NCLEX-PN Nursing — All Questions

A charge nurse is assigning tasks on a medical unit. Which task is appropriate to delegate to the LPN/LVN?

• a.Providing discharge teaching about a new diagnosis
• b.Administering an oral antibiotic to a stable client✓
• c.Performing the admission assessment on an unstable client
• d.Developing the initial nursing care plan for a new admission

Administering routine oral medications to stable clients is within the LPN/LVN scope. Initial assessments, care-plan development, and client teaching about new content are RN responsibilities. The LPN/LVN reinforces teaching but does not perform the initial teaching.

The LPN/LVN receives a verbal order from a physician during an emergency. What is the most appropriate action?

• a.Write down the order, read it back, and have the RN or provider co-sign per policy✓
• b.Have a family member witness the order so no provider signature is needed later
• c.Carry out the order and document it several hours later at the end of the shift
• d.Refuse the order because an LPN/LVN may never accept a verbal order in an emergency

During an emergency a verbal order may be accepted, but it must be written down and read back to the provider to confirm accuracy. It should be signed by the provider within the facility's required timeframe. Read-back reduces transcription and communication errors.

Which client care assignment is most appropriate to give to unlicensed assistive personnel (UAP)?

• a.Assisting a stable client with a bath and recording oral intake✓
• b.Inserting an indwelling urinary catheter for a stable client
• c.Adjusting the flow rate of an IV infusion that is behind schedule
• d.Evaluating a client's response to pain medication and charting it

UAP may perform basic hygiene and record intake and output for stable clients. Catheter insertion, evaluating medication response, and adjusting IV rates require nursing judgment and licensure. Assessment and evaluation cannot be delegated to UAP.

An LPN/LVN notices a coworker documenting care that was not provided. What is the priority action?

• a.Ignore it because it is not the LPN/LVN's responsibility
• b.Alter the record to correct it personally
• c.Confront the coworker angrily in front of clients
• d.Report the concern to the charge nurse or supervisor✓

Falsifying documentation is a serious ethical and legal violation that must be reported through the chain of command. The LPN/LVN should not alter another person's entry or handle it confrontationally. Reporting protects clients and maintains accurate records.

When using the SBAR communication tool during a hand-off report, the 'R' stands for which component?

• a.Nurse's rationale
• b.Client response
• c.Recommendation✓
• d.Later reassessment

SBAR stands for Situation, Background, Assessment, and Recommendation. The recommendation states what the nurse wants done or is requesting next. Standardized hand-off tools reduce omissions and improve safety.

The LPN/LVN is caring for four clients. Which client should be assessed first?

• a.A client scheduled for discharge this afternoon
• b.A client asking about the lunch menu
• c.A client reporting new onset of shortness of breath✓
• d.A client requesting a second pillow

Airway and breathing problems take priority using the ABC framework. New shortness of breath could signal a life-threatening change and must be assessed immediately. The other requests are non-urgent.

A client refuses a prescribed medication. What is the LPN/LVN's best response?

• a.Tell the client they must take it or be discharged
• b.Respect the refusal, document it, and notify the RN or provider✓
• c.Insist repeatedly until the client agrees
• d.Hide the medication in food without telling the client

Competent adults have the right to refuse treatment. The nurse should honor the refusal, document it, and inform the RN or provider so follow-up can occur. Concealing medication violates client autonomy and trust.

Which situation represents a breach of client confidentiality under HIPAA?

• a.Giving a shift report to the oncoming nurse
• b.Discussing a client's diagnosis with a friend not involved in care✓
• c.Sharing information with the treating physician
• d.Reporting a client's abuse suspicion to authorities

Sharing protected health information with someone not involved in the client's care violates confidentiality. Reporting mandated concerns, communicating with the care team, and giving hand-off report are permitted. Only those with a need to know may access information.

The LPN/LVN is documenting in the electronic health record. Which entry is written correctly?

