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September 2026 · NCLEX-PN practice

Free NCLEX-PN practice questions with full rationales.

Every question below is written in current NCLEX-PN style and mapped to a Client Needs area on the 2026 PN test plan. Nothing is hidden — the answer, the reasoning, and the study tip are all here. Work them the way you would work the exam: read the last sentence of the stem first, predict your answer, then check.

Full PN test-plan guide Next Gen item types
September 2026 · free sample

10 NCLEX-PN questions, answers and rationales

Scope of practice, delegation, dosage calculation, precautions, therapeutic communication and data collection — the areas the PN exam returns to again and again.

1. LPN/LVN assignment and scopeSingle answer

The charge nurse is assigning clients on a medical unit. Which client is most appropriate to assign to the LPN/LVN?

  1. AA client admitted 30 minutes ago with new-onset chest pain
  2. BA client with stable chronic obstructive pulmonary disease receiving scheduled nebulizer treatments
  3. CA client who requires initial teaching about a new insulin pump
  4. DA client who is 2 hours post-operative from a thyroidectomy

Answer: The client with stable COPD receiving scheduled nebulizer treatments.

The LPN/LVN cares for clients whose condition is stable and whose outcomes are predictable. New-onset chest pain and the immediate post-thyroidectomy client are unstable and need registered-nurse assessment; initial teaching about a new device must be initiated by the RN, although the LPN/LVN may reinforce it afterwards.

Study tip: Stable + predictable = LPN. New, unstable, or first-time teaching = RN.

2. Assigning to unlicensed assistive personnelSelect all that apply

Which tasks may the LPN/LVN assign to unlicensed assistive personnel caring for stable clients? (Select all that apply.)

  1. AMeasuring and recording vital signs
  2. BAssisting a stable client to ambulate with a walker
  3. CReinforcing teaching about a low-sodium diet
  4. DRecording oral intake and urinary output
  5. EEvaluating whether a pain medication was effective
  6. FProviding a bed bath

Answer: Vital signs, assisted ambulation, intake and output, and a bed bath.

Unlicensed assistive personnel may perform standard, unchanging tasks on stable clients. Reinforcing teaching requires a licensed nurse, and evaluating the effect of a medication is nursing judgement that cannot be assigned.

Study tip: If the task needs teaching, judgement, or evaluation, it cannot go to a UAP.

3. Digoxin — data collection before administrationSingle answer

Before administering digoxin 0.125 mg orally to an older adult, which finding requires the LPN/LVN to hold the dose and notify the registered nurse?

  1. AApical pulse of 52 beats per minute
  2. BBlood pressure of 128/76 mm Hg
  3. CSerum potassium of 4.2 mEq/L
  4. DThe client reports the tablet looks different from yesterday's

Answer: Apical pulse of 52 beats per minute.

Digoxin slows conduction, and an apical rate below 60 beats per minute in an adult is the standard parameter for holding the dose and reporting. The blood pressure and potassium are within expected limits; a different-looking tablet should be verified but is not the priority hold parameter.

Study tip: Count the apical pulse for a full minute before every digoxin dose.

4. Transmission-based precautionsSingle answer

A client is admitted with suspected pulmonary tuberculosis. Which action should the LPN/LVN take first?

  1. APlace the client in a negative-pressure room and apply an N95 respirator before entering
  2. BPlace a surgical mask on the client and leave the door open for observation
  3. CWear a gown and gloves and place the client in a private room
  4. DCollect a sputum specimen before contacting the registered nurse

Answer: Negative-pressure room with an N95 respirator worn on entry.

Tuberculosis requires airborne precautions: an airborne-infection isolation room with negative pressure, the door kept closed, and a fit-tested N95 respirator for every person entering. A surgical mask on the client is used only for transport.

Study tip: Airborne = private negative-pressure room, door closed, N95 on the nurse.

5. Positioning after total hip replacementSelect all that apply

Which actions should the LPN/LVN take when caring for a client on the second day after a total hip arthroplasty with a posterior approach? (Select all that apply.)

  1. AKeep an abduction pillow between the legs while the client is in bed
  2. BHave the client sit in a low, soft armchair when out of bed
  3. CAvoid flexing the operative hip more than 90 degrees
  4. DEncourage the client to cross the ankles when resting
  5. EUse a raised toilet seat
  6. FTurn the client only toward the operative side

Answer: Abduction pillow, hip flexion kept under 90 degrees, and a raised toilet seat.

