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Choose the safest practical-nurse action, check it, and read the rationale before moving on.
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20 free NCLEX-PN practice questions
Try 20 original NCLEX-PN (LPN/LVN) questions that cover each 2026 Client Needs area. This is a skill check, not weighted like the real exam, not a CAT simulator, and not a prediction of a pass at 85 items.
Start question 1Coordinated CareStep 1 · Choose one answer
An LPN is assigned four stable clients. Unlicensed assistive personnel (UAP) are available. Which task is appropriate for the LPN to assign to the UAP?
Question review
All 20 NCLEX-PN questions with explanations
Try the set above first, then use this list to review. Each answer and explanation stays closed until you open it.
An LPN is assigned four stable clients. Unlicensed assistive personnel (UAP) are available. Which task is appropriate for the LPN to assign to the UAP?
- Teach a newly diagnosed client how to use an incentive spirometer
- Decide whether a client with new chest pressure can wait until after lunch
- Evaluate whether a newly prescribed analgesic reduced the client’s pain
- Obtain routine vital signs for a client who has been stable all shift
Show answer and explanation for question 1
Correct answer: D · Obtain routine vital signs for a client who has been stable all shift
Routine vital signs on a currently stable client are an appropriate UAP task. Teaching, evaluating pain-medication effectiveness, and deciding whether new chest pressure can wait are licensed-nurse judgments. The LPN contributes to assignment within facility policy and still reports unexpected findings to the RN.
Look for this next time: Assign to UAP only routine, stable tasks. Keep teaching, evaluation, and new-symptom decisions with licensed nurses.
A postoperative client’s blood pressure falls from 128/76 mm Hg to 88/54 mm Hg, the dressing is saturated, and the client is diaphoretic. What is the most appropriate LPN action?
- Increase the IV rate independently and recheck the blood pressure in one hour
- Reassure the family that a blood-pressure drop is expected in the first hours after surgery
- Stay with the client, apply dressing pressure per protocol, and notify the RN immediately
- Document the vital signs and wait for the next scheduled RN rounding time
Show answer and explanation for question 2
Correct answer: C · Stay with the client, apply dressing pressure per protocol, and notify the RN immediately
Sudden hypotension with a saturated dressing is an urgent change. The practical nurse monitors, supports the client, follows hemorrhage protocol within scope, and escalates to the RN now. Independently increasing an IV rate, delaying for family reassurance, or waiting for routine rounding leaves an unstable client without a registered nurse.
Look for this next time: When a client becomes unstable, the PN action is monitor, support, and notify the RN—not independently manage the crisis.
A client is on contact precautions for Clostridioides difficile diarrhea. Which infection-control action should the LPN take?
- Wear a gown and gloves on entering and wash hands with soap and water after care
- Use an alcohol-based hand rub as the only hand hygiene after removing the gown and gloves
- Keep the room door closed and wear a fit-tested N95 respirator for all care
- Discontinue precautions because diarrhea is no longer bloody
Show answer and explanation for question 3
Correct answer: A · Wear a gown and gloves on entering and wash hands with soap and water after care
C. difficile contact precautions require gown and gloves. Soap-and-water handwashing is used after care because alcohol-based rubs do not reliably inactivate C. difficile spores. An N95 and a closed door describe airborne precautions, and stopping isolation based only on stool color is not an LPN decision.
Look for this next time: Match PPE and hand hygiene to the organism. C. difficile needs contact precautions and soap-and-water handwashing.
A clinic LPN is reinforcing teaching for a parent after a 2-month well-child visit. Which statement by the parent indicates that the teaching about infant safety was understood?
- “I will put the baby to sleep on the stomach so spit-up drains.”
- “I will keep loose blankets and stuffed toys out of the crib.”
- “I can prop the bottle so I can do dishes during feeds.”
- “I will add honey to the bottle to help the baby sleep.”
Show answer and explanation for question 4
Correct answer: B · “I will keep loose blankets and stuffed toys out of the crib.”
A clear crib without loose bedding is a core safe-sleep teaching point. Stomach sleep, propped bottles, and honey in infancy are unsafe. The LPN reinforces teaching and reports ongoing misunderstanding to the RN; the LPN does not independently redesign the well-child plan.
Look for this next time: Health-promotion items on PN often test whether teaching was understood—not whether the LPN independently created the plan.
A client says, “I am a burden. My family would be better off without me.” What is the most appropriate LPN response?
- “You should not talk like that. Let’s discuss your medications instead.”
- “Everyone feels that way sometimes. Try to stay positive.”