• a."Client is being difficult and uncooperative with the entire staff."
• b."Client probably has appendicitis based on where the pain is."
• c."Client reports pain rated 7 of 10 in right lower abdomen at 0900."✓
• d."Client seems to be doing just fine today, with no real complaints."

Documentation should be objective, specific, and factual, including measurable data and time. Subjective judgments and unauthorized diagnoses are inappropriate. Clear entries support continuity and legal accuracy.

An LPN/LVN is floated to an unfamiliar unit. Which action is most appropriate?

• a.Care only for clients who need no medications and refuse other assignments
• b.Refuse the assignment and leave the facility before the shift begins
• c.Perform any task the charge nurse requests regardless of competence
• d.Accept tasks within the LPN/LVN scope and ask for orientation to the unit✓

A floated nurse should accept assignments within their scope and competence while requesting orientation to unfamiliar equipment and routines. Refusing to work may be abandonment, but performing unsafe tasks is negligent. Communicating limitations protects clients.

Which task performed by UAP requires the LPN/LVN to intervene immediately?

• a.Ambulating a stable client down the hallway with a gait belt
• b.Emptying a urinary drainage bag and recording the output volume
• c.Repositioning a client's oxygen tubing and adjusting the liter flow✓
• d.Feeding a client who has no swallowing difficulty at lunchtime

Adjusting oxygen flow rate is outside the UAP scope and requires nursing judgment. Feeding a client with no swallowing risk, ambulating with a gait belt, and recording drainage are acceptable UAP tasks. The nurse must correct the unsafe action.

The LPN/LVN is reinforcing discharge instructions. Which statement indicates the client understood teaching about a wound?

• a."I only need to call the clinic if the wound falls off completely."
• b."I will wash my hands before and after changing the dressing."✓
• c."I will remove the dressing and leave the wound open to air right away."
• d."Redness and warmth spreading around the wound are normal for weeks."

Hand hygiene before and after dressing changes prevents infection and reflects correct understanding. Spreading redness and warmth are signs of infection that should be reported. Dressings should be managed as ordered, not removed prematurely.

A client's family asks the LPN/LVN to explain the surgeon's plan for an upcoming operation. What is the best response?

• a."I cannot discuss anything about the surgery with you."
• b."Let me describe the entire surgical procedure for you."
• c."The surgery is simple, so there is nothing to worry about."
• d."I will let the surgeon know you have questions about the plan."✓

Explaining the surgical plan and obtaining informed consent are the provider's responsibility. The nurse should facilitate communication by notifying the surgeon of the family's questions. Reassurance or refusal without follow-up does not meet the family's needs.

Which principle guides prioritization when the LPN/LVN plans care for multiple clients?

• a.Always perform the quickest tasks first so the shift stays on schedule
• b.Address physiologic and safety needs before comfort or teaching needs✓
• c.See the client whose family requests attention first, then the others
• d.Complete tasks in the order the rooms are numbered on the hallway

Maslow's hierarchy directs the nurse to meet physiologic and safety needs before higher-level needs like comfort and education. Room number, task length, and family preference are not valid prioritization frameworks. Life-threatening problems come first.

An advance directive states a client does not want cardiopulmonary resuscitation. The client stops breathing. What should the LPN/LVN do?

• a.Wait several minutes to see whether the client resumes breathing
• b.Begin full CPR immediately, since the directive expired at admission
• c.Follow the do-not-resuscitate order and notify the RN and provider✓
• d.Call the family first and ask them whether to start resuscitation

A valid do-not-resuscitate order must be honored, so resuscitation is not initiated. The nurse provides comfort measures and notifies the RN and provider. Ignoring a legal directive violates the client's expressed wishes.

The LPN/LVN is part of an interdisciplinary care conference. What is the LPN/LVN's primary contribution?

• a.Ordering the diagnostic laboratory tests the team will need
• b.Prescribing the client's physical therapy program and its frequency
• c.Reporting ongoing observations of the client's response to care✓
• d.Determining the client's medical diagnosis for the record

The LPN/LVN contributes bedside observations and data about how the client is responding to interventions. Ordering tests, prescribing therapies, and making medical diagnoses are outside the LPN/LVN scope. Collaboration relies on accurate frontline information.

