Click Study Flashcards above to open the flashcard hub — hundreds of NCLEX-PN cards you can flip, match, type, or quiz yourself on. Every card is drawn from the NCSBN Client Needs categories and written to the LPN/VN scope, so you study exactly what the licensure exam tests.[1] Pair them with our free practice questions and study guide.
NCLEX-PN Flashcard Study Modes
Flip mode is for first passes, front to back, one card at a time. Match times you pairing terms with definitions, which keeps short fronts moving fast. Type shows the definition and asks you to produce the term, so you read the description and type SBAR. Quiz rebuilds the same cards as multiple choice so you can check recall under pressure.
Why Flashcards Work for the NCLEX-PN
Three domains tie for the largest share of this 300-card deck at 35 cards each. Psychosocial Integrity drills mental health vocabulary and therapeutic communication through fronts such as Delirium, Dementia, and Offering self. Pharmacological Therapies covers drug classes, anticoagulation, and dosage work with cards like Heparin, Warfarin, and Med calc. Reduction of Risk Potential leans on labs and monitoring data, including HbA1c, ABG pH, and NG tube.
Coordinated Care carries 31 cards on handoff language, delegation, and the boundaries of practice, with fronts such as SBAR, Delegate to UAP, and Unsafe order. Health Promotion & Maintenance also carries 31 cards and runs across the lifespan, from APGAR and BUBBLE-HE to Teach-back, mixing newborn and postpartum assessment with client education terms.
Safety & Infection Prevention and Control holds 30 cards on hazards, precautions, and protective equipment, including Restraints, RACE (fire), and Don PPE order. Exam Logistics & Clinical Judgment adds 27 cards on how the test itself is built and scored, with fronts like NCJMM 6 steps, Test format, and Governing body.
Physiological Adaptation contributes 25 cards on managing altered body systems and devices, among them Dialysis, Ostomy care, and COPD teaching. Clinical Judgment — First Action adds 23 cards that force a single next step, with prompts such as Suicidal hint, Acute new confusion, and Unsafe/unclear order.
Basic Care & Comfort rounds out daily nursing with 18 cards on nutrition, mobility, and comfort, including Renal diet, Pain scales, and ROM. Core PN Scope Distinctions closes the deck with 10 focused cards that separate what a PN may do from what belongs to the RN, such as Stable client monitoring, Scope authority, and Plan (initial).
That matters on the NCLEX-PN, where facts like lab values, drug watch points, and isolation precautions must be instantly available. Used alongside our practice questions and study guide, flashcards turn review time into measurable progress.
NCLEX-PN Flashcards by Topic
The cards are organized by the NCSBN Client Needs categories. Weight your study toward the heaviest ones — Physiological Integrity (about 45% across four subcategories) and Coordinated Care (the single largest subcategory at 18–24%) carry the most points:[1]
| NCSBN Client Needs category | PN % range |
|---|---|
| Coordinated Care | 18–24% |
| Safety & Infection Prevention and Control | 10–16% |
| Health Promotion & Maintenance | 6–12% |
| Psychosocial Integrity | 9–15% |
| Basic Care & Comfort | 7–13% |
| Pharmacological Therapies | 10–16% |
| Reduction of Risk Potential | 9–15% |
| Physiological Adaptation | 7–13% |
How to Get the Most Out of These Flashcards
- Start with the 35-card blocks. Psychosocial Integrity, Pharmacological Therapies, and Reduction of Risk Potential are the deck’s largest domains, so early Flip passes there move the most cards.
- Type-drill the exact recall. Cards like Med calc and BUBBLE-HE reward producing the term from the definition rather than recognizing it, which is where vague memory shows up fast.
- Use Match for value cards. Short lab and gas fronts such as PaCO₂ and HCO₃⁻ pair quickly under a timer, and speed there frees attention for judgment items.
- Move to the practice test once Quiz holds. When Coordinated Care and Clinical Judgment — First Action cards stop tripping you in Quiz mode, test full-length questions and use the study guide for gaps.
