NCLEX-PN Nursing — All Questions

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.

A client with depression states, "I feel like a burden to everyone." Which response is most therapeutic?

• a."You shouldn't feel that way; everyone loves you."
• b."Tell me more about how you have been feeling."✓
• c."At least you have a supportive family."
• d."Let's talk about something more pleasant."

Encouraging the client to say more invites expression of feelings and conveys genuine interest. Minimizing feelings, changing the subject, and comparing to others block communication. Open-ended exploration is therapeutic.

A client with dementia becomes agitated in the evening. Which intervention is most appropriate?

• a.Frequently change caregivers to provide stimulation
• b.Increase environmental noise and activity
• c.Provide a calm, well-lit environment and a consistent routine✓
• d.Restrain the client to prevent wandering

A calm, well-lit environment with consistent routines and caregivers reduces evening agitation, sometimes called sundowning. Excess stimulation, restraints, and frequent caregiver changes worsen confusion. Predictability promotes security.

A client who has been assaulted appears withdrawn and avoids eye contact. What is the nurse's best initial approach?

• a.Provide a safe, private environment and allow the client to talk when ready✓
• b.Insist that the client describe the assault in detail before any other care
• c.Discuss the incident in the hallway within earshot of other clients
• d.Tell the client to move past the experience and focus on going home

Providing safety, privacy, and unhurried support helps a trauma survivor feel secure and regain a sense of control. Forcing disclosure or minimizing feelings is harmful. The nurse follows the client's pace.

Which behavior indicates a client may be at immediate risk for suicide and requires priority intervention?

• a.Attending group therapy sessions each morning
• b.Expressing hope about plans after discharge
• c.Giving away personal possessions and stating goodbyes✓
• d.Discussing new coping strategies with the nurse

Giving away belongings and saying goodbye can signal a suicide plan and requires immediate assessment and safety measures. Hopeful statements and engagement in therapy are positive signs. Direct assessment of suicidal intent is essential.

A client from a culture that values family decision-making asks that all information be shared with the family. What is the nurse's best response?

• a.Refuse the request because sharing anything with family violates confidentiality
• b.Respect the client's wishes and involve the family as the client directs✓
• c.Insist that only the client receive information about the diagnosis
• d.Share the information with the client's employer instead of the family

Culturally sensitive care respects the client's preferences about who participates in decisions. When a competent client authorizes family involvement, the nurse honors that choice. Individual and cultural values guide communication.

A client experiencing alcohol withdrawal is anxious and tremulous. Which environment is most appropriate?

• a.A brightly lit, busy room to keep the client engaged and awake
• b.A dark, isolated room checked once at the end of the shift
• c.A quiet room with reduced stimulation and frequent monitoring✓
• d.A shared room with several visitors coming and going

A quiet, low-stimulation environment with close monitoring helps reduce agitation and detects worsening withdrawal. Excess stimulation can heighten anxiety, and isolation without supervision is unsafe. Safety and calm are priorities.

A client verbalizes anger at the nursing staff about the diagnosis. Which response by the nurse is most therapeutic?

• a."You have no reason to be angry with the nursing staff."
• b."You seem upset. Can you tell me what is troubling you?"✓
• c."If you keep yelling at me, I will leave the room."
• d."Calm down and stop being difficult with the staff."

Acknowledging the client's feelings and inviting them to talk helps identify the underlying concern. Defensive or dismissive responses escalate anger and block communication. Reflecting emotion is a therapeutic technique.

Which coping strategy is considered adaptive for a client experiencing situational stress?

• a.Denying that any problem exists until the stress passes
• b.Talking with a trusted friend and using relaxation techniques✓
• c.Withdrawing from all social contact until the situation resolves
• d.Using alcohol each evening to relax and fall asleep faster

Seeking social support and using relaxation are healthy, adaptive coping strategies. Alcohol use, social withdrawal, and denial are maladaptive and can worsen stress. Reinforcing positive coping supports mental health.

A client with a new colostomy states, "I don't want to look at it. It's disgusting." What is the nurse's best response?

