2020 NCLEX-PN Test Prep. Questions and Answers with Explanations (2020)

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2020 NCLEX-PN Test Prep. Questions and Answers with Explanations (2020) covers key exam topics to help you succeed on test day.

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First Printing, 2020
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INTRODUCTION
Welcome to the NCLEX-PN Test Prep Questions and Answers with
Explanations: Study Guide to Passing the License Exam Effortlessly. This
book will help you get ready to take and pass the Licensing Exam for
Practical Nurses. This book gives you a review of the required
information and techniques to obtain licensure.
The NCLEX-PN Test Prep Questions and Answers with Explanations
helps you practice taking questions written in the NCLEX® format. This
book is targeted at test preparation and review. It does not teach you
everything you need to know about the subject of nursing. Instead, they
present you with the essential materials that you are likely to face on the
exam. Using a simplified approach, this will help you understand the key
elements needed to know to pass your exam on the first try.
The NCLEX-PN® is comprised of questions from the cognitive levels of
knowledge, comprehension, application, and analysis. The majority of
questions here are composed at the application and analysis level.
Questions encompass the five stages of the nursing process (assessment,
diagnosis, planning, implementation, and evaluation) and the four
categories of client needs.
The most effective way to pass the NCLEX® is to review the information
you have learned in nursing school and take the time to study it
thoroughly. The exam is difficult and those that do not pass will need to
take the test again. Do not put off studying. Cramming at the last minute
will only lead to a poor outcome. Take your time; allow yourself plenty of

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7 SECRETS TO STUDYING
Hints on How To Pass Any Exam!
Exams! A cause of nervousness, fear, and even terror, yet a necessary rite
of passage toward a worthwhile goal.
The good news is there are many things you can do before and during
your final exam that will almost guarantee a passing grade.
The two most important things you need are motivation and an
effective study plan!
Motivation will take a bit of effort, but it’s the key to achieving your goals.
To stay motivated, remember why you took this course and review the
benefits you’ll derive from passing the exam and receiving your
certificate. Perhaps you’re looking forward to increased income,
increased self-respect or self-employment. You enrolled in this course
because you’re looking forward to a brighter future!
In the following pages, we’ll provide tips and information on how to
create an effective study plan. You’ll discover seven guidelines for
creating a worthwhile program for yourself. If you want to do well and
you want to put forth the effort, use these simple techniques. They have
helped many people succeed, and if you use them, they will work for you
as well!

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SECRET #1: No Excuses! Make Studying a Habit Worth Having
The very first thing you need to do is accept the fact that studying is a
requirement, and a necessary part of the learning process.
Set up a Winning Schedule
Next, set up a schedule and follow it! By doing so, you are developing a
HABIT of studying. A habit (as you may already know) takes on a life of
its own and starts to generate its own energy, making it easier and easier
for you to continue. Remember, consistency is the key to developing a
positive study habit.
How to develop a strong, effective study habit:
• Start small. Start with only 10-15 minutes of studying at a time and
then build up to longer amounts as you progress in the material.
• Set time aside for studying every day if possible.
• On the other hand, be realistic. Be sure to set up a
reasonable schedule that you can easily follow.
SECRET #2: Create the “Right” Study Environment
Avoid All Distractions
Try your best to avoid distractions during your study time. Eliminate all

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the obvious distractions like phone calls, or friends dropping by. Tell
your family members, spouse or children that you need time alone to
concentrate on your studies. Unplug your phone, shut the door, move the
newspaper and magazines to another part of the house. Keep the
television and radio off. Take control of your environment!
Don’t Procrastinate!
Don’t be tempted to put off studying for even two or three hours just
because the garage needs to be cleaned out, or the closets need
reorganizing. Those tasks can wait.
Remember to stick to your schedule.
BONUS TIP: Study Shorter, More Often!
We absorb a lot more information if we learn in small, manageable
portions, instead of trying to learn everything at once.
Break it down! Study small sections, take a break, then study
again.
SECRET #2: Create the “Right” Environment (continued)
Where to Study
Find a quiet, comfortable (but not too comfortable) place to study. If you
find too many distractions at home, go to your local library. Find a part of