- Rotate two domains a session. With 300 cards, pair a heavy domain with a smaller one like Core PN Scope Distinctions, then revisit missed cards the next session before adding new ones.
NCLEX-PN Flashcards FAQ
Hundreds of free NCLEX-PN flashcards, organized across the NCSBN Client Needs categories tested on the LPN/VN licensure exam. They're free to use with no account required.
Yes. Flashcards use active recall — retrieving an answer from memory — which research shows is one of the most effective ways to make information stick, especially in short sessions spread over several days.
All four NCSBN Client Needs categories: Safe and Effective Care Environment (Coordinated Care and Safety and Infection Prevention and Control), Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity (basic care, pharmacology, reduction of risk, and physiological adaptation), plus exam logistics and clinical judgment.
Yes. Every card is written to the LPN/VN scope the NCLEX-PN actually tests — data collection rather than full assessment, reinforcing teaching rather than initial teaching, and care of stable clients under the direction of an RN or provider.
Mix the modes: flip to learn, type to test recall, match for speed, and quiz to check yourself. Spend the most time on Physiological Integrity (about 45%) and Coordinated Care (18–24%) — together they are the bulk of the exam.
Yes — 100% free, all four study modes, no paywall.
NCLEX-PN flashcard bank
All 300 cards, by topic
A reference copy of every card in this deck. Each answer stays hidden until you choose to show it. To study with Flip, Match, Type and Quiz modes and track what you have mastered, use Study Flashcards at the top of the page.
Exam Logistics & Clinical Judgment (27)
- NCLEX-PN
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National licensure exam for Licensed Practical/Vocational Nurses (LPN/LVN), administered by NCSBN.
- Governing body
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National Council of State Boards of Nursing (NCSBN).
- Current test plan
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2026 NCLEX-PN Test Plan, effective April 2026.
- Test format
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Computerized Adaptive Testing (CAT), variable length, one item at a time, no going back.
- Minimum items (PN)
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85.
- Maximum items (PN)
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150.
- Pretest (unscored) items
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15 on every exam.
- Time limit (PN)
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5 hours total (includes breaks).
- 85-item exam breakdown
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52 content items + 18 case-study items + 15 pretest.
- Passing standard
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at or above the set ability level (−0.18 logits); no fixed % passes.
- 95% Confidence Interval Rule
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exam stops when 95% certain candidate is above/below standard.
- Maximum-Length Exam Rule
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at 150 items, use final ability estimate only.
- Run-Out-Of-Time (R.O.O.T.) Rule
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<85 items answered = fail; = scored on final estimate.
- Exam length & result
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length does NOT indicate pass/fail.
- Registration fee
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$200 USD.
- Retake wait
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45 test-free days between attempts (NCSBN); up to 8/year; states may be stricter.
- NGN launch
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April 1, 2023 (measures clinical judgment).
- NCJMM
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NCSBN Clinical Judgment Measurement Model.
- NCJMM 6 steps
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Recognize cues, Analyze cues, Prioritize hypotheses, Generate solutions, Take action, Evaluate outcomes.
- Case study
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6-item set on one unfolding client, one item per NCJMM step.
- NGN item types
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extended multiple response, matrix/grid, cloze/drop-down, drag-and-drop, bow-tie, highlight, trend.
- Partial-credit scoring methods
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plus/minus, zero/one, rationale.
- Integrated processes
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Caring, Clinical Judgment, Nursing Process, Communication/Documentation, Culture/Spirituality, Teaching/Learning.
- PN nursing-process verb
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"data collection" (RN = full "assessment").
- Largest content subcategory
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Coordinated Care (18–24%).
- Largest major category
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Physiological Integrity (~45% combined).
- PN content variance
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distributions may vary per category.
Coordinated Care (31)
- Coordinated Care
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PN name for the subcategory the RN plan calls "Management of Care."
- LPN/VN role
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collaborates with/under the direction of the RN and provider.
- LPN scope
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collect data, reinforce teaching, perform routine skills, monitor stable clients.
- RN-only (not LPN)
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initial assessment, care-plan creation, initial teaching, unstable clients, IV-push high-alert meds, blood initiation, triage, first evaluation.