• a."Let's not discuss the stoma at all until you are feeling better."
• b."Most people adjust to a colostomy very quickly, so there is really no need to worry."
• c."You will have to look at it eventually, so you may as well get it over with now."
• d."It is normal to have these feelings after surgery. Would you like to talk about it?"✓

Acknowledging feelings about an altered body image and inviting discussion supports adjustment. Pressuring the client or minimizing feelings is nontherapeutic. Emotional support precedes self-care teaching.

A confused older adult repeatedly asks to go home. Which nursing response is most therapeutic?

• a."You cannot go home, so please stop asking me about it."
• b."Your family left you here and they are not coming back for you."
• c."You seem worried. You are safe here, and I will stay with you."✓
• d."I have already answered that same question three times today."

Providing reassurance, orientation, and a calm presence reduces anxiety in a confused client. Harsh or dismissive replies increase distress. Validating feelings and offering comfort are therapeutic.

A client scheduled for a mastectomy says, "I can't imagine looking at myself afterward." The most therapeutic response is:

• a."Why does your appearance matter so much to you?"
• b."Don't worry — reconstruction results are excellent nowadays."
• c."It sounds like you're worried about how your body will change."✓
• d."You should concentrate all your energy on beating the cancer first."

The most therapeutic response reflects the client's feeling and invites more. False reassurance, advice to focus on the cancer, and a "why" question are nontherapeutic and close the conversation.

On a behavioral-health unit, which client is the highest priority?

• a.A client who has refused to attend the morning group session again
• b.A client pacing the day room and repeatedly asking the staff when lunch will be served
• c.A client who gave away his belongings and says he "won't be a burden much longer"✓
• d.A client who is tearful after an upsetting phone call from home

Giving away belongings plus a veiled goodbye are suicide warning signs — this client is the highest priority. Safety first: ask directly and ensure a safe environment. The other clients are distressed but not in immediate danger.

A client is undergoing alcohol withdrawal. Which environment is most appropriate?

• a.A brightly lit room with the television on for stimulation
• b.A quiet, low-stimulation room with close monitoring✓
• c.A shared room to encourage socialization
• d.A room near the busy nurses' station for activity

Alcohol withdrawal requires a quiet, low-stimulation environment with close monitoring, because withdrawal can progress to seizures and delirium tremens. Bright light, television, socialization, and a busy location all add harmful stimulation.

Which statement by the nurse best reflects therapeutic communication?

• a."Everything is going to be just fine, don't worry."
• b."Why didn't you call the office sooner?"
• c."You seem anxious about going home. Tell me more about that."✓
• d."If I were you, I would have the surgery."

Reflecting the client's anxiety and inviting them to say more is therapeutic. False reassurance, giving advice, and a "why" question are nontherapeutic.

A client with a new colostomy turns away and says he "doesn't want to deal with it." The nurse should first:

• a.Insist that the client look at the stoma so he will adjust to it faster
• b.Tell the client that the colostomy may turn out to be temporary
• c.Begin detailed self-care teaching right away to build his confidence
• d.Acknowledge the client's feelings before starting self-care teaching✓

With a new colostomy, acknowledge the client's feelings about the body-image change before beginning self-care teaching. Jumping straight into teaching, minimizing with "it may be temporary," or insisting the client look at the stoma ignores the emotional readiness needed first.

A client says, 'I have saved up my pills and I am going to take them all tonight.' What should the LPN/VN do?

• a.Search the client's belongings for the medication supply
• b.Stay with the client and tell the supervisor✓
• c.Ask the client to promise not to act on the plan tonight
• d.Encourage the client to discuss this at the group session

A stated plan with available means requires that the client not be left alone and that the chain of command be notified so the client can be evaluated. A safety promise has no protective value, searching alone leaves the client unobserved, and deferring to group delays urgent care.

A client who was told this morning about a new cancer diagnosis is crying quietly. What should the LPN/VN do?

• a.Notify the registered nurse that the client cries
• b.Suggest the client wait until more is known
• c.Sit with the client and allow silence for a time✓
• d.Explain the treatment options that are usually offered

Presence and silence give the client room to express grief and are within the LPN/VN role. Escalating an expected emotional response, supplying treatment information, and asking the client to postpone feelings all close off the expression.

A client with dementia becomes agitated and shouts in the hallway during the evening. What should the LPN/VN do first?

