NCLEX-PN Nursing — All Questions

A client with a hearing impairment is scheduled for a procedure and reads lips. What should the LPN/VN do?

• a.Face the client in good light while speaking✓
• b.Stand beside the client and speak into the ear
• c.Exaggerate the mouth movements while speaking
• d.Speak louder so the words are easier to catch

Lip reading requires an unobstructed, well-lit view of the speaker's face at a normal speaking rate. Volume does not help a lip reader, exaggerated movement distorts the shapes, and standing at the side removes the view entirely.

An LPN/VN finds a client in tears after a family visit and the client says, 'Please do not tell anyone.' The client then describes being hit at home. What should the LPN/VN do?

• a.Explain that the report must be made✓
• b.Wait for the client to bring it up again before acting
• c.Agree to keep the disclosure between the two of them
• d.Ask the client to repeat the account to the family

Suspected abuse is a mandatory report, and the client is told honestly that confidentiality cannot be promised here. Agreeing to secrecy, involving the family, and waiting for another disclosure all leave the client unprotected.

An LPN/VN is caring for a client who has been placed on one-to-one observation for self-harm risk. Which action is correct?

• a.Ask another client to alert staff if anything happens
• b.Stay in the doorway while the client uses the bathroom
• c.Check on the client every fifteen minutes as ordered
• d.Remain within arm's reach of the client at all times✓

One-to-one observation means continuous, arm's-length presence including in the bathroom. Interval checks, a doorway position, and relying on another client all create unobserved time.

A client from a culture that values family decision-making asks that the adult children be present for all care discussions. What should the LPN/VN do?

• a.Ask the client to designate one child as the contact
• b.Provide the information and let the client relay it
• c.Explain that health information is given to the client
• d.Arrange the discussions when the children can attend✓

Client-reported cultural preferences are incorporated when the client wants them. Overriding the request, narrowing it to one person, and shifting the work of communication to the client all disregard the client's stated choice.

An LPN/VN notices that a client on the unit has stopped attending meals and sits alone. What should the LPN/VN do?

• a.Sit with the client and ask how the day has been✓
• b.Notify the nursing supervisor of the change
• c.Bring a meal tray to the room to save the client effort
• d.Remind the client that meals are served in the dining room

Approaching the client directly gathers the data that any next step depends on and offers support. Escalating without data, accommodating the isolation, and restating the schedule all miss the change the nurse observed.

An LPN/VN is providing postmortem care and the family asks to stay in the room. What should the LPN/VN do?

• a.Explain that the care must be completed right away
• b.Invite the family to help with the postmortem care
• c.Ask the family to wait in the lounge during the care
• d.Offer the family private time before the care begins✓

Allowing private time supports grieving and is standard practice before postmortem care. Refusing, redirecting the family to a lounge, and recruiting them into the physical care all disregard the family's request.

An LPN/VN is participating in a reminiscence activity with older adults. Which action fits that therapy?

• a.Ask the group to name today's date and season
• b.Ask the group about a favorite childhood meal✓
• c.Ask each member to state a goal for the week
• d.Ask the group to identify the objects on a tray

Reminiscence therapy invites recall of meaningful past experiences. Naming the date is reality orientation, goal setting is a different intervention, and object identification is a cognitive screening task.

A client who is blind is admitted to the unit. Which action should the LPN/VN take?

• a.Rearrange the furniture so the path is the shortest
• b.Ask the family to stay overnight for the first night
• c.Keep the door closed so hallway noise is reduced
• d.Orient the client to the room by walking the layout✓

Systematic orientation to a fixed room layout lets the client move safely and independently. Rearranging furniture, relying on family presence, and closing off sound cues all reduce the client's ability to navigate.

A client repeatedly presses the call light within minutes of each visit. What should the LPN/VN do?

