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NCLEX-PN practice questions

20 free NCLEX-PN practice questions for LPN/LVN candidates, written to PN scope across the 2026 NCLEX-PN test plan, each with the answer and a full rationale.

Tap an answer to check it, or open "Show the answer and rationale" under each question. Every client is fictional. For exam practice only, not medical advice.

In the app, pick NCLEX-PN under "Which exam?" and every practice set is weighted like the 2026 NCLEX-PN test plan.

Question 1 of 20

A practical nurse is reinforcing the RN's teaching with a client who had a total hip replacement through a posterior approach and has hip precautions prescribed. Which statement by the client indicates a need for more teaching?

  1. "I'll bend down to tie my shoes while I sit in a low chair."
  2. "I'll sleep on my unoperated side with a pillow between my knees."
  3. "I'll back up to the car seat, sit down, and then turn to bring my legs in."
  4. "I'll step up the stairs with my unoperated leg first."
Show the answer and rationale

Answer: A

After a posterior-approach hip replacement, the precautions keep the new joint from dislocating: no bending the hip past 90 degrees, no crossing the legs and no turning the operated leg inward. Bending forward to tie shoes from a low chair flexes the hip well past 90 degrees, so the client needs a reacher, a long-handled shoehorn or slip-on shoes instead. Turning on the car seat to bring the legs in sounds like twisting, but backing up, sitting first and moving the body as a unit keeps the hip from bending too far, so it is correct. Leading with the unoperated leg going up the stairs follows the rule of up with the good and down with the operated leg, and a pillow between the knees when lying on the unoperated side stops the leg from crossing the midline, so those statements show the teaching was understood. The precautions last as long as the surgeon prescribes them.

๐Ÿ“š Learn it: Positions That Protect: Hips, Spines, Lungs and Enemas

Question 2 of 20

While helping an assistive personnel (AP) turn an older client who spends most of the day in bed, a practical nurse sees a reddened area over the sacrum that does not blanch when pressed. The skin is intact. What should the nurse do?

  1. Keep the client off the area and report the finding to the RN
  2. Report it to the RN, then lay the client supine with the head raised
  3. Massage the reddened area to bring blood flow back to it
  4. Apply a foam dressing to the area and recheck it at the next turn
Show the answer and rationale

Answer: A

Intact skin with redness that does not blanch is a stage 1 pressure injury. The nurse keeps pressure off it with a turning schedule and positioning devices and reports it to the RN, who completes the skin assessment and updates the plan of care. A foam dressing can protect the skin from friction and shear, but it does not relieve pressure, and waiting for the next turn leaves the RN unaware. Reporting is right, but lying on the back with the head raised puts shear and pressure right on the sacrum. Massaging a reddened bony area damages the tissue further.

๐Ÿ“š Learn it: Pressure Injuries: Stage It, Turn Them, Feed Them

Question 3 of 20

A practical nurse is supervising an assistive personnel (AP) caring for a client with an indwelling urinary catheter. Which action by the AP requires the nurse to intervene?

  1. Washing the catheter with soap and water, not an antiseptic
  2. Coiling extra tubing on the bed to avoid a low loop
  3. Resting the drainage bag on the floor beside the bed
  4. Hanging the bag on the bed frame, not the side rail
Show the answer and rationale

Answer: C

A drainage bag on the floor picks up organisms that can travel up the catheter, so it is hung on the bed frame, below the bladder but off the floor, to prevent a catheter-associated urinary tract infection. Washing with plain soap and water sounds less thorough than an antiseptic, but routine hygiene, cleaning from the meatus outward, is what current guidelines advise, and antiseptics add no protection. Coiling extra tubing on the bed keeps a loop from trapping urine, and the bed frame is used because a side rail moves and can lift the bag above the bladder.

๐Ÿ“š Learn it: Catheters, Ostomies and the Stoma Color Chart

Question 4 of 20

A practical nurse on a medical-surgical unit receives an assignment from the charge nurse. Which client assignment should the practical nurse question?