• a.Ask the client to explain why the shouting has started
• b.Tell the client that shouting disturbs the other residents
• c.Notify the nursing supervisor about the client's shouting
• d.Move the client to a quiet area and speak calmly✓

Reducing stimulation and using a calm approach are the first de-escalation steps and are within the LPN/VN role. Escalating, demanding an explanation from a cognitively impaired client, and correcting the behavior all tend to increase agitation.

A client in alcohol withdrawal says, 'There are bugs crawling all over the wall.' What is the appropriate response?

• a.There are no bugs, so you should try to relax now
• b.Tell me how many bugs you can see on that wall
• c.I do not see any bugs, and I will stay here with you✓
• d.I will get something to spray the wall for the bugs

The nurse presents reality without arguing and offers presence, which reduces fear. Playing along reinforces the hallucination, a flat correction with an order to relax dismisses the client, and asking for detail focuses the client on the false perception.

A client tells the LPN/VN, 'I am not taking that blood pressure pill anymore.' What should the LPN/VN say?

• a.Help me understand what has changed for you✓
• b.Your provider prescribed it, so it should be taken
• c.Many clients dislike it at first and then adjust to it
• d.The medication is important for preventing a stroke

Exploring the reason for nonadherence is a listed LPN/VN activity and is what determines the next step. A warning, an appeal to authority, and a generalization all answer before the reason is known.

An angry client is pacing, clenching the fists, and speaking loudly. What should the LPN/VN do?

• a.Keep an arm's length distance and lower the voice✓
• b.Tell the client the behavior must stop
• c.Notify the registered nurse before entering the room
• d.Stand close to the client to show attentive concern

Maintaining personal space and a calm, quiet voice de-escalates an agitated client and keeps an exit available. Escalating first, closing the distance, and issuing a command all raise the risk of assault.

A client who is dying asks the LPN/VN, 'Am I going to die tonight?' What is the appropriate response?

• a.No one can predict how much time is left
• b.Let me get your family so you can talk together
• c.You should try to rest and stay comfortable now
• d.What are you thinking about as you ask me that✓

An open response invites the client to say what the question is really about. A factual deflection, calling in family, and redirecting to comfort all end the conversation the client opened.

An LPN/VN is collecting psychosocial data on a newly admitted client. Which question is appropriate for the LPN/VN to ask?

• a.Which psychiatric diagnosis fits you best
• b.Which of your coping mechanisms are unhealthy for you
• c.How severe would you rate your depression clinically
• d.How have you been sleeping over the past two weeks✓

Collecting concrete data such as sleep patterns is within the LPN/VN role. Assigning a diagnosis, rating clinical severity, and labeling a client's coping as unhealthy are all interpretive judgments.

A client in a long-term care facility repeatedly asks to go home to a house sold years ago. Which approach uses validation therapy?

• a.Your house was sold, and this is your home now
• b.Look at the calendar for today's date
• c.Tell me about the home that you are missing✓
• d.We will talk about going home a little later on

Validation therapy responds to the feeling behind the statement rather than the facts. Correcting the client, orienting to the date, and postponing the topic are all reality-based or dismissive responses that increase distress in advanced dementia.

A client discloses that a staff member slapped the client's hand during the night shift. What should the LPN/VN do?

• a.Ask the client whether the contact could have been accidental
• b.Observe the staff member during this shift
• c.Report the allegation to the nursing supervisor at once✓
• d.Record the client's statement and continue with morning care

An allegation of abuse by staff is reported immediately through the chain of command so an investigation and protection can begin. Questioning the report, watching for a repeat, and documenting alone all leave the client in contact with the accused staff member.

A client with a new colostomy refuses to look at the stoma during the dressing change. What should the LPN/VN do?

• a.Complete the change quickly without any discussion
• b.Tell the client that most people adjust within weeks
• c.Insist that the client observe the procedure today
• d.Acknowledge the difficulty and continue the care✓

Accepting the client's pace while continuing needed care supports adaptation to an altered body image. Insisting, rushing in silence, and offering a generalization all disregard where the client actually is.

An LPN/VN is assisting with a client group session on the psychiatric unit. Which action is appropriate for the LPN/VN?