- Data collection vs assessment
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LPN collects data; RN assesses.
- Reinforce teaching
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LPN repeats/clarifies education the RN/provider started.
- 5 Rights of Delegation
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right task, circumstance, person, direction/communication, supervision/evaluation.
- Delegate to UAP
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stable/predictable ADLs: bathing, feeding (no swallow risk), ambulating, positioning, toileting, vitals, I&O, weight, routine specimens.
- Never delegate to UAP
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assessment, planning, evaluation, teaching, nursing judgment, unstable clients.
- Delegation accountability
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the delegating nurse retains accountability for outcomes.
- Prioritization #1
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ABCs: Airway → Breathing → Circulation.
- Maslow
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physiologic needs before safety before psychosocial (physical before emotional).
- Stable vs unstable
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see the acute/unstable/unexpected client first; refer instability to RN.
- Scope of practice source
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state Nurse Practice Act / Board of Nursing (not the employer).
- Informed consent roles
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provider explains/obtains; nurse witnesses signature & confirms understanding.
- Consent doubt
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client unsure before signing → stop and notify the provider.
- Advance directive
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living will / durable power of attorney for health care; honor it.
- Mandatory reporting
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abuse, neglect, gunshot/stab wounds, certain communicable diseases.
- Suspected abuse
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report; proof not required.
- Confidentiality (HIPAA)
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disclose only on need-to-know; provide privacy.
- Unsafe order
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clarify with the prescriber before carrying it out.
- Unsafe practice by staff
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recognize, intervene, and report up the chain.
- Self-limitation
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recognize limits and seek assistance.
- Incident/occurrence report
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documents errors/near-misses; not part of the chart; don't chart that it was filed.
- SBAR
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Situation, Background, Assessment/data, Recommendation (hand-off communication).
- Client advocacy
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advocate for client rights/needs; promote self-advocacy.
- Interdisciplinary team
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RN, provider, PT, OT, RD, pharmacy, social work.
- Quality improvement
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participate (data collection, committees) for cost-effective care.
- Equal-access care
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unbiased regardless of culture, ethnicity, sexual orientation, gender identity/expression.
- Continuity of care
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participate in admission, discharge, transfer, referral, follow-up.
- Documentation rule
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objective, factual, timely; charts validate care.
Safety & Infection Prevention and Control (30)
- Standard Precautions
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apply to ALL clients; assume blood/body fluids infectious.
- #1 infection-prevention measure
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hand hygiene.
- Soap & water required
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visibly soiled hands, C. difficile, spores, norovirus.
- Alcohol-based rub
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acceptable for routinely soiled (non-spore) hands.
- Contact Precautions
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gown + gloves (MRSA, VRE, C. diff, RSV, scabies).
- C. difficile
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contact precautions; soap & water; bleach cleaning (alcohol won't kill spores).
- Droplet Precautions
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surgical mask within ~6 ft (flu, pertussis, mumps, meningococcus, group A strep).
- Airborne Precautions
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N95 + negative-pressure (AIIR) room, door closed.
- Airborne diseases
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Measles, Chickenpox/Varicella, TB (+ disseminated zoster) = "My Chicken Has TB."
- Varicella precautions
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airborne + contact.
- Don PPE order
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gown → mask → goggles → gloves.
- Doff PPE order
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gloves → goggles → gown → mask; hand hygiene last.
- Protective/reverse isolation
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protects the immunocompromised client (no raw produce/fresh flowers).
- Two identifiers
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verify name + DOB/MRN before meds, procedures, specimens, blood.
- Fall prevention
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bed low/locked, call light in reach, nonskid footwear, alarms, rounding.
- Restraints
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least restrictive; need a provider order (not PRN); try alternatives first.
- Restraint emergency
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may apply first, obtain order within facility timeframe.
- Restraint monitoring
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circulation/skin/ROM/toileting; q15min behavioral; quick-release knot to bed frame, not side rail.
- RACE (fire)
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Rescue, Alarm, Confine, Extinguish/Evacuate.
