National Council Licensure Examination(NCLEX-PN) 2024 Practice Test

NCLEX-PN Exam Format | Course Contents | Course Outline | Exam Syllabus | Exam Objectives

The test plan is reviewed and approved by the NCLEX®
Examination Committee (NEC) every three years.
Multiple resources are used, including the recent practice analysis of licensed practical/vocational nurses
(LPN/VNs), and expert opinions of the NEC, NCSBN staff and nursing regulatory bodies (NRBs) to ensure that
the test plan is consistent with nurse practice acts. Following the endorsement of proposed revisions by
the NEC, the test plan document is presented for approval to the Delegate Assembly, which is the decisionmaking body of NCSBN.
The test plan serves a variety of purposes. It is used to guide candidates preparing for the examination, to
direct item writers in the development of items, and to facilitate the classification of examination items. This
document offers a comprehensive listing of content for each client needs category and subcategory outlined
in the test plan. Sample items are provided at the end of each category, which are specific to the client needs
category in that section. There is an item writing guide along with sample case scenarios, which provide
nurse educators with hands-on experience in writing NCLEX-style test items.

Entry into the practice of nursing is regulated by the licensing authorities within each of the NCSBN nursing
regulatory bodies (state, commonwealth and territorial boards of nursing). To ensure public protection, each
jurisdiction requires candidates for licensure to meet set requirements that include passing an examination
that measures the competencies needed to perform safely and effectively as a licensed practical/vocational
nurse (LPN/VN). NCSBN develops a licensure examination, the National Council Licensure Examination for
Practical Nurses (NCLEX-PN®), which is used by U.S. members to assist in making licensure decisions.
Several steps occur in the development of the NCLEX-PN Test Plan. The first step is conducting a practice
analysis that is used to collect data on the current practice of entry-level LPN/VNs (Report of Findings from
the 2018 LPN/VN Practice Analysis: Linking the NCLEX-PN® Examination to Practice, NCSBN, 2019). Twelve
thousand newly licensed practical/vocational nurses are asked about the frequency and priority of performing nursing care activities. Nursing care activities are then analyzed in relation to the frequency of performance, impact on maintaining client safety and client care settings where the activities are performed. This
analysis guides the development of a framework for entry-level nursing practice that incorporates specific
client needs, as well as processes that are fundamental to the practice of nursing. The next step is the
development of the NCLEX-PN Test Plan, which guides the selection of content and behaviors to be tested.
Variations in jurisdiction laws and regulations are considered in the development of the test plan.
The NCLEX-PN Test Plan provides a concise summary of the content and scope of the licensure examination.
It serves as a guide for examination development as well as candidate preparation. The NCLEX® assesses the knowledge, skills and abilities that are essential for the entry-level LPN/VN to use in order to meet the needs
of clients requiring the promotion, maintenance and restoration of health. The following sections describe
beliefs about people and nursing that are integral to the examination, cognitive abilities that will be tested in
the examination and specific components of the NCLEX-PN Test Plan.

Client Needs
Percentage of Items from Each
Category/Subcategory
Safe and Effective Care Environment
„ Coordinated Care 18–24%
„ Safety and Infection Control 10–16%
Health Promotion and Maintenance 6–12%
Psychosocial Integrity 9–15%
Physiological Integrity
„ Basic Care and Comfort 7–13%
„ Pharmacological Therapies 10–16%
„ Reduction of Risk Potential 9–15%
„ Physiological Adaptation 7–13%

