NCLEX-PN Nursing — All Questions

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.

An LPN/VN is assisting with a lumbar puncture. How should the client be positioned?

• a.Prone with a pillow placed under the abdomen
• b.Sitting upright with the neck extended backward
• c.Side-lying with the knees drawn up to the chest✓
• d.Supine with the head of the bed fully flat

A side-lying curled position separates the vertebral spaces so the needle can pass. Prone positioning blocks access, supine positioning gives no separation, and neck extension does not affect the lumbar spine.

An LPN/VN is caring for a client with a central venous catheter and notices the cap is off and the line is open to air. What should the LPN/VN do first?

• a.Place a new sterile cap on the open catheter hub
• b.Lower the head of the bed and observe the client
• c.Clamp the catheter close to the insertion site✓
• d.Notify the nursing supervisor about the open line

Clamping stops air entry immediately, which is the danger in an open central line. Reporting, capping before clamping, and repositioning all leave the line open while they are done.

An LPN/VN is collecting a sputum specimen for culture. When should the specimen be collected?

• a.At bedtime after the evening oral care
• b.Immediately after the client finishes breakfast
• c.Early in the morning before the client eats✓
• d.During the afternoon when secretions loosen

An early morning specimen contains overnight secretions and the highest organism yield. Post-meal collection risks emesis and contamination, and afternoon and bedtime specimens are more dilute.

An LPN/VN is applying elastic compression stockings. When should they be applied?

• a.In the evening before the client goes to sleep
• b.After the client has been sitting up for an hour
• c.In the morning before the client gets out of bed✓
• d.After the client has walked in the hallway once

Applying them before the legs become dependent prevents venous pooling. Any application after the client has been upright traps the pooled blood the stockings are meant to prevent.

An LPN/VN is monitoring a client on a continuous cardiac monitor and the tracing shows a flat line. What should the LPN/VN do first?

• a.Check the client for a pulse and responsiveness✓
• b.Notify the nursing supervisor about the tracing
• c.Print the strip and place it in the client's record
• d.Replace the electrodes and reposition the leads

A monitor finding is confirmed at the bedside before anything else, because the client is either in asystole or the leads are loose. Reporting, changing electrodes, and printing all delay identifying an arrest.

An LPN/VN is caring for a client scheduled for a colonoscopy. Which finding indicates the preparation was effective?

• a.The client drank half of the prescribed solution
• b.The client reports feeling hungry now
• c.The client passed three formed stools overnight
• d.The last stool passed was clear yellow liquid✓

Clear liquid effluent shows the bowel is adequately cleansed. Formed stool, partial preparation intake, and hunger do not demonstrate cleansing.

An LPN/VN is performing a circulatory check on a client's leg after a vascular procedure. Which technique is correct?

• a.Assess only the leg that had the procedure done
• b.Compare pulses, color, and warmth to the other leg✓
• c.Ask the client whether the leg feels the same as before
• d.Use a blood pressure cuff to check the leg pulses

Side-to-side comparison identifies changes that a single-limb check misses. Checking only the treated leg, using a cuff instead of palpating pulses, and relying on the client's sensation all miss early arterial compromise.

An LPN/VN is preparing to perform a 12-lead electrocardiogram. Where is lead V1 placed?

• a.At the fourth intercostal space to the left of the sternum
• b.At the fifth intercostal space in the anterior axillary line
• c.At the fifth intercostal space in the midclavicular line
• d.At the fourth intercostal space to the right of the sternum✓

V1 sits at the fourth intercostal space at the right sternal border. The left fourth space is V2, the left fifth midclavicular is V4, and the left fifth anterior axillary is V5.

An LPN/VN reviews a client's laboratory results and finds a potassium level of 2.8 mEq/L. Which finding is consistent with this result?

• a.Increased deep tendon reflexes with cramping
• b.Muscle weakness with a soft, distended abdomen✓
• c.Muscle spasm with a positive Chvostek sign
• d.Numbness of the lips with muscle twitching

Hypokalemia produces skeletal muscle weakness and decreased gastrointestinal motility. Chvostek sign, perioral numbness with twitching, and hyperreflexia all reflect hypocalcemia rather than low potassium.

An LPN/VN is monitoring a client with a peripheral intravenous catheter and finds the vein red, warm, and firm along its course. What should the LPN/VN do?

• a.Flush the catheter with saline to test the patency
• b.Apply a cold pack and leave the catheter in place
• c.Discontinue the infusion and remove the catheter✓
• d.Reduce the infusion rate and continue the therapy

A red, warm, cordlike vein is phlebitis, and the catheter is removed. Slowing the rate, cooling the site, and flushing all continue to expose the inflamed vein.

An LPN/VN is preparing to insert an indwelling urinary catheter in a female client. Which action maintains sterile technique?

• a.Hold the labia apart until the catheter is inserted✓
• b.Release the labia to reach for the lubricated catheter
• c.Use the dominant hand to hold the labia apart
• d.Reposition the client after the field has been opened

The hand separating the labia becomes contaminated and must not move until the catheter is in place. Releasing the labia recontaminates the meatus, holding with the dominant hand contaminates the insertion hand, and repositioning disturbs the field.

An LPN/VN measures a client's orthostatic vital signs. Which result indicates orthostatic hypotension?

• a.A pulse increase of 8 beats per minute on standing
• b.A diastolic drop of 6 millimeters of mercury on standing
• c.A systolic drop of 8 millimeters of mercury on standing
• d.A systolic drop of 24 millimeters of mercury on standing✓

Orthostatic hypotension is a fall of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing. Drops of 8 and 6 mmHg and a rise of 8 beats per minute are all within normal variation.

An LPN/VN is reinforcing education before a client's magnetic resonance imaging study. Which client statement requires follow-up?

• a.I still have my pacemaker from last year✓
• b.I can ask for earplugs during the loud scan
• c.I will need to lie still for the whole study
• d.I removed my watch and my wedding ring

An implanted pacemaker may be a contraindication and must be reported before the study. Lying still, noise protection, and removing metal objects are all correct understandings.

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

• a.A weight that is 3 kilograms lower than before
• b.A report of relief from the abdominal pressure
• c.A small amount of fluid at the site
• d.A pulse of 124 with a falling blood pressure✓

Tachycardia with hypotension after fluid removal suggests hypovolemia or bleeding. Minor site leakage, symptom relief, and weight loss matching the volume removed are all expected.

An LPN/VN is caring for a client whose only working glucometer on the unit has failed its quality control check. What should the LPN/VN do?

• a.Borrow a client's personal meter from the bedside
• b.Delay the glucose checks until the next work shift
• c.Use the failed meter and note the result
• d.Ask the nursing supervisor for a working meter✓

A device that fails quality control is removed from use and replacement equipment is arranged through the chain of command. Using it anyway, borrowing an uncalibrated personal device, and skipping ordered checks all produce unsafe glucose management.