- PASS (extinguisher)
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Pull, Aim, Squeeze, Sweep.
- Oxygen safety
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no smoking/flame/sparks; combustion hazard; secure cylinders.
- Latex allergy
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identify, band, avoid latex products.
- Body mechanics
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bend at knees, load close, push > pull, get help.
- Transfer devices
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gait/transfer belt, slide board, mechanical lift.
- Mass-casualty triage
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greatest good for greatest number.
- Security alerts
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infant abduction, elopement/flight risk.
- Sharps safety
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no recapping; puncture-resistant container.
- Timed monitoring
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safety checks (e.g., q15min suicide precautions).
- Home safety
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remove scatter rugs, add grab bars/lighting, smoke/CO detectors, safe med storage.
- Equipment safety
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ensure safe functioning; remove/report malfunctioning devices.
Health Promotion & Maintenance (31)
- Scope
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growth/development knowledge + prevention/early detection.
- PN role
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collect health history/baseline data; reinforce prevention teaching.
- NCSBN age bands
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newborn <1 mo, infant/toddler yr, 3–17 yr, adult 18–64, older adult 65+.
- Erikson infant
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trust vs. mistrust.
- Erikson toddler
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autonomy vs. shame/doubt.
- Erikson preschool
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initiative vs. guilt.
- Erikson school-age
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industry vs. inferiority.
- Erikson adolescent
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identity vs. role confusion.
- Erikson older adult
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integrity vs. despair.
- Social smile
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~2 months.
- Sits unsupported
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~6–8 months.
- Walks
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~12–15 months.
- Birth weight doubles
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~6 months; triples ~12 months.
- Anterior fontanel closes
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~12–18 months.
- Primary prevention
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prevent disease (immunizations, education, seat belts).
- Secondary prevention
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screening/early detection (BP, mammogram, Pap, glucose).
- Tertiary prevention
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limit disability (rehab, support groups).
- APGAR
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HR, respiratory effort, tone, reflex, color at 1 & 5 min (7–10 reassuring).
- Newborn vitals
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HR 110–160, RR 30–60.
- BUBBLE-HE
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postpartum assessment (Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy, Homan's, Emotions).
- Lochia progression
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rubra → serosa → alba.
- Boggy fundus
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massage first, then notify.
- Live vaccines
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MMR, varicella, intranasal flu, rotavirus.
- Live vaccine contraindication
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pregnancy and immunocompromise.
- Immunization source
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current CDC schedule (updated regularly).
- Teach-back
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confirm understanding ("tell me in your own words").
- Learning barriers
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language, literacy, sensory deficit, pain, anxiety, developmental level, culture.
- Normal aging
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presbyopia, presbycusis, slower reaction, reduced renal/hepatic clearance.
- Acute confusion in elder
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NOT normal aging → investigate cause (infection, dehydration, drugs).
- Community resources
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home health, Meals on Wheels, hospice, support groups.
- High-risk behavior prevention
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substance misuse, unsafe sex, smoking cessation education.
Psychosocial Integrity (35)
- Scope
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assist with emotional, mental, social well-being.
- Therapeutic communication goal
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acknowledge feelings, keep client talking.
- Open-ended question
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therapeutic ("Tell me more…").
- Offering self
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"I'll sit with you."
- Reflecting/restating
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therapeutic.
- False reassurance
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NON-therapeutic ("Everything will be fine").
- Giving advice
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NON-therapeutic.
- "Why" questions
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NON-therapeutic (accusatory).
- Feelings before facts
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address emotion before teaching.
- Empathy vs sympathy
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choose empathy.
- Defense mechanisms
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denial, projection, rationalization, regression, displacement, sublimation.
- Kübler-Ross grief
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denial, anger, bargaining, depression, acceptance (not linear).
- Anxiety levels
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mild, moderate, severe, panic.
- Panic anxiety
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never leave the client alone; reduce stimuli; short sentences.
- Suicide assessment
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ask directly about ideation/plan; asking does NOT plant the idea.
- Highest suicide risk
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specific plan + available means.
- Sudden mood lift in depression
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may signal decision to act → increase vigilance.