Before administering a medication, the LPN/LVN should verify at least how many client identifiers?

• a.One
• b.Five
• c.Two✓
• d.Four

The standard of care requires at least two client identifiers, such as name and date of birth, before medication administration. The room number is not an acceptable identifier. Correct identification prevents wrong-client errors.

A client is placed on contact precautions for Clostridioides difficile. Which action is essential?

• a.Wear an N95 respirator when entering the room
• b.Keep the client's door closed with negative pressure
• c.Use alcohol-based hand rub only
• d.Wash hands with soap and water after removing gloves✓

C. difficile spores are not reliably killed by alcohol, so hand washing with soap and water is required. An N95 and negative-pressure room are for airborne precautions, not contact. Gloves and gowns are also used for contact precautions.

The LPN/LVN finds a small fire in a trash can in a client's room. Using the RACE acronym, what is the first action?

• a.Rescue the client from immediate danger✓
• b.Extinguish the fire before doing anything else
• c.Contain the fire by closing the door first
• d.Activate the alarm and wait for the fire team

RACE stands for Rescue, Alarm, Contain, and Extinguish. The first priority is to rescue anyone in immediate danger from the fire. Only after people are safe does the nurse activate the alarm, contain, and extinguish.

Which client is at highest risk for falls and should have safety precautions reinforced?

• a.A 40-year-old awaiting routine discharge this afternoon
• b.An 80-year-old on sedatives with a history of dizziness✓
• c.A 25-year-old admitted overnight for observation
• d.A 30-year-old ambulating independently without aids

Advanced age, sedating medications, and a history of dizziness are major fall-risk factors. Independent younger clients without these factors are at lower risk. Fall precautions such as a low bed and call light within reach are indicated.

The LPN/LVN is about to use a fire extinguisher. Using the PASS technique, what is the first step?

• a.Sweep side to side
• b.Squeeze the handle
• c.Pull the pin✓
• d.Aim at the flames

PASS stands for Pull, Aim, Squeeze, and Sweep. The first step is to pull the safety pin. Then the nurse aims at the base of the fire, squeezes the handle, and sweeps side to side.

A client requires airborne precautions for pulmonary tuberculosis. Which personal protective equipment is required to enter the room?

• a.A face shield only
• b.A standard surgical mask
• c.A gown and gloves only
• d.A fitted N95 respirator✓

Airborne precautions for tuberculosis require a fitted N95 respirator and a negative-pressure room. A standard surgical mask does not filter the small airborne droplet nuclei. Respiratory protection is essential to prevent transmission.

The LPN/LVN prepares to move a heavy client up in bed. Which action best protects the nurse from injury?

• a.Use a friction-reducing device and get help✓
• b.Move the client alone quickly
• c.Keep the feet close together for balance
• d.Bend at the waist and lift with the back

Using a friction-reducing device and additional staff reduces strain and prevents injury. Lifting with the back and working alone increase injury risk. A wide base of support and using leg muscles also protect the nurse.

Which action reduces the risk of a medication error during administration?

• a.Preparing medications for several clients at once and giving them later
• b.Checking the medication label against the order three times✓
• c.Relying on memory instead of the medication record
• d.Leaving medications at the bedside for the client to take later

Checking the label against the order three times and following the rights of administration reduces errors. Pre-pouring for multiple clients and leaving medications at the bedside increase risk. Medications should be given and documented immediately.

A client with a seizure disorder begins to have a generalized seizure. What is the priority nursing action?

• a.Hold the client firmly to stop the movements
• b.Protect the head and turn the client to the side✓
• c.Insert a padded tongue blade into the mouth
• d.Restrain the client's arms and legs

During a seizure the nurse protects the client from injury by cushioning the head and turning them to the side to maintain the airway. Nothing should be forced into the mouth, and the client should not be restrained. Movements should not be held back.