The activity statements used in the 2018 LPN/VN Practice Analysis: Linking the NCLEX-PN®
Examination to
Practice (NCSBN, 2019) preface each of the eight content categories and are identified throughout the test
plan by an asterisk (*). NCSBN performs an analysis of those activities used frequently and identified as
important by entry-level nurses to ensure client safety. This is called a practice analysis; it provides data to
support the NCLEX as a reliable, valid measure of competent, entry-level LPN/VN practice. The practice analysis is conducted every three years.
In addition to the practice analysis, NCSBN conducts a knowledge, skills and abilities (KSA) survey. The primary purpose of this study is to identify the knowledge needed by newly licensed practical/vocational nurses
in order to provide safe and effective care. Findings from both the 2018 LPN/VN Practice Analysis: Linking
the NCLEX-PN®
Examination to Practice (NCSBN, 2019) and the 2018 LPN/VN Nursing Knowledge Survey
(NCSBN, 2019) can be found at www.ncsbn.org/1235.htm. Both documents are used in the development of
the NCLEX-PN Test Plan as well as to inform item development.
All task statements in the 2020 NCLEX-PN®
Test Plan require the nurse to apply the fundamental principles
of clinical decision making and critical thinking to nursing practice. The test plan also makes the assumption
that the nurse integrates concepts from the following bodies of knowledge:
„ Social Sciences (psychology and sociology); and
„ Biological Sciences (anatomy, physiology, biology and microbiology) Collaboration with Interdisciplinary Team
„ Identify roles/responsibilities of health care team members
„ Identify need for nursing or interdisciplinary client care conference
„ Contribute to the development of and/or update the client plan of care
„ Contribute to planning interdisciplinary client care conferences
„ Participate as a member of an interdisciplinary team Concepts of Management and Supervision
„ Recognize and report staff conflict
„ Verify abilities of staff members to perform assigned tasks (e.g., job description, scope of practice, training, experience)
„ Provide input for performance evaluation of other staff
„ Participate in staff education (e.g., inservices, continued competency)
„ Use data from various credible sources in making clinical decisions
„ Serve as resource person to other staff
„ Monitor activities of assistive personnel
Confidentiality/Information Security
„ Identify staff actions that impact client confidentiality and intervene as needed (e.g., access to medical records, discussions at nurses station, change-of-shift reports)
„ Recognize staff member and client understanding of confidentiality requirements
„ Apply knowledge of facility regulations when accessing client records
„ Maintain client confidentiality*
„ Provide for privacy needs Continuity of Care
„ Follow up with client after discharge*
„ Participate in client discharge or transfer*
„ Provide follow-up for unresolved client care issues
„ Provide and receive report*
„ Record client information (e.g., medical record, referral/transfer form)
„ Use agency guidelines to guide client care (e.g., clinical pathways, care maps, care plans)
Establishing Priorities
„ Organize and prioritize care based on client needs*
„ Participate in planning client care based upon client needs (e.g., diagnosis, abilities, prescribed treatment)
„ Use effective time management skills
Ethical Practice
„ Identify ethical issues affecting staff or client
„ Inform client of ethical issues affecting client care
„ Intervene to promote ethical practice
„ Practice in a manner consistent with code of ethics for nurses*
„ Review client and staff member knowledge of ethical issues affecting client care Informed Consent
„ Identify appropriate person to provide informed consent for client (e.g., client, parent, legal guardian)
„ Participate in client consent process*
„ Describe informed consent requirements (e.g., purpose for procedure, risks of procedure)
„ Recognize that informed consent was obtained (e.g., completed consent form, client understanding of procedure)
Information Technology
„ Use information technology in client care*
„ Access data for client or staff through online databases and journals
„ Enter computer documentation accurately, completely and in a timely manner
Legal Responsibilities
„ Identify legal issues affecting staff and client (e.g., refusing treatment)
„ Verify and process health care provider orders*
„ Recognize self-limitations of task/assignments and seek assistance when needed*
„ Respond to the unsafe practice of a health care provider (e.g., intervene, report)*
„ Follow regulation/policy for reporting specific issues (e.g., abuse, neglect, gunshot wound,
communicable disease)*
„ Document client care
„ Provide care within the legal scope of practice*
Performance Improvement (Quality Improvement)
„ Identify impact of performance improvement/quality improvement activities on client care
outcomes
„ Participate in quality improvement (QI) activity (e.g., collecting data, serving on QI committee)*
„ Document performance improvement/quality improvement activities
„ Report identified performance improvement/quality improvement concerns to appropriate
personnel (e.g., nurse manager, risk manager)
„ Apply evidence-based practice when providing care*