- Suicide precaution
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ensure safety, remove means, timed checks/one-to-one.
- Mania care
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decrease stimulation, structure, finger foods, set limits.
- Hallucination
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false sensory perception; acknowledge experience, present reality.
- Command hallucination
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assess safety risk (commands to harm).
- Delusion
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fixed false belief; don't argue or agree; focus on feelings/reality.
- Paranoid client
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don't touch without warning.
- Alcohol withdrawal
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24–72 h; tachycardia, tremor, hallucinations, seizures, DTs (can be fatal).
- Opioid overdose
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respiratory depression, pinpoint pupils → naloxone.
- Delirium
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acute, fluctuating, often reversible (infection, drugs, dehydration, hypoxia).
- Dementia
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chronic, progressive, irreversible.
- De-escalation
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calm voice, space, choices, set limits; restraints last resort.
- Therapeutic milieu
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safe, structured, supportive environment.
- Reminiscence/validation/reality therapy
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match technique to cognitively impaired client.
- Culture/spirituality
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treat as client self-reported; honor preferences.
- End-of-life care
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comfort, honor advance directives, support family/grief.
- Nonadherence
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explore reasons rather than judge.
- Self-esteem
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give genuine, specific recognition.
- Reinforce caregiver education
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managing client with behavioral disorders.
Basic Care & Comfort (18)
- Scope
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comfort and ADL assistance.
- Enteral feeding safety
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HOB during/after; verify placement; check residuals.
- Aspiration prevention
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upright, thickened liquids, chin-tuck, no straws.
- Pressure injury prevention
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reposition q2h, offload, moisture/nutrition.
- Pressure injury stages
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1–4 + unstageable + deep tissue.
- Pain
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"what the client says it is"; 5th vital sign.
- Pain scales
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0–10 numeric; FACES (peds/nonverbal); FLACC (infants).
- Nonpharmacological pain relief
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imagery, massage, repositioning, heat/cold, music, distraction.
- Low-sodium diet
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heart failure, hypertension.
- Renal diet
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limit potassium, phosphorus, protein (per stage).
- Diabetic diet
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carbohydrate-consistent.
- I&O monitoring
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track intake and output.
- Irrigation
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catheter, bladder, wound, ear, nose, eye.
- Sleep/rest
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provide measures to promote.
- Postmortem care
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provide after death.
- Immobility complications
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pressure injury, VTE, atelectasis, constipation, contractures.
- ROM
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maintain joint mobility in immobilized client.
- Complementary therapy
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music, pet therapy as appropriate.
Pharmacological Therapies (35)
- Rights of med administration
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client, drug, dose, route, time (+documentation, reason, response, refuse, education).
- High-alert meds
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insulin, anticoagulants, opioids, concentrated electrolytes (KCl); double-check.
- Three label checks
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verify drug 3 times before giving.
- Pre-administration data
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allergies, contraindications, current meds, relevant vitals/labs.
- Controlled substances
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count and report discrepancies.
- ID injection angle
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5–15°.
- Subcut injection angle
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45–90°.
- IM injection angle
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90°.
- Heparin subcut
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don't aspirate, don't massage; rotate sites.
- Insulin IV
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only regular insulin is IV-compatible.
- Med calc
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.
- IV rate
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.
- Warfarin
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monitor INR (~2–3); antidote vitamin K.
- Heparin
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monitor aPTT; antidote protamine sulfate.
- Digoxin
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check apical pulse 1 min; hold if <60 bpm (adult).
- Digoxin toxicity
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N/V, visual halos, bradycardia, anorexia; worsened by hypokalemia.
- Digoxin therapeutic level
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ng/mL; antidote digoxin immune Fab.
- Lithium therapeutic range
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0.6–1.2 mEq/L; toxicity .
- Lithium teaching
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maintain fluid and sodium intake; report tremor/GI/confusion.
- Insulin hypoglycemia
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shaky, diaphoretic, confused → 15 g fast carb / glucagon.
- Opioids
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respiratory depression, constipation; antidote naloxone.
