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NCLEX-PN® Examination practice questions

221 free questions with answers and explanations.

Practice test
  1. 101.A client is prescribed intravenous potassium chloride (KCl) 20 mEq to be infused over 2 hours. The pharmacy supplies 20 mEq of KCl in 100 mL of 0.9% Sodium Chloride. The LPN needs to set the infusion pump rate in mL/hour. What is the correct infusion rate?Pharmacological Therapies
  2. 102.A client is prescribed potassium chloride (KCl) 40 mEq mixed in 500 mL of 0.9% Normal Saline to infuse over 4 hours. The drop factor of the manual IV tubing is 15 gtt/mL. The LPN should set the infusion rate to deliver how many gtt/min? (Round to the nearest whole number. Do not use trailing zeros.)Pharmacological Therapies
  3. 103.A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed a new medication. The LPN notes the medication is propranolol, a non-selective beta-blocker. What is the LPN's primary concern regarding this medication for this client?Pharmacological Therapies
  4. 104.An LPN is preparing to administer a subcutaneous injection of enoxaparin. The client has a BMI of 32. Which site is most appropriate for this injection?Pharmacological Therapies
  5. 105.An LPN is assisting a registered nurse (RN) to care for a client who is diagnosed with a highly contagious airborne disease. The client requires frequent monitoring and medication administration. Which action by the LPN BEST demonstrates effective collaboration with the interdisciplinary team?Coordinated Care
  6. 106.A client admitted with a severe gastrointestinal bleed has a hemoglobin of 6.2 g/dL and is hypotensive. The nurse is preparing to administer 2 units of packed red blood cells (PRBCs). Which of the following is the most critical nursing action prior to initiating the transfusion?Physiological Adaptation
  7. 107.A client is admitted with dengue fever and is being monitored for signs of progression to severe dengue. The nurse should prioritize assessment for which of the following signs, indicating a critical phase and potential for shock?Physiological Adaptation
  8. 108.An LPN is assisting with the admission of a client who has a history of substance use disorder and is currently experiencing withdrawal symptoms. The client states, 'I'm not sure I can go through this again. I always relapse.' Which action by the LPN BEST demonstrates client advocacy?Coordinated Care
  9. 109.A client is experiencing signs of impending cardiogenic shock, including a blood pressure of 80/50 mmHg, heart rate of 120 bpm, cool and clammy skin, and decreased urine output. Which of the following medications would the nurse anticipate administering to improve cardiac output and tissue perfusion?Physiological Adaptation
  10. 110.An LPN is assisting with the care of a client who has a history of opioid use disorder and is receiving methadone maintenance therapy. The client expresses concern about the stigma associated with methadone and requests that their family not be informed about this treatment. What is the LPN's MOST appropriate action regarding confidentiality?Coordinated Care
  11. 111.A client is exhibiting symptoms of thyroid storm, including a temperature of 104.2°F (40.1°C), heart rate of 160 bpm, profuse sweating, and altered mental status. The nurse anticipates administering which medication as a priority to block the synthesis of thyroid hormones?Physiological Adaptation
  12. 112.A client is experiencing an acute exacerbation of Crohn's disease, with severe diarrhea and abdominal pain. The nurse notes a blood pressure of 90/60 mmHg, heart rate of 110 bpm, and reports increased thirst. The client's last urine output was 15 mL in the last hour. Which of the following fluid and electrolyte imbalances is the client most likely experiencing?Physiological Adaptation
  13. 113.A client with a history of heart failure is being discharged home. The LPN is reinforcing discharge teaching regarding medication management, diet, and activity restrictions. The client lives alone and expresses concern about managing their care independently. Which referral is MOST appropriate for the LPN to suggest to the RN for this client?Coordinated Care
  14. 114.A client is experiencing severe epistaxis that has not responded to direct pressure. The nurse notes the client is becoming increasingly anxious, and blood is trickling down the back of the throat. Which of the following is the most appropriate next nursing action?Physiological Adaptation
  15. 115.A client with a history of heart failure is prescribed a new medication, sacubitril/valsartan (Entresto). The nurse should monitor for which adverse effect specific to this medication combination?Physiological Adaptation
