Free NCLEX-PN Practice Test – Part 1 (85 Questions) Updated 2026

1. A client with limited mobility is being taught how to use a walker for ambulation. Which instruction should the LPN/LVN include in the teaching?

2. The LPN is performing a skin assessment on an older adult client and notes the following findings: skin is warm, dry, intact, with decreased turgor and multiple ecchymoses on the forearms. Which finding requires immediate reporting to the RN?

3. A 68-year-old client receiving intermittent enteral feedings through a PEG tube develops diarrhea after 4 days of feedings. The PN reviews the feeding schedule and notes that the feedings are being administered at room temperature and the rate has been stable. Which additional factor should the PN assess and report to the RN?

4. A client with a urinary tract infection has developed sepsis. Current vital signs: temperature 39.4°C (102.9°F), heart rate 126, blood pressure 88/52, respiratory rate 24, SpO2 94% on 2L oxygen. The provider has ordered IV antibiotics, blood cultures, and a 500 mL normal saline bolus. Which intervention should the LPN/LVN perform FIRST?

5. The LPN is assessing pain in a 4-year-old child. Which pain assessment tool is most appropriate for this age group?

6. Which staffing model assigns specific tasks (such as medication administration or wound care) to individual nurses who perform those tasks for all patients on the unit?

7. A client admitted after a suicide attempt is being placed on suicide precautions. Which action by the practical nurse is most appropriate for ensuring environmental safety?

8. A client is scheduled for a cardiac catheterization procedure tomorrow morning. Which pre-procedure instruction is most important for the LPN to reinforce?

9. The nurse is caring for a 68-year-old male patient with benign prostatic hyperplasia (BPH) who has not voided in 8 hours following surgery. The nurse assesses the abdomen and notes a rounded, firm mass above the symphysis pubis. The patient reports feeling pressure but is unable to void. Which action should the nurse take first?

10. A client is being discharged with a sliding board for wheelchair-to-bed transfers. The nurse includes which instruction in the teaching plan?

11. An elderly client is scheduled for a surgical procedure. The surgeon explains the risks and benefits, and the client signs the consent form. Later, the practical nurse enters the room and the client asks, “The doctor said something about my heart possibly stopping during surgery. Does that mean I might die?” Which response by the practical nurse best demonstrates support for informed consent?

12. A client with a spinal cord injury at T4 reports a severe pounding headache and is sweating profusely above the level of injury. The blood pressure is 210/110 mmHg. Which action should the PN take FIRST?

13. A nurse is caring for a client on contact precautions for MRSA. The nurse needs to take the client’s blood pressure and then assist with a wound dressing change. What is the correct sequence for personal protective equipment (PPE) use?

14. A client who underwent abdominal surgery 3 days ago has the following findings: temperature 99.8°F (37.7°C), incision with slight serous drainage, WBC 11,500/mm³, and states “I feel fine.” On day 4, the temperature is 101.6°F (38.7°C), WBC is 18,000/mm³, incision has purulent drainage with increased redness, and the client reports feeling “weak and dizzy.” The practical nurse interprets these findings as:

15. A patient who is 2 days post-colostomy surgery asks the practical nurse how to manage odor from the pouch. Which instruction should the nurse provide?

16. An LPN is caring for a patient who refuses a prescribed blood transfusion based on religious beliefs. The patient is alert, oriented, and understands the risks of refusing treatment. Which ethical principle is the LPN upholding by respecting the patient’s decision?

17. The PN is caring for four clients on a busy medical unit. At 1400, the nursing assistant reports: Client 1 with a stroke is having difficulty swallowing during lunch; Client 2 with chronic back pain is requesting pain medication; Client 3 with type 2 diabetes has a blood glucose of 65 mg/dL; Client 4 with depression is refusing to participate in group therapy. Using the ABC framework, Maslow’s Hierarchy, and principles of stability, which client should the PN assess FIRST?

18. Which of the following is a National Patient Safety Goal established by The Joint Commission?

19. Which nursing intervention is most appropriate for maintaining a safe environment for a client with schizophrenia who is experiencing paranoid delusions?

20. A patient with chronic alcohol use disorder is being assessed using the CIWA-Ar scale. The nurse observes the patient is moderately tremulous when extending arms, appears mildly anxious, and reports “bugs crawling on my skin.” Which withdrawal symptom category is being assessed?

21. An LPN is working on a postpartum unit. Which action by the nurse BEST helps prevent infant abduction?

22. A 68-year-old male patient is in bilateral wrist restraints after repeatedly trying to pull out his urinary catheter. The PN enters the room for the 2-hour monitoring check. Which actions should the PN take? Select all that apply, then identify the SINGLE BEST answer from the options.

The PN should: assess skin integrity under the restraints, check bilateral radial pulses, evaluate capillary refill, ask the patient about sensation in his hands, release restraints temporarily for range of motion, check vital signs, and document findings.

23. A client is being evaluated for metabolic syndrome. Which finding is NOT part of the diagnostic criteria for metabolic syndrome?

