NCLEX-PN Practice Test: 40 Free Questions With Answers

The NCLEX-PN is the licensing exam for practical and vocational nurses (LPN/LVN). It is computer adaptive: each answer sets how hard the next question is, and the exam stops once it is clear whether you passed.

Every candidate answers at least 85 questions. The most anyone answers is 150, within a five-hour limit. If time runs out after the minimum, the exam is scored on every question you completed; stopping before the minimum is a fail.

The test plan groups questions by client needs. The table shows each area and its share of the exam, from the NCSBN 2026 PN Test Plan.

Answer 10 questions at a time. After each pick you see whether you were right and why. At the end you get your score.

Every question here is original, written to the test plan areas above. None is copied from the real exam or a test bank.

Coordinated Care is the biggest area, so start your review there if your score is low: delegation, priorities, client rights and safety.

1. Day 1: take this test once and write down the areas you missed most.
2. Days 2 to 4: study your two weakest areas, then take another 10 questions in each.
3. Day 5: medications. Review drug classes, safe dosing and what to watch for after a dose.
4. Day 6: a full-length timed practice exam, at the pace of the real one.
5. Day 7: rest, and review only the questions you missed.

Your state board of nursing issues your license. Then the job search starts: see LPN jobs near you, the LPN resume guide and the LPN interview questions.