- Acetaminophen toxicity
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hepatotoxic; antidote N-acetylcysteine.
- Benzodiazepines
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sedation/resp depression; antidote flumazenil.
- Loop diuretics (furosemide)
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hypokalemia, ototoxicity; monitor K⁺.
- ACE inhibitors (-pril)
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dry cough, hyperkalemia, angioedema, first-dose hypotension.
- Beta blockers (-olol)
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bradycardia, hypotension; don't stop abruptly; mask hypoglycemia.
- Aminoglycosides/vancomycin
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nephro/ototoxic; monitor trough.
- Corticosteroids
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hyperglycemia, infection masking, taper, take with food.
- MAOIs
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avoid tyramine (aged cheese, wine) → hypertensive crisis.
- Statins
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report muscle pain (rhabdomyolysis), liver monitoring.
- Transfusion reaction
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stop, run normal saline, notify; fever/chills/back pain/dyspnea.
- PCA/epidural
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maintain; monitor; don't adjust beyond scope.
- Medication reconciliation
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prescriptions + OTC + herbals.
- IV piggyback
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secondary infusion (state-dependent LPN scope).
- Expired/incompatible meds
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check storage, dates, compatibility.
Reduction of Risk Potential (35)
- Scope
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reduce complications from treatments/procedures/conditions.
- Sodium normal
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135–145 mEq/L.
- Potassium normal
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3.5–5.0 mEq/L.
- Calcium normal
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9.0–10.5 mg/dL.
- Magnesium normal
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1.5–2.5 mEq/L.
- Fasting glucose normal
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70–110 mg/dL.
- HbA1c
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<5.7% normal; diabetes goal often <7%.
- BUN normal
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10–20 mg/dL.
- Creatinine normal
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0.6–1.2 mg/dL.
- WBC normal
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5,000–10,000 /µL.
- Platelets normal
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150,000–400,000 /µL.
- Hgb normal
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M 14–18, F 12–16 g/dL.
- INR therapeutic
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~2–3.
- ABG pH
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7.35–7.45.
- PaCO₂
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35–45 mmHg.
- HCO₃⁻
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22–26 mEq/L.
- PaO₂
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80–100 mmHg.
- Hyperkalemia ECG
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peaked T-waves; emergency dysrhythmia risk.
- Hypokalemia
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flat T/U-wave, weakness, ↑digoxin toxicity.
- Hyponatremia
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confusion, seizures.
- Hypercalcemia
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"stones, bones, groans."
- Point-of-care tests
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glucose, pregnancy, troponin, urine dipstick.
- Specimen collection
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blood, urine, stool, sputum.
- Venipuncture
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collect blood specimens.
- EKG/ECG
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perform per scope; report abnormalities.
- Bladder scan
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check for urinary retention.
- Urinary catheter
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sterile insertion → prevent CAUTI.
- NG tube
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verify placement before use.
- SCDs/compression stockings
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VTE prevention.
- Pre-op care
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consent witnessed, NPO, baseline vitals, reinforce teaching.
- Post-op monitoring
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airway, bleeding, pain, VTE, vitals.
- Focused data collection
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neuro checks, circulation checks per condition.
- Central venous catheter
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maintain per scope.
- Peripheral IV
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maintain/remove; monitor for infiltration/phlebitis.
- Prenatal complication signs
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identify and report.
Physiological Adaptation (25)
- Scope
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care for acute, chronic, life-threatening conditions.
- Life-threatening response
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CPR/BLS; recognize arrest, high-quality compressions.
- Change in condition
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recognize and report early.
- Respiratory intervention
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breathing treatments, suctioning, repositioning.
- Tracheostomy care
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suction PRN, humidify, stoma care, keep spare trach/obturator at bedside.
- Ventilator client
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provide care per scope; monitor.
- Cardiac monitor
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recognize/report basic abnormalities (RN/provider interprets complex).
- Wound care
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perform dressing changes; remove sutures/staples per order.
- Drainage devices
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care for wound drains, chest tubes.
- Ostomy care
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skin protection, appliance care, output monitoring (colostomy/ileostomy/urostomy).