- “You sound hopeless. Are you thinking about harming yourself?”
- “I will leave you alone so you can rest and think it over.”
Show answer and explanation for question 5
Correct answer: C · “You sound hopeless. Are you thinking about harming yourself?”
Statements of being a burden with “better off without me” require a direct, calm suicide-risk question and immediate reporting to the RN. Changing the subject, offering empty reassurance, or leaving the client alone delays safety. The LPN does not diagnose or independently start a psychiatric medication change.
Look for this next time: Ask about suicide risk directly, stay with the client, and escalate. Do not argue, minimize, or leave the person alone.
An older adult reports sacral discomfort after sitting for two hours. The skin over the sacrum is intact and blanched when pressed. What is the most appropriate LPN action?
- Leave the client in the chair until after lunch so the meal and visit are not interrupted
- Massage the blanched area firmly with lotion for several minutes to restore circulation
- Reposition off the sacrum, check the skin, and report non-blanching redness to the RN
- Apply a heating pad to the sacrum on low to increase blood flow to the tissue
Show answer and explanation for question 6
Correct answer: C · Reposition off the sacrum, check the skin, and report non-blanching redness to the RN
Relief of pressure, skin inspection, and reporting of pressure-injury risk are core Basic Care and Comfort actions. Massaging reddened or blanched tissue and applying heat can worsen injury. Comfort care does not mean delaying a position change.
Look for this next time: Relieve pressure, inspect skin, and report early pressure-injury signs. Do not massage reddened sacral tissue.
An LPN is preparing to give morning digoxin. The order says to hold the dose and notify the RN if the apical pulse is below 60 beats/min. The pulse is 52, and the client says, “I feel more nauseated than yesterday.” What should the LPN do?
- Give the tablet with food because nausea is a common, harmless effect
- Switch the client to a different heart medication based on the pulse
- Double the next dose this evening to keep the blood level steady
- Hold the dose, document the pulse and nausea, and notify the RN
Show answer and explanation for question 7
Correct answer: D · Hold the dose, document the pulse and nausea, and notify the RN
Bradycardia plus new nausea are classic digoxin-toxicity warning signs. The LPN withholds the dose per safety parameters, documents, and notifies the RN. Giving the dose, doubling later, or substituting another cardiac drug is outside practical-nurse scope.
Look for this next time: Hold a cardiac drug when its ordered parameters are not met, then report. Do not independently change the regimen.
A client with type 1 diabetes has a bedside glucose of 48 mg/dL, is sweaty and shaky, and can swallow. What is the most appropriate LPN action?
- Give the scheduled insulin now so the next meal tray will cover the dose
- Encourage a 12-ounce caffeinated soda, then document it without rechecking or notifying anyone
- Provide a rapid-acting carbohydrate per protocol, recheck the glucose, and notify the RN
- Wait 30 minutes to see if the shakiness passes on its own before treating the client
Show answer and explanation for question 8
Correct answer: C · Provide a rapid-acting carbohydrate per protocol, recheck the glucose, and notify the RN
Symptomatic hypoglycemia in a client who can swallow is treated promptly with a rapid-acting carbohydrate according to protocol, then rechecked and reported. Giving insulin, delaying, or treating without follow-up and RN notification increases harm risk.
Look for this next time: Treat hypoglycemia first, recheck, and report. Insulin is not the first action for a glucose of 48 mg/dL.
A client with heart failure who has been able to lie nearly flat now needs three pillows to breathe and has new crackles at both bases. What should the LPN do first?
- Place the client upright, apply oxygen if ordered, and notify the RN of the change
- Encourage the client to drink extra water to thin secretions
- Hold the next diuretic because increased work of breathing means the client is dry
- Tell the client to walk in the hall to improve lung expansion
Show answer and explanation for question 9
Correct answer: A · Place the client upright, apply oxygen if ordered, and notify the RN of the change
Increasing orthopnea and new crackles suggest worsening pulmonary congestion. The LPN supports breathing with upright positioning and ordered oxygen, then reports the change so the RN can reassess and contact the provider. Extra fluids, withholding a diuretic, or sending the client walking are unsafe first moves.
Look for this next time: Support oxygenation first, then escalate. Worsening heart-failure breathing is not a wait-and-see finding.
Shortly after an IV antibiotic infusion is started, a client develops a new raised rash, facial swelling, and wheezing. Which action should the LPN take first?