1. A resident with advanced dementia cannot describe pain. Which tool should the LPN use to rate the resident's pain?
   Answer: PAINAD scale. The PAINAD scale scores breathing, sounds such as moaning, facial expression, body language, and how easily the person can be comforted. It is made for people with advanced dementia who cannot report pain.
2. The LPN is going into a room that needs a gown, mask, goggles, and gloves. Which item should the LPN put on first?
   Answer: Gown. The CDC order for putting on PPE is gown, then mask or respirator, then goggles or face shield, then gloves.
3. On the first day after a vaginal birth, the LPN finds the client's uterus soft and boggy at 2 cm above the navel. What should the LPN do first?
   Answer: Gently massage the fundus until it feels firm. A boggy uterus can lead to heavy bleeding. Fundal massage helps the uterus contract and firm up, and the finding is then reported.
4. An LPN in a long-term care facility is working with a certified nursing assistant (CNA). Which task is appropriate for the LPN to assign to the CNA?
   Answer: Help a resident with a stable condition walk to the dining room. Walking with a stable resident is a routine task within the CNA role. Teaching, admission data collection, and giving medications require a licensed nurse.
5. An adult is unresponsive, is not breathing normally, and has no pulse. The LPN starts chest compressions. Which rate and depth are correct?
   Answer: 100 to 120 per minute, at least 2 inches deep. Adult compressions should be 100 to 120 per minute and at least 2 inches (5 cm) deep, but not more than 2.4 inches.
6. A pregnant client asks if she can get the measles, mumps, and rubella (MMR) vaccine today. What is the LPN's best response?
   Answer: MMR is a live vaccine, so it is not given during pregnancy. MMR contains live, weakened virus. The CDC advises against giving it during pregnancy. Clients who need it get it after the birth.
7. A client needs a 24-hour urine collection starting at 7:00 a.m. What should the LPN do with the first urine the client passes at 7:00 a.m.?
   Answer: Throw it away and start timing the collection. The first void empties urine made before the test began, so it is discarded. All urine after that, through 7:00 a.m. the next day, is saved.
8. The LPN reinforces teaching on an incentive spirometer after surgery. Which client statement shows correct understanding?
   Answer: "I will breathe in slowly and deeply about 10 times each hour I am awake.". Slow, deep breaths through the spirometer, about 10 times an hour while awake, open the small airways and help prevent lung problems after surgery.
9. Before giving medication, which action correctly identifies the client?
   Answer: Ask the client to state full name and birth date, then compare with the ID band. Two client identifiers, such as name and birth date, must be checked against the ID band. Room numbers are never an identifier, and yes or no questions can get a wrong answer.
10. A client who drinks alcohol daily was admitted 2 days ago. The client now has shaky hands, heavy sweating, a heart rate of 118, and says there are bugs on the wall. The LPN should recognize these as signs of what?
    Answer: Alcohol withdrawal. Tremors, sweating, a fast heart rate, and hallucinations 1 to 3 days after the last drink are signs of alcohol withdrawal. They must be reported right away because withdrawal can become life threatening.
11. A client has weakness in the left leg and will use a cane. Which instruction should the LPN reinforce?
    Answer: Hold the cane in your right hand and move it with your left leg. The cane is held on the strong side, opposite the weak leg. It moves forward with the weak leg to share the weight.
12. A client with depression tells the LPN, "My family would be better off without me." What should the LPN say?
    Answer: "Are you thinking about killing yourself?". Asking directly about suicide is the right step. It does not plant the idea, and it tells the team how much danger the client is in.
13. A client's Braden score is 12. Which action should the LPN include in care?
    Answer: Turn the client at least every 2 hours and use a pressure-relief surface. A low Braden score means high risk for pressure injury. Regular turning and pressure-relief surfaces lower that risk. Massaging bony areas and donut cushions can harm tissue.
14. The LPN sees smoke coming from a client's room. What should the LPN do first?
    Answer: Move the client away from the danger. The RACE steps are Rescue, Alarm, Confine, and Extinguish. Removing the client from immediate danger comes first.
15. A client is pacing in the hall and yelling that no one is listening. What should the LPN do first?
    Answer: Speak calmly in a low voice and stay a safe distance away. A calm voice and a safe distance help lower tension and protect everyone. Touch or threats can make an agitated client more upset.
16. The LPN uses a blood pressure cuff that is too small for the client's arm. How will this affect the reading?
    Answer: The reading will likely be falsely high. A cuff that is too small needs more pressure to close the artery, so the reading comes out falsely high.
17. A client receiving a continuous tube feeding asks to lie flat to sleep. What should the LPN do?
    Answer: Keep the head of the bed up at least 30 degrees and explain why. Raising the head of the bed at least 30 degrees during feeding lowers the risk of aspiration. The LPN should not stop a feeding without an order.
18. A client received a sedative before surgery 20 minutes ago. The LPN then sees that the surgical consent form was never signed. What should the LPN do?
    Answer: Tell the RN and the surgeon that consent was not signed before sedation. Consent must be given while the client can think clearly. A sedated client cannot give valid consent, so the surgeon and RN must be told before surgery goes forward.
19. A caller says she is a neighbor of a client on the unit and asks how the client is doing after surgery. What should the LPN say?
    Answer: I am not able to share any information about clients. Privacy law protects health information. The LPN cannot confirm details or even share general updates with someone the client has not approved.
20. A client taking warfarin asks about diet. Which instruction should the LPN reinforce?
    Answer: Keep the amount of leafy green vegetables about the same each day. Vitamin K in green vegetables affects how warfarin works. A steady intake keeps the INR more stable. Aspirin raises bleeding risk.