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the library that is well-lit and ventilated. This will help you to
concentrate. Pack a box with everything you need to study, so that when
it’s time to go, you can just pick up the box and take off.
The RIGHT Study Environment:
• Studying in the same place each time will help you concentrate and will
reinforce your positive study habits.
• If your exam is proctored, try to recreate the same environment as your
final exam. This means that if you will be taking the exam sitting at a
desk, make sure you study sitting at a desk. If you do this, you will form
an association with knowing the material and sitting at a desk. Make
your study situation as similar as possible to the exam situation, and,
believe it or not, this will actually help you during the exam!
(Later we’ll talk about forming a “mental attitude” during study that you
will duplicate during the exam.)
The WRONG Study Environment:
• Don’t study lying in bed. Your unconscious mind associates your bed
with sleep. You’re more likely to nod off than get any real studying done!
• Don’t study in front of the television set.
• Don’t eat while studying. Food can be the greatest distraction of all!
BONUS TIP: Eat Light & Eat Right

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Do you study in the evening? If you feel sluggish, it could be because you
ate a heavy meal.
Also stay away from foods high in sugar, like candy bars or chocolate.
You’ll get an initial surge, but you’ll soon crash! Instead, eat
carbohydrates (bread or pasta), fruits or protein (nuts, meat).
SECRET #3: Maximize Your Time
Take Study Breaks
Make sure you take a break! Periodically stand up, gently rotate your
neck, touch your toes and feel the stretch along the back of your legs. If
possible, take a short walk to get some fresh air.
Find Your Peak Performance Time
Have you noticed that you’re more alert during a certain time of day? For
some, their peak time of day is in the afternoon, while others feel
sharpest in the early morning hours. Most people claim they’re either a
morning person or a night owl. Which are you? Find out, then study
during those hours, whether it’s 7:00 a.m. or midnight. However, don’t
study when you’re too tired. It’s a waste of your valuable time and it
won’t do you any good!
BONUS TIP: Avoid Cramming!

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Cramming is a good way to guarantee poor results. Don’t expect to retain
any information you try to learn at the last minute. In the days before
your exam, you should review the material you’ve already gone over.
SECRET #4: Use Study Aids to Your Advantage
Plan a review of each chapter as you go along, so that you don’t have to
review everything all at once right before the exam. Remember, no
cramming!
Make up your own questions for each chapter. Use the chapter headings
and subheadings for ideas. Can you answer these questions quickly?
Flash cards are very good tools, particularly for memorization of
important terms and definitions. You can create them out of the words
and terms you’re having the most difficulty with. Review them in random
order until you feel confident that you know them.
Videos, (if offered with your course) are excellent study aids, because
watching and listening to videos involve more of your senses than just
reading. Plus, videos can be rewound and replayed as often as you need.
Practice exams (if available) can also help prepare you for the real thing.
If you can score 90% or more on your practice exams, you’re doing well!
Remember, effective studying is a result of active involvement, not just
passively reading the text and materials.

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BONUS TIP: Score at least 90% correct on your study aids
Your study aids are a valuable tool! Use them to track your progress.
You’ll know instantly which topics you’re weaker on and which areas
you need to review again.
SECRET #5: Remember to use Memorization Tools!
Associative Memory Techniques
What’s the best way to recall important facts? When you associate
something familiar to you with those facts. Here are some examples of
associative memory techniques that will work for you.
Acrostics
Have you ever heard of the phrase, “Every good boy does fine?” This is an
example of an acrostic. The first letter in each word stands for the note
on the musical staff — “E, G, B, D, F”. This is an aid to memory. For
instance, in real estate, when you want to remember property tax dates,
use the acrostic “No Darn Fooling Around” (for November, December,
February, and April). See if you can make up creative acrostics for areas
you need help remembering. Sometimes the more outrageous, the better!
Acronyms
Acronyms are actual words formed from the first letters of a series or list
of words you need to remember. In grade school when you had to
remember the names of the Great Lakes, you probably used the word
“homes” to remember all five lakes - Huron, Ontario, Michigan, Erie, and

