from danger.
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Substance use disorders: relapse prevention strategies (sponsors, recovery programs).
8. Professional Accountability
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Incident reporting for narcotics and safety events.
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Quality improvement: acuity reporting, EMR use.
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Maintaining expertise through continuing education.
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Collaboration with RNs and HCPs for safe delegation and follow-up.