NCLEX-PN Practice Test & Study Guide

NCLEX-PN Exam Study Guide

The National Council Licensure Examination for Practical Nurses, or NCLEX-PN, is the certification exam for prospective practical nurses. Candidates attempting to gain certification as a Practical Nurse (PN), also called a Licensed Practical Nurse (LPN) or a Licensed Vocational Nurse (LVN), must pass the NCLEX-PN exam to practice. This exam, along with the NCLEX-RN for Registered Nurses, is used by the National Council of State Boards of Nursing and is meant to determine whether it is safe for a candidate to work in the care environment within their scope of practice.

The NCLEX-PN exam, also called the NCLEX-LPN, reflects the day-to-day critical thinking skills LPNs will need to use when they begin working. These decisions relate to patient safety, quality of life, comfort care, and other aspects of patient care that fall within the LPN's scope of practice. LPNs must also be assessed in their ability to take direction from RNs. Essentially, the NCLEX-PN exam provides the basis for current nursing best practices with a focus on the specific duties practical nurses will encounter.

Similar to the NCLEX-RN, the questions on the NCLEX-PN are based on Bloom's taxonomy, the concept of asking questions that require higher levels of cognitive ability. Since LPNs will have to use complex critical thinking skills in their career, the questions on the exam reflect the need to test competency in this area.

NCLEX-LPN Content

The content on the NCLEX-PN is organized into categories based on Client Needs. These categories reflect the major areas in which LPNs must be proficient.

The categories on the NCLEX-PN exam are as follows:

• Safe and Effective Care Environment
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity

Within these four categories, test-takers must demonstrate the integrated processes of clinical problem solving, caring, communication/documentation, teaching/learning, and culture/spirituality, as well as appropriate knowledge of psychology/sociology and biological sciences. These categories and processes represent the main areas of expertise needed for nursing. It's important to understand the types of content that will appear on the exam. These categories and subcategories are outlined in the NCLEX-PN study guide below, as well as the percentage of each type of question.

Safe and Effective Care Environment

This category focuses on the LPN's ability to enhance the health care environment. The category is broken into the following subcategories:

• Coordinate Care (18-24%) - This includes patient rights, confidentiality, and consent. It also includes the LPN's use of proper technology and ethical practices, as well as the organization and prioritization of care. Test-takers can expect to see questions related to advance directives, care assignments, patient advocacy, collaboration with other members of the care team, and informed consent.
• Safety and Infection Control (10-16%) - This includes injury prevention, safety precautions, infection prevention and control, and appropriate patient monitoring. Test-takers may see questions on emergency response plans, patient allergies, ergonomics, handling hazardous materials, and patient restraints.

Health Promotion and Maintenance (6-12%)

This content area pertains to the LPN's knowledge of patient growth and development and the ability to detect health issues. NCLEX-PN prep for this part of the exam should include a focus on providing age-specific care and assessing patients for physical data. Test-takers may also see questions about the aging process, postpartum care, data collection, disease prevention, and community resources for patients. To be proficient in health promotion and maintenance questions, LPNs must be able to communicate effectively with patients of all ages and life stages, as well as understand the unique developmental milestones for each age group. This includes a complete understanding of the assistance each patient needs with self-care.

Psychosocial Integrity (9-15%)

Psychosocial Integrity refers to the emotional, mental, and social well-being of patients. This category of questions assesses a candidate's ability to care for more than just the physical needs of a patient. LPNs should be able to appropriately assist with patient therapy and de-escalation techniques, help patients use effective coping mechanisms and provide a therapeutic and positive environment. Candidates should also be able to use assessment tools to collect data on this information.

Being an LPN is about more than just caring for the patient's physical needs. Candidates should expect to assist patients with grief, loss, spirituality, and end-of-life needs.

Physiological Integrity

This category makes up the highest percentage of questions on the NCLEX-PN exam and focuses on physical tasks LPNs must perform in their day-to-day work to assist the RNs with patient care, as well as recognizing and assessing when patients are in need of care interventions. A candidate's score on the exam is highly dependent on their performance in the physiological integrity category because it covers the most integral parts of the LPN's scope of practice. The category is broken into four subcategories: Basic Care and Comfort, Pharmacological Therapies, Reduction of Risk Potential, and Physiological Adaptation. The percentage of questions in each of these content areas is denoted below.

Basic Care and Comfort (7-13%)

This subcategory covers questions related to nursing best practices for assistance, as well as the support of patients in their basic daily activities. Specifically, LPNs must be able to provide care related to toileting, irrigation, mobility, skin integrity, alternative therapy, comfort, repositioning, feedings, and assistive devices. Candidates should be prepared to demonstrate their ability to monitor patients' intake and output, provide non-pharmacological comfort measures, provide nutrition, and assist patients in providing personal hygiene. Questions in this section may ask candidates to decide the best way to assist a patient in moving or promote proper blood circulation. This content area is integral to any patient's quality of life.

