NCLEX-PN practice questions, NCLEX-PN practice test and LPN prep for the April 2026 test plan
The NCLEX-PN changed on April 1, 2026. A lot of prep still describes the 2023 test plan and its old category percentages. Practice the blueprint that is actually being administered now, with the case-study format that carries 18 items of every minimum-length exam.
- Unlimited NCLEX-PN-style questions on the current April 2026 test plan
- Clinical judgment case studies in the six-item NCJMM format the exam uses
- Every answer explained, including why each distractor is wrong
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The short answer
The NCLEX-PN is the licensure exam practical and vocational nurses pass to become an LPN or LVN in the United States. It is a computer-adaptive test of 85 to 150 items taken in a five-hour session that includes all breaks, of which 15 items are unscored pretest items. A new NCLEX-PN Test Plan took effect on April 1, 2026, and NCSBN has held the passing standard at -0.18 logits through March 31, 2029. In 2025, 86.6% of first-time, US-educated candidates passed. Aspirants.ai generates unlimited NCLEX-PN-style questions and clinical judgment case studies across every content area, explains every answer, and costs from $9 a month.
Last updated July 2026
Work the questions
NCLEX-PN practice questions with answers and rationales
Eight questions, one from each client needs category on the NCLEX-PN test plan, written in the style of the exam rather than copied from it. NCLEX items are secure and copyrighted, and no legitimate bank reproduces them.
Question 1 · Coordinated Care
A charge nurse is making assignments on a medical unit. Which client is least appropriate to assign to a licensed practical nurse?
- A. A client with stable COPD receiving scheduled nebulizer treatments
- B. A client admitted two hours ago who has not yet had an admission assessment
- C. A client three days after a hip replacement who is ambulating with a walker
- D. A client with a chronic wound requiring a routine dressing change
Show the answer and explanation Answer
B. A client admitted two hours ago who has not yet had an admission assessment
The initial admission assessment and the nursing care plan that comes from it belong to the registered nurse in every state, and no amount of LPN experience transfers that responsibility. The other three clients are all stable with predictable needs and established plans of care, which is exactly the profile an LPN assignment should have. The trap in this question is that option B looks like ordinary admission work. Watch for the words initial, unstable and evaluate: they usually mark the answer as RN territory, while implementing, reinforcing and monitoring a stable client are squarely within LPN scope.
Question 2 · Safety and Infection Control
A client is admitted with a productive cough, night sweats and weight loss, and pulmonary tuberculosis is suspected. Which precautions should the nurse implement?
- A. Contact precautions in a private room
- B. Droplet precautions with a surgical mask
- C. Airborne precautions in a negative pressure room with an N95 respirator
- D. Standard precautions only until the diagnosis is confirmed
Show the answer and explanation Answer
C. Airborne precautions in a negative pressure room with an N95 respirator
Tuberculosis spreads on droplet nuclei small enough to stay suspended in the air for hours, which is what separates airborne from droplet transmission. That requires a negative pressure room, the door kept closed, and a fitted N95 or higher respirator for anyone entering. Waiting for confirmation is the most dangerous option on the list, because suspicion is the trigger for precautions and cultures can take weeks. Droplet precautions with a surgical mask cover organisms that travel in larger particles and fall quickly, such as influenza and pertussis. Contact precautions address transmission by touch, as with C. difficile or MRSA.
Question 3 · Health Promotion and Maintenance
A nurse is reinforcing teaching about safe sleep with the parents of a 2-month-old. Which statement indicates the teaching was effective?
- A. "We will put her down on her back in her own crib with nothing else in it."
- B. "We will lay her on her side so she does not choke if she spits up."
- C. "We will use a wedge to keep her from rolling over during the night."
- D. "We will let her sleep in our bed so we can hear her breathing."
