NCLEX-PN Practice Test

The National Council Licensure Examination for Practical Nurses is more commonly known as the NCLEX-PN. This licensure exam measures the competencies for entry-level nurses to ensure that they can peform safely and effectively. Our free NCLEX-PN practice test is a great way to begin your test prep. As you study for the exam you should work through as many NCLEX-PN questions as possible.


NCLEX-PN Questions

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Question 1
After administering pain medication, the nurse returns to check the client’s level of comfort. This stage of the nursing process is known as:

A
assessment
B
planning
C
implementation
D
evaluation
Question 1 Explanation: 
In the evaluation step, the nurse determines if the interventions were effective. Assessment is the identification of signs and symptoms the patient is presently complaining of through the physical examination and secondary sources of patient information. Planning is the step of the nursing process that allows the nurse to determine what are the desired goals and outcomes for the patient to achieve. After a thorough assessment and stating the desired outcomes, the nurse moves to the implementation stage of the nursing process where she assists and provides nursing care to the patient through independent, dependent, and collaborative actions.
Question 2
The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client?

A
Clean the meatus, begin voiding, then catch urine stream
B
Void a little, clean the meatus, then collect specimen
C
Clean the meatus, then urinate into container
D
Void continuously and catch some of the urine
Question 2 Explanation: 
A clean catch urine specimen is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, it’s best to just slip the container into the stream once the client has begun voiding. Other responses do not reflect correct technique.
Question 3
A client has been tentatively diagnosed with Graves' disease (hyperthyroidism). Which of these findings noted on the initial nursing assessment requires quick intervention by the nurse?

A
a report of 10 pounds weight loss in the last month
B
a comment by the client "I just can't sit still"
C
the appearance of eyeballs that appear to "pop" out of the client's eye socket
D
a report of the sudden onset of irritability in the past 2 weeks
Question 3 Explanation: 
Exophthalmos or protruding eyeballs is a distinctive characteristic of Graves' Disease. It can result in corneal abrasions with severe eye pain or damage when the eyelid is unable to blink down over the protruding eyeball. Eye drops or ointment may be needed.
Question 4
The nurse has performed the initial assessments of 4 clients admitted with an acute episode of asthma. Which assessment finding would cause the nurse to call the provider immediately?

A
prolonged inspiration with each breath
B
expiratory wheezes that are suddenly absent in 1 lobe
C
expectoration of large amounts of purulent mucous
D
appearance of the use of abdominal muscles for breathing
Question 4 Explanation: 
Acute asthma is characterized by expiratory wheezes caused by obstruction of the airways. Wheezes are high-pitched musical sounds produced by air moving through narrowed airways. Clients often associate wheezes with the feeling of tightness in the chest. However, sudden cessation of wheezing is an ominous or bad sign that indicates an emergency—the small airways are now collapsed.
Question 5
An 80 year-old client admitted with a diagnosis of possible cerebral vascular accident has had a blood pressure from 160/100 to 180/110 over the past 2 hours. The nurse has also noted increased lethargy. Which assessment finding should the nurse report immediately to the provider?

A
Slurred speech
B
Incontinence
C
Muscle weakness
D
Rapid pulse
Question 5 Explanation: 
Changes in speech patterns and level of consciousness can be indicators of continued intracranial bleeding or extension of the stroke. Further diagnostic testing may be indicated.
Question 6
A school-aged child has had a long leg (hip to ankle) synthetic cast applied 4 hours ago. Which statement from the parent indicates that teaching has been inadequate?

A
"I will keep the cast uncovered for the next day to prevent burning of the skin.”
B
"I can apply an ice pack over the area to relieve itching inside the cast.”
C
"The cast should be propped on at least 2 pillows when my child is lying down.”
D
"I think I remember that my child should not stand until after 72 hours."
Question 6 Explanation: 
Synthetic casts will typically set up in 30 minutes and dry in a few hours. Thus, the client may stand within the initial 24 hours. With plaster casts, the set up and drying time, especially in a long leg cast which is thicker than an arm cast, can take up to 72 hours. Both types of casts give off a lot of heat when drying and it is preferable to keep the cast uncovered for the first 24 hours. Clients may complain of a chill from the wet cast and therefore can simply be covered lightly with a sheet or blanket. Applying ice is a safe method of relieving the itching.
Question 7
The nurse is preparing a client with a deep vein thrombosis (DVT) for a Venous Doppler evaluation. Which of the following would be necessary for preparing the client for this test?

A
Client should be NPO after midnight
B
Client should receive a sedative medication prior to the test
C
Discontinue anti-coagulant therapy prior to the test
D
No special preparation is necessary
Question 7 Explanation: 
This is a non-invasive procedure and does not require preparation other than client education.
Question 8
A client is admitted with infective endocarditis (IE). Which finding would alert the nurse to a complication of this condition?