• a.Move the call light farther from the client's reach
• b.Report the frequent calls to the nursing supervisor
• c.Explain that other clients also need the nurse's time
• d.Round on the client at planned set intervals✓

Scheduled rounding meets the underlying need for reassurance and reduces call frequency. Escalating, appealing to fairness, and moving the call light out of reach all leave the need unmet, and the last is unsafe.

An LPN/VN is preparing to give a bolus feeding through a nasogastric tube. How should the client be positioned?

• a.With the head of the bed raised 30 to 45 degrees✓
• b.Flat on the back with the head turned to one side
• c.Sitting upright with the neck flexed toward the chest
• d.On the left side with the head of the bed lowered

Elevating the head of the bed 30 to 45 degrees during and after a feeding reduces reflux and aspiration. Supine positioning and Trendelenburg increase reflux, and neck flexion narrows the airway.

A client with a newly inserted nasogastric tube is about to receive the first feeding. What confirms correct tube placement?

• a.A radiograph read after the tube was inserted✓
• b.Air injected while listening over the epigastrium
• c.Aspirate with a pH of 5.5 from the tube
• d.Absence of coughing when the client swallows water

Radiographic confirmation is the standard before the first use of a blindly inserted feeding tube. A pH of 5.5 is not clearly gastric, the auscultatory air method is unreliable, and absence of coughing does not exclude a tube in the airway.

An LPN/VN is repositioning a client who is on bed rest. How should the client be turned to reduce pressure on the trochanter?

• a.To a 90-degree side-lying position on the hip
• b.To a 30-degree side-lying position✓
• c.To a prone position with the arms above the head
• d.To a fully supine position with the knees flexed

A 30-degree lateral tilt keeps weight off the greater trochanter. Lying directly on the hip concentrates pressure there, supine loading shifts pressure to the sacrum and heels, and prone positioning is not tolerated by most clients.

An LPN/VN observes a reddened area over a client's sacrum that does not turn white when pressed. How should this be described?

• a.Intact skin with nonblanchable redness of the area✓
• b.Partial-thickness skin loss with a shallow open base
• c.Skin loss covered by adherent yellow slough tissue
• d.Full-thickness skin loss with visible subcutaneous fat

Nonblanchable erythema over intact skin is the earliest recognizable pressure injury. Partial-thickness loss, visible fat, and slough-covered loss all describe deeper or obscured injuries.

An LPN/VN is providing care for a client with a stage 2 pressure injury on the heel. Which action is appropriate?

• a.Position the client on that heel for short periods
• b.Massage the reddened skin around the injury
• c.Apply a heat lamp to the area twice each day
• d.Keep the heel elevated off the surface of the bed✓

Offloading the heel removes the pressure that caused the injury. Massage over a compromised area causes further tissue damage, heat lamps dry and burn fragile skin, and any weight bearing continues the injury.

A client who had a stroke has difficulty swallowing. What should the LPN/VN do during meals?

• a.Place food on the weaker side of the client's mouth
• b.Offer thin liquids through a straw between the bites
• c.Seat the client upright and have the chin tucked down✓
• d.Seat the client upright and have the chin lifted up

An upright position with a chin tuck narrows the airway entrance and directs food toward the esophagus. Chin lift opens the airway to food, thin liquids through a straw move fastest and are hardest to control, and the weaker side pockets food.

An LPN/VN is helping a client ambulate with a cane after a right hip replacement. How should the cane be used?

• a.Held in the left hand and moved with the right leg✓
• b.Held in the left hand and moved with the left leg
• c.Held in the right hand and moved before both legs
• d.Held in the right hand and moved with the right leg

The cane is held on the stronger side and advanced together with the weaker leg so the two share the load. Holding it on the affected side, pairing it with the strong leg, or advancing it alone all fail to unload the operative hip.

An LPN/VN is teaching a client with an ostomy about emptying the pouch. When should the pouch be emptied?