  1. A client with type 2 diabetes and a glucose of 210 mg/dL who needs sliding-scale insulin
  2. A client with a new colostomy whose RN-started pouch teaching needs reinforcing
  3. A client admitted 30 minutes ago with chest pain who needs an admission assessment
  4. A client with heart failure who needs a daily weight, a lung sound check and oral furosemide
Show the answer and rationale

Answer: C

A new admission with chest pain is unstable and unpredictable, and the admission assessment that establishes the client's baseline and plan of care is an RN responsibility, so the practical nurse should question this assignment. The heart failure client sounds like an assessment task, but weighing the client, listening to lung sounds and giving oral furosemide are focused data collection and routine care for a chronic, predictable condition, which is within PN scope. Reinforcing teaching the RN has started is a PN role, and checking glucose and giving sliding-scale subcutaneous insulin for an expected high reading in type 2 diabetes is routine PN care.

๐Ÿ“š Learn it: Delegation Cheat Code: Never Delegate What You EAT

Question 5 of 20

A practical nurse at a community health screening is measuring the blood pressure of an adult client who has just climbed a flight of stairs. Which action by the nurse helps ensure an accurate reading?

  1. Support the client's arm on a chair armrest positioned slightly below heart level
  2. Have the client rest quietly for 2 minutes in the chair before inflating the cuff
  3. Select a cuff whose bladder encircles about 60% of the client's upper arm
  4. Seat the client with back and arm supported, feet flat on the floor
Show the answer and rationale

Answer: D

An accurate reading needs about 5 minutes of quiet rest after exertion, with the client seated, back supported, legs uncrossed, feet flat on the floor and the arm supported at heart level, using a cuff on the bare arm whose bladder encircles about 80% of the arm. The runner-up is resting quietly for 2 minutes first: resting after climbing stairs is the right idea, but 2 minutes is too short and the reading can still be falsely high. A bladder encircling only about 60% of the arm is too small and also reads falsely high, and an arm supported below heart level raises the measured pressure as well.

๐Ÿ“š Learn it: Who Gets Screened for What, and When

Question 6 of 20 ยท Select all that apply

A practical nurse is supervising an assistive personnel (AP) who is moving a client with left-sided weakness after a stroke from the bed to a wheelchair. Which actions by the AP are appropriate? Select all that apply.

  1. Lifts the client by pulling up under both arms
  2. Leaves the footrests down so the client can step onto them
  3. Fastens a gait belt snugly around the client's waist
  4. Places the wheelchair on the client's right side, angled toward the bed
  5. Locks the brakes on the bed and the wheelchair before the move
  6. Has the client pivot on the left foot to turn toward the chair
Show the answer and rationale

Answer: C, D, E

The wheelchair goes on the client's strong right side, so the client can stand and pivot on the right leg and reach for the armrest with the right hand. Locked brakes on both the bed and the chair keep either one from rolling away, and a gait belt gives the AP a safe handhold. Pulling under the arms can injure the weak shoulder, which easily partly dislocates after a stroke. Pivoting on the weak left leg risks a fall, and footrests left down are a trip hazard and can tip the chair, so they are swung out of the way until the client is seated.

๐Ÿ“š Learn it: Positions That Protect: Hips, Spines, Lungs and Enemas

Question 7 of 20

A practical nurse in a prenatal clinic collects data on four clients. Which client's finding should the nurse report to the RN right away?

  1. A client at 30 weeks with 1+ ankle swelling by evening, BP 118/76 mm Hg, and no headache
  2. A client at 32 weeks with BP 152/98 mm Hg and a headache acetaminophen did not relieve
  3. A client at 28 weeks with heartburn after large meals, BP 110/70 mm Hg, and urine negative for protein
  4. A client at 34 weeks whose fundal height measures 34 cm
Show the answer and rationale

Answer: B

A blood pressure of 140/90 mm Hg or higher after 20 weeks with a headache that does not go away with acetaminophen suggests preeclampsia with a severe feature, which can progress to eclamptic seizures, stroke or placental abruption, so it is reported at once. The runner-up is the client at 30 weeks with ankle swelling: swelling can accompany preeclampsia, but hers is mild, clears overnight, and comes with a normal blood pressure and no headache, which fits expected dependent edema. Heartburn after large meals with a normal blood pressure and no protein in the urine is a common discomfort of pregnancy, and a fundal height in centimeters matching the weeks of gestation between 20 and 36 weeks shows normal fetal growth.