Show the answer and explanation Answer
A. "We will put her down on her back in her own crib with nothing else in it."
Back to sleep, on a firm flat surface, in the parents' room but on a separate sleep surface, with no soft bedding, pillows, bumpers or positioning devices. Side lying is not a safe alternative and never was; an infant placed on the side can roll to the prone position, and the choking argument in option B is the single most persistent piece of misinformation parents repeat. Wedges and positioners are not recommended and have been associated with suffocation. Bed sharing raises the risk of sleep-related infant death, which is why room sharing without bed sharing is the recommendation.
Question 4 · Psychosocial Integrity
A client admitted 48 hours ago for a fractured wrist is now tremulous and diaphoretic, has a blood pressure of 168/96 and reports seeing insects on the wall. What should the nurse do first?
- A. Reorient the client and dim the lights
- B. Report the findings to the registered nurse immediately
- C. Document the observation and recheck in one hour
- D. Restrain the client to prevent injury
Show the answer and explanation Answer
B. Report the findings to the registered nurse immediately
This picture, appearing roughly 48 to 72 hours after the last drink, is alcohol withdrawal delirium, and it carries real mortality. It needs medical evaluation, symptom-triggered medication and seizure precautions now, none of which the LPN initiates independently. Reorienting and reducing stimulation are genuinely useful and belong in the plan, but doing them instead of escalating delays treatment for a condition that can deteriorate within hours. Documenting and waiting an hour is the clearest wrong answer. Restraints are a last resort after less restrictive measures fail and require an order, and they do nothing about the underlying withdrawal.
Question 5 · Basic Care and Comfort
A nurse is assisting a client with dysphagia to eat. Which action best reduces the risk of aspiration?
- A. Position the client upright at 90 degrees and have them tuck the chin while swallowing
- B. Offer thin liquids between bites to help clear the mouth
- C. Encourage the client to eat quickly while they still have energy
- D. Position the client at 30 degrees with the head turned to the side
Show the answer and explanation Answer
A. Position the client upright at 90 degrees and have them tuck the chin while swallowing
Sitting fully upright uses gravity to keep the bolus moving in the right direction, and the chin tuck narrows the airway entrance so material is directed toward the esophagus. Thin liquids are the hardest consistency for a client with dysphagia to control and are usually the first thing thickened, so offering them between bites increases risk rather than reducing it. Rushing a meal is the opposite of what helps; small bites, a slow pace and a check that the mouth is empty before the next bite are what protect the airway. Thirty degrees is not upright enough for eating.
Question 6 · Pharmacological Therapies
A nurse is preparing to administer digoxin to an adult client. The apical pulse is 52 beats per minute. What should the nurse do?
- A. Administer the dose and recheck the pulse in one hour
- B. Hold the dose and report the finding to the registered nurse
- C. Administer half the ordered dose
- D. Have the client lie flat and recheck the radial pulse
Show the answer and explanation Answer
B. Hold the dose and report the finding to the registered nurse
The standing rule for an adult is to count the apical pulse for a full minute and hold digoxin if it is below 60, then report. Giving the drug to a client already at 52 pushes the heart rate lower, because slowing conduction through the AV node is exactly what digoxin does. Nurses never adjust a dose on their own authority, which rules out option C outright. Rechecking the radial pulse does not help, since the apical rate is the one the parameter is written against and a radial count can miss beats. Also watch for early toxicity: nausea, vomiting, visual halos and confusion.
Question 7 · Reduction of Risk Potential
A client returns to the unit after a cardiac catheterization performed through the right femoral artery. Which finding requires immediate action?
- A. The client reports mild discomfort at the insertion site
- B. The right foot is cool and the pedal pulse cannot be palpated
- C. The client is drowsy but easily roused
- D. Urine output has been 60 mL over the past hour
Show the answer and explanation Answer
B. The right foot is cool and the pedal pulse cannot be palpated
A cool extremity with an absent pulse distal to the access site points to arterial occlusion or a developing hematoma compressing the vessel, and circulation to the limb is time critical. Compare the affected leg with the other one, check color, temperature, capillary refill and sensation, and escalate at once. Mild soreness at the puncture site is expected. Drowsiness that reverses with stimulation is normal after procedural sedation. Sixty milliliters in an hour is an entirely normal output for an adult, well above the 30 mL per hour threshold that would concern you.