The LPN/LVN receives a client's meal tray. Before assisting with feeding, what should the nurse verify first?

• a.Whether the client would prefer to eat the dessert first
• b.The client's name against the diet order and tray card✓
• c.The temperature of the food and beverages on the tray
• d.The client's favorite foods and least-liked items

The nurse must confirm the tray matches the correct client and the prescribed diet before feeding, preventing errors such as giving a regular diet to a client who is NPO. Food temperature and preferences are secondary. Matching client to order is a core safety check.

Which finding requires the LPN/LVN to question the use of physical restraints?

• a.Regular monitoring of skin and circulation
• b.A current provider order specifying type and duration
• c.Documentation of less restrictive measures tried first
• d.The restraint was applied only for staff convenience✓

Restraints may never be used for staff convenience or discipline. They require a time-limited provider order, trial of less restrictive alternatives, and frequent monitoring. Using restraints for convenience is unsafe and unethical.

The LPN/LVN notes a client's oxygen is in use. Which safety instruction is most important?

• a.Post 'no smoking' signs and keep oxygen away from open flames✓
• b.Allow smoking in the room as long as the window is open
• c.Use petroleum-based lip balm freely to prevent dry lips
• d.Store the oxygen tank lying flat on the floor beside the bed

Oxygen supports combustion, so open flames and smoking must be prohibited and clearly posted. Petroleum-based products near oxygen are a fire hazard, and tanks should be secured upright. Fire prevention is the priority with oxygen therapy.

A client's identification band is missing at the time of a blood glucose check. What should the LPN/LVN do first?

• a.Proceed using the room number as identification
• b.Ask the client next door to confirm the client's name
• c.Skip the check until the next shift
• d.Verify identity and apply a new band before proceeding✓

A missing identification band must be replaced after verifying identity before care that depends on correct identification. Room numbers and other clients are not reliable identifiers. Accurate identification prevents errors.

Which practice best prevents catheter-associated urinary tract infection?

• a.Routinely irrigating the catheter every shift
• b.Disconnecting the tubing to collect samples
• c.Placing the drainage bag on the client's abdomen during transport
• d.Keeping the drainage bag below the level of the bladder✓

Keeping the drainage bag below bladder level prevents backflow of urine and reduces infection risk. Unnecessary irrigation and breaking the closed system increase infection risk. Maintaining a closed, dependent drainage system is key.

According to recommended immunization schedules, an infant should receive the first dose of the hepatitis B vaccine at what age?

• a.Shortly after birth✓
• b.At the 11-year checkup
• c.At the 12-month checkup
• d.At the 4-year checkup

The first hepatitis B dose is recommended shortly after birth, ideally within the first 24 hours. The series continues in infancy. Early vaccination protects against perinatal transmission.

A mother asks when her infant will typically begin to sit without support. What is the best response?

• a.Around 2 months
• b.Around 18 months
• c.Around 12 months
• d.Around 6 months✓

Most infants can sit without support around 6 months of age. Sitting develops after head control and before pulling to stand. Milestones vary somewhat but follow a predictable sequence.

The LPN/LVN reinforces teaching about breast self-awareness. Which client statement indicates a need for further teaching?

• a."If I feel fine, I never need any screening."✓
• b."I will follow my provider's screening recommendations."
• c."I will report any new lump to my provider."
• d."I will note changes in the skin or nipple."

Feeling well does not eliminate the need for recommended screening such as mammography. Reporting new lumps and skin or nipple changes and following screening guidance are correct. Screening detects problems before symptoms appear.

Which nutrition guidance is appropriate for a healthy pregnant client in the first trimester?

• a.Avoid all dairy products for the first trimester
• b.Take a prenatal vitamin containing folic acid✓
• c.Eliminate protein from the diet to reduce nausea
• d.Take a daily megadose of vitamin A for fetal growth

Folic acid supplementation helps prevent neural tube defects and is recommended before and during early pregnancy. Dairy and protein are important nutrients, not to be eliminated. High-dose vitamin A can be harmful in pregnancy.

