NCLEX-PN (National Council Licensure Examination for Practical Nurses) — Questions and Answers

Question 1: Which side effect of benzodiazepines causes the MOST concern when prescribed to older adult patients?

Elevated blood pressure
Increased alertness and restlessness
Fall risk secondary to excessive sedation (Correct answer)
Increased appetite and weight gain

Correct answer: Fall risk secondary to excessive sedation

Benzodiazepines cause sedation and impaired coordination in older adults, significantly increasing their risk of falls and fractures.

Question 2: During change-of-shift report, which information is most critical for the oncoming nurse to receive?

Housekeeping requests for the room
Dietary preferences from the previous week
The patient's insurance information
Current vital signs, significant changes, and pending orders (Correct answer)

Correct answer: Current vital signs, significant changes, and pending orders

Change-of-shift report must include current clinical status, significant changes, and any pending or new orders to ensure continuity of care.

Question 3: A foam dressing is MOST appropriate for which type of wound?

A heavily exudating wound requiring absorption (Correct answer)
A wound with exposed tendon needing a non-adherent surface only
A superficial abrasion in a dry environment
A dry wound with minimal exudate needing moisture donation

Correct answer: A heavily exudating wound requiring absorption

Foam dressings are highly absorbent and best suited for moderate-to-heavily draining wounds.

Question 4: Which behavior is commonly associated with 'sundowning' in patients with dementia?

Sudden improvement in memory at night
Increased confusion and agitation in the late afternoon or evening (Correct answer)
Improved orientation after a nap
Increased sleepiness and withdrawal during the day

Correct answer: Increased confusion and agitation in the late afternoon or evening

Sundowning refers to worsening confusion, restlessness, and behavioral disturbances that occur in the late afternoon and evening.

Question 5: After removing PPE in the correct sequence, the LVN's final step should be:

Performing hand hygiene (Correct answer)
Removing eye protection
Removing the mask or respirator
Removing the gown

Correct answer: Performing hand hygiene

Hand hygiene is always the final step after removing all PPE to remove any contaminants that may have transferred during doffing.

Question 6: Which action should the LVN take when disposing of an unused controlled substance after partial administration?

Store the remaining controlled substance in a personal locker until the next dose is due
Waste the remainder in the presence of a witness and document per facility policy (Correct answer)
Pour it down the sink alone without documentation
Return it to the pharmacy without documentation

Correct answer: Waste the remainder in the presence of a witness and document per facility policy

Controlled substances must be wasted with a witness and documented to prevent diversion and comply with regulatory requirements.

Question 7: What is family-centered care in pediatrics?

Only letting parents visit during visiting hours
Allowing families to provide all nursing care
An approach recognizing the family as central to the child's care, involving them in decisions and treatment (Correct answer)
Care without family involvement

Correct answer: An approach recognizing the family as central to the child's care, involving them in decisions and treatment

Family-centered care partners with families, respecting their knowledge of the child and involving them in care planning.

Question 8: Standard precautions apply to:

Respiratory secretions only
Only patients with known infections
Patients in private rooms only
Blood, body fluids, non-intact skin, and mucous membranes of all patients (Correct answer)

Correct answer: Blood, body fluids, non-intact skin, and mucous membranes of all patients

Standard precautions treat all patients as potentially infectious and apply to blood, all body fluids, non-intact skin, and mucous membranes.

Question 9: An LVN suspects a colleague documented care that was never actually provided. The most appropriate action is to:

Ignore it and assume there was a misunderstanding
Confront the colleague publicly at the nursing station
Alter the colleague's entry to reflect what likely occurred
Report the concern to the charge nurse or supervisor per facility policy (Correct answer)

Correct answer: Report the concern to the charge nurse or supervisor per facility policy

Falsification of medical records is a serious legal and ethical violation; the LVN must report the concern through proper channels.

Question 10: The minimum necessary standard under HIPAA means that an LVN should:

Only access and share the amount of PHI needed to accomplish the specific task (Correct answer)
Access all available patient data to be thorough
Print all records when communicating with other providers
Avoid documenting sensitive information to minimize exposure

Correct answer: Only access and share the amount of PHI needed to accomplish the specific task

The minimum necessary standard requires that only the PHI required for a specific purpose be accessed, used, or disclosed.

Question 11: What are the stages of wound healing?

Hemostasis, inflammation, proliferation, and remodeling (Correct answer)
Infection then healing
Only one stage exists
Healing happens instantly

Correct answer: Hemostasis, inflammation, proliferation, and remodeling

Wound healing progresses through four overlapping phases, each essential for complete tissue repair.

Question 12: What is the purpose of I&O (intake and output) monitoring?