A
dyspnea
B
heart murmur
C
macular rash
D
hemorrhage
Question 8 Explanation: 
Large, soft, rapidly developing vegetations attach to the heart valves. They have a tendency to break off, causing emboli and leaving ulcerations on the valve leaflets. These emboli produce findings of cardiac murmur, fever, anorexia, malaise and neurologic sequelae of emboli. Furthermore, the vegetations may travel to various organs such as spleen, kidney, coronary artery, brain and lungs, and obstruct blood flow.
Question 9
The nurse explains an autograft to a client scheduled for excision of a skin tumor. The nurse knows the client understands the procedure when the client says, "I will receive tissue from _______."

A
a tissue bank
B
a pig
C
my thigh
D
synthetic skin
Question 9 Explanation: 
Autografts are done with tissue transplanted from the client's own skin.
Question 10
When teaching the old-old adult (over age 85) who has been diagnosed with a new illness, the nurse recognizes this age group:

A
needs client teaching at a slower pace, with visual aids and repetition
B
does not profit from patient teaching
C
learns at the same rate as young-old adults
D
is generally cognitively impaired and unable to learn new information
Question 10 Explanation: 
Due to neurovascular and sensory losses, older adults need adjustment in teaching methods, although they still have the ability to learn.
Question 11
A client has been admitted with a fractured femur and has been placed in skeletal traction. Which of the following nursing interventions should receive priority?

A
Maintaining proper body alignment
B
Frequent neurovascular assessments of the affected leg
C
Inspection of pin sites for evidence of drainage or inflammation
D
Applying an over-bed trapeze to assist the client with movement in bed
Question 11 Explanation: 
The most important activity for the nurse is to assess neurovascular status. Compartment syndrome is a serious complication of fractures. Prompt recognition of this neurovascular problem and early intervention may prevent permanent limb damage.
Question 12
The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. The client has many questions about this condition. What area is a priority for the nurse to discuss at this time?

A
Daily needs and concerns
B
The overview of cardiac rehabilitation
C
Medication and diet guideline
D
Activity and rest guidelines
Question 12 Explanation: 
At 2 days post-MI, the client’s education should be focused on the immediate needs and concerns for the day.
Question 13
A client has just lost his girlfriend in an automobile accident. When the nurse asks the client about what happened, the client responds with a firm,“I don’t want to talk about it.” An appropriate response by the nurse would be:

A
To sit quietly with the client.
B
“You need to talk about the accident.”
C
“Not sharing your loss can make you ill.”
D
“You’ll feel better if you talk about the accident.”
Question 13 Explanation: 
Sitting with the client conveys acceptance to the client and lets him know the nurse is available to him. The other options do not show respect for the client’s view.
Question 14
An elderly client signs a DNR (do not resuscitate) statement in a living will. Then, during lunch, the client chokes on food and loses consciousness. The nurse has a responsibility to:

A
perform the Heimlich maneuver.
B
call the doctor to get an order for resuscitation.
C
call a code and perform the Heimlich maneuver.
D
do nothing, since the client signed a DNR order.
Question 14 Explanation: 
DNR orders are intended for near-death situations. Since the choking event was accidental, the nurse has a responsibility to treat the client, attempt to remove the obstruction, and preserve life.
Question 15
The client’s ascites is severe and is causing difficulty breathing and shortness of breath. The nurse prepares the client for a paracentesis to remove excess fluid by instructing the client to:

A
lie on the right side.
B
lie on the left side.
C
empty the bladder.
D
drink nothing by mouth 12 hours prior to the procedure.
Question 15 Explanation: 
The client should void immediately prior to the procedure to avoid accidental bladder puncture. The client is usually positioned in a sitting position and does not have to be NPO.
Question 16
A patient with venous stasis ulcers complains of pain and swelling. The patient refuses to prop their legs up on an ottoman and asks what else she can do to help the ulcers heal. Which of the following suggestions could the nurse make?

A
“Why don’t you try getting a massage for your legs every now and then? It would do them good.”
B
“You should wear compression stockings.”
C
“There is no other option. You really have to elevate them, even if it’s uncomfortable at first.”
D
“A diuretic prescribed by the doctor can help your symptoms.”
Question 16 Explanation: 
This answer is correct and is the second available option to help heal venous stasis ulcers. Diuretics may help by relieving fluid, but the nurse does not have an order for it at this time.
Question 17
Which of the following prescriptions would the nurse expect to be ordered for a patient with atrial fibrillation?