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National Council Licensure Examination(NCLEX-PN) 2023
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Question: 1441
Which of the following is most likely to impact the body image of an infant newly diagnosed with Hemophilia?
A. immobility
B. altered growth and development
C. hemarthrosis
D. altered family processes
Answer: D
Explanation:
Altered Family Processes is a potential nursing diagnosis for the family and client with a new diagnosis of
Hemophilia. Infants are aware of how their caregivers respond to their needs. Stresses can have an immediate
impact on the infant�s development of trust and how others relate to them because of their diagnosis. The longterm
effects of hemophilia can include problems related to immobility. Altered growth and development could not have
developed in a newly diagnosed client. Hemarthrosis is acute bleeding into a joint space that is characteristic of
hemophilia. It does not have an immediate effect on the body image of a newly diagnosed hemophiliac.Health
Promotion and Maintenance
Question: 1442
Teaching about the need to avoid foods high in potassium is most important for which client?
A. a client receiving diuretic therapy
B. a client with an ileostomy
C. a client with metabolic alkalosis
D. a client with renal disease
Answer: D
Explanation:
Clients with renal disease are predisposed to hyperkalemia and should avoid foods high in potassium. Choices 1, 2,
and 3 are incorrect because clients receiving diuretics with ileostomy or with metabolic alkalosis are at risk for
hypokalemia and should be encouraged to eat foods high in potassium.Physiological Adaptation
Question: 1443
What do the following ABG values indicate: pH 7.38, PO2 78 mmHg, PCO2 36mmHg, and HCO3 24 mEq/L?
A. metabolic alkalosis
B. homeostasis
C. respiratory acidosis
D. respiratory alkalosis
Answer: B
Explanation:
These ABG values are within normal limits. Choices 1, 3, and 4 are incorrect because the ABG values indicate
none of these acid-base disturbances.Physiological Adaptation
Question: 1444
When administering intravenous electrolyte solution, the nurse should take which of the following precautions?
A. Infuse hypertonic solutions rapidly.
B. Mix no more than 80 mEq of potassium per liter of fluid.
C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
D. As appropriate, reevaluate the client�s digitalis dosage. He might need an increased dosage because IV
calcium diminishes digitalis�s action.
Answer: C
Explanation:
Preventing tissue infiltration is important to avoid tissue necrosis. Choice 1 is incorrect because hypertonic
solutions should be infused cautiously and checked with the RN if there is a concern. Choice 2 is incorrect because
potassium, mixed in the pharmacy per physician order, is mixed at a concentration no higher than 60 mEq/L.
Physiological Adaptation
Question: 1445
Which of the following physical findings indicates that an 1112-month-old child is at risk for developmental
dysplasia of the hip?
A. refusal to walk
B. not pulling to a standing position
C. negative Trendelenburg sign
D. negative Ortolani sign
Answer: B
Explanation:
The nurse might be concerned about developmental dysplasia of the hip if an 1112-month-old child doesn�t pull to
a standing position. An infant who does not walk by 15 months of age should be evaluated. Children should start
walking between 1115 months of age. Trendelenberg sign is related to weakness of the gluteus medius muscle, not
hip dysplasia. Ortolani sign is used to identify congenital subluxation or dislocation of the hip in infants.Health
Promotion and Maintenance
Question: 1446
When obtaining a health history on a menopausal woman, which information should a nurse recognize as a
contraindication for hormone replacement therapy?
A. family history of stroke
B. ovaries removed before age 45
C. frequent hot flashes and/or night sweats
D. unexplained vaginal bleeding
Answer: D
Explanation:
Unexplained vaginal bleeding is a contraindication for hormone replacement therapy. Family history of stroke is
not a contraindication for hormone replacement therapy. If the woman herself had a history of stroke or other
blood-clotting events, hormone therapy could be contraindicated. Frequent hot flashes and/or night sweats can be
relieved by hormone replacement therapy.Health Promotion and Maintenance
Question: 1447
Which of the following statements, if made by the parents of a newborn, does not indicate a need for further
teaching about cord care?
A. "I should put alcohol on my baby�s cord 34 times a day."
B. "I should put the baby�s diaper on so that it covers the cord."
C. "I should call the physician if the cord becomes dark."
D. "I should wash my hands before and after I take care of the cord."
Answer: D
Explanation:
Parents should be taught to wash their hands before and after providing cord care. This prevents transferring
pathogens to and from the cord. Folding the diaper below the cord exposes the cord to air and allows for drying. It
also prevents wet or soiled diapers from coming into contact with the cord. Current recommendations include
cleaning the area around the cord 34 times a day with a cotton swab but do not include putting alcohol or other
antimicrobials on the cord. It is normal for the cord to turn dark as it dries.Health Promotion and Maintenance
Question: 1448
The nurse is teaching parents of a newborn about feeding their infant. Which of the following instructions should
the nurse include?
A. Use the defrost setting on microwave ovensto warm bottles.
B. When refrigerating formula, don�t feed the baby partially used bottles after 24 hours.
C. When using formula concentrate, mix two parts water and one part concentrate.
D. If a portion of one bottle is left for the next feeding, go ahead and add new formula to fill it.
Answer: A
Explanation:
Parents must be careful when warming bottles in a microwave oven because the milk can become superheated.
When a microwave oven is used, the defrost setting should be chosen, and the temperature of the formula should be
checked before giving it to the baby. Refrigerated, partially used bottles should be discarded after 4 hours because
the baby might have introduced some pathogens into the formula. Returning the bottle to the refrigerator does not
destroy pathogens. Formula concentrate and water are usually mixed in a 1:1 ratio of one part concentrate and
one part water. Infants should be offered fresh formula at each feeding. Partially used bottles should not have fresh
formula added to them. Pathogens can grow in partially used bottles of formula and be transferred to the new
formula.Health Promotion and Maintenance
Question: 1449
The nurse is assessing the dental status of an 18-month-old child. How many teeth should the nurse expect to
examine?
A. 6
B. 8
C. 12
D. 16
Answer: C
Explanation:
In general, children begin dentition around 6 months of age. During the first 2 years of life, a quick guide to the
number of teeth a child should have is as follows: Subtract the number 6 from the number of months in the age of
the child. In this example, the child is 18 months old, so the formula is 18 6 = 12. An 18-month-old child should
have approximately 12 teeth.Health Promotion and Maintenance
Question: 1450
A middle-aged woman tells the nurse that she has been experiencing irregular menses for the past six months. The
nurse should assess the woman for other symptoms of:
A. climacteric.
B. menopause.
C. perimenopause.
D. postmenopause.
Answer: C
Explanation:
Perimenopause refers to a period of time in which hormonal changes occur gradually, ovarian function diminishes,
and menses become irregular. Perimenopause lasts approximately five years.
Climacteric is a term applied to the period of life in which physiologic changes occur and result in cessation of a
woman�s reproductive ability and lessened sexual activity in males. The term applies to both genders. Climacteric
and menopause are interchangeable terms when used for females. Menopause is the period when permanent
cessation of menses has occurred. Postmenopause refers to the period after the changes accompanying menopause
are complete.Health Promotion and Maintenance

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