Tracking medication doses
Measuring food portions
To track fluid balance by measuring all fluids consumed and excreted (Correct answer)
Only counting glasses of water

Correct answer: To track fluid balance by measuring all fluids consumed and excreted

I&O monitoring identifies fluid imbalances that could indicate kidney, heart, or other organ dysfunction.

Question 13: Which of the following is an example of objective data to document in a patient's chart?

Patient appears anxious
Patient states 'I feel dizzy'
Patient seems to be in pain
Blood pressure 148/92 mmHg (Correct answer)

Correct answer: Blood pressure 148/92 mmHg

Objective data is measurable and observable; a specific blood pressure reading is a clear example.

Question 14: An LVN notices a pattern of a patient's blood pressure readings trending upward over several shifts. The most appropriate communication action is to:

Continue monitoring and report at the end of the week
Document only in the flow sheet and say nothing
Notify the charge nurse and document the trend and notification (Correct answer)
Wait for the physician to review the chart independently

Correct answer: Notify the charge nurse and document the trend and notification

Trending vital signs that may indicate deterioration must be reported promptly to the charge nurse, with documentation of the pattern and the communication.

Question 15: The chain of infection includes six links. Which link does hand hygiene primarily break?

Mode of transmission (Correct answer)
Infectious agent
Portal of entry
Susceptible host

Correct answer: Mode of transmission

Hand hygiene interrupts the mode of transmission by removing pathogens from the hands before they can reach a new host.

Question 16: What is the importance of growth and development monitoring in pediatric nursing?

Monitoring starts only at school age
Growth monitoring is only for premature babies
All children grow at the same rate
Tracking growth patterns helps identify developmental delays, nutritional problems, and health conditions early (Correct answer)

Correct answer: Tracking growth patterns helps identify developmental delays, nutritional problems, and health conditions early

Regular measurement of height, weight, and developmental milestones enables early detection of problems.

Question 17: A physician gives the LVN a verbal order over the phone. What is the correct procedure?

Carry out the order immediately and document it later
Have another nurse listen and co-sign the verbal order before acting
Write the order, read it back to the physician for confirmation, then carry it out (Correct answer)
Refuse verbal orders and request a written order only

Correct answer: Write the order, read it back to the physician for confirmation, then carry it out

Verbal orders require a read-back verification to confirm accuracy before implementation, then must be signed by the physician within facility-defined timeframes.

Question 18: A patient with schizophrenia is prescribed risperidone (Risperdal). The nurse should monitor the patient for which potential adverse effect?

Excessive salivation
Orthostatic hypotension (Correct answer)
Weight loss
Hyperactivity

Correct answer: Orthostatic hypotension

Risperidone (Risperdal) is an atypical antipsychotic that can cause orthostatic hypotension, a sudden drop in blood pressure upon standing. This adverse effect is due to its alpha-adrenergic blocking properties and can lead to dizziness, lightheadedness, and an increased risk of falls. Therefore, monitoring blood pressure and advising patients to change positions slowly are important nursing actions.

Question 19: When using SBAR to communicate a change in a client's condition to the physician, which component provides the nurse's professional assessment and recommendation?

A — Assessment and R — Recommendation (Correct answer)
R — Recommendation only
S — Situation
B — Background

Correct answer: A — Assessment and R — Recommendation

The A (Assessment) and R (Recommendation) components convey the nurse's clinical judgment and what action is needed.

Question 20: Which finding in a diabetic foot wound warrants URGENT referral for further evaluation for osteomyelitis?

A superficial wound with granulating base and scant drainage
Mild peripheral edema with intact overlying skin
A deep wound that probes to bone with surrounding erythema (Correct answer)
A wound covered in dry eschar without surrounding inflammation

Correct answer: A deep wound that probes to bone with surrounding erythema

The 'probe-to-bone' test — when a sterile instrument contacts bone within a diabetic foot ulcer — has high predictive value for osteomyelitis.

Question 21: An LVN is caring for a patient with schizophrenia who appears to be responding to internal stimuli. Which response is most therapeutic?

'I don't hear anything, but I can see this is distressing to you.' (Correct answer)
'I'll give you some space until you've calmed down.'
'There are no voices — you are imagining things.'
'Tell me in detail exactly what the voices are saying.'

Correct answer: 'I don't hear anything, but I can see this is distressing to you.'

This response acknowledges the patient's distress without reinforcing delusional content or dismissing their experience.

Question 22: The LVN finds a sharps container that is three-quarters full. What is the appropriate action?

Continue using the container until it is completely full
Push the contents down to make more room
Cap the needles before disposing to free up space
Replace the container with a new one (Correct answer)

Correct answer: Replace the container with a new one

Sharps containers should be replaced when three-quarters full to prevent overfilling, which increases the risk of needlestick injury.

