NCLEX-PN Pharmacology Practice Test
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25 practice questions
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Question 1 of 25Medium
During a home visit, a client taking warfarin tells the nurse that a friend suggested a ginkgo supplement to improve memory and that it was started last week. Which response by the nurse is best?
- A. Ginkgo is a natural product, so it is safe to use along with warfarin.
- B. Take the warfarin and the ginkgo at least four hours apart every day.
- C. Report the supplement to the provider, since it may increase bleeding.
- D. Stop taking the warfarin until the provider reviews the new supplement.
Show answer to question 1
Answer: C. Report the supplement to the provider, since it may increase bleeding.
Ginkgo can affect platelet function and may add to the bleeding risk of warfarin. The nurse should report the supplement so the provider can evaluate it and decide on monitoring.
Why the other options are wrong
- ANatural products can interact with medications, and ginkgo is known to increase bleeding risk when taken with anticoagulants.
- BSeparating the dose times does not remove a pharmacodynamic interaction that increases bleeding risk.
- DClients must never stop warfarin on their own, because doing so raises the risk of dangerous clots.
Question 2 of 25Hard
A clinic nurse reviews data for a 78-year-old client who takes digoxin and furosemide. Which finding is the most important for the nurse to report to the provider before the next digoxin dose?
- A. Blood pressure 126/78 mmHg and weight down 2 lb from last visit
- B. Mild ankle swelling that is unchanged from the previous visit
- C. Heart rate 74/min with a regular rhythm
- D. Serum potassium 3.1 mEq/L with new loss of appetite and nausea
Show answer to question 2
Answer: D. Serum potassium 3.1 mEq/L with new loss of appetite and nausea
Low potassium from furosemide increases myocardial sensitivity to digoxin, and anorexia and nausea are early signs of toxicity, so this must be reported.
Why the other options are wrong
- AStable blood pressure and a small weight loss are consistent with an effective diuretic response.
- BUnchanged mild edema is not a new or urgent finding.
- CA regular heart rate of 74/min is within the expected range for digoxin therapy.
Question 3 of 25Hard
During a home health visit, a client who started lisinopril two weeks ago reports that the lips and tongue began swelling an hour ago. The nurse notes hoarseness. What is the nurse's priority action?
- A. Tell the client to take the next dose with food and recheck the swelling tomorrow
- B. Call emergency services and stay with the client while monitoring the airway
- C. Measure the client's blood pressure and call the provider's office later in the day
- D. Apply a cool compress to the face and encourage the client to rest
Show answer to question 3
Answer: B. Call emergency services and stay with the client while monitoring the airway
Swelling of the lips and tongue with hoarseness suggests angioedema, a rare but dangerous reaction to ACE inhibitors that can obstruct the airway. Emergency services must be called right away while the nurse monitors breathing.
Why the other options are wrong
- AThe medication must not be continued, and delaying reassessment until tomorrow risks complete airway obstruction.
- CBlood pressure is not the priority, and postponing the call delays treatment of a potential airway emergency.
- DA cool compress and rest do not address airway compromise and delay needed emergency care.
Question 4 of 25Medium
A nurse in a long-term care facility finds a 70-year-old woman who takes insulin sweating and trembling. She is alert and able to swallow, and her blood glucose is 52 mg/dL. What action should the nurse take first?
- A. Give peanut butter crackers and recheck glucose in 1 hour
- B. Give glucagon by injection and call the provider
- C. Have the client lie down and recheck glucose in 30 minutes
- D. Give 4 oz (120 mL) of juice and recheck glucose in 15 minutes
Show answer to question 4
Answer: D. Give 4 oz (120 mL) of juice and recheck glucose in 15 minutes
An alert client who can swallow should receive a quick-acting carbohydrate such as juice, then be rechecked in about 15 minutes. The nurse should report the event to the RN.
Why the other options are wrong
- ACrackers with fat act too slowly, and waiting an hour risks worsening hypoglycemia.
- BGlucagon is for clients who cannot safely swallow or are unresponsive.
- CResting without treatment does not raise the glucose, and 30 minutes is too long to wait.
Question 5 of 25Easy
A health care provider prescribes amoxicillin oral suspension 250 mg every 8 hours for a 6-year-old child. The pharmacy label reads 125 mg/5 mL. How many mL should the nurse administer per dose?
