Free NCLEX-PN Practice Test – Part 12 (65 Questions) Updated 2026

1. A client with chronic lower back pain reports that heating pads provide better relief than pain medication. The client asks if they can use heat therapy at home. What instruction should the practical nurse provide?

2. A client receiving total parenteral nutrition (TPN) through a central venous catheter develops a fever of 101.2°F, and the PN notices redness and tenderness at the catheter insertion site. Which action should the PN take FIRST?

3. ### Question
A client arrives at the emergency department with a penetrating chest wound from a stabbing. The nurse notes a small open wound on the left chest with a sucking sound on inspiration. The client’s oxygen saturation is 88% on room air. Which intervention should the nurse implement first?

4. A client with chronic kidney disease has the following laboratory values: Potassium 5.8 mEq/L, Sodium 133 mEq/L, Calcium 8.2 mg/dL, Magnesium 2.8 mEq/L. The client reports muscle weakness and irregular heartbeat. Which electrolyte abnormality requires the MOST immediate intervention by the LPN/LVN?

5. A nurse is providing discharge teaching to a client newly diagnosed with type 2 diabetes. Which statement by the client indicates a need for further teaching about hypoglycemia prevention?

6. A client who had knee replacement surgery is prescribed a continuous passive motion (CPM) machine. The client asks the LPN/LVN why this device is being used. Which explanation is most accurate?

7. A client arrives at the emergency department with sudden onset of facial drooping, arm weakness, and slurred speech that began 2 hours ago. The spouse reports the symptoms started while watching television. Which action should the PN prioritize FIRST?

8. During a bed-to-chair transfer, the nurse feels a sudden strain in their lower back. What should the nurse do first?

9. A client with hyperparathyroidism has a serum calcium level of 14.2 mg/dL (normal: 8.6-10.2 mg/dL). The LPN/LVN should monitor this client MOST closely for which complication?

10. A client with insomnia has been taking zolpidem (Ambien) nightly for 6 weeks. The client tells the nurse, “I need to keep taking this because I still can’t sleep without it.” Which response by the nurse is most appropriate?

11. When administering IV potassium chloride (KCl) to a client with hypokalemia, which action by the LPN/LVN is MOST critical for client safety?

12. A client with schizophrenia is experiencing auditory hallucinations. Which statement by the client indicates the presence of positive symptoms?

13. Which clinical manifestation should the practical nurse recognize as an early sign of internal bleeding in a postoperative client?

14. A practical nurse is reinforcing teaching for a client with mild dehydration about increasing fluid intake. The client asks which fluids are best for rehydration. Which response by the nurse is MOST appropriate?

15. The nurse is performing post-mortem care for a patient who has just died. The patient was Muslim. Which intervention is most appropriate when the nurse prepares the body?

16.

17. A nurse is caring for a client with a central venous catheter (CVC) used for antibiotic administration. The dressing over the insertion site is transparent, dry, and intact, and was changed 5 days ago. The client’s IV antibiotic is due. What is the appropriate nursing action?

18. The practical nurse is preparing to give a back massage to a client who has been on bed rest for three days. The client has a history of deep vein thrombosis (DVT) in the right leg. Which action is most important for the nurse to take before beginning the massage?

19. When using a gait belt during ambulation, how should the LPN position themselves in relation to the client?

20. A nurse is caring for a client who is 2 days postoperative and has not had a bowel movement. The client reports abdominal discomfort and bloating. Which intervention should the nurse implement FIRST?

21. ### Question
A 68-year-old client presents to the emergency department with chest pain, shortness of breath, and diaphoresis. Assessment reveals blood pressure 84/50 mm Hg, heart rate 120 beats/minute, respiratory rate 28 breaths/minute, and jugular venous distension. Heart sounds reveal an S3 gallop. The nurse should recognize that this client is most likely experiencing which type of shock?

22. A 72-year-old female patient reports leaking small amounts of urine when she coughs, sneezes, or laughs. The nurse recognizes this as which type of urinary incontinence?