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Superior. Be creative in making up acronyms for yourself!
Rhymes
Making up a simple rhyme can be a very effective memorization tool.
Remember, “I before e, except after c?”
Imaging Techniques
Visualization engages a different part of your brain than reading or
listening, thereby adding to your learning success. You can use
“LINKING” to recall a list or series of words by creating a visualization
that contains all the words you need to recall. The more outlandish the
image, the more likely you’ll remember it. For instance, say you want to
recall the errands you need to run that day. You need to go to the post
office, buy milk, pick up your daughter at soccer practice, and buy dog
food. “Link” these together by visualizing a dog with a letter in its mouth
being chased by a cow kicking a soccer ball. It might sound strange, but it
works!
BONUS TIP: Make Sure You Understand What You Read
NEVER go past a word you don’t understand in the textbook. Stop and
look it up, then continue. If you don’t understand a sentence or
paragraph in the text, take it a phrase at a time until it makes sense to
you. Write down any term you find difficult and make it into a flash card.
Review it the next day at the start of your study session. Soon you’ll
know them all!
SECRET #5: Remember to use Memorization Tools! (continued)

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Other Memory Techniques
Recitation
Probably the most powerful tool you have to transfer ideas from your
short-term memory to your long-term memory is to say those ideas out
loud and in your own words.
Interest
You’ll remember things better if you are truly interested in remembering
them. It may sound simple, but it’s true! Therefore, periodically recall
your reasons for taking this course in the first place. Imagine all the
benefits of your new career. Keep your goals in sight. This will refresh
your interest in learning the material and aid in your study success.
Repetition
Remember, memory is interest plus repetition. Reading and re-reading is
helpful, but also say things out loud, write them down, invent acronyms
or use the linking technique. Practice what you’ve learned on your family
or friends. Have them ask you questions based on the material you’ve
studied. We learn through repetition. How do you think we learn the
lyrics to a popular song or all those television ad lines and jingles?
Because we’ve heard them over and over and over and . . .
SECRET #6: Visualize Your Success and Tame Your Fears!
If you’re like most people, you may have a little discomfort at the thought
of taking a quiz or an exam. You may remember past experiences that

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didn’t work out, or you may focus on how you’ll feel if you don’t do well.
Your anxiety may even be intense enough to classify as real fear.
However, it’s important to transform a fearful or negative attitude into a
positive attitude, because a positive attitude counts for at least a third of
your success on any exam! Luckily, we have the power to focus our
attention on thoughts and feelings that serve us better.
BONUS TIP: The past doesn’t equal the future!
Whatever happened before is not destined to happen again. So if you’ve
failed in the past, it doesn’t mean you’ll fail in the future. The past is gone,
so forget it. Let’s start fresh!
SECRET #6: Visualize Your Fears and Tame Your Success!
(continued)
But how do you generate a positive attitude? First, let’s shift our focus
away from how we’ll feel if we fail to how we’ll feel when we succeed!
Each night (or day) at the end of your study session, visualize yourself
receiving your Certificate of Completion. See the words,
“Congratulations, you’ve passed your course.” Smile, take a deep breath,
relax and imagine telling your best friend or family member the good
news. Enjoy your success. Pat yourself on the back for all that studying
and good work. You deserve it!
At first, you may have difficulty visualizing if your fear level is high or if
you’ve had a disappointment or two in the past. However, if you persist,

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little by little, the visualization will become easier. It can actually be quite
fun!
Here’s another visualization tip. Remember when we talked about
duplicating the same study environment that you’d have during the
actual exam as an aid to doing well? Another good visualization
technique is to duplicate the “mental attitude” during study that you’d
like to have during the exam.
You’d probably like to be relaxed, confident, clear-minded and alert
during the exam. So, before each study session, take a minute to imagine
yourself in the exam room, your feet planted on the floor, a clock on the
wall in view, your pencils, eraser, and calculator on the desk in front of
you. If this makes you nervous — fine. Next, close your eyes and take a
long, deep breath. Inhale through your nose, slowly filling up your
diaphragm first, then inhaling upward, filling your lungs. Hold your
breath to the count of three, then exhale slowly through your mouth
while saying the word “relax” in your mind. As you exhale, imagine your
whole body letting go of any tension. Do this three or four times until you
feel relaxed. With your eyes still closed, take a moment and concentrate
on how it feels to be relaxed. Tell yourself, “I am in the exam room and
I’m completely relaxed and feeling fine. I feel confident and intelligent! I
remember everything I studied.” (If you wish, substitute other sentences
that feel helpful to you.) If you do this breathing technique and
affirmation each time you study, you will develop a relaxation response.
This relaxation response will become stronger each time you practice it.
BONUS TIP: Anticipation Jitters are Normal!