- A. 5 mL
- B. 10 mL
- C. 15 mL
- D. 2.5 mL
Show answer to question 5
Answer: B. 10 mL
The dose needed is 250 mg and the supply is 125 mg per 5 mL. 250 ÷ 125 = 2, and 2 × 5 mL = 10 mL.
Why the other options are wrong
- A5 mL delivers only 125 mg, which is half of the prescribed dose.
- C15 mL delivers 375 mg, which is more than the prescribed dose.
- D2.5 mL delivers only 62.5 mg, far below the prescribed dose.
Question 6 of 25Medium
A client is admitted to a medical unit. The client's home medication list includes metoprolol, but the admission orders do not include it, and no reason is documented. What is the nurse's best action?
- A. Give the client's own home supply of metoprolol at the usual time.
- B. Leave it off the record and document that the client takes it at home.
- C. Add metoprolol to the medication administration record from the client's list.
- D. Notify the RN or provider to clarify the omission before the next scheduled dose.
Show answer to question 6
Answer: D. Notify the RN or provider to clarify the omission before the next scheduled dose.
A discrepancy found during reconciliation must be clarified with the prescriber, since the omission may be intentional or an error. Abrupt beta blocker interruption can also be harmful.
Why the other options are wrong
- AMedications require a valid order, and home supplies should not be given without one.
- BDocumenting without clarification leaves a possible error unresolved and may cause harm.
- CNurses cannot add medications to the record without a prescriber order.
Question 7 of 25Easy
A practical nurse is preparing to administer antibiotic ear drops to a 2-year-old child with otitis externa. Which action should the nurse take to straighten the child's ear canal?
- A. Pull the pinna upward and backward
- B. Pull the pinna downward and backward
- C. Press the tragus firmly inward
- D. Pull the pinna straight outward
Show answer to question 7
Answer: B. Pull the pinna downward and backward
For children younger than 3 years, the nurse straightens the external auditory canal by pulling the pinna downward and backward. Pulling the pinna upward and backward is the correct technique used for adults and children older than 3 years. Pressing the tragus may help distribute drops after instillation, but it does not straighten the canal.
Question 8 of 25Medium
A practical nurse inspects a client's peripheral IV insertion site and observes purulent drainage around the catheter entry point, localized erythema, and warmth. Which action should the nurse take?
- A. Discontinue the catheter, save the drainage for culture if ordered, and notify the provider.
- B. Slow the IV infusion rate, apply an ice pack over the dressing, and re-evaluate in 4 hours.
- C. Cleanse the insertion site with alcohol, apply a fresh transparent dressing, and continue the infusion.
- D. Flush the catheter with 10 mL of normal saline to clear the drainage from the insertion point.
Show answer to question 8
Answer: A. Discontinue the catheter, save the drainage for culture if ordered, and notify the provider.
Purulent drainage, erythema, and localized warmth indicate a local catheter-related infection. The nurse should immediately discontinue the infusion and remove the catheter, culture the purulent drainage or catheter tip according to provider orders and facility policy, and notify the healthcare provider. Leaving the infected catheter in place or cleansing the surface while continuing therapy places the client at high risk for a systemic bloodstream infection.
Question 9 of 25Hard
At a clinic visit, a 78-year-old woman reports new confusion, constipation, and dry mouth. She says she takes an over-the-counter diphenhydramine product every night for sleep. What is the nurse's best action?
- A. Reassure her that confusion, constipation, and dry mouth are normal parts of aging.
- B. Report the nightly diphenhydramine use and these symptoms to the provider promptly.
- C. Advise her to take the diphenhydramine earlier in the evening to limit side effects.
- D. Suggest adding a second over-the-counter sleep aid with a different active ingredient.
Show answer to question 9
Answer: B. Report the nightly diphenhydramine use and these symptoms to the provider promptly.
Diphenhydramine is strongly anticholinergic and can cause confusion, constipation, and dry mouth in older adults. The nurse should report the pattern so the provider can reassess the medication and sleep options.
Why the other options are wrong
- AThese symptoms are not normal aging, and calling them expected delays finding the likely medication cause.
- CTaking it earlier does not remove the anticholinergic effects, so confusion, constipation, and dry mouth would continue.
