NCLEXPN National Council Licensureination NCLEXPN Free Practice Test — 30 Questions

Question 1

A pediatric unit is experiencing an unforeseen and significant increase in admissions due to a community-wide viral outbreak, coinciding with several scheduled staff absences. The nurse manager, Elara Vance, is faced with a critical staffing deficit, potentially jeopardizing adherence to mandated patient-to-nurse ratios and impacting the quality of care. Elara needs to immediately implement a strategy to manage the increased patient load with reduced personnel while ensuring patient safety and maintaining staff morale. Which of the following actions should Elara prioritize as the most effective initial response?

Accepted Answer

Conduct a brief, focused huddle with the available staff to reassess patient acuity, clarify immediate priorities, and reassign tasks based on current capacity and expertise.

Question 2

Following a diagnostic workup, Mr. Henderson has received a new diagnosis of active pulmonary tuberculosis. As the licensed practical nurse, what is the most crucial initial nursing action to implement?

Accepted Answer

Educate Mr. Henderson on the importance of strict adherence to his multidrug regimen, completing the full course of treatment, and practicing respiratory hygiene.

Question 3

A licensed practical nurse (LPN) in a long-term care facility is preparing to administer morning medications. For Mr. Henderson, a resident with a history of atrial fibrillation, the physician\'s order reads \"CardioStabil 50mg PO daily.\" Upon retrieving the medication, the LPN observes that the available CardioStabil tablets are marked as \"25mg.\" What is the most appropriate initial action for the LPN to take in this situation?

Accepted Answer

Contact the prescribing physician or the facility pharmacist to clarify the medication order and tablet strength.

Question 4

A unit manager observes a consistent pattern of increased staff absenteeism and a significant number of resignations within the first year of employment on their unit. During team meetings, staff express feelings of being undervalued and overwhelmed by fluctuating patient acuity and unpredictable staffing schedules. Which core leadership competency should the manager prioritize to foster a more supportive and stable work environment?

Accepted Answer

Motivating team members through recognition and empowerment initiatives.

Question 5

A nurse is assigned to care for a client admitted with a history of chronic alcohol abuse who is now exhibiting signs of severe alcohol withdrawal, including marked agitation, disorientation to time and place, visual hallucinations, and diaphoresis. The client is pacing in their room and attempting to strike at perceived threats. The nurse\'s immediate priority is to ensure the client\'s safety and manage the acute symptoms. Which of the following actions should the nurse implement first?

Accepted Answer

Administer the prescribed dose of lorazepam intramuscularly.

Question 6

A licensed practical nurse (LPN) is supervising a UAP in a long-term care facility. The LPN is reviewing the care plan for a client who requires assistance with daily living. Which of the following tasks, if delegated to the UAP, would represent an inappropriate use of delegation principles and potentially violate nursing scope of practice regulations?

Accepted Answer

Administering a prescribed oral antibiotic to the client.

Question 7

A registered nurse receives an admission for Mr. Elias Thorne, a 72-year-old male with a known history of COPD exacerbation, who is presenting with significantly increased dyspnea and audible wheezing. The nurse is preparing to conduct the initial patient assessment. Which of the following nursing actions should be prioritized to address Mr. Thorne\'s immediate physiological needs?

Accepted Answer

Auscultate lung sounds and assess oxygen saturation levels.

Question 8

A nurse is preparing to administer a prescribed intravenous antibiotic to Mr. Abernathy, a new admission with a history of a severe allergic reaction to penicillin. The medication administration record indicates the antibiotic is to be given immediately. As the nurse retrieves the medication from the automated dispensing unit, what is the most critical preceding action to ensure patient safety?

Accepted Answer

Confirm the prescribed antibiotic is not a penicillin-based medication and review Mr. Abernathy's allergy documentation.

Question 9

A nurse is admitting a client diagnosed with Guillain-Barré syndrome (GBS). The client reports increasing weakness in their legs and arms over the past 48 hours. Which assessment finding would be the MOST critical to monitor for and report immediately to the healthcare provider?

Accepted Answer

A decrease in the partial pressure of arterial oxygen (PaO2) to $65$ mmHg and an increase in the partial pressure of arterial carbon dioxide (PaCO2) to $50$ mmHg.

Question 10

A healthcare facility is transitioning to a new electronic health record (EHR) system. The nursing staff expresses significant apprehension, citing concerns about the steep learning curve and the potential for decreased efficiency during the initial implementation phase. Elara, the nurse manager, recognizes that simply mandating the new system will likely result in resistance and suboptimal adoption. Instead, she schedules one-on-one sessions with each team member to discuss their specific worries and preferred learning styles, followed by the creation of small, department-specific training cohorts focused on the most relevant functionalities for each unit. Which of the following leadership and change management strategies is Elara primarily employing to foster adaptability and overcome team resistance?

Accepted Answer

Personalized engagement and tailored training to address individual concerns and learning preferences.