  16. 116.A client is admitted with a suspected CVA (Cerebrovascular Accident) and is experiencing right-sided weakness and expressive aphasia. The nurse understands the importance of maintaining a patent airway. Which of the following is the most appropriate initial nursing intervention to prevent aspiration?Physiological Adaptation
  17. 117.A client is admitted to the intensive care unit with a severe traumatic brain injury (TBI). The nurse understands that maintaining a cerebral perfusion pressure (CPP) between 60-70 mmHg is crucial. If the client's intracranial pressure (ICP) is 20 mmHg and the mean arterial pressure (MAP) is 80 mmHg, what is the client's current CPP?Physiological Adaptation
  18. 118.An LPN is supervising a nursing assistant (NA) who is providing morning care for a client with a new colostomy. The LPN observes the NA attempting to change the colostomy bag without wearing gloves. What is the LPN's MOST appropriate immediate action?Coordinated Care
  19. 119.An LPN is assisting with the care of a client who is scheduled for a surgical procedure. The client expresses concern about the cost of the surgery and their ability to pay. What is the MOST appropriate initial action for the LPN to take?Coordinated Care
  20. 120.A client is admitted with a suspected ruptured cerebral aneurysm. The nurse notes a sudden, severe headache, nuchal rigidity, and photophobia. The client's Glasgow Coma Scale (GCS) score is 13. Which of the following is the priority nursing intervention?Physiological Adaptation
  21. 121.A client is admitted to the emergency department with a suspected ruptured esophageal varices. The nurse understands that which medication is most likely to be prescribed to reduce portal pressure and control bleeding?Physiological Adaptation
  22. 122.An LPN is caring for a client who is alert and oriented but refuses to take their prescribed oral medication, stating, 'I don't think it's helping me.' The LPN has already explained the medication's purpose. What is the MOST appropriate next action for the LPN?Coordinated Care
  23. 123.An LPN is preparing to transfer a client from the medical-surgical unit to a long-term care facility. Which information is MOST important for the LPN to include in the transfer report?Coordinated Care
  24. 124.An LPN is assigned to care for a client who is scheduled for a surgical procedure and requires an informed consent form to be signed. The client states, 'I'm not really sure what the doctor said about the risks, but I trust them.' What is the MOST appropriate action for the LPN to take?Coordinated Care
  25. 125.An LPN is assisting with the care of a client who has been diagnosed with a terminal illness and is making end-of-life decisions. The client asks the LPN, 'What would you do if you were in my shoes?' What is the MOST appropriate response by the LPN?Coordinated Care
  26. 126.A client presents to the emergency department with sudden-onset shortness of breath, pleuritic chest pain, and a feeling of impending doom. The client denies any recent trauma but reports a long flight yesterday. On assessment, the nurse notes tachycardia, tachypnea, and oxygen saturation of 88% on room air. Which of the following initial nursing interventions is the most appropriate?Physiological Adaptation
  27. 127.A client is experiencing an acute asthma exacerbation. The nurse administers a prescribed albuterol nebulizer treatment. Which of the following findings indicates the medication is having its intended therapeutic effect?Physiological Adaptation
  28. 128.A client with a history of chronic kidney disease (CKD) is admitted with a serum potassium level of 6.8 mEq/L. The nurse anticipates administering which medication as a priority to stabilize the cardiac membrane?Physiological Adaptation
  29. 129.A client with a history of liver cirrhosis is admitted with ascites and reports increasing shortness of breath. The nurse assesses the client and notes diminished breath sounds at the lung bases, dullness to percussion, and oxygen saturation of 90% on room air. Which of the following is the most likely cause of the client's respiratory distress?Physiological Adaptation
  30. 130.A client with a traumatic brain injury (TBI) is exhibiting signs of increased intracranial pressure (ICP), including a Glasgow Coma Scale (GCS) score of 8, unilateral pupillary dilation, and decorticate posturing. The nurse should anticipate administering which medication to reduce cerebral edema?Physiological Adaptation
  31. 131.An LPN is preparing to administer medication to a client. The LPN scans the client's wristband, but the electronic health record (EHR) system is experiencing a temporary outage, preventing medication verification. What is the MOST appropriate action for the LPN to take?Coordinated Care