Pharmacological Therapies (10-16%)

Under the aid and supervision of an RN, LPNs may pass medications to patients. This category assesses whether it is safe for a candidate to do so. Topics in this content area include proper documentation, calculations, and management of pain control. LPNs must know how to administer medications orally, as well as intravenously (IV), via a gastrointestinal tube, or in the form of a shot. They must also know how to administer medications by ear, eye, nose, rectum, vagina, or skin. Preparation for this category should include dosage calculations, expected outcomes for different pain management interventions, monitoring of blood and IV transfusions, and collecting data on pharmacological interventions.

Reduction of Risk Potential (9-15%)

Another important aspect of the LPN's scope of practice is the reduction of risk potential. This essentially means recognizing risks in the healthcare setting and preventing negative outcomes. This category covers a wide range of topics, from monitoring the patient's well-being to performing important care tasks. Questions may test a candidate's ability to monitor vital signs, perform venipuncture, monitor glucose readings, collect specimens, perform bladder scans or ultrasounds, apply assistive devices like compression stockings or braces, and insert/maintain nasogastric tubes, IVs, and urinary catheters. The skills necessary for comprehension in this category are probably skills that test-takers will have practiced in clinical or lab.

Physiological Adaptation (7-13%)

This subcategory tests the prospective LPN's ability to provide care in the acute care setting, such as a hospital, or for patients with life-threatening conditions. Like questions about risk reduction, questions about physiological adaptations may test a candidate's ability to perform certain tasks, such as providing care for drains, chest tubes, ostomy bags, ventilators, or tracheostomies, as well as monitoring the patient's condition on these devices/appliances. LPNs must also know how to perform CPR and respond appropriately to life-threatening situations. The ideal candidate will be able to identify changes in their patient's status and provide measures to prevent negative outcomes.

NCLEX-PN Exam Logistics

The following section outlines the basic information test-takers should know before they register for the NCLEX-PN exam. Some aspects of the NCLEX exams have been updated, so candidates should make sure they understand what is being asked of them. The updated versions of the exam still require candidates to use complex critical thinking skills but reflect the growing need for healthcare workers in the workforce by allowing candidates to pass with fewer total questions. Candidates should expect to see questions in the form of multiple-choice, multiple responses, fill-in-the-blank, ordered responses, and more. Questions may include audio or multimedia components like patient/body sounds or charts/graphs.

• Question Count - The NCLEX-PN exam is adaptive, meaning the number of questions can range anywhere from 75 to 145 questions. Note that 15 of these are pretest questions and are unscored.
• Session Length - The session ends when the test-taker has either passed or failed, with a maximum time limit of five hours. That is about two and a half minutes per question, assuming you answer all 145 questions.
• How to Register - Candidates can register for the NCLEX-PN with Pearson VUE, the company that administers the test. The test fee is due at the time of registration.
• Test costs - There is a $200 fee to take the NCLEX-PN, with additional scheduling fees. Candidates should also be prepared to pay a fee for the registration after they pass the exam.
• Test sites - There are NCLEX test sites located all around the country and internationally. These may be located at universities or Pearson test centers. The test is always administered via computer.
• Passing score - The test will end when the computer has determined with 95% confidence that the test-taker is clearly above or clearly below the passing standard. The minimum number of questions a candidate can answer to pass the NCLEX-PN exam is 75.
• Scoring and Reporting - Computer Adaptive Testing (CAT) refers to the responsive nature of the NCLEX exam. If test-takers are performing well, the test will automatically begin to ask more complex and difficult questions, skipping over more basic questions and allowing the candidate to finish the exam quicker. Conversely, if a test-taker is performing poorly, they will not advance to more difficult questions until they have shown mastery of less complex topics. However, the number of questions answered is not a direct indication of how well a candidate is doing.

When candidates are confident in what they must do to register and take the exam, they can instead focus on learning how to pass the NCLEX-LPN.

NCLEX-PN Review Questions and Practice Tests

Learning how to study for the NCLEX-PN exam is half the battle in obtaining your nursing license. Some candidates have learned enough in the classroom and at clinical to be proficient LPNs who can safely practice nursing; however, they do not pass the exam on their first try simply because they do not understand the style of NCLEX-PN questions.

Practice tests are one of the most effective ways future LPNs can prepare to take the NCLEX. When candidates utilize NCLEX-LVN practice questions, they can become familiar with the type of questions that will appear on the exam, as well as identify the content areas they still need further examination. There are many NCLEX-PN review courses available to students online.

Expert Contributor

Christina Flores

Christina Flores, BSN has 4 years of experience in nursing. She has worked as both an RN and as a Prenatal Care Coordinator. To earn her certification, Christina passed the NCLEX and TEAS exams. Christina obtained her BSN from Valparaiso University.