• a.Decide which members should attend the sessions
• b.Set the therapeutic goals for the group session
• c.Encourage a quiet member to share with the group✓
• d.Interpret the meaning of a member's statement

Participating in a group session by supporting engagement is within LPN/VN scope. Interpretation, goal setting, and membership decisions belong to the group leader or the registered nurse.

A client says, 'Since my stroke I am useless to my family.' What is the most therapeutic response?

• a.You will regain much of your function with therapy
• b.Your family told me they are glad you are here
• c.Everyone feels discouraged after a stroke at first
• d.You feel that you no longer contribute at home✓

Reflecting the client's feeling invites the client to say more and shows the message was heard. Reporting what the family said, promising recovery, and normalizing the feeling all move away from what the client expressed.

An LPN/VN is reinforcing education for the family of a client with Alzheimer disease who becomes agitated at dusk. Which instruction should be included?

• a.Let the client nap for several hours late in the day
• b.Keep the evening routine and the lighting consistent✓
• c.Ask the client each evening what caused the upset
• d.Introduce new activities in the evening for interest

A consistent routine and adequate light reduce sundowning. Novel evening activity increases stimulation, questioning a confused client adds demand, and long late naps disrupt the sleep-wake cycle.

A client who uses a wheelchair says, 'Do not talk to my husband about me as if I am not here.' What should the LPN/VN do?

• a.Apologize and continue the conversation as it was
• b.Ask the husband to step out during future discussions
• c.Explain that the husband asked most of the questions
• d.Address the client directly during all conversations✓

Speaking directly to the client promotes self-advocacy and dignity. Justifying the behavior, removing the spouse, and apologizing without changing the behavior all fail to correct the problem the client identified.

An LPN/VN is caring for a client experiencing an opioid overdose who has a respiratory rate of 6 breaths per minute. What should the LPN/VN do first?

• a.Turn the client to the side
• b.Attempt to arouse the client with a sternal rub
• c.Report the respiratory rate to the nursing supervisor
• d.Open the airway and begin assisted ventilation✓

Severe respiratory depression is treated by supporting ventilation immediately. Reporting, attempting arousal, and side-lying positioning all leave the client hypoventilating while they are carried out.

A client with schizophrenia states that the television is sending personal messages. What is the appropriate response?

• a.I understand that seems real, and I do not hear it✓
• b.The television cannot send messages to any person
• c.Let us turn the television off so it will stop now
• d.What message is the television sending to you now

Acknowledging the client's experience while stating the nurse's own perception maintains trust without reinforcing the delusion. Flat contradiction invites argument, exploring content reinforces the delusion, and removing the television treats it as real.

An LPN/VN observes that a client with depression has not showered in three days. What should the LPN/VN do?

• a.Wait until the client's mood improves this week
• b.Offer a specific time and assist with the shower✓
• c.Explain why daily hygiene matters for the client
• d.Ask the client whether a shower is wanted today

A client with depression is often unable to initiate, so structure and hands-on assistance work best. An open choice invites refusal, an explanation adds no capacity, and waiting for the mood to improve leaves the need unmet.

A client is admitted with a blood alcohol level well above the legal limit and reports drinking daily for years. Which finding should the LPN/VN report as an early sign of withdrawal?

• a.A flushed face with the odor of alcohol present
• b.Pinpoint pupils with slow, shallow respirations
• c.Hand tremors with a pulse of 108 beats per minute✓
• d.Slurred speech with an unsteady, wide-based gait

Tremor and tachycardia in the first hours after the last drink are early withdrawal signs and must be reported. Slurred speech and ataxia reflect intoxication, pinpoint pupils suggest opioids, and flushing with odor reflects recent drinking.

An LPN/VN is caring for a client who reports feeling anxious before surgery. Which action helps most?

• a.Ask what the client understands about the surgery✓
• b.Offer to close the door so the client can be alone
• c.Tell the client the surgeon has done many of these
• d.Describe the recovery room in step-by-step detail

Finding out what the client already knows identifies the specific fear that is driving the anxiety. Reassurance about the surgeon, unrequested detail, and leaving the client alone all address anxiety without knowing its source.

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.