- Document the rash at the end of the shift and continue the infusion
- Stop the infusion, keep the IV line, sit the client up, and call the RN immediately
- Give an extra oral antihistamine from another client’s drawer
- Tell the client the rash is an expected antibiotic effect and finish the bag as ordered
Show answer and explanation for question 10
Correct answer: B · Stop the infusion, keep the IV line, sit the client up, and call the RN immediately
New rash, facial swelling, and wheezing are cues of a possible anaphylactic reaction. Stopping the suspected infusion, supporting the airway position, and calling the RN immediately is the PN Take Action step. Continuing the drug, borrowing another client’s medication, or delaying until end-of-shift documentation is unsafe.
Look for this next time: Clinical-judgment items still follow PN scope: recognize the cue, stop the harm, support the client, and get the RN.
An LPN is caring for four clients who were stable this morning and must decide whom to see first after lunch. Which finding should be reported to the RN before the others?
- A client wants the blinds closed because the afternoon sun is in their eyes
- A client is asking when the evening meal tray arrives and whether dessert is included
- A postoperative client who now has a rigid, painful abdomen and a rising heart rate
- A client’s family is requesting an extra chair and a pillow for an overnight stay
Show answer and explanation for question 11
Correct answer: C · A postoperative client who now has a rigid, painful abdomen and a rising heart rate
A newly rigid abdomen and a rising heart rate can signal bleeding or another acute abdominal change. The LPN sees that client and notifies the RN immediately. Comfort requests and a meal-time question can wait.
Look for this next time: Report a new rigid abdomen and tachycardia before routine comfort requests.
A client is on contact precautions for a draining wound colonized with MRSA. Which action fits the precaution?
- Wear a gown and gloves for care that may contact the wound or the client’s environment
- Use only a surgical mask and leave the door shut as if it were airborne isolation
- Remove gloves in the hallway so the room trash does not fill up
- Double-glove and then skip hand hygiene
Show answer and explanation for question 12
Correct answer: A · Wear a gown and gloves for care that may contact the wound or the client’s environment
Contact precautions use a gown and gloves for likely contact, and the equipment comes off before leaving the room. MRSA in a wound is not managed like airborne tuberculosis. Hand hygiene still happens after the gloves come off.
Look for this next time: Contact precautions mean gown and gloves, then hand hygiene. Do not swap in an airborne setup.
An older adult who takes a blood-pressure medicine says they feel lightheaded for a few seconds when getting up from a chair. Which reinforcement is most appropriate?
- Stand up quickly in one motion so the dizziness has less time to start
- Drink only when thirsty so extra fluid in the body does not cause more dizziness
- Stop taking all prescribed blood-pressure medicine until the lightheaded spells stop completely
- Sit at the chair’s edge first, stand holding a stable surface, and tell the nurse if it recurs
Show answer and explanation for question 13
Correct answer: D · Sit at the chair’s edge first, stand holding a stable surface, and tell the nurse if it recurs
Brief lightheadedness on standing suggests an orthostatic blood-pressure drop. A pause before standing and a stable handhold are practical fall-prevention steps the LPN can reinforce, and repeated episodes are reported. Stopping a blood-pressure medicine is not an LPN or client decision. Standing faster and restricting fluids do not make the transfer safer.
Look for this next time: Reinforce a slow, supported stand. Do not tell the client to stop a prescribed medicine.
A client stares at the floor and says, “There is no point in talking about it.” Which LPN response is most appropriate?
- “You have to talk about it if you want to get better and go home.”
- “I’ll sit with you. We can start with whatever feels easiest.”
- “Other clients on this unit have much worse problems than this.”
- “Why are you being so difficult with the staff today?”
Show answer and explanation for question 14
Correct answer: B · “I’ll sit with you. We can start with whatever feels easiest.”
Offering presence and a small opening respects the client’s pace. Forcing talk, comparing suffering, or asking “why” increases distance. The LPN does not need a perfect speech to stay with the client.
Look for this next time: Offer to stay and start small. Do not pressure, compare, or challenge the silence.
A client with a swallowing problem has an order for nectar-thick liquids. The breakfast tray includes thin apple juice. What should the LPN do?
- Hold the thin juice and provide the ordered nectar-thick liquids
- Give the thin juice because the client prefers it and drinks slowly
- Add a straw so the thin juice is safer
- Thicken the juice to pudding consistency without an order
Show answer and explanation for question 15
Correct answer: A · Hold the thin juice and provide the ordered nectar-thick liquids
The ordered consistency is part of the aspiration-prevention plan. Thin juice, even with a straw, does not meet that order. Making it thicker than ordered is also a change the LPN should not invent. Provide the nectar-thick liquids and report the tray error.