21. The LPN checks a client's new colostomy. Which finding should be reported right away?
    Answer: The stoma is dark purple and dusky. A dark purple, black, or pale stoma may mean poor blood flow and must be reported. A healthy stoma is red and moist, and slight bleeding and swelling are expected early on.
22. A client with diabetes has a blood glucose of 58 mg/dL. The client is awake and can swallow. What should the LPN do?
    Answer: Give 15 grams of fast sugar, like 4 ounces of juice, and recheck in 15 minutes. Blood glucose under 70 mg/dL is low. Treat with 15 grams of fast-acting carbohydrate and recheck in 15 minutes, repeating if still low.
23. The order is digoxin 0.25 mg by mouth once daily. Each tablet contains 0.125 mg. How many tablets should the LPN give?
    Answer: 2 tablets. 0.25 mg divided by 0.125 mg per tablet equals 2 tablets.
24. A client recovering from a stroke says, "I don't think I'll ever be able to go home." Which response by the LPN is most therapeutic?
    Answer: "You are worried that you may not be able to go home.". Reflecting the client's feeling invites the client to keep talking. False comfort, "why" questions, and changing the subject block communication.
25. Before giving digoxin, the LPN counts an apical pulse of 52 beats per minute in an adult client. What should the LPN do?
    Answer: Hold the dose and report the heart rate. Digoxin slows the heart. An adult apical pulse under 60 is a reason to hold the dose and notify the RN or provider.
26. While eating lunch, a client suddenly has a drooping face on one side and slurred speech. What should the LPN do first?
    Answer: Call for the RN or rapid response team and note when it started. These are signs of a stroke. Fast treatment depends on getting help right away and knowing the time symptoms began. Giving food or fluids could cause choking.
27. A client asks the LPN, "What is a health care power of attorney?" Which answer is correct?
    Answer: It names a person you choose to make health decisions if you cannot. A health care power of attorney is an advance directive. It names someone to make health care decisions when the client can no longer speak for themselves.
28. The LPN is doing neuro checks on a client with a head injury. Which finding is often the earliest sign that the client is getting worse?
    Answer: New restlessness or confusion. A change in level of consciousness, such as new restlessness or confusion, is often the first sign of worsening brain function. It must be reported at once.
29. During a shift, the LPN notices that a coworker has slurred speech and smells of alcohol. What should the LPN do?
    Answer: Report the concern to the charge nurse or supervisor right away. A nurse who may be impaired puts clients at risk. The LPN must report the concern at once so a supervisor can act and keep clients safe.
30. A 15-year-old in the hospital wants to wear her own clothes and spends hours texting friends. According to Erikson, which stage is she in?
    Answer: Identity versus role confusion. Teens are in the identity versus role confusion stage. Peer contact and personal style help them form their sense of self.
31. A provider has ordered wrist restraints for a client. Where should the LPN secure the restraint straps?
    Answer: To the bed frame part that moves with the bed, using a quick-release knot. Tying to the movable bed frame with a quick-release knot keeps the strap from tightening when the bed moves and allows fast release. Side rails can injure the client when lowered.
32. An LPN takes a telephone order from a health care provider for a new medication. After writing the order down, what should the LPN do next?
    Answer: Read the whole order back and have the provider confirm it. Reading the order back closes the communication loop. The provider confirms the drug, dose, route, and time before the call ends, which prevents errors.
33. A client is admitted with a cough, night sweats, and suspected pulmonary tuberculosis. Which precautions should the LPN expect?
    Answer: An airborne infection isolation room and a fit-tested N95 respirator. Tuberculosis spreads through tiny airborne particles. The client needs a negative-pressure isolation room, and staff wear a fit-tested N95 or higher respirator.
34. After morning report, the LPN has four clients. Which client should the LPN see first?
    Answer: A client with COPD who has an oxygen saturation of 84 percent and new confusion. Low oxygen with new confusion is a breathing problem that can get worse quickly. Airway and breathing needs come before pain, routine glucose checks, and discharge.
35. A client takes lisinopril and spironolactone. Which lab result should the LPN report right away?
    Answer: Potassium 6.1 mEq/L. Normal potassium is about 3.5 to 5.0 mEq/L. Both drugs can raise potassium, and a level of 6.1 can cause dangerous heart rhythms. The other values are normal.
36. Mr. Tran speaks Vietnamese and only a little English. His 15-year-old son offers to translate the discharge instructions. What is the best action by the LPN?
    Answer: Arrange for a trained medical interpreter. A trained medical interpreter gives accurate, private communication. Family members, especially children, may leave out or change medical details.
37. Ten minutes into a red blood cell transfusion, a client has chills, back pain, and a rising temperature. What should the LPN do first?
    Answer: Stop the transfusion. These are signs of a transfusion reaction. The transfusion is stopped at once, the IV is kept open with normal saline, and the RN and provider are notified.
38. A parent brings a 9-month-old to a well-child visit. Which skill does the LPN expect most babies to have at this age?
    Answer: Sits without support. The CDC lists sitting without support as a 9-month milestone. Walking alone, two-word phrases, and kicking a ball come later.
39. Mrs. Hall, who has Alzheimer disease, says she must go home to feed her baby. Her children are now adults. Which response uses validation therapy?
    Answer: "Tell me about your baby.". Validation therapy accepts the feelings behind what the person says. Asking about the baby respects her feelings without arguing or telling a lie.
40. A client has insulin lispro ordered at breakfast. The breakfast trays are running 1 hour late. What should the LPN do?
    Answer: Wait to give the insulin until the tray arrives. Insulin lispro is rapid acting. It is given within 15 minutes before a meal or right after, so giving it an hour early could cause low blood sugar.

• NCSBN: 2026 NCLEX-PN Test Plan
• NCSBN: 2026 NCLEX-PN Test Plan publication page