A client at a wellness clinic asks about recommended physical activity. Which guidance reflects general recommendations for healthy adults?

• a.About 150 minutes of moderate aerobic activity per week✓
• b.Vigorous activity once a month is enough for most healthy adults
• c.Exercise only when symptoms such as fatigue or breathlessness appear
• d.Strength training should be avoided at any age to prevent injury

General guidelines recommend about 150 minutes of moderate aerobic activity weekly plus muscle-strengthening on two or more days. Occasional or symptom-triggered activity is insufficient. Regular activity promotes cardiovascular and metabolic health.

The LPN/LVN is teaching new parents about safe infant sleep. Which position reduces the risk of sudden infant death syndrome?

• a.Prone on a soft mattress with the head turned
• b.Supine on a firm surface without loose bedding✓
• c.Prone with a loose blanket tucked around for warmth
• d.Side-lying propped with pillows to support the back

Placing infants on their back (supine) on a firm surface without soft bedding reduces SIDS risk. Prone and side-lying positions and soft bedding increase risk. A safe sleep environment is a key teaching point.

A pregnant client in the third trimester reports occasional painless swelling of the feet at the end of the day. What is the best response?

• a."Swelling of the feet at any point in pregnancy means your kidneys have already failed."
• b."You must be admitted to the hospital tonight, because swelling this late is an emergency."
• c."Stop drinking fluids until the swelling is gone, since less fluid in means less swelling."
• d."Mild foot swelling late in the day is common; elevate your legs and report sudden or facial swelling."✓

Mild dependent edema is common in late pregnancy and improves with leg elevation. Sudden, severe, or facial swelling should be reported as it may indicate preeclampsia. Restricting fluids is not recommended.

Which finding in a toddler indicates normal growth and development for a 2-year-old?

• a.Walks up stairs and uses two-word phrases✓
• b.Speaks in full paragraphs about the day
• c.Rides a two-wheeled bicycle without training wheels
• d.Ties own shoelaces without any help from an adult

A typical 2-year-old walks up stairs and combines two words into short phrases. Riding a bicycle, tying shoes, and speaking in paragraphs are later skills. Recognizing normal milestones guides anticipatory guidance.

The LPN/LVN reinforces teaching to a postmenopausal client about preventing osteoporosis. Which recommendation is appropriate?

• a.Increase daily caffeine and alcohol intake to stimulate bone turnover
• b.Avoid all physical activity, since weight on the bones causes thinning
• c.Avoid sunlight completely, because sun exposure destroys stored calcium
• d.Ensure adequate calcium and vitamin D and perform weight-bearing exercise✓

Adequate calcium and vitamin D plus weight-bearing exercise help maintain bone density. Inactivity, excess caffeine, and alcohol can worsen bone loss. Moderate sun exposure supports vitamin D synthesis.

A new mother asks about introducing solid foods. Which guidance is generally appropriate?

• a.Start solids at birth
• b.Introduce single-ingredient foods around 6 months✓
• c.Begin with mixed foods to identify allergies faster
• d.Give honey in the first month for energy

Solid foods are typically introduced around 6 months, starting with single-ingredient foods a few days apart to monitor for allergies. Honey is avoided in the first year because of botulism risk. Introducing one food at a time helps identify reactions.

During a health screening, which blood pressure reading in an adult should prompt reinforcement of lifestyle and follow-up?

• a.115/72 mmHg
• b.148/94 mmHg✓
• c.108/68 mmHg
• d.118/76 mmHg

A reading of 148/94 mmHg is elevated and warrants lifestyle counseling and follow-up. The other readings fall within a normal range. Early identification supports blood pressure control.

The LPN/LVN teaches an older adult about preventing constipation. Which recommendation is most appropriate?