Question 11

A licensed practical nurse (LPN) is working on a medical-surgical unit when the charge nurse announces that a new experimental medication, recently approved for limited use, will be administered to several elderly patients with complex cardiac conditions. The LPN has reviewed the limited available data, which suggests potential for significant adverse cardiac events, and has not seen any formal in-service or competency validation for administering this specific drug. The charge nurse insists on immediate implementation, stating, \"We need to be on the cutting edge, and these patients need every available option.\" What is the LPN\'s most appropriate initial action?

Accepted Answer

Report the concerns regarding the medication's safety profile and lack of staff competency validation to the Nurse Manager or Director of Nursing.

Question 12

A nurse manager, Ms. Anya Sharma, is overseeing a critical departmental restructuring that involves the implementation of a new electronic health record (EHR) system. She has observed that a significant portion of her team is struggling to adapt, leading to delayed patient documentation and increased staff anxiety. Some team members are proficient, while others exhibit noticeable difficulty and frustration with the system\'s interface and workflows. Ms. Sharma needs to devise a strategy that not only improves EHR adoption but also supports her team\'s ability to navigate this significant operational shift effectively.

Which of the following strategies would best address the observed challenges and promote team adaptability during this transition?

Accepted Answer

Conduct individualized, needs-based training sessions for staff members exhibiting difficulty, coupled with consistent positive reinforcement for incremental progress in EHR utilization.

Question 13

A licensed practical nurse is assigned to care for four stable clients on a medical-surgical unit. Midway through the shift, a new admission, a critically ill client requiring continuous monitoring and frequent interventions, is assigned to the unit, and one of the assigned nurses calls in sick. Which of the following actions demonstrates the most effective approach to this evolving situation?

Accepted Answer

Immediately re-evaluate the current patient assignments and the acuity of the new admission to reprioritize care tasks for all clients.

Question 14

A nurse is providing initial education to a client newly diagnosed with Type 2 diabetes. The client expresses anxiety and a desire to understand how to manage their condition effectively. Which of the following teaching points should the nurse prioritize as the foundational element of self-management education?

Accepted Answer

The physiological impact of diet and exercise on blood glucose levels and the importance of self-monitoring.

Question 15

Mr. Henderson, a 78-year-old male admitted for pneumonia, has begun exhibiting increased confusion, agitation, and a tendency to wander from his room. His family reports he has been increasingly forgetful and has had several falls at home in the past month. The nurse observes that Mr. Henderson becomes distressed when his routine is disrupted. Which nursing intervention is most appropriate to promote Mr. Henderson\'s safety and well-being in this context?

Accepted Answer

Establish a consistent daily routine and introduce one new activity at a time.

Question 16

A licensed practical nurse is administering a prescribed intravenous antibiotic to a client experiencing a severe respiratory infection. Within minutes of initiating the infusion, the client develops a widespread urticarial rash across their trunk and extremities. What is the nurse\'s most immediate and critical action?

Accepted Answer

Discontinue the intravenous infusion immediately.

Question 17

A licensed practical nurse (LPN) is preparing to administer medications to a client and notices a new medication, \"CardioStabilin,\" prescribed via verbal order by the physician, which is not yet listed on the client\'s current medication administration record (MAR). The physician is currently unavailable. What is the LPN\'s MOST appropriate immediate action?

Accepted Answer

Contact the physician to confirm the verbal order and request it be documented on the MAR.

Question 18

A registered nurse is performing a routine home health visit for Mr. Abernathy, an 82-year-old gentleman with a history of mild cognitive impairment. During the visit, the nurse observes multiple ecchymoses on Mr. Abernathy\'s forearms, which he attributes to \"bumping into things.\" The nurse notes that Mr. Abernathy appears unusually anxious and hesitant to speak freely, often glancing at his son, who remains in the room throughout the visit and frequently interjects with comments like, \"He\'s just a bit forgetful, nothing to worry about.\" The nurse also observes a tear in Mr. Abernathy\'s clothing that appears inconsistent with the reported cause of the bruises. What is the most appropriate immediate nursing action in this situation?

Accepted Answer

Report the suspected elder abuse to the appropriate state protective services agency.

Question 19

A nurse manager is overseeing the transition to a new electronic health record (EHR) system. Her team consists of nurses with diverse technological backgrounds and varying degrees of enthusiasm for adopting new workflows. To ensure a smooth and effective integration of the new EHR, which leadership strategy would most effectively address the team\'s adaptability and foster collaborative engagement during this significant operational shift?

Accepted Answer

Facilitate a series of workshops to collaboratively develop implementation strategies, provide comprehensive training tailored to different skill levels, and establish a feedback mechanism for ongoing adjustments.

Question 20

A nurse assistant is assigned to four patients. Mr. Henderson, the nurse assistant, is currently assisting Patient A with ambulation. Suddenly, Patient B calls out, reporting a sudden onset of chest tightness and difficulty breathing. Simultaneously, Patient C requests assistance with eating their lunch, and Patient D asks for a refill of their pain medication, stating the current dose is not effective. What is Mr. Henderson\'s most appropriate initial action?

Accepted Answer

Immediately go to Patient B, assess their vital signs, and notify the licensed nurse of the reported symptoms.