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Don’t deny what you’re feeling! You’re experiencing anxiety because you
realize the importance of passing this exam it’s a natural reaction.
However, don’t let this fear paralyze you. Remember your visualization
and relaxation techniques.
SECRET #6: Visualize Your Fears and Tame Your Success!
(continued)
When you actually find yourself in the exam room, you can close your
eyes and repeat this procedure. The relaxation response you developed
sitting in your study area will be recalled by your body and will help you
relax during the exam. It works!
You can also add a cue to your relaxation response if you’d like. For
example, in order to relax during an exam, you can program yourself to
deep breathe and relax while gently tapping your index finger on the
table. Practice this technique over and over again until your mind
associates the relaxation response with the tapping of your finger. Then,
if you feel tense when you’re taking the actual exam, all you need to do is
gently tap your index finger on the desk and you’ll calm down!
If you psychologically prepare yourself for success, your chances for real
success will increase dramatically. Professional athletes frequently use
visualization techniques to improve their performance. They don’t allow
room for a single negative thought, and neither should you. Tell yourself
you’re looking forward to your exam, because it will be the culmination
of all your hard work and in the end, you’ll have a rewarding new career!

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SECRET #7: Don’t Cram The Night Before - What to Do Instead!
The Day Before the Exam...
If your exam is proctored and you need to drive to the location, make
sure you load the car up with gas the day before your exam. Also review
the two routes you’ve planned to take to get to the exam location. Think
through and write down your pre-exam schedule so that you know when
you have to leave the house to arrive at the exam early. Give yourself
adequate time to shower, dress, eat, etc. Gather all the materials you’ll
need for the exam and put them in a box or bag.
The Night Before...
Some people recommend not studying at all after dinner on the night
before the exam. Instead, go for a long walk, or read, or hit some golf
balls - whatever relaxes you. If you’ve followed your study schedule and
used the suggestions in this booklet, you should be well prepared! Now
all you need to do is make sure you get a good night’s sleep. Staying up
late, or going out to a party won’t help your test results!
BONUS SECTION: Tips For During The Exam
Regardless of whether your exam is proctored or not, read the directions
carefully. Don’t assume you already know what they say. Take nothing
for granted. Be sure to note if you’ll be penalized for wrong answers or
not. If you’re not penalized for wrong answers, then it’s okay to guess.

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Next, do a quick preview of the exam. If you don’t already know how the
exam is broken down, this will give you some idea. If any information
comes into your mind during the preview, write it down quickly on your
scrap paper for use later. Previewing the exam quickly may even give
you some answers to questions. Also, your subconscious will be working
on the difficult questions you’ve seen before you get to them.
Once you know how the exam breaks down, then you can quickly
calculate how much time is reasonable to allot for each section. For
instance, an essay question worth only a few points is not worth
spending 30 minutes on!
If the exam is all multiple choice, you can calculate how much time each
question should take in the following manner. Divide your time into
quarterly segments. For instance, if you have 4 hours to complete the
exam, and there are 150 questions, then set a goal to finish the exam in 3
hours. (We will explain why later.) Therefore, divide 3 hours by 4 and
you’ll get 4 forty-five minute segments. Write down when you should be
done with one-quarter of the questions, one- half of the questions, three-
quarters of the questions, and finally the whole exam. It will look
something like this.
Time Question #
9:00 - 9:45 #1-#39
9:45 - 10:30 #38 - #75
10:30 - 11:15 #76 - #113
11:15 - 12:00 #114 - #150