- DA second sleep aid adds sedation and adverse effect risk and does not address the likely cause of her symptoms.
Question 10 of 25Hard
A client on the first day after hip surgery received oxycodone 2 hours ago. During rounds the nurse finds the client difficult to arouse with a respiratory rate of 8 breaths per minute and an oxygen saturation of 89%. Which action should the nurse take first?
- A. Record the respiratory rate and recheck the client in one hour
- B. Lower the head of the bed and let the client sleep quietly
- C. Give the scheduled stool softener and report findings later
- D. Stimulate the client, stay present, and notify the RN now
Show answer to question 10
Answer: D. Stimulate the client, stay present, and notify the RN now
These findings suggest opioid-induced respiratory depression, which is life threatening. The nurse stimulates the client, stays at the bedside, and notifies the RN immediately so oxygen and a naloxone order can be obtained.
Why the other options are wrong
- AWaiting an hour delays treatment for a client who is already hypoxemic and hypoventilating.
- BLowering the head of the bed can worsen breathing, and letting the client sleep allows further deterioration.
- CA stool softener is not a priority, and delaying the report puts the client at risk.
Question 11 of 25Easy
A client in a clinic takes a first dose of oral amoxicillin. Ten minutes later the client reports itching, and the nurse sees hives on the chest. Which additional finding would most strongly suggest a developing systemic allergic reaction?
- A. Wheezing with throat tightness
- B. Mild nausea without any vomiting
- C. Dry mouth with increased thirst
- D. Slight drowsiness with yawning
Show answer to question 11
Answer: A. Wheezing with throat tightness
Wheezing and throat tightness indicate airway involvement, which with hives suggests a systemic allergic reaction that may progress to anaphylaxis. The nurse must report it and obtain emergency help immediately.
Why the other options are wrong
- BMild nausea without vomiting is a common gastrointestinal side effect of amoxicillin and does not by itself indicate a systemic allergic reaction.
- CDry mouth with increased thirst is not a typical allergic sign with this antibiotic and does not suggest airway involvement.
- DSlight drowsiness with yawning is not a recognized sign of penicillin allergy and does not point to systemic involvement.
Question 12 of 25Hard
A nurse is admitting a client to a long-term care facility and reviewing the home medication list. The client takes sertraline daily and also takes St. John's wort, which is not on the prescriber's admission orders. What is the nurse's best action?
- A. Leave the supplement off the list since it is not a drug.
- B. Tell the client to stop the sertraline until the supplement is reviewed.
- C. Document the supplement and report it to the RN or provider for review.
- D. Add the supplement to the orders and give it with the sertraline.
Show answer to question 12
Answer: C. Document the supplement and report it to the RN or provider for review.
St. John's wort can interact with sertraline and increase the risk of serotonin syndrome. Herbal products belong on the medication list, and the provider must review them before orders are finalized.
Why the other options are wrong
- AHerbal supplements can cause significant interactions and must be recorded on the medication list.
- BStopping a prescribed antidepressant is not the nurse's decision and may cause withdrawal or relapse.
- DThe nurse cannot create orders, and giving both without review could harm the client.
Question 13 of 25Medium
A licensed practical nurse (LPN) assists with medication reconciliation for a newly admitted client. The client's home medication list includes acetaminophen 500 mg by mouth every 6 hours as needed. The provider prescribes hydrocodone/acetaminophen 5 mg/325 mg by mouth every 4 hours as needed for pain. What is the nurse's priority action?
- A. Tell the client to choose one medication to take at home.
- B. Administer both medications simultaneously for severe pain.
- C. Discontinue the home medication without consulting the provider.
- D. Notify the registered nurse or provider about the duplicate ingredient.
Show answer to question 13
Answer: D. Notify the registered nurse or provider about the duplicate ingredient.
Medication reconciliation identifies discrepancies such as therapeutic duplications; taking both medications could lead to acetaminophen toxicity exceeding the maximum safe daily dose. Informing the registered nurse or provider ensures an order adjustment before administration occurs, whereas an LPN cannot independently discontinue a prescribed medication.
Question 14 of 25Medium
A client with chronic back pain receives scheduled extended-release oral morphine and has a prescription for immediate-release oral oxycodone PRN every 4 hours. Which finding indicates to the nurse that the PRN medication is needed?