  32. 132.A client with a history of chronic kidney disease (CKD) is admitted with lethargy, muscle weakness, and peaked T-waves on the electrocardiogram. The nurse anticipates that the client's serum potassium level is likely:Physiological Adaptation
  33. 133.A client with a history of chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 L/min via nasal cannula. The nurse notes the client is becoming increasingly drowsy and confused, with a respiratory rate of 10 breaths/min. Which of the following is the most appropriate initial nursing action?Physiological Adaptation
  34. 134.A client is admitted with acute pancreatitis. The nurse is monitoring for complications. Which of the following findings would indicate a potential complication of hypocalcemia?Physiological Adaptation
  35. 135.A client is experiencing an acute asthma exacerbation. The LPN notes the client is anxious, using accessory muscles to breathe, and has an oxygen saturation of 89% on room air. Which action should the LPN take FIRST?Reduction of Risk Potential
  36. 136.An LPN is reviewing the laboratory results for a client with chronic kidney disease. Which finding is most important to report to the registered nurse (RN) or healthcare provider immediately?Reduction of Risk Potential
  37. 137.A client is receiving oxygen therapy via nasal cannula at 4 L/min. The LPN notes the client's oxygen saturation is 90%, and the client reports increased shortness of breath. The LPN should first adjust the oxygen flow rate to:Reduction of Risk Potential
  38. 138.An LPN is monitoring a client who is receiving a continuous bladder irrigation (CBI) after a transurethral resection of the prostate (TURP). The LPN observes dark red urine with several blood clots in the drainage bag. What is the most appropriate initial nursing action?Reduction of Risk Potential
  39. 139.A client is scheduled for a magnetic resonance imaging (MRI) of the brain. Which client statement indicates the need for further nursing assessment and possible intervention?Reduction of Risk Potential
  40. 140.A client is scheduled for a barium swallow study. Which instruction should the LPN provide regarding post-procedure care?Reduction of Risk Potential
  41. 141.A licensed practical nurse (LPN) is reviewing the arterial blood gas (ABG) results for a client with chronic obstructive pulmonary disease (COPD). The results are: pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L, PaO2 78 mmHg. Which acid-base imbalance does this indicate?Reduction of Risk Potential
  42. 142.A client with a history of heart failure is scheduled for a transthoracic echocardiogram (TTE). The client asks the LPN, 'What should I expect during this test?' Which response by the LPN is most appropriate?Reduction of Risk Potential
  43. 143.A client is scheduled for a magnetic resonance imaging (MRI) of the knee. Which information obtained by the LPN during the client interview would be most critical to report to the MRI technologist?Reduction of Risk Potential
  44. 144.A client is scheduled for a lumbar puncture. The LPN should ensure the client is placed in which position for the procedure?Reduction of Risk Potential
  45. 145.A client with a history of heart failure reports sudden shortness of breath, orthopnea, and cough producing pink, frothy sputum. The LPN notes crackles in the lung bases and an oxygen saturation of 88% on room air. Which is the priority nursing action?Reduction of Risk Potential
  46. 146.A client is receiving a continuous intravenous (IV) infusion of 0.9% Normal Saline at 125 mL/hr. The IV tubing has a drop factor of 15 drops/mL. The LPN needs to calculate the drops per minute. What is the correct drip rate?Reduction of Risk Potential
  47. 147.An LPN is assisting with the care of a client who underwent a thyroidectomy 12 hours ago. Which finding would be the MOST concerning and require immediate intervention?Reduction of Risk Potential
  48. 148.An LPN is caring for a client with a new prescription for warfarin. The LPN should recognize that which laboratory value is used to monitor the therapeutic effects of warfarin?Reduction of Risk Potential
  49. 149.An LPN is assisting with the care of a client who underwent abdominal surgery 2 days ago. The client reports severe pain (8/10), is restless, and has a respiratory rate of 24 breaths/min and shallow breathing. The client's abdomen is distended and firm to palpation, and no bowel sounds are audible. Which complication should the LPN suspect?Reduction of Risk Potential
  50. 150.A client undergoing a thoracentesis suddenly develops dyspnea, tachypnea, and diminished breath sounds on the affected side. The LPN should recognize these findings as indicative of which complication?Reduction of Risk Potential