Look for this next time: Match the ordered liquid thickness. A straw does not make a thin liquid safe.
Before giving the first dose of a newly ordered antibiotic, the client says, “I got hives and wheezing the last time I took that drug.” What should the LPN do?
- Give a half dose to test whether the reaction returns
- Document the comment and give the dose because the order is already active
- Give the dose with diphenhydramine so the rash is milder
- Hold the dose, tell the RN, and do not give the drug until it is clarified
Show answer and explanation for question 16
Correct answer: D · Hold the dose, tell the RN, and do not give the drug until it is clarified
Hives plus wheezing describe a serious prior reaction, not a preference. The LPN holds the drug and escalates. A test dose, premedicating, or giving it because the order exists can repeat anaphylaxis.
Look for this next time: A reported allergy with hives and wheezing stops the dose. Clarify it before giving the drug.
A client who was walking in the hall stops, holds a fist against the chest, and says the pain started one minute ago and feels like pressure. What is the LPN’s priority?
- Finish the walk back to the room so the pain can be compared at rest
- Help the client sit or lie down, stay there, and notify the RN now
- Offer a carbonated drink in case the pain is gas
- Schedule a pain recheck for the next routine vital-sign round
Show answer and explanation for question 17
Correct answer: B · Help the client sit or lie down, stay there, and notify the RN now
New pressure in the chest is treated as a possible cardiac event until it is assessed. The LPN stops activity, stays with the client, and gets the RN immediately. Walking farther, offering soda, or waiting for the next round delays that assessment.
Look for this next time: New chest pressure stops the activity. Notify the RN now rather than waiting for the next round.
A client is six hours after abdominal surgery and is reluctant to use the incentive spirometer. Which LPN action best supports recovery?
- Coach the client to sit up, splint the incision, and take slow, deep breaths on the spirometer
- Cancel the breathing exercises until the incision pain is gone and the client feels ready
- Tell the client that shallow breathing is safer for a new incision during the first 24 hours
- Replace the spirometer with a paper bag for rebreathing exercises every hour
Show answer and explanation for question 18
Correct answer: A · Coach the client to sit up, splint the incision, and take slow, deep breaths on the spirometer
Splinted, coached deep breathing helps keep alveoli open after surgery. Waiting until pain is gone, encouraging shallow breaths, or using a paper bag works against that goal. Pain can be treated so the exercise is possible, but the exercise is not cancelled.
Look for this next time: Coach splinted deep breathing after surgery. Do not wait for a pain-free day to start.
A newly admitted client asks the LPN to explain a brand-new diagnosis and to choose the treatment. What is the appropriate LPN role?
- Give the initial diagnosis teaching and select the treatment plan with the client
- Ask unlicensed assistive personnel to explain the diagnosis
- Tell the client that practical nurses are not allowed to speak with newly admitted people
- Collect data for the RN, then reinforce teaching after the RN or provider has given it
Show answer and explanation for question 19
Correct answer: D · Collect data for the RN, then reinforce teaching after the RN or provider has given it
The LPN contributes data and reinforces teaching that has already been given. The initial explanation of a new diagnosis and the choice of treatment belong to the RN or provider. Refusing all contact, or delegating the explanation to assistive personnel, misses the practical-nurse role.
Look for this next time: LPNs reinforce teaching. They do not independently deliver the first explanation of a new diagnosis.
An LPN is at the bedside with a unit-dose medication. Which check best confirms the right client before the dose is given?
- Ask the roommate to point out which person in the room is the client
- Check two identifiers, such as name and date of birth, against the ID band and medication record
- Rely on recognizing the client’s face from yesterday’s assignment on the same unit
- Give the dose if the room and bed number match both the medication label and the assignment sheet
Show answer and explanation for question 20
Correct answer: B · Check two identifiers, such as name and date of birth, against the ID band and medication record
Two client-specific identifiers, such as name and date of birth, checked against the identification band and the medication record confirm the person. A roommate, memory from yesterday, or a room number can point to the wrong client. The check happens at the bedside before the dose is given.
Look for this next time: Match two identifiers to the medication record. A room number is not an identifier.
Use the sample well
The rationale matters more than the score.
A short set can show you what deserves another look. It is intentionally small, so it cannot measure full NCLEX-PN readiness or predict a CAT result.
Read every rationale
Confirm why the best option fits, even when you were right.
Follow the pattern
Use recurring misses—not one score—to choose your next focus.
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