Question 23: What is an advance directive?

An insurance authorization
A hospital admission form
A medication list
A legal document expressing a patient's wishes about future medical treatment if they cannot communicate (Correct answer)

Correct answer: A legal document expressing a patient's wishes about future medical treatment if they cannot communicate

Advance directives include living wills and healthcare powers of attorney, guiding care when patients cannot speak for themselves.

Question 24: What is proper PPE donning and doffing sequence?

Gloves first always
Any order is acceptable
Remove everything at once
Don: gown, mask, goggles, gloves. Doff: gloves, goggles, gown, mask — with hand hygiene between steps (Correct answer)

Correct answer: Don: gown, mask, goggles, gloves. Doff: gloves, goggles, gown, mask — with hand hygiene between steps

Proper sequence prevents self-contamination during removal.

Question 25: When communicating with a patient diagnosed with antisocial personality disorder, the nurse should:

Provide excessive praise and attention for positive behaviors
Allow the patient to manipulate others to maintain peace
Avoid confrontation or conflict to prevent aggression
Set firm boundaries and consequences for inappropriate behavior (Correct answer)

Correct answer: Set firm boundaries and consequences for inappropriate behavior

Patients with antisocial personality disorder often exhibit manipulative and deceitful behaviors, disregarding rules and the rights of others. Setting firm, consistent boundaries and clearly defined consequences is essential to establish limits, promote accountability, and prevent manipulation. This approach fosters a safe and structured therapeutic environment for both the patient and others.

Question 26: A patient with fluid overload would most likely exhibit which assessment finding?

Dependent pitting edema (Correct answer)
Sunken fontanelles
Tenting of skin
Decreased blood pressure

Correct answer: Dependent pitting edema

Fluid overload causes excess fluid to accumulate in dependent areas due to gravity, resulting in pitting edema of the ankles and legs.

Question 27: Which behavior indicates a patient is maintaining appropriate therapeutic boundaries with the nurse?

Offering the nurse a monetary gift as a thank-you
Asking the nurse to be their friend on social media
Discussing only care-related concerns during interactions (Correct answer)
Sharing personal problems with the nurse to get advice

Correct answer: Discussing only care-related concerns during interactions

Therapeutic relationships remain focused on the patient's health needs; socializing, gifts, and personal advice fall outside professional boundaries.

Question 28: Under HIPAA, which of the following is permissible without specific patient authorization?

Giving records to the patient's spouse without the patient's consent
Releasing information to other treating providers for continuity of care (Correct answer)
Sharing records with the patient's employer
Disclosing information to law enforcement without a subpoena

Correct answer: Releasing information to other treating providers for continuity of care

HIPAA permits disclosure of PHI to other treating providers without authorization because it is needed for treatment purposes.

Question 29: Which patient profile represents the HIGHEST risk for a completed suicide?

A 30-year-old man who makes vague, non-specific threats when frustrated.
A 25-year-old woman who expresses sadness and cries frequently during sessions.
A 40-year-old woman with a chronic history of superficial, non-lethal self-cutting.
A 65-year-old widowed man who is socially isolated and has a specific plan involving a firearm. (Correct answer)

Correct answer: A 65-year-old widowed man who is socially isolated and has a specific plan involving a firearm.

Older age, male sex, widowhood, social isolation, and a lethal, specific plan are the highest-risk factors for completed suicide.

Question 30: When a medication order reads 'morphine 2–4 mg IV PRN pain q4h,' what does PRN mean?

Administer as needed when the patient reports pain (Correct answer)
Administer every 4 hours regardless of pain level
Administer before meals
Administer only at night

Correct answer: Administer as needed when the patient reports pain

PRN (pro re nata) means 'as needed,' so the nurse administers the drug when the patient requires it.

Question 31: Which dressing type is BEST for a wound with minimal exudate that requires a moist healing environment and protection from external contamination?

Hydrocolloid dressing (Correct answer)
Calcium alginate sheet
Dry sterile gauze
Wet-to-dry gauze dressing

Correct answer: Hydrocolloid dressing

Hydrocolloid dressings create and maintain a moist wound environment, absorb light exudate, and provide a bacterial barrier for wounds with minimal drainage.

NCLEX-PN (National Council Licensure Examination for Practical Nurses)

The NCLEX-PN is the computer-adaptive licensing exam required for Licensed Vocational Nurses (LVNs) and Licensed Practical Nurses (LPNs) across the US, assessing entry-level nursing competency across clinical knowledge and patient care domains.

Questions

35 min

Time Limit

70%

To Pass

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