- Pacing device
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assist in care.
- Dialysis
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care for peritoneal/hemodialysis (monitor access, weights, complications).
- Fluid/electrolyte imbalance
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provide care and monitor.
- Cooling/warming
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restore normal body temperature.
- Heart failure teaching
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daily weights; report >2–3 lb/day or 5 lb/week; low sodium.
- COPD teaching
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pursed-lip breathing, low-flow O₂, energy conservation.
- Diabetes teaching
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glucose, foot care, sick-day rules, hypo/hyperglycemia.
- Hypoglycemia signs
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shaky, sweaty, confused, tachycardia.
- Hyperglycemia/DKA signs
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polyuria, polydipsia, fruity breath, Kussmaul respirations.
- ROME (acid-base)
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Respiratory Opposite, Metabolic Equal.
- Respiratory acidosis
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↓pH, ↑CO₂ (hypoventilation, COPD).
- Respiratory alkalosis
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↑pH, ↓CO₂ (hyperventilation, anxiety).
- Metabolic acidosis
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↓pH, ↓HCO₃ (DKA, diarrhea, renal failure).
- Metabolic alkalosis
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↑pH, ↑HCO₃ (vomiting, antacids).
- Stroke/neuro deficit
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reinforce care; monitor; aspiration precautions.
Clinical Judgment — First Action (23)
- Two clients, one airway issue
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airway client first (ABCs).
- Unstable/changing client (LPN)
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notify the RN/provider.
- Unsafe/unclear order
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clarify with prescriber before acting.
- Task needing judgment offered to UAP
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do not delegate.
- Client doubts consent
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stop, notify provider.
- Digoxin + apical <60
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hold and notify.
- Tube feeding + cough/flat HOB
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stop feeding, raise HOB, suction.
- Transfusion reaction
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stop transfusion, run NS, notify.
- Hyperkalemia peaked T-waves
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emergency, report immediately.
- Suicidal hint
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ask directly, ensure safety first.
- Agitated client
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de-escalate before restraints; restraints need order.
- Acute new confusion
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suspect delirium; find reversible cause.
- Live vaccine + pregnancy
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hold and notify.
- Boggy postpartum fundus
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massage first.
- C. diff isolation
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contact precautions + soap & water.
- Suspected TB/measles/varicella
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N95 + negative-pressure before entry.
- Fire
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RACE; rescue client first.
- Doffing PPE
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gloves off first; hand hygiene last.
- Client distress
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respond to the feeling (open-ended/empathic), no false reassurance.
- Visibly soiled hands
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soap and water (not alcohol rub).
- Abnormal finding, stable client
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LPN collects more data and reports.
- Initial assessment / care plan / initial teaching / triage
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RN, not LPN.
- Worst-first prioritization
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least stable/most acute client first.
Core PN Scope Distinctions (10)
- Assess
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RN (LPN collects data).
- Plan (initial)
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RN (LPN updates/contributes).
- Teach (initial)
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RN (LPN reinforces).
- Evaluate (first)
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RN (LPN monitors/reports response).
- Unstable client
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RN.
- Blood initiation / TPN / chemo / titrated drips / IV-push high-alert
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RN (state-dependent).
- Routine skills (wound care, catheter, NG, ostomy, glucose, suction)
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LPN within scope.
- Stable client monitoring
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LPN.
- Med administration (PO, topical, subcut, IM, many IV)
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LPN (IV scope varies by state).
- Scope authority
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defined by state Nurse Practice Act / Board of Nursing.
References
- 1.National Council of State Boards of Nursing (NCSBN). “2026 NCLEX-PN Test Plan (effective April 2026).” NCSBN.org. ↑
- 2.National Council of State Boards of Nursing (NCSBN). “Computerized Adaptive Testing (CAT) & NGN.” NCLEX.com. ↑
- 3.Centers for Disease Control and Prevention (CDC). “Transmission-Based Precautions.” CDC.gov. ↑
- 4.U.S. Food and Drug Administration (FDA). “Narrow Therapeutic Index Drugs.” FDA.gov. ↑
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