23. A client who overdosed on opioids is brought to the emergency department. The PN notes the respiratory rate is 8 breaths/min and shallow. The PN anticipates which acid-base imbalance will develop if this continues untreated?

24. A client with hypercalcemia (serum calcium 11.8 mg/dL) is prescribed IV fluids and a bisphosphonate. Which nursing intervention should the LPN/LVN prioritize?

25. A client with hyperkalemia (serum potassium 6.2 mEq/L) has an order for sodium polystyrene sulfonate (Kayexalate). What is the expected outcome of this medication?

26. A client is being treated for diabetic ketoacidosis with IV insulin and fluids. Which laboratory value requires the MOST vigilant monitoring during the first 24 hours of treatment?

27. A nurse is implementing sleep hygiene measures for a hospitalized client. Which intervention should the nurse prioritize?

28. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen at 2 L/min via nasal cannula. The client’s family member increases the oxygen to 6 L/min because the client “looks like they’re struggling to breathe.” What is the nurse’s priority action?

29. Which pain assessment tool is MOST appropriate for a 4-year-old child who is crying and holding their abdomen?

30. When communicating with a patient who has hearing impairment and is experiencing acute anxiety, which action by the LPN demonstrates appropriate therapeutic communication?

31. A client is diagnosed with disseminated intravascular coagulation (DIC). What should the practical nurse understand about this condition?

32. A nurse is caring for a client with heart failure who has been receiving furosemide (Lasix) 40 mg IV twice daily. The nurse monitors for which electrolyte imbalance as the highest risk?

33. A client with acute heart failure is receiving IV furosemide (Lasix) 40 mg. The LPN/LVN should monitor for which expected therapeutic effect?

34. A client with renal failure has ABG results: pH 7.28, PaCO2 35 mm Hg, HCO3- 18 mEq/L. The PN recognizes that the kidneys’ inability to excrete acid and
B. Partially compensated respiratory alkalosis
C. Uncompensated metabolic acidosis
D. Fully compensated metabolic alkalosis
C
The ABG shows metabolic acidosis (low pH, low HCO3-) with normal PaCO2, indicating no respiratory compensation yet. In renal failure, the kidneys cannot excrete hydrogen ions or
– A. Uncompensated respiratory acidosis: Incorrect because PaCO2 is normal (35 mm Hg), not elevated. Respiratory acidosis requires elevated PaCO2.
– B. Partially compensated respiratory alkalosis: Incorrect because pH is low (acidosis), not high (alkalosis), and PaCO2 is not decreased.
– D. Fully compensated metabolic alkalosis: Incorrect because pH is abnormal (7.28), indicating no full compensation, and HCO3- is low, not high.
Renal failure → metabolic acidosis (kidneys can’t excrete acid or make bicarb). Watch for hyperkalemia, which can cause fatal arrhythmias.

35. A nurse is monitoring a client who is 6 hours postoperative following an abdominal hysterectomy. Which assessment finding requires immediate notification of the healthcare provider?

36. ### Question
The nurse is caring for a client who sustained multiple injuries in a motor vehicle collision. The client has an open chest wound, a fractured femur, and facial lacerations. Using the ABCDE framework, which injury should the nurse address first?

37. The nurse is caring for a 78-year-old client who has not had a bowel movement in four days. The client’s usual pattern is daily. The client is alert, oriented, and reports mild abdominal discomfort but denies nausea or vomiting. Abdominal assessment reveals hypoactive bowel sounds and a firm, distended abdomen. Which intervention should the nurse implement first?

38. A nurse discovers that a controlled substance (oxycodone) was wasted during medication administration, but the waste was not witnessed by another nurse as required by facility policy. The medication was already administered to the client. What is the most appropriate action?

39. A client with diabetic ketoacidosis (DKA) is receiving IV fluids and insulin per protocol. The PN notes the client’s breathing has become deep and rapid (Kussmaul respirations). What is the PN’s best action?

