NCLEX-PN Nursing — All Questions

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 parent asks when to introduce solid foods to an infant. The correct teaching is to begin around:

• a.6 months, with single-ingredient foods✓
• b.3 months, with mashed fruit
• c.2 months, with cereal in the bottle
• d.12 months, after all teeth appear

Introduce single-ingredient solid foods around 6 months. Cereal in a bottle and solids in the first few months are unsafe, and waiting until 12 months is unnecessarily late.

A pregnant client at 32 weeks reports a severe headache with swelling of the face and hands. The nurse should:

• a.Tell her to rest and recheck in the morning
• b.Recommend an over-the-counter pain reliever
• c.Reassure her that facial swelling is normal
• d.Report the findings promptly as possible preeclampsia✓

Severe headache with facial and hand swelling are danger signs of preeclampsia and must be reported promptly. Facial swelling is not the normal dependent edema of pregnancy; analgesics and waiting until morning delay urgent care.

Which infant sleep practice should the nurse reinforce to reduce the risk of SIDS?

• a.Prone position to prevent aspiration
• b.Supine with soft blankets tucked around the infant
• c.Supine on a firm surface with no loose bedding✓
• d.Side-lying with a rolled towel for support

Safe infant sleep is supine (on the back) on a firm surface with no loose bedding. Side-lying, prone positioning, and soft blankets tucked around the infant all increase SIDS risk.

A nurse reinforces sun-safety teaching. Which statement by the client indicates correct understanding?

• a."A base tan from a tanning bed will protect my skin from real damage."
• b."Once I have a good tan I won't need to use sunscreen anymore."
• c."I'll use broad-spectrum sunscreen and reapply it every two hours."✓
• d."Sunscreen is really only needed for long days at the beach."

Correct sun safety is broad-spectrum sunscreen reapplied every 2 hours. Relying on a "base tan," using sunscreen only at the beach, and stopping once tanned all reflect misunderstanding.

A nurse is teaching a parent about a mild fever and soreness after a childhood vaccine. The nurse explains that these reactions are:

• a.A reason to give a double dose next time
• b.Common, expected, and usually self-limiting✓
• c.A sign the vaccine should be stopped
• d.An allergic reaction requiring epinephrine

Mild fever and soreness after a vaccine are common, expected, and self-limiting. They are not a reason to stop the series, never a reason to change a dose, and not an allergic emergency.

An LPN/VN is comparing a 15-month-old child to the CDC developmental milestone checklist for that age. Which finding is expected?

• a.The child speaks in phrases of three or four words
• b.The child walks up a flight of stairs alternating feet
• c.The child pedals a small tricycle
• d.The child takes a few steps without being held✓

Taking a few steps alone and stacking two small objects appear on the CDC 15-month checklist. Three- to four-word phrases, alternating feet on stairs, and pedaling a tricycle are milestones of the preschool years, not of a 15-month-old.

An LPN/VN is collecting a health history from a newly admitted client. Which question best elicits the information needed?

• a.Have you had any serious health problems before
• b.Do you have diabetes, hypertension, or asthma
• c.Is there anything in your history I should know
• d.Tell me about the health problems you have had✓

An open-ended invitation lets the client supply history the nurse would not know to ask about. A yes-or-no question, a fixed list, and a vague closing question all narrow the answer before it is given.

An LPN/VN is monitoring a client in early labor. Which finding should be reported to the registered nurse without delay?

• a.Clear fluid with the cord visible at the introitus✓
• b.Contractions lasting 45 seconds every five minutes
• c.Blood-tinged mucus discharge from the vagina
• d.A fetal heart rate of 140 beats per minute at rest

A visible umbilical cord is a prolapse and an obstetric emergency. Contractions every five minutes, bloody show, and a fetal heart rate of 140 are all expected findings in early labor.

An LPN/VN is monitoring a client four hours after a vaginal birth. Which finding requires immediate reporting?

• a.A uterine fundus that is soft and above the umbilicus✓
• b.A fundus that is firm and at the level of the umbilicus
• c.Moderate red lochia saturating one pad in four hours
• d.Afterpains that increase during newborn breastfeeding

A boggy fundus displaced upward suggests uterine atony with possible hemorrhage. A firm midline fundus, moderate lochia at that rate, and afterpains during feeding are all normal postpartum findings.

An LPN/VN is caring for a newborn whose mother tested positive for hepatitis B surface antigen. What should the newborn receive?

• a.Hepatitis B immune globulin at the first well-child visit
• b.Hepatitis B vaccine and immune globulin within 12 hours✓
• c.Hepatitis B vaccine alone within 12 hours of the birth
• d.Hepatitis B vaccine beginning at two months of age

An infant born to a mother who is HBsAg positive receives both hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth, at separate sites. Vaccine alone, delayed immune globulin, and a delayed series all leave the infant unprotected during the highest-risk period.