๐Ÿ“š Learn it: Prenatal Basics: Due Dates, Visits and Danger Signs

Question 8 of 20

A practical nurse is collecting data on a 79-year-old client at a follow-up clinic visit. Which finding should the nurse report to the RN?

  1. Needs more light to read than before
  2. New confusion about where she is
  3. Slower to recall names, then remembers
  4. Slow skin recoil on the back of the hand
Show the answer and rationale

Answer: B

New confusion about place, especially when it comes on over hours to days, is delirium until proven otherwise and often signals an infection, a medication effect, dehydration or another acute illness, so it is never written off as normal aging and is reported promptly. Slow skin recoil can look like dehydration, but skin loses elasticity with age, so turgor on the back of the hand is unreliable in older adults and is better checked over the sternum. Needing more light to read (smaller pupils and a thicker lens) and slower recall of names that come back later are normal changes of aging that do not interfere with daily life.

๐Ÿ“š Learn it: Normal Aging Versus the Thing You Must Not Call Normal

Question 9 of 20

A client is 14 hours into a 24-hour urine collection for creatinine clearance. The assistive personnel (AP) tells the practical nurse that the client voided into the toilet and flushed it before the AP could save the urine. What should the practical nurse do?

  1. Write the missed void on the lab slip, keep collecting, and tell the RN at handoff
  2. Extend the 24-hour collection by 1 hour to replace the lost void, and chart the new end time
  3. Keep collecting, and have the client void into a urine hat so no more urine is lost
  4. Discard the urine collected so far and restart the 24 hours, and report it to the RN
Show the answer and rationale

Answer: D

A 24-hour test measures everything the kidneys put out over exactly 24 hours, so once a void is lost the result is no longer accurate and the collection has to start over. The nurse follows the lab's policy, which usually means discarding what has been saved and starting a new 24-hour period (the client empties the bladder, that urine is discarded, and the start time is written down), and tells the RN, who may need to let the provider and lab know about the delay. Noting the missed void and telling the RN at handoff sounds responsible, but the lab still gets a sample that does not reflect 24 hours of kidney function, and the RN hears about it hours late. An extra hour does not replace the urine that was lost, and a urine hat helps prevent a repeat but does not fix the collection already in progress.

๐Ÿ“š Learn it: Urinalysis, Specific Gravity and Collecting It Right

Question 10 of 20

Before discharge, a practical nurse reinforces umbilical cord care with the parents of a 2-day-old newborn. Which statement by a parent indicates a need for more teaching?

  1. 'I won't put alcohol on it; I'll just keep the cord clean and dry.'
  2. 'Once it's hanging by a thread, I can gently pull it off.'
  3. 'A few drops of blood when the stump comes off can be normal.'
  4. 'I'll give her sponge baths until the cord falls off.'
Show the answer and rationale

Answer: B

The cord stump is left to dry and separate on its own, usually within 1 to 3 weeks; pulling it off, even when it looks almost detached, can cause bleeding and open a route for infection, so the nurse reinforces the teaching and tells the RN. Skipping alcohol sounds like skipping a step, but dry cord care, keeping the stump clean and dry, is the current recommendation. A few drops of blood when the stump separates can be normal, while continued bleeding, spreading redness, foul-smelling drainage or fever can signal omphalitis and are reported. Sponge baths until the stump falls off help keep it dry.

๐Ÿ“š Learn it: The First Hour: APGAR, Warmth, Vitamin K and Sugar

Practice 10 more NCLEX-PN questions free โ†’

A timed or tutor-mode set in the app, scored by area, with every miss saved for review. Free, no sign-up needed.