- A. Gradual development of constipation over the past three days
- B. Mild stiffness in the morning that improves with gentle stretching
- C. A sudden increase in pain intensity that exceeds baseline levels
- D. Difficulty falling asleep at night due to environmental noise
Show answer to question 14
Answer: C. A sudden increase in pain intensity that exceeds baseline levels
Breakthrough pain is a transient, severe flare of pain that occurs despite adequate around-the-clock baseline analgesia, signaling the need for an immediate-release PRN medication. Opioids must not be administered to promote sedation for insomnia or sleep disturbances. Morning stiffness relieved by stretching reflects mechanical musculoskeletal symptoms rather than opioid-responsive breakthrough pain.
Question 15 of 25Medium
A licensed practical nurse is monitoring a client who takes digoxin 0.25 mg daily. Which assessment finding should alert the nurse to potential digoxin toxicity?
- A. Metallic taste in the mouth
- B. Heart rate of 104 beats per minute
- C. Fine resting tremors in both hands
- D. Yellowish halos around light sources
Show answer to question 15
Answer: D. Yellowish halos around light sources
Visual disturbances, such as seeing yellow-green halos around lights, photophobia, and blurred vision, are classic signs of digoxin toxicity alongside gastrointestinal upset and cardiac dysrhythmias. A heart rate of 104 beats per minute reflects tachycardia, whereas digoxin toxicity typically manifests as bradycardia or conduction blocks. Resting tremors are associated with parkinsonian symptoms rather than digitalis toxicity.
Question 16 of 25Medium
A client taking oral clonidine twice daily for hypertension tells the practical nurse (PN) that they plan to stop the medication immediately because their blood pressure has been normal for three months. Which response by the PN is most appropriate?
- A. You should cut the tablets in half for two days before discontinuing the medication entirely.
- B. Stopping this medication abruptly can cause a dangerous spike in your blood pressure.
- C. You may stop taking the medication as long as you log your blood pressure twice a day.
- D. Stopping the medication is safe because it remains active in your system for several weeks.
Show answer to question 16
Answer: B. Stopping this medication abruptly can cause a dangerous spike in your blood pressure.
Clonidine is a centrally acting alpha-2 agonist, and abrupt discontinuation can precipitate severe rebound hypertension, tachycardia, and tremors due to an acute surge in sympathetic tone. Recommending self-tapering or stopping the drug without provider supervision is unsafe and outside the practical nurse's scope.
Question 17 of 25Medium
A nurse in a long-term care facility receives a new prescription for spironolactone for an 84-year-old client. The nurse is unfamiliar with the drug's purpose and monitoring needs. Which action is best?
- A. Ask a coworker who has given the drug before to explain it
- B. Give the drug and observe for any changes in the client
- C. Check a current drug reference or consult the pharmacist
- D. Wait until the provider visits to ask about the drug
Show answer to question 17
Answer: C. Check a current drug reference or consult the pharmacist
A current drug reference or a pharmacist provides reliable, up-to-date information on actions, adverse effects and monitoring before the drug is given.
Why the other options are wrong
- AA coworker's memory may be incomplete or outdated and is not a verified resource.
- BGiving an unfamiliar drug without knowing its purpose and risks is unsafe.
- DWaiting delays information the nurse can obtain immediately and may delay care.
Question 18 of 25Easy
The licensed practical nurse (LPN) is collecting data on a client who has been taking haloperidol for two weeks. Which finding should the nurse recognize as pseudoparkinsonism?
- A. Shuffling gait accompanied by hand tremors
- B. Sudden, painful backward twisting of the neck
- C. Rapid, continuous involuntary eye blinking
- D. Inability to sit still with persistent pacing
Show answer to question 18
Answer: A. Shuffling gait accompanied by hand tremors
A shuffling gait, resting tremors, bradykinesia, and rigidity are classic signs of pseudoparkinsonism, an extrapyramidal side effect caused by dopamine receptor blockade from typical antipsychotics. Persistent pacing and motor restlessness indicate akathisia, not pseudoparkinsonism. Sudden twisting of the neck describes acute dystonia, and continuous involuntary eye blinking is suggestive of tardive dyskinesia.