24. Which statement accurately describes the practical nurse’s role as a mandatory reporter?

25. A client with limited mobility due to arthritis asks for assistance getting out of bed. The client is able to bear weight on both legs but has weak grip strength. Which assistive device should the LPN/LVN plan to use for the safest transfer?

26. The practical nurse notices that a patient scheduled for discharge today has not received the prescribed antibiotic dose due at 0800. The discharge teaching materials have already been reviewed, and the patient is waiting for transportation. Which action should the nurse take first?

27. The PN is working on a unit with four clients experiencing pain. Which client’s pain should the PN address FIRST?

28. The PN is caring for four clients. Which client is at HIGHEST risk for a life-threatening complication and requires closest monitoring?

29. A nurse is caring for a patient with Clostridium difficile (C. diff) infection who has frequent watery diarrhea. The nurse observes a new assistive personnel (AP) entering the room and using alcohol-based hand sanitizer before leaving. What should the nurse do?

30. Which statement by an LPN indicates CORRECT understanding of when to check medication labels?

31. A client is newly diagnosed with obstructive sleep apnea (OSA) and will be using CPAP at home. Which statement by the client indicates a need for further teaching?

32. The PN is assigned four clients for the shift. Which client requires assessment FIRST due to time-critical intervention needs?

33. Which preoperative teaching intervention is most important for preventing postoperative pulmonary complications?

34. The nurse is teaching a client’s family about wheelchair safety in the home environment. Which statement by the family member indicates a need for additional teaching?

35. A practical nurse observes that a newly hired nursing assistant is not using proper hand hygiene before assisting clients with meals. Which action by the practical nurse demonstrates appropriate client advocacy?

36. The nurse is assessing a client with a nasogastric tube who has been receiving bolus tube feedings. The client reports having six loose, watery stools in the past 24 hours. Which action should the nurse take first?

37. A client is admitted with suspected active pulmonary tuberculosis. Which type of room should the LPN/LVN ensure the client is placed in?

38.

39. A patient taking atorvastatin reports unexplained muscle pain and weakness. Which laboratory test should the nurse anticipate being ordered?

40. A licensed practical nurse is assessing a client’s pressure injury and observes full-thickness skin loss with visible subcutaneous fat but no exposure of bone, tendon, or muscle. How should this injury be staged?

41. A client who had abdominal surgery 4 days ago reports feeling a “pop” in the incision area while coughing. The nurse assesses the wound and notes a loop of bowel protruding through the incision. What is the priority nursing action?

42. The LPN is caring for a patient who has been diagnosed with major depressive disorder. The patient states, “I don’t see the point in continuing treatment. Nothing will ever get better.” What is the priority nursing action?

43. Five minutes after receiving an intramuscular influenza vaccine, a patient reports feeling “funny” and develops urticaria (hives) on the face and neck, wheezing, and difficulty swallowing. The practical nurse recognizes signs of anaphylaxis. Which is the priority action?

44. The healthcare provider orders 1,000 mL of 0.9% sodium chloride to infuse over 8 hours. The IV pump should be set to what rate in mL/hr?

45. A practical nurse on a medical-surgical unit is caring for four patients. Patient A has HIV and is on standard precautions. Patient B has an open surgical wound with a dressing. Patient C has an indwelling urinary catheter. Patient D has a newly placed peripheral IV. The nurse’s hands are visibly clean with no apparent soil. Between which patient interactions would alcohol-based hand rub be appropriate versus requiring soap and water?

46. A nurse working on a medical-surgical unit is preparing to administer potassium chloride (KCl) 20 mEq IV to a patient with hypokalemia. The nurse reviews the medication administration record and notices the KCl is available as a concentrated solution in a vial. Which action should the nurse take?

47. A patient has had an indwelling urinary catheter for 5 days. The nurse notes that the urine has become cloudy and has a strong odor. The patient’s temperature is 100.8°F (38.2°C). Which intervention is most important for the nurse to implement?

48. A nurse is calculating a medication dose for a pediatric client. The order reads: “Amoxicillin 250 mg PO every 8 hours.” The available suspension is 125 mg/5 mL. How many mL should the nurse administer per dose?

49. An LPN is administering a controlled substance (oxycodone) for pain. After drawing up the prescribed dose, there is 0.5 mL remaining in the vial. What is the CORRECT procedure?

50.

51. Which statement best describes the Nurse Licensure Compact (NLC)?

52. The LPN is assisting a 78-year-old client with ambulation down the hallway. The client suddenly becomes dizzy, pale, and begins to slide down the wall. What is the LPN’s BEST action?

53. Which intervention is part of the “timeout” procedure performed before surgery?

54. A practical nurse working in a long-term care facility is preparing to administer an intramuscular injection to a resident. The nurse observes a small drop of blood on the bedside table from a previous procedure. Which action should the nurse take first?

55. A 52-year-old male client asks the PN about prostate cancer screening. The PN knows that prostate screening typically includes which TWO tests? (Select the primary screening methods the PN should discuss with the provider.)

56. A client with a tracheostomy requires suctioning. The nurse notes thick, tenacious secretions that are difficult to remove. What action should the nurse take?