A
Simvastatin
B
Warfarin
C
Aspirin
D
Vancomycin
Question 17 Explanation: 
Warfarin is a blood-thinner used to treat atrial fibrillation by reducing the risk of emboli and stroke.
Question 18
A patient has been diagnosed with essential hypertension. The nurse knows that this type of hypertension:

A
is unpreventable.
B
has only modifiable risk factors.
C
has no identifiable cause.
D
is secondary to a disease or condition.
Question 18 Explanation: 
Essential hypertension is difficult to pinpoint and the cause is usually unknown. Both essential and secondary hypertension have modifiable risk factors. Only secondary hypertension is caused by a disease or condition.
Question 19
A  64-year-old patient in the ICU goes into ventricular tachycardia. With a team of healthcare professionals, the nurse performs CPR. The nurse knows she is giving effective compressions if the patient's sternum is compressed:

A
⅓ of the chest.
B
⅛ of the chest.
C
1.5 inches.
D
2 inches.
Question 19 Explanation: 
Correct chest compression of an adult should be 2 inches in depth. 1.5 inches or ⅓ of the chest is correct for infants under 1 year of age.
Question 20
The nurse cares for a patient with depression who tells her about her two prize-winning cocker spaniels at home. “I’ll miss them,” the patient says. The nurse knows that her next action should be:

A
to inform the physician.
B
to ask why the patient will miss them.
C
to discharge the patient home to her dogs.
D
to call the patient’s husbands and find out more about the dogs.
Question 20 Explanation: 
The physician must be informed due to the risk of suicide. Suicidal behaviors often include vague statements such as “I may not be around” or “I’ll miss that.”
Question 21
A patient with schizophrenia complains that he sees clowns on the walls of his room and they keep him up at night. The nurse’s best response is:

A
“Do the clowns frighten you?”
B
“Don’t worry—I’ll get rid of them for you.”
C
“I don’t see anything, but that sounds scary to me.”
D
“There are no clowns. Take your medications now, please.”
Question 21 Explanation: 
The nurse should not acknowledge the hallucinations. Instead, the nurse can reassure the patient and bring them back to reality.
Question 22
A patient is returned to the unit after undergoing a liver biopsy. The patient has been positioned laterally on their left side. The nurse knows that:

A
this is the correct position after a liver biopsy.
B
this is an incorrect position after a liver biopsy.
C
there is special positioning required after a liver biopsy.
D
most doctors prefer patients to be supine after a liver biopsy.
Question 22 Explanation: 
The correct position after a liver biopsy is to lay the patient laterally on the right side to put pressure on the site and stop bleeding.
Question 23
The nurse is administering flu shots under the supervision of a charge nurse. The charge nurse asks what condition would be a contraindication to a flu shot, and the nurse correctly responds:

A
History of shingles.
B
History of Amyotrophic Lateral Sclerosis (ALS).
C
History of allergy to clams.
D
History of Guillan-Barre syndrome.
Question 23 Explanation: 
Guillan-Barre is a syndrome characterized by sudden lower leg weakness that progresses to paralysis and is often suspected to be triggered by viruses, such as those in a flu shot.
Question 24
The nurse would expect the medication Cogentin to be ordered for which of the following patients?

A
A patient with difficulty swallowing.
B
A patient who is also prescribed Haloperidol.
C
A patient who is also prescribed Risperdal.
D
A patient who is also prescribed Oxycodone.
Question 24 Explanation: 
Haloperidol is a longterm antipsychotic that often triggers EPS (extrapyramidal side effects) which can be treated with Cogentin.
Question 25
The nurse cares for a patient with Bell’s palsy and notes an eye patch on the night table of the patient’s bed. The nurse knows this eye patch should be worn:

A
during the day.
B
at night.
C
day and night.
D
never, because it weakens the eye muscle further.
Question 25 Explanation: 
The eye patch should be worn at night to protect the open eye on the paralyzed side of the face from corneal abrasion.
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More NCLEX Resources:

NCLEX-PN Exam

The NCLEX-PN exam is administered with computerized adaptive testing (CAT). With CAT, each test that is given is completely unique. There are a large pool of questions in the computer that are organized by category and difficulty level. After each answer the computer calculates an ability estimate of the test taker, and chooses the next question that will best measure this ability. The computer will continue to present new questions in this manner until a pass or fail decision is made.

Each practical/vocational nurse candidate will be requried to answer a minimum of 85 questions and a maximum of 205 questions. There is an alotted 5-hour test period, which includes the tutorial, the sample questions, and all breaks. Question formats will include regular multiple choice items, but may also include multiple response, fill-in-the-blank calculations, ordered response, and hot spots.

This is a very challenging exam, so you will need to be fully prepared and do plenty of NCLEX-PN review. Practice with as many NCLEX-PN questions as possible, and make sure you carefully read the explanation whenever you get a question wrong. Good luck with your exam! Becoming a licensed practical nurse is a great step forward in your career.