Question 11 of 20

A practical nurse makes a home visit to a client in hospice care with end-stage heart failure. The client sleeps most of the day and takes only a few sips of fluid. Her son says, 'She's starving. Shouldn't we get her an IV or a feeding tube?' Which response by the nurse is best?

  1. 'Wake her every 2 hours for a few sips of water so that she does not get dehydrated.'
  2. 'Those decisions belong to the hospice team, so please bring it up at the next care meeting.'
  3. 'She may feel less thirsty with an IV. I'll ask the hospice RN to get an order for one today.'
  4. 'Eating less is a normal part of dying. Let me show you mouth care, and I'll tell the hospice RN you have questions.'
Show the answer and rationale

Answer: D

Near the end of life, appetite and thirst fade as the body slows down, and the client usually does not feel the hunger the family fears; mouth care and small sips if she wants them relieve dryness, and the RN and hospice team need to know about the son's question so they can talk through the goals of care with the family. Pointing the son to the hospice team is within the practical nurse's role, but making him wait for a care meeting leaves his worry and the comfort teaching unaddressed; such decisions are made case by case with the client, family and hospice team. Feeding tubes and IV fluids do not make dying clients more comfortable and can worsen edema, breathlessness and secretions in heart failure, and promising one is not the practical nurse's decision. Waking a drowsy client to drink risks aspiration.

๐Ÿ“š Learn it: Living Wills, Proxies and the DNR That Is Not 'Do Not Treat'

Question 12 of 20

A resident in a long-term care facility who has full decision-making capacity is prescribed mildly thick liquids after a swallow study showed a risk of aspiration. She tells the practical nurse, "I hate thickened drinks. I want my regular coffee, and I understand I could get pneumonia." What should the nurse do?

  1. Offer the thickened coffee in a covered cup so the texture is less noticeable
  2. Follow the diet order for this shift and note her refusal in the flow sheet
  3. Report her wishes to the RN and provider so her choice can be addressed
  4. Give her regular coffee and document that she accepted the risk
Show the answer and rationale

Answer: C

A resident with capacity may refuse a modified diet, and the practical nurse advocates by reporting her wishes to the RN and provider so the team can discuss risks, document her informed decision, and adjust the plan. The runner-up is simply giving regular coffee and documenting that she accepted the risk; it respects her wish, but a practical nurse cannot change a prescribed diet order alone. Following the order and only charting the refusal leaves her choice unaddressed, and disguising thickened coffee in a covered cup works around her decision instead of honoring it.

๐Ÿ“š Learn it: Six Ethical Principles the Exam Names by Name

Question 13 of 20

A practical nurse who recently moved to a new state starts work on a medical unit. The charge nurse asks her to give a client furosemide 40 mg by IV push. In the state where she trained, practical nurses did not give IV push medications. What should the nurse do?

  1. Decline, telling the charge nurse that her former state did not allow it
  2. Confirm that the state practice act and facility policy allow it first
  3. Give it with the charge nurse present to supervise this first dose
  4. Check the client's blood pressure and potassium level, then give it
Show the answer and rationale

Answer: B

Whether an LPN/LVN may give IV push medications depends on the state's nurse practice act and facility policy: some states allow it after IV therapy training, some limit it to certain drugs or settings, and others do not allow it, and a facility can be stricter than the law. The rules of the state where the client is located apply, so declining because her former state did not allow it sounds safe but applies the wrong law; she checks first and, if it is not allowed or she has not been validated as competent, tells the charge nurse right away so an RN can give the dose on time. Checking blood pressure and potassium is good practice before furosemide but skips the scope question, and every nurse is accountable for her own practice, so having the charge nurse watch does not make an out-of-scope task legal or document her competence.

๐Ÿ“š Learn it: Negligence, Malpractice, Assault, Battery, False Imprisonment

Question 14 of 20 ยท Select all that apply

A practical nurse is caring for a resident in a long-term care facility who is blind from glaucoma. Which actions by the nurse are appropriate? Select all that apply.