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BONUS SECTION: Tips For During The Exam (continued)
This way, if at 9:45 you’re still on question #12, you’ll know you’re
moving too slow. But luckily, you’ve spotted your error early and you
have time to pick up speed! If you’re right at question #38, you know
you’re on time and doing well. Keep checking your progress periodically.
Work on the easiest parts of the exam first, but be sure to allow enough
time for the difficult parts of the exam. If the exam is all multiple-choice
questions, then just go ahead sequentially. But if the exam contains some
multiple-choice and some essay questions, and you have a definite
preference for one type of question over the other, complete the type of
question you like better first. As a result, you’ll gain confidence and
momentum. Then when you go back to the harder questions, your
subconscious mind has already been working on them.
When answering essay questions, write notes in the margin of your scrap
paper to help you organize your ideas briefly before writing. Be sure to
make your writing easy to read.
Any question you don’t understand can be restated in your own words to
make it easier for you to understand. However, be sure not to change the
original meaning of the question!
Go Through Your Exam Four Times
You’re going to go through your exam four different times. That’s why we

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took that extra hour away from your first pass through the exam. This
last hour allows you time for the subsequent passes through the exam.
The first time through the exam, skip any questions you don’t know the
answers to. Draw a line on your scrap paper, and write down the
numbers of those questions you skip.
After you’ve gone all the way through the exam the first time, count how
many questions you’ve skipped and quickly calculate how much time you
have for each of them, then go back through the exam a second time to
answer those questions you’ve skipped. Try to answer them, but don’t
take longer than the time you allotted for each one. If you still don’t know
the answer, leave it blank.
The third time through the exam, go ahead and guess on those questions
you left blank (if you won’t be penalized for guessing).
BONUS SECTION: Tips For During The Exam (continued)
The fourth time through the exam, proofread your answers. When you
proofread, you’re looking for these three things: clerical, mathematical or
perceptual errors. Did you misunderstand the question? Is the decimal
point in the right place? Did you mistakenly pencil in “A” for answer #23
instead of “B” ? On the other hand, don’t change any of the answers
unless you’re absolutely sure they’re incorrect. Your first instincts are
usually right.
It may be difficult for you to review the exam the fourth time. You’re

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under stress and you may just want to finish as quickly as possible. But
don’t give up yet. You’ve worked hard, so see it through. Use all the time
you have been allotted for the exam. Don’t leave until the proctor says
“Time is up!”
After The Exam .....
Congratulations! You’ve worked hard, and you’ve done well, so now you
can relax. If you’ve faithfully followed these steps, you’ll soon be able to
enjoy your success!

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Study Mode
Practice Exam 1 (STUDY MODE)
1. The nurse is caring for a client scheduled for removal of a pituitary
tumor using the transsphenoidal approach. The nurse should be
particularly alert for:
A. Nasal congestion
B. Abdominal tenderness
C. Muscle tetany
D. Oliguria
Answer A: Removal of the pituitary gland is usually done by a
transsphenoidal approach, through the nose. Nasal congestion further
interferes with the airway. Answers B, C, and D are not correct because
they are not directly associated with the pituitary gland.
2. A client with cancer is admitted to the oncology unit. Stat lab values
reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets
178,000. The nurse evaluates that the client is experiencing which of the
following?
A. Hypernatremia
B. Hypokalemia

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C. Myelosuppression
D. Leukocytosis
Answer B: Hypokalemia is evident from the lab values listed. The other
laboratory findings are within normal limits, making answers A, C, and D
incorrect.
3. A 24-year-old female client is scheduled for surgery in the morning.
Which of the following is the primary responsibility of the nurse?
A. Taking the vital signs
B. Obtaining the permit
C. Explaining the procedure
D. Checking the lab work
Answer A: The primary responsibility of the nurse is to take the vital
signs before any surgery. The actions in answers B, C, and D are the
responsibility of the doctor and, therefore, are incorrect for this question.
4. The nurse is working in the emergency room when a client arrives
with severe burns of the left arm, hands, face, and neck. Which action
should receive priority?
A. Starting an IV
B. Applying oxygen
C. Obtaining blood gases

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D. Medicating the client for pain
Answer B: The client with burns to the neck needs airway assessment
and supplemental oxygen, so applying oxygen is the priority. The next
action should be to start an IV and medicate for pain, making answers A
and C incorrect. Answer D, obtaining blood gases, is ordered by the
doctor.
5. The nurse is visiting a home health client with osteoporosis. The client
has a new prescription for alendronate (Fosamax). Which instruction
should be given to the client?
A. Rest in bed after taking the medication for at least 30 minutes
B. Avoid rapid movements after taking the medication
C. Take the medication with water only
D. Allow at least 1 hour between taking the medicine and taking other
medications
Answer B: The client with burns to the neck needs airway assessment
and supplemental oxygen, so applying oxygen is the priority. The next
action should be to start an IV and medicate for pain, making answers A
and C incorrect. Answer D, obtaining blood gases, is ordered by the
doctor.
6. The nurse is making initial rounds on a client with a C5 fracture and
crutchfield tongs. Which equipment should be kept at the bedside?