An LPN/VN is reinforcing education with an adult client about colorectal cancer screening. Which statement should the LPN/VN include?

• a.Screening for average-risk adults begins at age 45✓
• b.Screening is needed only if a relative had the disease
• c.Screening begins after the first symptoms are noticed
• d.Screening is repeated every year regardless of method

Average-risk adults begin colorectal cancer screening at age 45 under current national recommendations. Restricting screening to those with a family history, waiting for symptoms, and applying one interval to every method are all incorrect.

An LPN/VN is collecting baseline physical data on an adult client at admission. Which measurement is part of that baseline?

• a.A diagnosis for the skin lesions that are present
• b.Interpretation of the client's breath sound pattern
• c.A judgment about the client's nutritional status
• d.Height, weight, and condition of the skin✓

Collecting objective baseline data such as height, weight, and skin condition is squarely within LPN/VN scope. Interpreting findings, diagnosing lesions, and drawing a nutritional conclusion are assessment judgments reserved to the registered nurse.

An LPN/VN is reinforcing education about smoking cessation with a client who has just decided to quit. Which action is most helpful?

• a.Describe the long-term risks of continued smoking
• b.Help the client choose a specific quit date✓
• c.Provide a pamphlet on tobacco use
• d.Tell the client to cut down gradually over a year

A client in the preparation stage benefits most from concrete planning, and setting a quit date is the first step. Restating risks, recommending indefinite tapering, and handing over a pamphlet all fit an earlier stage of change.

An LPN/VN is caring for an 82-year-old client who is hard of hearing. Which action improves communication?

• a.Cover the mouth to reduce movement
• b.Speak loudly into the client's better-hearing ear
• c.Face the client and speak in a lower pitch✓
• d.Raise the pitch of the voice to carry the sound

Age-related hearing loss affects high frequencies first, so lowering pitch and allowing the client to see the face helps most. Shouting distorts speech, raising pitch worsens comprehension, and covering the mouth removes visual cues.

An LPN/VN is teaching an adult client who reads at a low literacy level. Which barrier to learning should the LPN/VN address first?

• a.Use the standard printed teaching sheet in larger type
• b.Give the instructions verbally with a demonstration✓
• c.Provide a detailed written handout to read at home
• d.Ask the client to read the instructions back aloud

Matching the method to the client removes the barrier: verbal instruction with demonstration does not depend on reading. A handout, reading aloud, and larger type all still require literacy.

An LPN/VN is assisting with a community blood pressure screening event. Which action is within the LPN/VN role?

• a.Diagnose hypertension in participants with high readings
• b.Decide which participants need urgent care
• c.Tell participants which antihypertensive to request
• d.Measure blood pressures and record the readings✓

Participating in a health screening program by taking and recording measurements is an LPN/VN activity. Recommending drugs, diagnosing, and triaging urgency require a provider or registered nurse.

A client who is 30 weeks pregnant reports a headache that will not go away, blurred vision, and swelling of the face. What should the LPN/VN do?

• a.Darken the room and recheck the client in one hour
• b.Report the findings to the registered nurse immediately✓
• c.Give the client the acetaminophen ordered as needed
• d.Ask the client to lie on the left side and rest quietly

Persistent headache, visual changes, and facial edema in late pregnancy suggest preeclampsia, a potential prenatal complication that must be reported at once. Waiting an hour, treating the headache, and repositioning all delay evaluation of a condition that can progress to seizures.

An LPN/VN is helping an older adult client adjust to retirement. Which response supports this life transition?

• a.Suggest that the client take up a hobby
• b.Ask the client what activities now fill the day✓
• c.Recommend a senior center the client could attend
• d.Reassure the client that the adjustment takes time

Exploring how the client is actually spending time opens the conversation and identifies what support is needed. Suggesting a hobby, offering reassurance, and naming a program all supply an answer before the client's situation is known.

An LPN/VN is caring for a 2-day-old newborn. Which finding should be reported to the registered nurse?

• a.Six wet diapers with a dark green sticky stool
• b.A weight that is 6 percent below the birth weight
• c.A soft, flat anterior fontanel that pulsates slightly
• d.Yellow discoloration of the face and upper chest✓

Visible jaundice extending down the chest at 2 days needs evaluation of the bilirubin level. A soft flat fontanel, transitional stools with adequate voiding, and a 6 percent weight loss are all expected in the first days.

An LPN/VN is asked to help a client identify community resources after discharge. What should the LPN/VN do?

• a.Give the client the facility's list of local agencies✓
• b.Decide which agency best matches the client's income
• c.Notify the nursing supervisor that the client needs help
• d.Tell the client to search for agencies online at home

Identifying community resources for clients is a listed LPN/VN activity, and supplying the prepared list accomplishes it. Escalating a routine task, sending the client away to search alone, and determining eligibility all fail the client or exceed the role.