Posterior-approach precautions prevent dislocation: keep the legs abducted, avoid flexion beyond 90 degrees, and avoid internal rotation and adduction. Low soft chairs force excessive flexion, crossing the legs adducts the hip, and turning is normally toward the unaffected side unless prescribed otherwise.

Study tip: No bending past 90°, no crossing, no twisting inward.

6. Therapeutic communicationSingle answer

A client newly diagnosed with heart failure says, "I don't see the point in taking all these pills." Which response by the LPN/LVN is most therapeutic?

  1. A"You really do need to take them or you will end up back in the hospital."
  2. B"Tell me more about what is making you feel that way."
  3. C"Everyone feels like that at first — it gets easier."
  4. D"I will ask the provider to reduce the number of medications."

Answer: "Tell me more about what is making you feel that way."

An open-ended invitation explores the client's feelings and keeps the conversation going. Warning about rehospitalisation is a threat, false reassurance dismisses the concern, and promising a medication change is outside scope and may not be possible.

Study tip: Therapeutic answers explore feelings; they never advise, reassure, or judge.

7. Laboratory values to reportSingle answer

The LPN/LVN reviews morning laboratory results for four clients. Which value should be reported to the registered nurse first?

  1. ASerum potassium 2.8 mEq/L in a client receiving furosemide
  2. BHaemoglobin 11.2 g/dL in a client with chronic kidney disease
  3. CWhite blood cell count 11,200/mm³ in a post-operative client
  4. DFasting blood glucose 128 mg/dL in a client with type 2 diabetes

Answer: Serum potassium 2.8 mEq/L.

Potassium of 2.8 mEq/L is critically low and, combined with a loop diuretic, places the client at immediate risk of life-threatening dysrhythmias. The other values are abnormal but expected for the clinical picture and are not immediately dangerous.

Study tip: Potassium outside 3.5–5.0 mEq/L is an escalate-now value every time.

8. Dosage calculationSingle answer

A child weighing 22 kg is prescribed amoxicillin 40 mg/kg/day orally divided into three equal doses. The suspension is supplied as 250 mg/5 mL. How many millilitres should the LPN/LVN administer per dose?

  1. A5.9 mL
  2. B7.3 mL
  3. C11.7 mL
  4. D17.6 mL

Answer: 5.9 mL per dose.

40 mg/kg × 22 kg = 880 mg per day. Divided into three doses gives 293.3 mg per dose. 293.3 mg ÷ 250 mg × 5 mL = 5.87 mL, rounded to 5.9 mL.

Study tip: Total daily dose first, then divide by frequency, then convert to volume.

9. Recognising hypoglycaemiaSelect all that apply

Which findings in an older adult receiving insulin should the LPN/LVN recognise as possible hypoglycaemia? (Select all that apply.)

  1. ANew confusion and slurred speech
  2. BCool, clammy skin
  3. CFruity-smelling breath
  4. DTremors and reported hunger
  5. EDeep, rapid respirations
  6. FHeart rate of 112 beats per minute

Answer: Confusion, cool clammy skin, tremors with hunger, and tachycardia.

Hypoglycaemia produces adrenergic signs (diaphoresis, tremor, tachycardia, hunger) and neuroglycopenic signs (confusion, slurred speech), and in older adults the neurological picture often comes first. Fruity breath and Kussmaul respirations belong to diabetic ketoacidosis, a hyperglycaemic emergency.

Study tip: Cold and clammy, needs candy. Hot and dry, sugar high.

10. Reinforcing teachingSingle answer

Which statement by a client scheduled for a colonoscopy indicates that reinforced teaching has been effective?

  1. A"I will eat a light breakfast the morning of the test."
  2. B"I will finish the whole bowel preparation even if my stools are already clear."
  3. C"I can drive myself home afterwards since the test is quick."
  4. D"I should stop drinking all fluids 24 hours before the test."

Answer: "I will finish the whole bowel preparation even if my stools are already clear."

The full preparation is completed as prescribed so the entire bowel is visualised. Solid food is withheld, clear liquids are usually permitted until several hours before, and sedation means the client must have a ride home.

Study tip: Sedation always means arranged transport home — a frequent PN teaching item.

That was 10 questions. The pack has the rest.

The September 2026 question pack covers every Client Needs category for both the RN and the PN test plan, including Next Gen case studies, bow-tie, matrix, cloze and highlight items — each with the answer, a full rationale, and a study tip. One payment, yours to keep, refreshed every month.