57. A 65-year-old patient asks about pneumococcal vaccination. They received PCV13 (Prevnar 13) 5 years ago and PPSV23 (Pneumovax 23) 3 years ago. The patient has type 2 diabetes with no other high-risk conditions. Which response by the practical nurse is correct?

58. A client who is 4 hours postoperative following a total hip arthroplasty reports sudden onset of shortness of breath and chest pain. The nurse notes the client’s oxygen saturation has dropped from 96% to 88%. Which action should the nurse take FIRST?

59. An LPN is providing anticipatory guidance to parents of a 9-month-old infant. Which statement by the parents indicates understanding of safety measures appropriate for this developmental stage?

60. A patient with a PICC line develops redness, warmth, and purulent drainage at the insertion site. The patient’s temperature is 38.5°C (101.3°F). What is the LPN’s priority action?

61. A client who had a below-knee amputation 3 weeks ago refuses to look at the residual limb and states, “I can’t believe this happened to me. I’m worthless now.” Which nursing diagnosis should the LPN report to the RN?

62. The practical nurse is caring for a 72-year-old client who recently retired after 45 years as a teacher. The client states, “I feel useless now that I’m not working. My whole life was about teaching, and now I have nothing to contribute.” According to Erikson’s theory, which psychosocial task is this client struggling with?

63. A client with schizophrenia is being discharged to a group home. The client says, “I don’t need to take my medication anymore. I feel fine now.” What is the LPN’s priority action?

64. A client diagnosed with influenza requires transport to the radiology department for a chest X-ray. Which action should the practical nurse take to prevent transmission during transport?

65. A 7-year-old child presents with bruises on the upper arms and back in various stages of healing. The child says they “fell off a swing.” Which documentation by the practical nurse is most appropriate?

66. A client with fluid volume deficit is prescribed 0.9% Normal Saline IV. What is the primary purpose of this isotonic solution?

67. A client who received a blood transfusion 4 hours ago develops fever, chills, and tachycardia. The transfusion was completed without incident. The practical nurse suspects a febrile non-hemolytic reaction. Which statement best explains why this reaction occurred?

68. Which personal protective equipment (PPE) is required by OSHA when there is potential for exposure to bloodborne pathogens?

69. A client with a urinary tract infection develops the following vital signs: temperature 101.8°F (38.8°C), heart rate 118 bpm, respiratory rate 24/min, WBC 16,000/mm³. The practical nurse recognizes these findings meet the criteria for:

70. A practical nurse is reviewing the components of the PDSA cycle for a performance improvement project. Which sequence correctly represents the PDSA cycle phases?

71. The LPN/LVN is supervising a UAP who is assisting with client care. Which situation requires IMMEDIATE intervention by the nurse?

72. An LPN is reinforcing teaching for a pregnant client at 12 weeks gestation about prenatal nutrition. Which statement by the client indicates a need for further teaching?

73. A client with a new colostomy is being discharged home. The RN asks the LPN/LVN to reinforce discharge teaching. Which action by the LPN/LVN demonstrates appropriate collaborative care?

74. An LPN is caring for a client who is a Jehovah’s Witness and has a signed document refusing blood transfusions. The client becomes unstable after surgery and is now unconscious. The client’s adult child arrives and demands a blood transfusion, stating, “They wouldn’t want to die over this.” The spouse (named in the DPOA-HC) insists on honoring the no-transfusion directive. What should the LPN do?

75. The PN is scheduling a 67-year-old female client for a bone density scan. The PN knows this screening test is called:

76. A client with dysphagia following a stroke is being fed by the LPN/LVN. The client begins to cough during the meal and appears to be choking. Which action should the LPN/LVN take first?

77.

78. A PN receives an assignment from the charge RN that includes administering IV push medications to three clients. The PN completed an IV therapy course during nursing school but has not performed IV push medication administration since graduation 6 months ago. The facility policy requires demonstrated competency before independent IV medication administration. What is the PN’s most appropriate action?

79. An elderly client with type 2 diabetes is brought to the emergency department with extreme dehydration, confusion, and a blood glucose of 650 mg/dL. There is no fruity breath odor, and urine ketones are negative. The LPN/LVN recognizes these findings as most consistent with:

80. A client with terminal cancer tells the LPN, “I don’t want to be resuscitated if my heart stops.” The client has not signed any formal documents. What is the LPN’s priority action?

81. A patient with type 1 diabetes asks the nurse about the onset of action for lispro insulin. Which response by the nurse is correct?

82. The nurse needs to administer ear drops to a 4-year-old child for otitis media. Which technique should the nurse use when instilling the ear drops?

83. A licensed practical nurse is assessing a client’s skin and notes a reddened area over the sacrum that does not blanch when pressed. How should the nurse document this finding?

84. The nurse is reviewing the laboratory results for a patient. Which serum sodium level would the nurse identify as consistent with hypernatremia?

85. A client with post-traumatic stress disorder becomes startled and agitated when a fire alarm sounds on the unit. The client shouts, “Get down! They’re coming!” Which intervention should the practical nurse implement first?