Test plan
NCLEX-PN Test Plan 2026: Client Needs Breakdown
The NCLEX-PN test plan 2026 divides the exam into eight Client Needs areas, led by Coordinated Care at 18 to 24% of items, with the other seven between 6 and 16% each. It runs from April 1, 2026 to March 31, 2029, and the format matches the NCLEX-RN: 85 to 150 adaptive items in up to 5 hours.
This post gives the official PN ranges side by side with the RN ranges, explains how Coordinated Care differs from the RN's Management of Care, shows how LPN/VN scope shapes the right answer, and turns the percentages into a study order. Two sample questions show the scope reasoning in action. For eligibility, fees and test-day rules, see the full NCLEX-PN Exam Guide linked below.
NCLEX-PN test plan 2026: Client Needs ranges
| Client Needs area | PN range | PN midpoint | RN range |
|---|---|---|---|
| Coordinated Care (RN: Management of Care) | 18 to 24% | 21% | 15 to 21% |
| Safety and Infection Prevention and Control | 10 to 16% | 13% | 10 to 16% |
| Health Promotion and Maintenance | 6 to 12% | 9% | 6 to 12% |
| Psychosocial Integrity | 9 to 15% | 12% | 6 to 12% |
| Basic Care and Comfort | 7 to 13% | 10% | 6 to 12% |
| Pharmacological Therapies (RN: and Parenteral) | 10 to 16% | 13% | 13 to 19% |
| Reduction of Risk Potential | 9 to 15% | 12% | 9 to 15% |
| Physiological Adaptation | 7 to 13% | 10% | 11 to 17% |
The PN plan leans toward coordinating care, psychosocial care and basic care, and away from pharmacology and acute physiological change. That fits the role: the LPN/VN cares mostly for stable clients and works under the direction of an RN or provider.
NCLEX-PN format
| Feature | NCLEX-PN in 2026 |
|---|---|
| Length | 85 to 150 items |
| At the minimum length | 52 Client Needs items, 18 items in three six-item case studies, 15 unscored pretest items |
| Time | 5 hours, including the introduction and all optional breaks |
| Stopping rules | 95% confidence rule, maximum length (150 items) or run out of time |
| Passing standard | -0.18 logits (the RN standard is 0.00) |
| Item types | Multiple choice, select all that apply, select N, calculation, and the clinical judgment formats: matrix, drop-down, highlight, drag and drop, bow-tie |
The adaptive rules are the same as on the RN exam. The computer stops once it is 95% sure your ability is above or below the passing standard. If you are close to the line, it runs to 150 items and decides on your final ability estimate. If time runs out before 85 items, the result is a fail.
The lower PN passing standard reflects entry-level PN practice, not an easier version of the same test. PN items are written to PN activities, so the content itself differs.
Coordinated Care vs Management of Care
Coordinated Care is the PN version of the RN's Management of Care, and the name says what changes. The RN manages: assesses comprehensively, builds the plan, delegates, evaluates. The LPN/VN coordinates: contributes to the plan, collects data, carries out care within it, assigns routine tasks to assistive personnel, and reports changes to the RN or provider.
| Task | RN | LPN/VN |
|---|---|---|
| Assessment | Comprehensive and admission assessment | Collects data and focused checks |
| Care plan | Develops it | Contributes to and updates it |
| Teaching | Initial teaching | Reinforces teaching |
| Evaluation | Evaluates the plan | Assists; evaluates client responses |
| Client type | Complex or unstable clients | Stable clients with predictable outcomes |
How LPN/VN scope changes the right answer
The PN plan lists the tasks it tests. Medications by the oral, tube, subcutaneous, intradermal, intramuscular, topical and inhaled routes are in. So are IV piggyback medications, calculating and monitoring IV flow rates, maintaining and removing peripheral IVs, maintaining central lines, and monitoring a blood transfusion. IV push medications and starting a transfusion are not listed.
On the exam, answer by that national PN scope. In practice, your state's nurse practice act and your facility's policy decide, and they can be narrower. When a client becomes unstable, the PN answer is usually to act within scope to protect the client (stop an infiltrated IV, hold a dose causing an adverse effect, start CPR), then report to the RN.
What changed in the 2026 PN plan
- Going by the two test plan documents, the percentages and the 85 to 150 items in 5 hours are unchanged from 2023.
- Safety and Infection Control was renamed Safety and Infection Prevention and Control, as on the RN plan.
- The PN passing standard stays at -0.18 logits through March 31, 2029.
NCSBN updates both test plans every three years from a practice analysis of newly licensed nurses, defined as nurses with no more than 12 months of experience.
How to study for the NCLEX-PN by weight
By midpoint, Coordinated Care (21%) is the largest block, followed by four areas at 12 to 13% each: Safety, Pharmacological Therapies, Psychosocial Integrity and Reduction of Risk Potential. Those five areas are about 71% of the exam.
- Take a baseline of about 20 questions per area and note where you miss.
- Start with Coordinated Care and scope: who does what, when to report, and how to assign to assistive personnel. This reasoning carries into every other area.
- Then Safety and Pharmacology: precautions, error prevention, high-alert drugs and what to check before each route.
- Then Psychosocial Integrity, which carries more weight on the PN exam than on the RN exam.
- Then Reduction of Risk Potential, Basic Care and Comfort and Physiological Adaptation, comparing labs and vital signs to normal and spotting changes from baseline.
- Practice case studies each week; 18 of the first 85 items come from them.
- Take an adaptive mock exam a few weeks out, then work your missed questions.
Sample NCLEX-PN questions on scope
An LPN on a medical-surgical unit is caring for a 66-year-old client with heart failure who has a peripheral IV and a PICC. Which prescribed task should the LPN ask the RN to perform?