• a.When it is completely full at the end of the day
• b.Only when the seal begins to leak
• c.Every four hours whether or not there is output
• d.When it is about one-third to one-half full✓

Emptying at one-third to one-half full keeps the weight from breaking the seal. Waiting until full or until leakage begins guarantees seal failure, and a fixed schedule ignores actual output.

An LPN/VN is caring for a client with an indwelling urinary catheter. Which action prevents infection?

• a.Empty the drainage bag once each work shift
• b.Coil the extra tubing loosely on the bed surface
• c.Disconnect the tubing to obtain a urine specimen
• d.Keep the drainage bag below the bladder✓

Keeping the bag below the bladder prevents backflow of contaminated urine. A fixed emptying schedule may allow overfilling, breaking the closed system introduces organisms, and tubing on the bed can allow dependent loops and reflux.

A client reports constipation and is on a bowel management protocol. Which nonpharmacological measure should the LPN/VN reinforce first?

• a.Increase fluid intake and daily walking as tolerated✓
• b.Increase dietary fiber without changing fluid intake
• c.Restrict food intake until the bowel pattern returns
• d.Use a bedpan rather than walking to the bathroom

Fluid and activity together restore normal transit. Fiber without fluid worsens constipation, bedpan use makes evacuation harder, and restricting food removes the bulk the colon needs.

An LPN/VN is providing morning care for a client with diabetes. Which foot care action is correct?

• a.Dry carefully between the toes after washing✓
• b.Soak the feet in warm water for twenty minutes
• c.Apply lotion generously between the toes
• d.Trim the toenails in a curve at the corners

Moisture between the toes promotes fungal infection and skin breakdown, so the area is dried thoroughly. Soaking macerates skin, curved nail trimming causes ingrown nails, and lotion between the toes traps moisture.

An LPN/VN is caring for a client who is receiving continuous enteral feeding. Which finding suggests intolerance?

• a.Two soft formed stools during the day shift
• b.Abdominal distention with new nausea✓
• c.A residual volume of 60 mL after four hours
• d.Bowel sounds present in all four quadrants

Distention with nausea suggests delayed gastric emptying and possible aspiration risk. A modest residual, normal stools, and present bowel sounds are all expected during tolerated feeding.

An LPN/VN is planning nonpharmacological pain relief for a client with chronic low back pain. Which measure is appropriate?

• a.Ice applied continuously for two hours at a time
• b.Vigorous deep massage directly over the spine
• c.Repositioning with pillow support and slow massage✓
• d.Complete bed rest until the pain fully resolves

Repositioning with support and gentle massage relieve muscle tension without harm. Prolonged bed rest worsens back pain, deep pressure over the spine can injure, and unbroken two-hour ice application damages tissue.

An LPN/VN is measuring intake and output for a client. Which item counts as intake?

• a.The applesauce the client ate at breakfast
• b.The gelatin dessert the client ate at lunch✓
• c.The mashed potatoes served with the dinner
• d.The oatmeal the client finished this morning

Gelatin is liquid at body temperature and is counted as fluid intake. Applesauce, mashed potatoes, and oatmeal are semisolid foods and are not recorded as fluid.

An LPN/VN is performing range-of-motion exercises for an immobilized client. Which action is correct?

• a.Move each joint to the point of resistance only✓
• b.Complete the movements as quickly as tolerated
• c.Perform the exercises only on the unaffected side
• d.Move each joint slightly beyond the point of pain

Movement stops at resistance to protect the joint. Pushing past pain injures tissue, exercising only one side allows contractures on the other, and rapid movement increases spasticity and injury risk.

A client with a hearing aid is admitted to a long-term care unit. How should the LPN/VN store the device overnight?

• a.Turned on and left in the client's bedside drawer
• b.Turned off and sealed in an airtight plastic bag
• c.Turned off with the battery compartment open✓
• d.Turned on and placed in a cup of clean water

Turning the aid off and opening the battery door conserves the battery and lets moisture escape. Water destroys the device, an airtight bag traps moisture, and leaving it on drains the battery.

