NCLEX PN Exam Questions & Answers 2026 (11–20)

Question 1

The LPN/LVN suspects a colleague is diverting controlled substances. What is the MOST appropriate initial action?

TheoryPractice · Accepted Answer

Report the suspicion to the charge nurse or nurse manager following facility policy.. Nurses have a legal and ethical obligation to report suspected diversion through the proper chain of command; the nurse manager or charge nurse is the appropriate first contact per standard facility policy and professional codes of conduct.

Question 2

An LPN/LVN is caring for four clients. Which situation requires the LPN/LVN to contact the RN FIRST, applying both ABCs and scope-of-practice principles?

TheoryPractice · Accepted Answer

A client with a chest tube who suddenly develops absent breath sounds on the affected side and increasing respiratory distress.. Absent breath sounds with a chest tube and worsening respiratory distress indicate a potential tension pneumothorax — an airway and breathing emergency that requires immediate RN notification and physician intervention beyond LPN/LVN independent action.

Question 3

A client with decision-making capacity refuses a blood transfusion that the care team believes is life-saving. The LPN/LVN should:

TheoryPractice · Accepted Answer

Document the refusal, notify the RN and physician, and ensure the client received information about consequences.. A competent client's right to refuse treatment is a fundamental legal and ethical principle; the nurse's responsibility is to document the informed refusal, ensure the client understands the consequences, and notify the responsible provider — not to override the decision.

Question 4

The LPN/LVN is reviewing priorities for a group of clients. Which combination of principles BEST justifies why a newly admitted client with an acute exacerbation of asthma is prioritized over a client with a newly diagnosed stage II pressure injury?

TheoryPractice · Accepted Answer

Acute respiratory compromise threatens immediate oxygenation (ABCs), while a stage II pressure injury, though urgent, does not present an immediate airway or breathing threat.. ABCs prioritization places airway and breathing above integumentary concerns; an acute asthma exacerbation represents an immediate threat to oxygenation, whereas a stage II pressure injury, while requiring timely care, does not pose an immediate life-threatening risk.

Question 5

A client is admitted with a diagnosis of active pulmonary tuberculosis (TB). Which type of transmission-based precaution should the LPN implement?

TheoryPractice · Accepted Answer

Airborne precautions with a negative-pressure room and N95 respirator. Pulmonary TB is transmitted via airborne particles (droplet nuclei smaller than 5 microns), requiring airborne precautions that include placement in an airborne infection isolation (negative-pressure) room and use of an N95 or higher-level respirator by caregivers.

Question 6

When should the LPN perform hand hygiene using alcohol-based hand rub instead of soap and water?

TheoryPractice · Accepted Answer

Before performing a sterile dressing change on a surgical wound. Alcohol-based hand rub is appropriate when hands are not visibly soiled; however, soap and water must be used when hands are visibly contaminated, after contact with C. diff spores, and after contact with norovirus, because alcohol does not reliably destroy bacterial spores or non-enveloped viruses.

Question 7

A client recovering from abdominal surgery needs a wound dressing change. Which action by the LPN best demonstrates correct clean technique?

TheoryPractice · Accepted Answer

Washing hands before the procedure and using clean gloves to remove the old dressing. Clean (medical aseptic) technique requires hand hygiene and clean gloves for removing soiled dressings; sterile technique is reserved for the application of new dressings onto open wounds, but the removal step uses clean technique.

Question 8

The LPN is preparing a sterile field for urinary catheter insertion. Which action would contaminate the sterile field?

TheoryPractice · Accepted Answer

Reaching across the sterile field to arrange supplies on the far side. Reaching across a sterile field allows non-sterile clothing or skin to pass over sterile items, which contaminates the field; the LPN must always work within the sterile zone without crossing over it.

Question 9

A fire breaks out in a client's room from an overheated electric blanket. Using the RACE acronym, what is the LPN's FIRST action?

TheoryPractice · Accepted Answer

Rescue any clients in immediate danger. The RACE mnemonic stands for Rescue, Alarm, Confine, Extinguish; rescuing clients in immediate danger is the priority because human life takes precedence over all other actions.

Question 10

A client on a medical-surgical unit is confused and attempts to climb out of bed repeatedly. The nurse has tried multiple non-restraint alternatives without success. Before applying a physical restraint, the LPN must obtain which of the following?

TheoryPractice · Accepted Answer

A written order from the licensed provider that includes the clinical justification. Regulatory standards (TJC and CMS) require a licensed provider's written order specifying the clinical indication before a physical restraint is applied; the charge nurse's approval and family consent are not substitutes for a provider order.

NCLEX PN Exam Questions & Answers 2026 (11–20)

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