  1. Speak more loudly than usual so the resident can follow along
  2. Describe the meal tray by clock positions, such as 'your coffee is at 2 o'clock'
  3. Put the chair and personal items back in the same places after cleaning
  4. Walk behind the resident and steer by holding both shoulders
  5. Say who you are when entering the room, before touching the resident
  6. Leave quietly without speaking so the resident is not disturbed
Show the answer and rationale

Answer: B, C, E

Announcing yourself before touching prevents startling the resident, describing food by clock positions lets the resident eat independently, and keeping furniture and belongings in the same places lets the resident move about safely and find things without help. Blindness does not affect hearing, so a louder voice is unnecessary and can feel patronizing. When walking, the nurse offers an elbow and walks half a step ahead so the resident can feel turns and stops, rather than pushing from behind, and the nurse says when leaving the room so the resident is not left talking to an empty room.

๐Ÿ“š Learn it: Normal Aging Versus the Thing You Must Not Call Normal

Question 15 of 20

A practical nurse is caring for a client 1 day after a bowel resection. Since the last check 2 hours ago, the client's heart rate has risen from 84 to 112 beats/min and the client has become restless. Which action by the nurse is most appropriate?

  1. Report the heart rate to the RN now and recheck vital signs in 30 minutes
  2. Check the blood pressure, oxygen saturation and dressing, then report to the RN
  3. Give the as-needed lorazepam prescribed for anxiety and reassess the client later
  4. Ask about pain, give the prescribed as-needed analgesic, and recheck the pulse
Show the answer and rationale

Answer: B

A rising heart rate and new restlessness after abdominal surgery can be early signs of bleeding, infection or low oxygen, so the practical nurse quickly collects the data that complete the picture (blood pressure, oxygen saturation, the dressing) and reports it to the RN using SBAR. Reporting the heart rate alone is the strongest distractor, because prompt reporting is right, but it gives the RN an incomplete picture, and waiting 30 minutes to recheck lets a deteriorating client get worse. Giving an analgesic assumes pain is the cause, and treating restlessness as anxiety with a sedative can hide hypoxia or shock.

๐Ÿ“š Learn it: SBAR, Handoffs and When to Climb the Chain of Command

Question 16 of 20

During a home health visit, a practical nurse notices bruises of different colors on both upper arms of an 84-year-old client with mild dementia. The client becomes quiet whenever her son, who is her caregiver, enters the room, and the son says, "She bruises easily." Which action by the nurse is most appropriate?

  1. Teach the son fall prevention, since older skin bruises easily
  2. Suggest respite care to ease the son's stress, and recheck next visit
  3. Describe the bruises objectively and report the concern promptly
  4. Ask the client alone if her son hurts her before reporting it
Show the answer and rationale

Answer: C

Bruises in different stages of healing on both upper arms, where a person is grabbed, and a client who withdraws around her caregiver are possible signs of elder abuse. A nurse needs reasonable suspicion, not proof, to report, so the practical nurse documents exactly what she sees and hears (location, size and color of each bruise, and both people's words in quotes) and notifies the agency RN or supervisor right away, calling 911 if the client is in immediate danger. Every state has an adult protective services (APS) system, and most make nurses mandated reporters; where she is one, telling the supervisor does not replace her own duty to report to APS, so she follows both state law and agency policy. Speaking with the client alone is reasonable, but waiting for a frightened client with dementia to confirm abuse before reporting delays protection. Fall teaching accepts an explanation that does not fit grab-pattern bruises, and respite care with a recheck next visit eases caregiver strain while leaving her unprotected.

๐Ÿ“š Learn it: Incident Reports, Root Causes and Who to Refer To

Question 17 of 20

A practical nurse is to give a client insulin lispro 6 units subcutaneously before lunch. The client's fingerstick glucose is 168 mg/dL. When should the nurse give the insulin?