An LPN/VN is providing postmortem care. Which action should be completed first?

• a.Confirm that the death has been pronounced✓
• b.Wash the body and apply a clean gown
• c.Remove all tubes and lines from the body
• d.Place the body in a supine position with a pillow

Care begins only after the death has been formally pronounced, and in some cases lines must remain in place for the medical examiner. Removing lines, positioning, and bathing all come after that confirmation.

An LPN/VN is preparing a client for sleep. Which measure promotes rest?

• a.Offer a caffeinated beverage in the early evening
• b.Encourage a two-hour nap in the late afternoon
• c.Cluster care so the client has uninterrupted time✓
• d.Keep the overhead lights on for safety checks

Grouping care allows longer uninterrupted sleep cycles. Evening caffeine, bright overhead light, and long late naps all interfere with sleep onset and continuity.

An LPN/VN is assisting a client with a bed bath. Which action is correct?

• a.Wash from the inner to the outer corner of the eye✓
• b.Wash from the outer to the inner corner of the eye
• c.Use soap on the eyelids to remove dried drainage
• d.Use the same section of cloth for both of the eyes

Cleansing from inner to outer canthus moves debris away from the lacrimal duct. Reversing the direction pushes debris into the duct, soap irritates the eye, and reusing the cloth transfers organisms between eyes.

A client with an ileostomy asks about the expected output. What should the LPN/VN reinforce?

• a.The output becomes formed within a few weeks
• b.The output should be measured only once each day
• c.The output requires irrigation each morning
• d.The output stays loose and is emptied often✓

An ileostomy drains loose stool continuously because the colon is no longer absorbing water, so the pouch is emptied frequently and the output never becomes formed. Formed stool, once-daily measurement, and irrigation apply to a descending or sigmoid colostomy, not an ileostomy.

An LPN/VN is caring for a client who uses a walker. Which observation indicates safe use?

• a.The client steps forward before moving the walker
• b.The client's elbows are slightly bent on the grips✓
• c.The client's arms are fully straight when gripping it
• d.The client lifts the walker with each single step

About 15 to 30 degrees of elbow flexion means the walker height is correct. Fully straight arms mean it is too tall, stepping before advancing it removes the support, and lifting it with every step is unstable for a client who needs one.

An LPN/VN is caring for a client on a bladder management protocol after catheter removal. Which finding should be reported?

• a.Voiding 250 mL four hours after the catheter removal
• b.No voiding eight hours after the catheter was removed✓
• c.Mild burning during the first voiding after removal
• d.A sensation of urgency with the first two voidings

No urine output eight hours after removal suggests retention and requires a bladder scan and further action. An adequate first void, transient urgency, and brief burning are all common after catheter removal.

An LPN/VN is irrigating a client's ear as ordered. Which action is correct?

• a.Direct the solution toward the wall of the ear canal✓
• b.Direct the solution straight at the tympanic membrane
• c.Occlude the canal with the syringe tip during flow
• d.Use a solution taken directly from the refrigerator

Aiming at the canal wall lets solution flow around and out, carrying debris with it. Direct pressure on the eardrum can rupture it, cold solution causes vertigo, and occluding the canal traps pressure inside.

An LPN/VN is assisting an immobilized client to prevent complications. Which measure prevents venous stasis?

• a.Keep the legs crossed at the ankles while in bed
• b.Place a pillow under the knees to support the legs
• c.Massage the calf muscles firmly twice each day
• d.Perform hourly ankle pumping while awake✓

Active ankle movement uses the calf muscle pump to move venous blood. A pillow under the knees and crossed ankles both compress popliteal vessels, and calf massage can dislodge an existing clot.

An LPN/VN is evaluating pain in a client with advanced dementia who cannot report it. Which tool is appropriate?