Question 19 of 25Easy
A nurse collects data on a client with cirrhosis and hepatic encephalopathy who has been receiving lactulose for 2 days. Which finding indicates that the medication is having the desired therapeutic effect?
- A. Improved orientation and alertness
- B. Decreased serum albumin concentration
- C. Increased accumulation of abdominal ascites
- D. Complete absence of daily bowel movements
Show answer to question 19
Answer: A. Improved orientation and alertness
Lactulose acidifies the colon to trap ammonia as ammonium, which is then eliminated in the stool to decrease systemic neurotoxicity and reverse hepatic encephalopathy. Improved orientation, alertness, and cognitive function demonstrate therapeutic success. Absence of bowel movements indicates a failure of the osmotic laxative action required to eliminate ammonia.
Question 20 of 25Medium
A client who has been receiving therapeutic doses of subcutaneous unfractionated heparin develops severe epistaxis and frank hematuria. Which reversal agent should the practical nurse anticipate administering?
- A. Protamine sulfate
- B. Phytonadione
- C. Deferoxamine
- D. Idarucizumab
Show answer to question 20
Answer: A. Protamine sulfate
Protamine sulfate is the specific reversal agent for unfractionated heparin and binds heparin to form an inactive salt. Phytonadione (vitamin K) is used to reverse warfarin toxicity rather than heparin. Idarucizumab is a reversal agent specifically for dabigatran, and deferoxamine is a chelating agent used for iron toxicity.
Question 21 of 25Easy
A client recovering from abdominal surgery has a patient-controlled analgesia (PCA) pump with morphine. The client's spouse asks to press the dose button while the client sleeps because the client looks uncomfortable. What is the nurse's best response?
- A. "You may press it, but no more than once an hour while the client sleeps."
- B. "Only the client should press it. I will assess pain and call if needed."
- C. "You may press it after you check the dose shown on the pump display."
- D. "Any family member who has watched me use the pump may press the button."
Show answer to question 21
Answer: B. "Only the client should press it. I will assess pain and call if needed."
PCA is safe because a sedated client stops pressing the button. Dosing by family members (PCA by proxy) bypasses this safeguard and can cause oversedation and respiratory depression.
Why the other options are wrong
- ALimiting the frequency does not remove the risk, because the person pressing is not the client and cannot judge sedation.
- CReading the display does not make proxy dosing safe or replace the client's own control.
- DWatching a demonstration does not qualify family members to give doses, and the practice is unsafe.
Question 22 of 25Easy
A 58-year-old man in a clinic is prescribed ibuprofen for knee osteoarthritis. Which finding in the client's history should the nurse report to the provider before the first dose?
- A. Seasonal allergic rhinitis in spring
- B. Mild hyperlipidemia controlled by diet
- C. Bleeding gastric ulcer last year
- D. Occasional tension headaches at work
Show answer to question 22
Answer: C. Bleeding gastric ulcer last year
NSAIDs such as ibuprofen irritate the gastric lining and impair platelet function, so a history of gastrointestinal bleeding is an important contraindication or caution that the provider must review.
Why the other options are wrong
- ASeasonal allergic rhinitis does not affect NSAID safety unless the client has aspirin-sensitive asthma, which is not described.
- BMild hyperlipidemia controlled by diet is not a contraindication to short-term ibuprofen use.
- DOccasional tension headaches at work are not a contraindication, and ibuprofen may even relieve them.
Question 23 of 25Hard
A nurse is reviewing laboratory results for a client with heart failure receiving oral digoxin and furosemide. Which laboratory finding places this client at the highest risk for developing digoxin toxicity?
- A. Serum magnesium level of 2.0 mEq/L (1.0 mmol/L)
- B. Serum calcium level of 9.2 mg/dL (2.3 mmol/L)
- C. Serum sodium level of 136 mEq/L (136 mmol/L)
- D. Serum potassium level of 2.9 mEq/L (2.9 mmol/L)
Show answer to question 23
Answer: D. Serum potassium level of 2.9 mEq/L (2.9 mmol/L)
Hypokalemia greatly enhances myocardial sensitivity to digoxin, substantially increasing the risk of life-threatening dysrhythmias and toxicity. Potassium-wasting loop diuretics such as furosemide frequently cause low potassium levels. The sodium, calcium, and magnesium levels listed fall within expected normal reference ranges and do not increase toxicity risk.