40. A client with chronic obstructive pulmonary disease (COPD) reports difficulty sleeping due to shortness of breath when lying flat. Which position should the nurse recommend to promote better sleep?

41. A patient with obsessive-compulsive disorder (OCD) spends 45 minutes washing hands before meals. The LPN is planning care with the RN. Which intervention should be included in the care plan?

42. A patient with schizophrenia is being discharged home. The LPN is reviewing the medication schedule with the patient and family. Which statement by the family member indicates understanding of the antipsychotic medication regimen?

43. A practical nurse is obtaining a daily weight on a client with chronic kidney disease. Which action by the nurse is MOST important to ensure accuracy?

44. A client with a Foley catheter has been diagnosed with a catheter-associated urinary tract infection (CAUTI). Which action by the practical nurse is most important for preventing future CAUTIs?

45. The PN is preparing to administer medications through a client’s nasogastric tube. The client is receiving continuous enteral feedings. Which action should the PN take to prevent medication-nutrient interactions?

46. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after the transfusion begins, the client reports chills and lower back pain. What is the nurse’s priority action?

47. Which assessment finding is the EARLIEST indicator that a client with sepsis is progressing to septic shock?

48. A client with type 1 diabetes is found confused and diaphoretic. A fingerstick blood glucose reads 42 mg/dL. The client is awake but unable to swallow safely. Which action should the LPN/LVN take FIRST?

49. A client reports moderate pain (6/10) at the surgical incision site 2 days postoperatively. Which non-pharmacological intervention should the LPN/LVN implement first to promote comfort?

50. A client with type 2 diabetes is being discharged. The client asks about exercise recommendations. Which instruction should the nurse include in the teaching plan?

51. The nurse is caring for an older adult client who uses a wheelchair. The client needs to transfer from the wheelchair to the bed. Which action should the nurse take FIRST before assisting with the transfer?

52. A nurse is documenting a client’s response to pain medication. Which documentation entry demonstrates the most complete and legally defensible nursing note?

53. A nurse observes a UAP transferring a client without locking the wheelchair brakes. What is the nurse’s priority action?

54. A client with schizophrenia tells the LPN/LVN, “The voices are telling me to hurt myself.” What is the priority intervention?

55. A nurse is reviewing medication orders for a client admitted with sepsis. The client is currently receiving vancomycin IV every 12 hours. The provider orders gentamicin 80 mg IV every 8 hours. The nurse should recognize that this combination requires:

56. An LPN is caring for a client with a Braden Scale score of 12. What is the priority nursing intervention?

57. A nurse is caring for a 72-year-old client who states, “I only sleep about 5 hours a night now, but I used to sleep 8 hours.” Which response by the nurse is most appropriate?

58. A nurse is providing wellness teaching to a group of older adults about preventing dehydration. Which statement by a participant indicates a need for further teaching?

59. A client with thrombocytopenia has a platelet count of 85,000/mm³. Which nursing intervention is most appropriate for this client?

60. A nurse is preparing to administer insulin to a client with diabetes. Which action by the nurse demonstrates adherence to the “Five Rights” of medication administration?

61. A client is receiving warfarin (Coumadin) therapy for atrial fibrillation. Which laboratory value should the practical nurse monitor to evaluate the therapeutic effect of this medication?

62. A nurse is caring for a client who is 1 day postoperative following total hip replacement. Which intervention is MOST important for preventing complications during mobility?

63. A client is admitted with diabetic ketoacidosis. The LPN/LVN expects to observe which classic respiratory pattern associated with this metabolic emergency?

64. A client who was in a motor vehicle accident yesterday is being discharged. The client states, “I keep replaying the accident in my head. I can’t sleep, and I jump every time I hear a loud noise.” Which action should the PN take first?

65. When documenting ambulation in the client’s medical record, which information is ESSENTIAL for the LPN to include?