• a.Increase dietary fiber, fluids, and activity as tolerated✓
• b.Rely on a daily enema, since an aging bowel cannot empty without one
• c.Avoid all physical activity, since walking tires the bowel muscle further
• d.Decrease fluid intake so that the stool does not become too bulky to pass

Adequate fiber, fluids, and activity promote normal bowel function and prevent constipation. Reducing fluids and activity worsens constipation, and routine enemas are not recommended. Lifestyle measures are the first-line approach.

A client asks how to reduce the risk of skin cancer. Which teaching is appropriate?

• a.Use tanning beds instead of the sun, since their light is safer
• b.Apply sunscreen only in winter, when the sun is closest
• c.Apply broad-spectrum sunscreen and avoid peak midday sun✓
• d.Rely on a base tan to protect the skin all summer

Broad-spectrum sunscreen, protective clothing, and avoiding peak sun reduce skin cancer risk. Tanning beds and 'base tans' increase ultraviolet damage. Sun protection is needed year-round.

The LPN/LVN reinforces teaching about pregnancy danger signs. Which symptom should the client report immediately?

• a.Increased frequency of urination during the day
• b.Vaginal bleeding with abdominal cramping✓
• c.Mild breast tenderness that eases with a support bra
• d.Occasional mild fatigue that is relieved by resting

Vaginal bleeding with cramping may indicate a serious complication and must be reported immediately. Breast tenderness, urinary frequency, and mild fatigue are common, expected changes. Teaching warning signs promotes timely care.

Which statement by an adolescent's parent indicates understanding of adolescent development?

• a."It is normal for my teen to seek independence and value peer relationships."✓
• b."My teen should have no interest in friends of her own age at this stage."
• c."My teen will accept every family rule without ever once questioning it."
• d."My teen should depend on me to make every decision, even the small ones."

Adolescence is characterized by developing identity, seeking independence, and valuing peers. Complete dependence and lack of peer interest are not typical. Understanding this stage helps parents respond supportively.

A client asks about recommended colorectal cancer screening for average-risk adults. Which response reflects general guidance?

• a.Screening should begin at age 70
• b.Regular screening is recommended beginning at around age 45✓
• c.Screening is never necessary without symptoms
• d.Only clients with a family history need screening

Average-risk adults are generally advised to begin colorectal cancer screening around age 45. Screening is recommended even without symptoms or family history. Early screening improves detection and outcomes.

A client newly diagnosed with a terminal illness states, "There must be a mistake in the lab results." Which stage of grief does this reflect?

• a.Acceptance
• b.Denial✓
• c.Depression
• d.Bargaining

Denial is characterized by disbelief and rejecting the reality of the diagnosis. Bargaining involves making deals, and acceptance involves coming to terms with the situation. Recognizing grief stages guides supportive communication.

Which therapeutic communication technique is demonstrated when the nurse restates the client's message in the nurse's own words?

• a.Giving advice
• b.Offering false reassurance
• c.Changing the subject
• d.Paraphrasing✓

Paraphrasing restates the client's message to confirm understanding and encourage further sharing. Giving advice and false reassurance are nontherapeutic. Effective communication supports the client's expression of feelings.

A client experiencing a panic attack is hyperventilating and pacing. What is the nurse's priority action?

• a.Encourage the client to make a list of stressors immediately
• b.Provide detailed education about anxiety disorders
• c.Leave the client alone to calm down
• d.Stay with the client and speak calmly using short, simple statements✓

During a panic attack the nurse should remain with the client and use a calm voice and simple directions to reduce stimulation. Detailed teaching and problem-solving are not effective during acute anxiety. Presence and reassurance promote safety.

The nurse suspects a client is a victim of elder abuse. What is the nurse's legal responsibility?

• a.Report the suspicion according to mandatory reporting laws✓
• b.Keep the suspicion private to avoid conflict with the family
• c.Wait for the client to file a complaint before reporting
• d.Confront the suspected abuser directly before telling anyone

Nurses are mandatory reporters and must report suspected abuse to the appropriate authorities. Confronting the abuser or waiting for the client to act can endanger the client. Reporting protects vulnerable individuals.