  1. About 30 minutes before the lunch trays are expected
  2. One to two hours after lunch, when the glucose has peaked
  3. As soon as the fingerstick glucose result is available
  4. When the tray has arrived and the client is ready to eat
Show the answer and rationale

Answer: D

Insulin lispro starts working in about 15 minutes, so it is given within 15 minutes before the meal, or right after it, which in practice means once the tray is in front of the client and the client is ready to eat. Giving it 30 minutes ahead sounds careful, but that timing fits regular insulin, and with lispro it risks hypoglycemia before food arrives, especially if the trays are late. The fingerstick is often done well before the meal, so dosing as soon as the result is known has the same problem, and waiting 1 to 2 hours after lunch means the insulin acts well after the meal's glucose rise. A glucose of 168 mg/dL before a meal is not a reason to hold mealtime insulin.

๐Ÿ“š Learn it: Insulin Peaks: When the Client Will Crash

Question 18 of 20

A practical nurse is reinforcing the RN's teaching with a client who will take warfarin at home. Which statement by the client indicates a need for more teaching?

  1. "I'll keep having my usual salad a few times a week."
  2. "I'll stop eating spinach and broccoli completely."
  3. "If I miss a dose, I won't take two the next day."
  4. "I'll ask my provider before any vitamin or herb."
Show the answer and rationale

Answer: B

Vitamin K in green vegetables counteracts warfarin, but the goal is a steady, consistent intake, not avoiding them: the dose is set around the client's usual diet, and suddenly cutting them out (or adding a lot) makes the INR swing. Keeping a usual salad a few times a week sounds like the mistake, but it is the consistent intake the client is taught. A missed dose is not made up by taking two the next day, which raises the bleeding risk, and many vitamins and herbal products can change the INR, so the client asks first.

๐Ÿ“š Learn it: Heparin, Warfarin and the Labs That Rule Them

Question 19 of 20

A client with stable angina has a prescription for nitroglycerin 0.4 mg sublingually every 5 minutes as needed for chest pain, up to 3 doses. The client reports chest pain and asks for a tablet. Which finding should cause the practical nurse to hold the nitroglycerin and report to the RN right away?

  1. The client took tadalafil for erectile dysfunction 4 days ago
  2. The client's blood pressure is 96/62 mm Hg
  3. The client had a headache rated 6/10 after the last nitroglycerin dose
  4. The client took sildenafil for erectile dysfunction 10 hours ago
Show the answer and rationale

Answer: D

Nitrates combined with sildenafil or vardenafil within 24 hours, or tadalafil within 48 hours, can cause a sudden severe fall in blood pressure, so sildenafil 10 hours ago means hold the dose and report to the RN at once while the chest pain still gets urgent attention. The runner-up is tadalafil 4 days ago: it is the same drug family, but 4 days is beyond the 48-hour window, so it does not block the dose. A blood pressure of 96/62 mm Hg is low-normal yet above the usual hold level of a systolic under 90, and a headache after a dose is an expected effect of nitroglycerin.

๐Ÿ“š Learn it: Digoxin, Beta Blockers and Nitro: Hold Parameters and Hard Stops

Question 20 of 20

A practical nurse who recently moved to a new state and started work at a long-term care facility is asked by the RN to hang an IV piggyback antibiotic through a client's existing peripheral IV. What should the practical nurse do first?

  1. Check that the state's practice act and facility policy allow it
  2. Hang it, since she gave IV piggybacks at her last job in another state
  3. Ask the RN to hang it, since IV medications are an RN responsibility
  4. Hang it with the RN present to supervise the first dose
Show the answer and rationale

Answer: A

Whether a practical nurse may hang an IV piggyback depends on the state's nurse practice act and facility policy, and often on completing an IV therapy course or competency check, so there is no single national answer. In a new state the nurse first confirms that the task is allowed and that she has the training it requires; if it is, she gives it, and if not, she tells the RN so the RN can give it. Handing the task to the RN sounds like the safe choice, but it assumes a rule that may not apply here, so she checks before deciding. Experience in another state does not carry over because each state sets its own scope, and an RN standing by does not extend a practical nurse's legal scope.

๐Ÿ“š Learn it: IV Fluids, Potassium Rules and the First 15 Minutes of a Transfusion

Practice 10 more NCLEX-PN questions free โ†’

A timed or tutor-mode set in the app, scored by area, with every miss saved for review. Free, no sign-up needed.

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