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A. A pair of forceps
B. A torque wrench
C. A pair of wire cutters
D. A screwdriver
Answer B: A torque wrench is kept at the bedside to tighten and loosen
the screws of crutchfield tongs. This wrench controls the amount of
pressure that is placed on the screws. A pair of forceps, wire cutters, and
a screwdriver, in answers A, C, and D, would not be used and, thus, are
incorrect.
7. An infant weighs 7 pounds at birth. The expected weight by 1 year
should be:
A. 10 pounds
B. 12 pounds
C. 18 pounds
D. 21 pounds
Answer D: A birth weight of 7 pounds would indicate 21 pounds in 1
year, or triple his birth weight. Answers A, B, and C therefore are
incorrect.
8. A client is admitted with a Ewing’s sarcoma. Which symptoms would
be expected due to this tumor’s location?

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A. Hemiplegia
B. Aphasia
C. Nausea
D. Bone pain
Answer D: Sarcoma is a type of bone cancer; therefore, bone pain would
be expected. Answers A, B, and C are not specific to this type of cancer
and are incorrect.
9. The nurse is caring for a client with epilepsy who is being treated with
carbamazepine (Tegretol). Which laboratory value might indicate a
serious side effect of this drug?
A. Uric acid of 5mg/dL
B. Hematocrit of 33%
C. WBC 2,000 per cubic millimeter
D. Platelets 150,000 per cubic millimeter
Answer C: Tegretol can suppress the bone marrow and decrease the
white blood cell count; thus, a lab value of WBC 2,000 per cubic
millimeter indicates side effects of the drug. Answers A and D are within
normal limits, and answer B is a lower limit of normal; therefore,
answers A, B, and D are incorrect.
10. A 6-month-old client is admitted with possible intussuception. Which

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question during the nursing history is least helpful in obtaining
information regarding this diagnosis?
A. “Tell me about his pain.”
B. “What does his vomit look like?”
C. “Describe his usual diet.”
D. “Have you noticed changes in his abdominal size?”
Answer C: The least-helpful questions are those describing his usual
diet. A, B, and D are useful in determining the extent of disease process
and, thus, are incorrect.
11. The nurse is assisting a client with diverticulosis to select
appropriate foods. Which food should be avoided?
A. Bran
B. Fresh peaches
C. Cucumber salad
D. Yeast rolls
Answer C: The client with diverticulitis should avoid foods with seeds.
The foods in answers A, B, and D are allowed; in fact, bran cereal and
fruit will help prevent constipation.
12. A client has rectal cancer and is scheduled for an abdominal perineal
resection. What should be the priority nursing care during the post-op

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period?
A. Teaching how to irrigate the illeostomy
B. Stopping electrolyte loss in the incisional area
C. Encouraging a high-fiber diet
D. Facilitating perineal wound drainage
Answer D: The client with a perineal resection will have a perineal
incision. Drains will be used to facilitate wound drainage. This will help
prevent infection of the surgical site. The client will not have an
illeostomy, as in answer A; he will have some electrolyte loss, but
treatment is not focused on preventing the loss, so answer B is incorrect.
A high-fiber diet, in answer C, is not ordered at this time.
13. The nurse is performing discharge teaching on a client with
diverticulitis who has been placed on a low-roughage diet. Which food
would have to be eliminated from this client’s diet?
A. Roasted chicken
B. Noodles
C. Cooked broccoli
D. Custard
Answer C: The client with diverticulitis should avoid eating foods that
are gas forming and that increase abdominal discomfort, such as cooked
broccoli. Foods such as those listed in answers A, B, and D are allowed.

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National Council Licensure Examination

2020 NCLEX-PN Test Prep. Questions and Answers with Explanations (2020)

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