Question 21

A pediatric unit supervisor is informed mid-shift that two experienced nurses have been unexpectedly called away for family emergencies, and concurrently, three newly admitted patients present with significantly higher acuity than anticipated. Which of the following behavioral competencies is most critical for the supervisor to effectively navigate this complex and rapidly evolving situation while ensuring optimal patient outcomes?

Accepted Answer

Adaptability and Flexibility

Question 22

A nurse is assigned to care for a client who has been receiving a thiazide diuretic for several weeks and is now reporting increased fatigue and experiencing occasional palpitations. Upon assessment, the nurse notes diminished deep tendon reflexes and shallow respirations. Which of the following nursing actions should be performed first?

Accepted Answer

Obtain a serum potassium level.

Question 23

A licensed practical nurse (LPN) is administering medications to a patient diagnosed with hypertension and atrial fibrillation. The physician\'s order is to administer digoxin 0.25 mg orally. Upon reviewing the patient\'s medication administration record and recent laboratory results, the LPN notes that the patient\'s potassium level is 3.2 mEq/L and their apical pulse is 58 beats per minute. What is the LPN\'s most appropriate immediate action?

Accepted Answer

Withhold the medication and contact the prescribing healthcare provider to report the low potassium level and slow heart rate before administering the digoxin.

Question 24

Anya, a nurse practitioner, is managing a patient\'s care. The patient presents with a new, concerning symptom. The physician who had been overseeing this patient\'s complex medication regimen has recently departed the practice, and a replacement has not yet been assigned. Anya has access to the patient\'s electronic health record, which contains previous treatment plans but lacks detailed notes from the departed physician regarding the rationale for certain medication choices in relation to the patient\'s specific condition. Anya must now decide on the most appropriate next step to ensure the patient\'s well-being and continuity of care.

Which of the following actions would best demonstrate Anya\'s adaptability and proactive problem-solving skills in this scenario?

Accepted Answer

Proactively reviewing the patient's chart for historical treatment rationale and consulting with a senior colleague for guidance on managing the new symptom while awaiting physician reassignment.

Question 25

A licensed practical nurse (LPN) in a skilled nursing facility is part of a team transitioning to a new electronic health record (EHR) system. The LPN attends all mandatory training sessions, independently explores the system\'s features during downtime, and volunteers to help less tech-savvy colleagues navigate the new software. Which core behavioral competency is most prominently demonstrated by this LPN\'s actions?

Accepted Answer

Adaptability and Flexibility

Question 26

A community health clinic receives an urgent notification from the state health department mandating immediate implementation of a revised patient screening protocol for a newly identified infectious agent. This directive arrives during a busy clinic day, with a backlog of scheduled appointments. Which action best exemplifies the nurse\'s adaptability and flexibility in response to this abrupt change in operational procedure?

Accepted Answer

Proactively reviewing the updated screening protocol documentation and seeking clarification from the clinic manager regarding any ambiguous steps before seeing the next patient.

Question 27

A nurse is providing care for an elderly patient diagnosed with moderate dementia who has a peripheral intravenous line in place for hydration. During the evening shift, the nurse observes the patient becoming increasingly restless and verbally agitated, attempting to pull out the IV catheter. The patient has no prior history of aggression or attempts to dislodge lines. Which of the following nursing actions is the most appropriate immediate response?

Accepted Answer

Perform a fall risk assessment and implement appropriate safety measures to prevent line dislodgement and potential injury.

Question 28

Observing a new graduate nurse being instructed by a supervising physician to administer an intravenous antibiotic via an intramuscular route, the licensed practical nurse (LPN) notes the discrepancy. The LPN is aware that this specific antibiotic is formulated for intravenous administration only and has never been approved for intramuscular use by the manufacturer or regulatory bodies. What is the LPN\'s most appropriate immediate action?

Accepted Answer

Politely and professionally inform the supervising physician that the prescribed route for the medication must be verified before administration.

Question 29

A licensed practical nurse is assigned to a unit with five stable adult patients. Suddenly, a new admission arrives with a critical diagnosis requiring immediate intensive monitoring and frequent vital sign checks. Simultaneously, a colleague calls out sick, leaving the unit with one less staff member than scheduled. Which of the following actions should the nurse prioritize to effectively manage this evolving situation?

Accepted Answer

Initiate the critical interventions for the new admission and then communicate the staffing and patient acuity changes to the charge nurse, while concurrently reassessing the remaining patients for any emergent needs.

Question 30

A registered nurse is providing care for a client diagnosed with a chronic respiratory condition. The client has consistently expressed a clear and documented refusal of a specific invasive ventilation procedure, citing personal beliefs and a desire for comfort care. During a shift change report, the oncoming physician orders the immediate initiation of this very procedure. The nurse is aware of the client\'s prior refusal and the current lack of any change in the client\'s mental status that would suggest a revocation of that refusal. What is the most appropriate immediate action for the nurse to take?

Accepted Answer

Politely inform the physician that the procedure cannot be initiated due to the client's documented refusal and request clarification or a revised order, while preparing to contact the charge nurse if the physician insists.

NCLEXPN National Council Licensureination NCLEXPN Free Practice Test — 30 Questions

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