- Furosemide 40 mg by IV push now through the peripheral IV
- Remove the peripheral IV catheter, which is no longer needed
- Change the PICC dressing under the central line protocol
- Vancomycin 1 g IV piggyback through the PICC over 60 minutes at 1000
Show the answer and rationale
Answer: A
- A. Correct. IV push medication is not among the IV tasks the NCLEX-PN plan lists for the LPN, so the LPN asks the RN to give it.
- B. Maintaining and removing a peripheral IV catheter are both listed in the PN plan.
- C. Maintaining a central venous catheter, including dressing care by protocol, is listed for the LPN in the PN plan.
- D. The plan has the LPN administer IV piggyback (secondary) medications and maintain central venous catheters, so this stays with the LPN.
The 2026 NCLEX-PN test plan lists these IV tasks for the LPN: give IV piggyback medications, calculate and monitor flow rates, maintain central venous catheters, maintain and remove peripheral IVs, and monitor transfusions. IV push is not listed. A rapid-acting IV diuretic needs the RN to give it and judge the response, including blood pressure and potassium. On the exam, choose national PN scope. In practice, the state nurse practice act and facility policy decide, and they may be stricter.
Sources: NCSBN/ANA Delegation Guidelines (2019); NCSBN NCLEX-PN Test Plan (2026)
An LPN on a long-term care unit is reviewing four clients assigned to a nursing assistant for the afternoon. Which client's status should the LPN report to the RN because the assignment may need to change?
- A client with a healing stage 2 sacral pressure injury who is due for a dressing change
- A client who usually chats at meals and today dozed through lunch without eating
- A client with COPD whose SpO2 is 89% on her prescribed 2 L/min, matching her baseline
- A client with Alzheimer disease who shouts and resists care near 1600, as on most days
Show the answer and rationale
Answer: B
- A. A scheduled dressing change on a healing wound is routine nursing care the LPN can provide; it does not signal a change in status.
- B. Correct. New drowsiness and withdrawal in a client who is usually sociable is an acute change from baseline and a possible sign of hypoactive delirium, so she is no longer stable and predictable.
- C. Tempting because 89% looks low, but it matches her documented baseline on the prescribed oxygen, so her condition has not changed.
- D. Late-afternoon agitation that follows her usual pattern looks alarming, but it is known, predictable behavior that the care plan already addresses.
The test is change from baseline, not how abnormal or noisy a finding looks. In older adults delirium most often takes the quiet, hypoactive form, which is easy to mistake for tiredness, is frequently missed and carries a worse prognosis; infection and medications are common triggers. In long-term care a significant change in a client's physical or mental status must be reported so the provider and family can be informed. National delegation guidelines require a stable client for assistive personnel, so the PN test plan expects the LPN to tell the supervisor when a change in status means assignments need to change, while the other three clients remain at their usual baseline.
Sources: NCSBN/ANA Delegation Guidelines (2019); Inouye et al., Lancet (2014); Requirements for Long-Term Care Facilities, 42 CFR Part 483; NCSBN NCLEX-PN Test Plan (2026)
How to reason through question 1
Ask of each task: is it on the PN list? An IV piggyback through a PICC, a central line dressing under protocol and removing a peripheral IV all are. IV push is not, and a rapid IV diuretic also needs someone to judge the response, including blood pressure and potassium. That is the task to hand back to the RN. The question rewards knowing the list, not guessing which task sounds hardest.
How to reason through question 2
Compare each client with their own baseline. A saturation of 89% that matches the client's usual COPD baseline is not a change. Evening agitation in Alzheimer disease that happens most days is not a change. A routine dressing on a healing wound is not a change. A client who usually chats at meals and today sleeps through lunch without eating is a change in mental status, even though it looks quiet. A changed client may no longer be stable enough for a nursing assistant, so the LPN reports it to the RN.
Frequently asked questions
What is the biggest section of the NCLEX-PN?
Coordinated Care, at 18 to 24% of items on the 2026 test plan.
Is the NCLEX-PN easier than the NCLEX-RN?
It tests a different scope at a different passing standard (-0.18 logits vs 0.00), with the same 85 to 150 adaptive items and 5-hour limit. It is not a shorter or simpler version of the RN exam.
Does the NCLEX-PN have Next Generation case studies?
Yes. At the minimum length of 85 items, 18 come from three six-item clinical judgment case studies, just as on the NCLEX-RN.
How many questions are on the NCLEX-PN?
Between 85 and 150. Fifteen of the first 85 are unscored pretest items, and you cannot tell which ones.
Related one-pagers
- NCLEX-PN Exam Guide2026 test plan, adaptive format, eligibility and an 8-week study plan
- NCLEX-PN: The LPN/VN RoleCoordinated Care, PN vs RN scope, what to report, working with UAP, and consent and client rights under the 2026 NCLEX-PN test plan
- Prioritization and DelegationWho to see first, five rights, scope, SBAR and escalation for NCLEX-RN and PN
- Next Gen NCLEX: Clinical JudgmentThe six NCJMM steps, NGN item types and partial-credit scoring on the 2026 NCLEX-RN and NCLEX-PN
Sources
- NCSBN. Test Plans (NCLEX.com). Link
- NCSBN. Computerized Adaptive Testing (CAT) (NCLEX.com). Link
- NCSBN. Passing Standard (NCLEX.com). Link
- NCSBN. Frequently Asked Questions (NCLEX.com). Link
- NCSBN Help Center. How long is the NCLEX? (updated June 2026) Link
- NCSBN Help Center. What is the current format and item types for the NCLEX? (updated June 2026) Link
- NCSBN Help Center. What is the definition of the entry-level nurse? Link
- NCSBN Help Center. How do the results of the practice analysis translate to a new test plan? Link