Question 24 of 25Hard
A 58-year-old man in an acute care unit received his first dose of lisinopril this morning. He now has swelling of his lips and tongue and a hoarse voice. Which action should the nurse take first?
- A. Stay with the client, keep his airway open and call for emergency help
- B. Hold the next dose and document the findings at the end of the shift
- C. Apply a cool compress to the lips and reassess in 30 minutes
- D. Offer an oral antihistamine from the client's personal supply
Show answer to question 24
Answer: A. Stay with the client, keep his airway open and call for emergency help
Lip and tongue swelling with hoarseness suggests angioedema, an airway emergency that can occur with ACE inhibitors. Airway protection and immediate emergency help are the priority.
Why the other options are wrong
- BHolding future doses is appropriate, but delaying documentation and response ignores the immediate threat to the airway.
- CA cool compress will not stop airway swelling, and waiting 30 minutes risks complete obstruction.
- DUsing an unprescribed personal medication is unsafe, and an oral drug may be difficult to swallow with a swollen tongue.
Question 25 of 25Medium
A nurse in a clinic is teaching a 68-year-old man who takes warfarin. He asks which nonprescription products are safe to buy. Which product should the nurse tell him to avoid?
- A. Calcium carbonate antacid tablets
- B. Saline nasal spray
- C. Aspirin tablets
- D. Loratadine tablets
Show answer to question 25
Answer: C. Aspirin tablets
Aspirin inhibits platelet function and irritates the stomach lining, which adds to the bleeding risk of warfarin. Clients on warfarin should avoid it unless the provider directs otherwise.
Why the other options are wrong
- ACalcium carbonate antacids do not meaningfully affect clotting or add to warfarin's bleeding risk.
- BSaline nasal spray is not absorbed systemically and does not interact with warfarin.
- DLoratadine is a nonsedating antihistamine without a significant interaction with warfarin.
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The full NCLEX-PN bank has 416 Pharmacology questions. See plans
Pharmacological Therapies is 10 to 16% of the questions on the NCLEX-PN, as a subcategory of Physiological Integrity in the NCSBN 2026 test plan. Below are 25 original Pharmacology practice questions, each with the answer and an explanation.
Source: NCSBN 2026 NCLEX-PN Test Plan.
Study guide lessons for Pharmacology
Short lessons on the same topics, each with audio in English and Spanish.
- Medication Rights, High-Alert Safeguards and Error ReportingOpen lesson
- Medication Reconciliation, Storage, Controlled Drugs and Teaching
- Dosage Calculations and Unit Conversions
- Oral, Enteral, Topical, Eye, Ear and Inhaled Medications
- Injections, IV Monitoring, Blood Products and TPN
- Drug Effects, Interactions, Allergies and Antimicrobials
- Cardiovascular Medications and Anticoagulants
- Insulin, Thyroid and Corticosteroid Medications
- Pain Medications: Opioids, Nonopioids and PRN Decisions
- Antidepressants, Mood Stabilizers and Antipsychotics
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Questions, answered
Are these actual NCLEX-PN questions?
No. They are original practice questions written from the public exam outline, not questions taken from the exam. Exam owners keep live questions confidential.
How much of the NCLEX-PN is Pharmacological Therapies?
10 to 16% of the questions, under the NCSBN 2026 NCLEX-PN Test Plan used from April 1, 2026 through March 31, 2029. The exam is computer adaptive, with 85 to 150 questions in up to 5 hours including breaks. Source: NCSBN 2026 NCLEX-PN Test Plan.
Is this NCLEX-PN Pharmacology practice test free?
Yes. The 25 questions on this page, with answers and explanations, are free to use, and there is no sign up. The full NCLEX-PN bank of 3,301 questions, with timed section tests and an AI tutor, comes with a plan.
How should I use this practice test?
Answer each question before you open Show answer, then read why the correct option is right and the others are not. Note the topics you miss and review them first. The NCLEX-PN study guide has 10 lessons for Pharmacology, listed on this page.
These are original practice questions written from the public exam outline. They are not actual exam questions. NCLEX and NCLEX-PN are registered trademarks of NCSBN. tests.global is not affiliated with or endorsed by NCSBN.
Updated November 1, 2026.