Most tested topics on the NCLEX-PN: the 2026 test plan categories ranked
Written and reviewed by Rachel Goldberg, MSN, RN, CEN · 4 min read · Updated November 2026
Short answer
The most tested area on the NCLEX-PN is Coordinated Care, at 18 to 24 percent of items under the 2026 PN test plan, followed by Safety and Infection Prevention and Control and Pharmacological Therapies at 10 to 16 percent each. NCSBN publishes no ranking of single diseases or drugs, so treat any list of high-yield conditions as an estimate.
The eight categories, ranked by NCSBN's percentages
The 2026 NCLEX-PN Test Plan, in effect from April 1, 2026 to March 31, 2029, assigns every scored content item to one of eight Client Needs categories. NCSBN gives each a range and, in its distribution chart, a single midpoint figure. Sorted by that midpoint, the order looks like this.
| Category | Official range | NCSBN chart figure |
|---|---|---|
| Coordinated Care | 18 to 24% | 21% |
| Safety and Infection Prevention and Control | 10 to 16% | 13% |
| Pharmacological Therapies | 10 to 16% | 13% |
| Psychosocial Integrity | 9 to 15% | 12% |
| Reduction of Risk Potential | 9 to 15% | 12% |
| Basic Care and Comfort | 7 to 13% | 10% |
| Physiological Adaptation | 7 to 13% | 10% |
| Health Promotion and Maintenance | 6 to 12% | 9% |
The ranges exist because the exam is adaptive and varies in length. NCSBN states that an individual candidate's content distribution may differ by up to 3 percent in each category, so two people can see slightly different mixes and both be on plan.
What Coordinated Care covers for an LPN
Coordinated Care is the PN version of the RN exam's Management of Care, and the wording shows the difference in role. The test plan lists activities such as contributing to the plan of care, assigning tasks to assistive personnel or another LPN/VN, organizing and prioritizing care, and verifying and processing provider orders.
It also covers legal and ethical work: the consent process, confidentiality, privacy, information about advance directives, reporting abuse or communicable disease as policy requires, responding to unsafe practice by staff, and providing care within the legal scope of practice. A large share of the PN exam is about what an LPN does, reports or hands off, not about rare conditions.
Pharmacology and the procedure categories
Pharmacological Therapies includes following the rights of medication administration, reconciling the medication record, calculating and monitoring IV flow rates, giving IV piggyback medications, monitoring blood product transfusions, counting controlled substances, maintaining PCA and epidural devices, and performing dosage calculations. Expect math to sit inside this category rather than in its own section.
Reduction of Risk Potential and Physiological Adaptation are hands-on. The plan names inserting and removing urinary catheters and nasogastric tubes, venipuncture, blood glucose checks, performing an EKG, maintaining central venous catheters, tracheostomy, ventilator and ostomy care, and recognizing and reporting basic abnormalities on a cardiac monitor strip.
Where the case studies fit
Every NCLEX-PN runs between 85 and 150 items in a five-hour limit that includes breaks. NCSBN breaks down the minimum-length exam as 52 content items in the stated percentages, 18 items from three clinical judgment case studies of six items each, and 15 unscored pretest items.
Case studies span any content area and are counted separately from the category percentages. NCSBN adds that roughly 10 percent of items are stand-alone clinical judgment items, chosen depending on exam length. So a topic such as postoperative care can surface in a category item and again inside a case study.
Turning the percentages into a study split
Use the chart figures as weights for your study time. With 60 hours before your test date, Coordinated Care gets about 13 hours (21 percent), Safety and Pharmacological Therapies about 8 hours each, Psychosocial Integrity and Reduction of Risk Potential about 7 each, Basic Care and Physiological Adaptation 6 each, and Health Promotion about 5.
Then adjust by your own weak areas. If a practice set or a Candidate Performance Report shows you below the standard in a smaller category, move hours there, since a candidate who is below the standard in a smaller category gains more from that category than from more review of a strong one. The plan's activity lists are the closest thing to an official topic checklist.
Sources
NCSBN, 2026 NCLEX-PN Test Plan. Client Needs ranges and chart figures, 3 percent variation, Coordinated Care, Pharmacological Therapies, Reduction of Risk Potential and Physiological Adaptation activity lists, 85 to 150 items, five hours, 52 plus 18 plus 15 minimum-length breakdown, about 10 percent stand-alone clinical judgment items.
NCLEX.com, Test Plans. PN test plan effective April 1, 2026 to March 31, 2029; plans revised every three years.
Common questions
What is on the NCLEX-PN?
Eight Client Needs categories set by the 2026 PN test plan, from Coordinated Care at 18 to 24 percent down to Health Promotion and Maintenance at 6 to 12 percent, plus three clinical judgment case studies. The exam runs 85 to 150 items in five hours, including 15 unscored pretest items.
Which category has the most questions on the NCLEX-PN?
Coordinated Care, at 18 to 24 percent of items, with 21 percent shown in NCSBN's distribution chart. No other category goes above 16 percent.
Is pharmacology the biggest part of the NCLEX-PN?
No. Pharmacological Therapies is 10 to 16 percent, tied with Safety and Infection Prevention and Control and well behind Coordinated Care. Medication content can also appear inside case studies, which NCSBN counts separately from the category percentages.