Question 8 · Physiological Adaptation
On the second day after surgery, a nurse assesses a new colostomy and finds the stoma is dusky purple and dry. What is the priority action?
- A. Apply a moist saline dressing and continue to monitor
- B. Report the finding to the registered nurse immediately
- C. Irrigate the stoma to improve circulation
- D. Document the finding as an expected postoperative change
Show the answer and explanation Answer
B. Report the finding to the registered nurse immediately
A healthy stoma is beefy red or pink and moist. Dusky, purple, gray or black coloring signals compromised blood supply and possible necrosis, which is a surgical emergency and never an expected finding. Documenting it as normal is the answer that does the most harm. A moist dressing does nothing for an ischemic bowel segment, and irrigating a stoma that may be necrotic risks perforation. Some edema and a small amount of bleeding when the stoma is cleaned are normal in the first days; a color change is not.
These eight are a sample. Inside Aspirants.ai you can generate unlimited NCLEX-PN practice questions across every category on the April 2026 test plan, including case studies, with the same rationale on every answer choice.
Generate more questions freeWhat the NCLEX-PN looks like now
The NCLEX-PN is a computer-adaptive test administered by NCSBN at Pearson VUE centers. Every candidate answers a minimum of 85 items, and the maximum is 150 items within a five-hour period that includes all breaks. The exam ends as soon as the computer is 95% confident your ability is above or below the passing standard, which is why finishing at 85 items tells you nothing about whether you passed. On a minimum-length exam, 52 items come from the eight content areas in their published percentages, 18 items make up three clinical judgment case studies, and the remaining 15 are unscored pretest items that are indistinguishable from scored ones. Treat every item as if it counts.
- Computer-adaptive: minimum 85 items, maximum 150
- Five-hour session, and that limit includes all breaks
- 15 unscored pretest items on every exam, unmarked
- Three six-item clinical judgment case studies (18 items)
The April 2026 NCLEX-PN test plan and its content percentages
The 2026 NCLEX-PN Test Plan took effect April 1, 2026 and is built on NCSBN's 2024 PN Practice Analysis. Content is organized under four Client Needs categories, two of which split into subcategories. Coordinated Care carries the largest share at 18% to 24%, followed by Safety and Infection Prevention and Control at 10% to 16% and Pharmacological Therapies at 10% to 16%. Psychosocial Integrity and Reduction of Risk Potential are 9% to 15% each. Basic Care and Comfort and Physiological Adaptation are 7% to 13% each, and Health Promotion and Maintenance is 6% to 12%. NCSBN notes actual exams may differ by up to plus or minus 3% in each category, so treat the ranges as targets rather than guarantees.
- Coordinated Care: 18% to 24%, the largest single area
- Safety and Infection Prevention and Control: 10% to 16%
- Pharmacological Therapies: 10% to 16%
- Actual exams can vary by up to plus or minus 3% per category
How the NCLEX-PN is scored
There is no percentage score and no numerical result. The NCLEX-PN is scored against a passing standard expressed in logits, a unit that compares your estimated ability against item difficulty. The NCSBN Board of Directors voted in December 2022 to hold the NCLEX-PN passing standard at -0.18 logits, and that standard runs through March 31, 2029. Because the exam adapts, two candidates who both pass can answer wildly different numbers of items and see completely different difficulty levels. The only outcome reported is pass or fail; candidates who fail receive a Candidate Performance Report showing how they did in each content area, which is the document to build a retake plan around.
