NCLEX-PN 2026 Safe Care & Clinical Judgment Workbook

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Sample questions from NCLEX-PN 2026 Safe Care & Clinical Judgment Workbook

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A practical nurse is caring for four clients. Which client should the nurse report to the RN immediately?

   • A.A client with chronic arthritis who reports usual knee pain of 4 out of 10
   • B.A client who suddenly becomes short of breath and has an oxygen saturation of 86%
   • C.A client with a healing incision who asks when the dressing will be changed
   • D.A client with diabetes whose premeal glucose is 142 mg/dL

   Rationale: Sudden dyspnea with oxygen saturation of 86% indicates possible acute respiratory compromise and requires immediate reporting and response within facility protocol. The arthritis pain is described as usual, the dressing question is not an emergency, and the glucose value alone does not indicate an immediate crisis. Prioritize sudden changes in airway, breathing, or circulation over stable needs.

2. 2.A client has a prescription for oral furosemide. Before administering the dose, which finding should the practical nurse report to the RN?

   • A.Blood pressure of 88/54 mm Hg and dizziness when sitting up
   • B.Mild ankle edema that is unchanged from yesterday
   • C.Urine output of 500 mL during the previous 8 hours
   • D.A request to take the medication with breakfast

   Rationale: Hypotension with dizziness may indicate poor tolerance of a diuretic and creates a fall risk, so the nurse should report it before giving the dose. Unchanged mild edema and the stated urine output do not by themselves establish an urgent change, while asking about breakfast is not a concerning finding. Check relevant data and clarify safety concerns before administering a medication.

3. 3.A practical nurse enters a room and finds a client on the floor beside the bed. What should the nurse do first?

   • A.Help the client back into bed using a gait belt
   • B.Ask the client to describe how the fall happened
   • C.Stay with the client and check responsiveness and apparent injury
   • D.Complete the facility incident report

   Rationale: The nurse should remain with the client and promptly check responsiveness and apparent injury before moving the client. Moving the client may worsen an injury, and obtaining a detailed account is secondary to immediate safety checks. An incident report is completed after the client's immediate needs are addressed, according to facility policy.

4. 4.A client with a new prescription for an oral antibiotic says, "I will stop taking it as soon as I feel better." Which response is best for the practical nurse?

   • A."That is fine if your fever is gone for 24 hours."
   • B."Take it exactly as prescribed, and contact the prescriber if you have a problem or reaction."
   • C."Save any leftover tablets in case the infection returns."
   • D."Double the next dose if you miss one."

   Answer and rationale are in the full material.

5. 5.A practical nurse is preparing to administer a scheduled oral medication. The client states, "This pill looks different from the one I take at home." What should the nurse do?

   • A.Administer it because the medication is listed on the medication record
   • B.Ask the client to take it and report any unusual effects
   • C.Hold the medication and verify the discrepancy with the RN or pharmacist according to policy
   • D.Crush the medication and mix it with applesauce

   Answer and rationale are in the full material.