• a.A numeric rating scale explained slowly to the client
• b.A visual analog line the client marks with a pen
• c.The family member's estimate of the client's pain
• d.A behavioral observation scale validated for dementia✓

A validated behavioral scale scores observed indicators such as breathing, vocalization, and body language. Numeric and visual analog scales require abstraction the client cannot do, and a family estimate is not a validated measure.

An LPN/VN is providing site care for a client's gastrostomy tube. Which finding should be reported?

• a.A small amount of clear drainage at the site
• b.Slight rotation of the external bumper on the tube
• c.Green drainage with redness at the site✓
• d.A healed track with intact skin around the tube

Purulent drainage with erythema suggests infection at the exit site. Scant clear drainage, minor bumper rotation, and intact healed skin are all expected findings.

A client on a mechanical soft diet is served a meal tray. Which item should the LPN/VN remove?

• a.The scrambled eggs served with the meal
• b.The raw carrot and celery sticks✓
• c.The ground meat with gravy on the plate
• d.The canned peaches in the small dish

Raw crisp vegetables require chewing that a mechanical soft diet is designed to avoid. Ground meat, scrambled eggs, and canned fruit all meet the texture requirement.

An LPN/VN uses music therapy with a client who has chronic pain. Which action is appropriate?

• a.Play the unit's usual relaxation recording for all
• b.Use the music instead of the ordered analgesic dose
• c.Play the music at a volume that masks unit noise
• d.Let the client select the music that will be played✓

Client-selected music is what makes the intervention effective. A standard recording ignores preference, substituting music for an ordered analgesic withholds treatment, and loud volume adds a stressor.

An LPN/VN finds a client's intravenous site cool, pale, and swollen with no blood return. What should the LPN/VN do first?

• a.Slow the infusion rate and recheck in an hour
• b.Stop the infusion and remove the catheter✓
• c.Reposition the arm and restart the infusion
• d.Apply a warm compress and continue the infusion

Infiltration is managed by stopping the infusion and removing the catheter, which the 2026 PN test plan lists as an LPN/VN activity. Repositioning and restarting, slowing the rate, and applying heat while the infusion continues all allow more fluid into the tissue.

An LPN/VN is monitoring a client receiving a unit of packed red blood cells. Which finding requires the transfusion to be stopped?

• a.Chills and low back pain fifteen minutes into the unit✓
• b.A brief feeling of coolness from the refrigerated blood
• c.Anxiety about receiving blood from an unknown donor
• d.A temperature rise from 36.8 to 37.0 degrees Celsius

Chills with flank or low back pain early in a transfusion suggests an acute hemolytic reaction, and the transfusion is stopped immediately with the line kept open by normal saline. A 0.2-degree rise, the sensation of cool blood, and anxiety are not transfusion reactions.

An LPN/VN is preparing to collect a clean-catch midstream urine specimen. Which instruction is correct?

• a.Begin voiding, then collect the middle portion✓
• b.Collect the entire voiding in the sterile cup
• c.Collect a specimen from the toilet water bowl
• d.Collect the first portion of the urine stream

The midstream portion is collected after the initial stream has flushed the urethra. The first portion carries periurethral organisms, a whole voiding overflows the cup, and toilet water is contaminated.

An LPN/VN performs a blood glucose check and the result is 48 mg/dL in an alert client. What should the LPN/VN do first?

• a.Recheck the glucose on a second meter
• b.Notify the nursing supervisor of the glucose value
• c.Give the client a peanut butter and cheese snack
• d.Give 15 grams of a fast-acting carbohydrate✓

An alert, hypoglycemic client is treated at once with 15 grams of rapidly absorbed carbohydrate and rechecked in 15 minutes. Reporting first, repeating the test, and offering a protein and fat snack all delay the sugar the client needs now.

An LPN/VN is applying sequential compression devices to a postoperative client. Which action is correct?