- Passing standard: -0.18 logits, held through March 31, 2029
- Reported as pass or fail, with no percentage or number
- Item count and difficulty tell you nothing about your result
- Failing candidates get a Candidate Performance Report by content area
NCLEX-PN pass rates and how hard it is
The NCLEX-PN is demanding but very passable for graduates who practice at volume. In 2025, 86.6% of first-time, US-educated candidates passed, out of 54,818 who tested, with state results ranging from 99.4% in Vermont down to 78.6% in Florida. The pass rate across all NCLEX-PN candidates, including repeat and internationally educated test takers, was lower at about 77%. The candidates who struggle are usually the ones who studied by rereading notes rather than by answering hundreds of application-level and clinical judgment items. The exam does not test recall of facts so much as what you would do next with a specific client.
Retakes, fees and how long to study
The NCLEX-PN registration fee is $200, paid to Pearson VUE, and your state board of nursing charges its own licensure fees on top. If you fail, NCSBN policy permits eight attempts per year with 45 test-free days between attempts, and there is no national lifetime cap, though individual state boards can and do set stricter rules, so check yours before you plan a retake. Most candidates prepare for four to six weeks after finishing their program, doing 75 to 150 practice questions a day and reviewing every rationale, including for questions they got right. Consistent daily question volume predicts a pass far better than total study hours.
- NCLEX-PN registration fee: $200 to Pearson VUE
- Up to eight attempts per year, 45 test-free days between them
- No national lifetime cap, but state boards may be stricter
- Four to six weeks of daily question practice is the typical plan
Compare the options
NCLEX-PN versus NCLEX-RN at a glance
The two exams share a format but differ in scope, standard and stakes. Both were updated with new test plans on April 1, 2026.
| NCLEX-PN (LPN/LVN) | NCLEX-RN (RN) | |
|---|---|---|
| Items | 85 to 150, computer-adaptive | 85 to 150, computer-adaptive |
| Time limit | 5 hours including breaks | 5 hours including breaks |
| Unscored pretest items | 15 | 15 |
| Passing standard | -0.18 logits (through March 2029) | 0.00 logits (through March 2029) |
| Largest content area | Coordinated Care, 18% to 24% | Management of Care, 15% to 21% |
| 2025 first-time US pass rate | 86.6% | about 87% to 91% |
| Registration fee | $200 | $200 |
The NCLEX-RN passing standard is the more demanding of the two despite the identical format, reflecting the wider scope of RN practice. Verify current fees with Pearson VUE and your state board.
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NCLEX-PN practice questions, answered straight.
The NCLEX-PN gives every candidate a minimum of 85 items and a maximum of 150, within a five-hour session that includes all breaks. Fifteen of those items are unscored pretest questions mixed in without any marking. Because the exam is computer-adaptive, it stops as soon as your result is statistically certain.
There is no percentage score. The NCLEX-PN passing standard is -0.18 logits, a measure comparing your estimated ability against item difficulty. NCSBN's Board of Directors set that standard in December 2022 and has held it through March 31, 2029. Results are reported only as pass or fail.
In 2025, 86.6% of first-time, US-educated candidates passed the NCLEX-PN, out of 54,818 who tested. State rates ranged from 99.4% in Vermont to 78.6% in Florida. Across all candidates, including repeat testers and internationally educated nurses, the rate was closer to 77%.
The two exams share an identical format, but the NCLEX-PN is set to a lower passing standard (-0.18 logits versus 0.00 for the RN) because LPN practice has a narrower scope. That makes the PN statistically easier to clear, but it is not an easy exam: roughly one in seven first-time US candidates still fails.
NCSBN policy allows up to eight attempts per year with 45 test-free days between each attempt, and sets no national lifetime cap. Individual state boards of nursing can impose stricter limits, including a maximum number of attempts or a retraining requirement, so confirm the rules with your own board before scheduling.
Most graduates study four to six weeks after finishing their practical nursing program. The pattern that works is 75 to 150 practice questions a day with a full review of every rationale, including the ones you answered correctly. Daily question volume predicts a pass much better than total hours of reading.
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