NCLEX-PN Nursing — All Questions

During an external disaster response, an LPN/VN is asked to help triage arriving clients. Which client should be treated first?

• a.A client with severe pain and no visible external injury
• b.A client with an open fracture of the lower right leg
• c.A client with noisy, obstructed breathing and a weak pulse✓
• d.A client with a deep laceration that has stopped bleeding

Airway compromise with shock is immediately life-threatening and is treated first. An open fracture, a controlled laceration, and undifferentiated pain are all urgent but survivable during the minutes that airway management requires.

An LPN/VN is reinforcing home safety education with an older adult who lives alone. Which instruction should the LPN/VN include?

• a.Keep the hallway lights off to save energy
• b.Use a rolling stool to reach items on high shelves
• c.Remove loose throw rugs from the walking paths✓
• d.Place an extension cord along the edge of the hallway

Loose rugs are a leading cause of falls in the home. Darkened hallways, an unstable rolling stool, and a cord across a walking route each add a hazard rather than remove one.

An LPN/VN sees an unlicensed assistive personnel preparing to reuse a glucometer lancet device on a second client. What should the LPN/VN do first?

• a.Stop the procedure before the second client is tested✓
• b.Document the observation and review the device policy
• c.Ask the assistive personnel to explain the unit routine
• d.Report the practice to the nursing supervisor right away

A lancing device shared between clients transmits bloodborne pathogens, so the act is interrupted before it happens. Reporting, seeking an explanation, and documenting all allow the exposure to occur first.

An LPN/VN is caring for a client with a draining wound. Which personal protective equipment is required to change the saturated dressing?

• a.A surgical mask and gloves for the dressing change
• b.Gloves alone for a wound that is already covered
• c.A gown and mask without any gloves
• d.Gloves and a gown for the anticipated splash✓

Standard precautions require protection matched to the anticipated exposure, and a saturated dressing means contact with body fluid on the hands and clothing. Gloves alone, a mask substituting for a gown, and omitting gloves all leave a predicted exposure route open.

An LPN/VN notes that a client's identification band is missing during the morning medication pass. What should the LPN/VN do?

• a.Ask the client to state the full name and give the dose
• b.Give the medication and request a band from admitting
• c.Apply a new band after verifying the client's identity✓
• d.Ask a coworker who knows the client to confirm identity

Identity is verified and the band replaced before care continues, so every later encounter has the identifier available. A single verbal check, deferring the band, and relying on a coworker's recognition all leave the client unbanded.

An LPN/VN is preparing to move a client with limited weight-bearing from bed to a stretcher. Which device is appropriate?

• a.A gait belt applied around the client's waist and chest
• b.A draw sheet pulled by one staff member at the head
• c.A mechanical lift operated by a single staff member
• d.A friction-reducing slide board with two staff members✓

A lateral transfer to a stretcher uses a slide board with at least two people. A gait belt is for ambulation and standing, one person pulling a draw sheet risks shearing and injury, and a mechanical lift is not operated alone.

A client on droplet precautions must go to the radiology department. What should the LPN/VN do?

• a.Wrap the client in a clean sheet for the entire transport
• b.Ask radiology to come to the unit with portable equipment
• c.Have the transport staff wear N95 respirators
• d.Place a surgical mask on the client for transport✓

Source control with a surgical mask on the client contains respiratory droplets during transport. Respirators on staff are not the droplet-precaution requirement, a sheet does not contain droplets, and portable equipment is not always an option for the ordered study.

An LPN/VN finds a client's intravenous pump alarming with an occlusion message and the tubing kinked under the client's arm. What should the LPN/VN do first?

• a.Silence the alarm and recheck the pump in ten minutes
• b.Straighten the tubing and check that flow resumes✓
• c.Notify the nursing supervisor that the pump is alarming
• d.Increase the pump rate to overcome the resistance

A visible mechanical cause is corrected on the spot, which is within the LPN/VN's scope. Reporting a kink, silencing an alarm, and raising the rate against an occlusion all delay or worsen the problem.

An LPN/VN notices that a client's oxygen tubing runs across the doorway of the room. What should the LPN/VN do?

• a.Shorten the tubing by coiling it beside the bed
• b.Reroute the tubing away from the doorway✓
• c.Place a warning sign at the entrance to the room
• d.Tape the tubing to the floor across the doorway

Removing the tubing from the walking path eliminates the trip hazard. Taping it down still leaves a raised ridge, a sign relies on people reading it, and coiling excess tubing beside the bed can kink the oxygen flow.

An LPN/VN is assigned to perform safety checks on a client who is in seclusion. How often should the client be observed?

• a.At the beginning and the end of the seclusion period
• b.Once each hour while the client remains in seclusion
• c.Continuously, according to facility policy and the order✓
• d.Every thirty minutes until the seclusion is discontinued

A client in seclusion requires continuous monitoring in the manner the facility policy and order specify, because the client cannot summon help. Half-hourly, hourly, and start-and-end checks all leave long unobserved intervals.

An LPN/VN is caring for a client who has a latex allergy. Which action is appropriate?

• a.Ask the client to describe the reaction before changing supplies
• b.Wear powder-free latex gloves when giving direct care
• c.Remove latex items only from the client's bedside table
• d.Post the allergy and use latex-free supplies at the bedside✓

Latex is removed from the client's environment and the allergy is communicated to everyone entering the room. Powder-free latex is still latex, clearing one surface leaves other sources, and taking a history does not remove exposure.

An LPN/VN finds a spill of blood on the floor of a client's room. What should the LPN/VN do first?

• a.Ask housekeeping to bring a spill kit later
• b.Notify the nursing supervisor about the spill on the floor
• c.Wipe the spill with paper towels from the bedside table
• d.Contain the area so no one walks through the spill✓

Preventing contact and tracking comes first, before the spill is cleaned with the approved kit and disinfectant. Reporting, improvising with paper towels, and requesting a delayed cleanup all leave people walking through a bloodborne hazard.

An LPN/VN is preparing a client's room for a client on protective environment precautions after a stem cell transplant. Which action is appropriate?

• a.Limit the client to a single visitor at any one time
• b.Keep the door open so staff can observe the client
• c.Place a container of alcohol-based rub inside the room
• d.Remove fresh flowers and potted plants from the room✓

Fresh flowers and soil harbor Aspergillus and other fungi that endanger a severely neutropenic client. Hand rub, visitor limits, and an open door do not address that specific hazard, and an open door defeats the positive-pressure airflow.

An LPN/VN observes that a newly hired assistive personnel is not wearing gloves while emptying a urinary drainage bag. What should the LPN/VN do?

• a.Report the practice to the registered nurse later
• b.Ask whether the person received training on standard precautions
• c.Ask the person to stop and put on gloves before continuing✓
• d.Empty the remaining drainage bags on the unit personally

An unsafe practice in progress is stopped immediately, then addressed through education and reporting. A delayed report, a training question, and taking over the rest of the task all allow this exposure to be completed.

An LPN/VN is asked to check that emergency suction equipment at a bedside is ready for use. Which finding indicates the equipment is ready?

• a.The catheter package at the bedside is sealed and dry
• b.The suction tubing is coiled and connected to the wall
• c.The suction generates the set pressure when occluded✓
• d.The collection canister is empty and correctly seated

Only occluding the tubing and watching the gauge reach the set pressure demonstrates that the system actually works. An empty canister, connected tubing, and an intact catheter package are all necessary but none of them tests function.

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.

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.