• a.Apply the sleeves over the client's knee-high socks
• b.Confirm that two fingers fit under the applied sleeve✓
• c.Apply the sleeves to a leg with a newly reddened calf
• d.Remove the sleeves only during the night sleep hours

A two-finger fit means the sleeve is snug without constricting. Applying over bunched socks creates pressure points, removing them at night defeats their purpose during the least mobile hours, and applying them to a leg with suspected thrombosis can dislodge a clot.

An LPN/VN is performing a venipuncture. How long may the tourniquet remain in place?

• a.Until the site has been cleaned and has dried
• b.Until every tube in the order has been filled
• c.No longer than five minutes
• d.No longer than one minute before the draw✓

A tourniquet left longer than about one minute causes hemoconcentration and alters results. Five minutes, the length of the whole draw, and the cleaning interval all exceed that limit.

An LPN/VN is caring for a client who returned from a cardiac catheterization through the right femoral artery. Which finding requires immediate reporting?

• a.A heart rate of 68 with the client lying flat
• b.A cool right foot with a weak pedal pulse✓
• c.A report of mild aching in the right groin area
• d.A small bruise at the insertion site of the catheter

Coolness with a diminished distal pulse suggests arterial occlusion in the catheterized limb. Bruising, mild groin aching, and a normal heart rate on bed rest are expected after the procedure.

An LPN/VN is monitoring a client after a thyroidectomy. Which finding should be reported immediately?

• a.A small amount of drainage on the dressing
• b.A sore throat when the client swallows fluids
• c.Tingling around the mouth and in the fingers✓
• d.Hoarseness of the voice on the first day

Perioral and fingertip tingling suggests hypocalcemia from parathyroid injury and can progress to tetany and laryngospasm. Sore throat, temporary hoarseness, and scant drainage are expected after this surgery.

An LPN/VN is caring for a client with a new plaster cast on the right forearm. Which finding requires immediate reporting?

• a.An itching sensation under the cast
• b.Slight swelling of the fingers on elevation
• c.Pain that increases despite analgesia✓
• d.Warmth of the cast during the drying period

Escalating pain unrelieved by analgesia is the earliest sign of compartment syndrome. Itching, warmth from the curing plaster, and mild swelling that responds to elevation are all expected.

An LPN/VN is preparing a client for surgery in the morning. Which action reduces postoperative pulmonary complications?

• a.Teach the incentive spirometer before surgery✓
• b.Plan to keep the client on bed rest for two days
• c.Teach the client to breathe rapidly and shallowly
• d.Teach the client to avoid coughing after surgery

Learning the spirometer before surgery, when the client is comfortable and alert, makes postoperative use effective. Avoiding cough, prolonged bed rest, and shallow breathing all promote atelectasis.

An LPN/VN checks a client for urinary retention. Which method gives the most reliable measurement?

• a.The client's report of a full or empty bladder
• b.Palpation of the lower abdomen above the pubis
• c.A bladder scan done after the client voids✓
• d.A record of the volume of the client's last void

A postvoid bladder scan measures residual volume directly and noninvasively. Palpation is imprecise, a voided volume says nothing about what remains, and a client's sensation is unreliable in retention.

An LPN/VN is monitoring nasogastric suction for a client after abdominal surgery. Which finding should be reported?

• a.Green drainage collecting slowly in the canister
• b.Complaints of dryness of the mouth and lips
• c.Bright red blood filling the collection canister✓
• d.Intermittent bubbling in the suction control chamber

Bright red blood in gastric drainage suggests active bleeding and must be reported. Green gastric drainage, expected suction function, and oral dryness are all typical during nasogastric suction.

An LPN/VN is performing neurological checks on a client after a head injury. Which change should be reported immediately?

• a.A blood pressure that has risen by 4 millimeters
• b.A pulse that has changed from 74 to 80 per minute
• c.A report of a mild headache relieved by rest
• d.A pupil that is now larger and reacts sluggishly✓

A newly dilated, sluggish pupil suggests rising intracranial pressure with cranial nerve compression. Small blood pressure and pulse changes and a relieved headache are not signs of deterioration.