NCLEX-RN® ACTUAL COMPREHENSIVE
PRACTICE EXAM 2026/2027 | Simulated CAT-Style
Questions with Verified Answers | Aligned to NCSBN
Test Plan | Pass Guarantee Target - A+ Graded
Section 1: Safe and Effective Care Environment - Management of Care (25 questions)
Q1: The nurse is caring for four clients. Which client requires immediate assessment by the
registered nurse? A. A client 2 hours post-op appendectomy with pain rated 6/10 B. A client with
heart failure reporting weight gain of 2 lbs in one week C. A client with new onset confusion and
oxygen saturation of 88% [CORRECT] D. A client scheduled for discharge who needs
medication teaching Correct Answer: C
Q2: [Multiple Response - Select All That Apply] The nurse is delegating tasks to an unlicensed
assistive personnel (UAP). Which tasks are appropriate to delegate? (Select all that apply.) A.
Measuring and recording intake and output for a stable client [CORRECT] B. Assisting a client
with ambulation after physical therapy clearance [CORRECT] C. Administering oral
medications to a client with dysphagia D. Performing post-mortem care [CORRECT] E.
Monitoring a client receiving their first dose of chemotherapy Correct Answers: A, B, D
Q3: A client with diabetes mellitus is scheduled for surgery. The surgeon has ordered NPO after
midnight. The client's morning blood glucose is 48 mg/dL. What is the nurse's priority action? A.
Administer the client's scheduled insulin as ordered B. Notify the surgeon and request
clarification of NPO status [CORRECT] C. Give the client orange juice to treat hypoglycemia D.
Document the finding and continue with pre-op preparations Correct Answer: B
Q4: [Cloze - Fill-in-the-Blank] A client is receiving heparin infusion at 1,000 units/hour. The
pharmacy supplies heparin 25,000 units in 500 mL D5W. At what rate (mL/hour) should the
infusion pump be set? _____ mL/hour
Correct Answer: 20 mL/hour
Q5: The charge nurse is making assignments for the shift. Which client is most appropriate to
assign to a float nurse from the pediatric unit? A. A 45-year-old client admitted for exacerbation
of asthma [CORRECT] B. An 82-year-old client with new onset atrial fibrillation C. A 38-year-
old client 1 day post-op coronary artery bypass graft D. A 65-year-old client with acute kidney
injury requiring dialysis Correct Answer: A
Q6: [Drag & Drop - Prioritization] Place the following nursing actions in order of priority when
caring for a client who has fallen and is complaining of severe hip pain.
, • A. Assess neurovascular status of affected extremity
• B. Notify the healthcare provider
• C. Immobilize the affected limb
• D. Administer pain medication as ordered
Correct Order: C, A, B, D
Q7: A client is being prepared for a colonoscopy. The client states, "I don't want this procedure.
My neighbor had complications." What is the nurse's most appropriate response? A. "You don't
have to have the procedure if you don't want to." B. "Your doctor knows what's best for you." C.
"Tell me more about your concerns regarding the procedure." [CORRECT] D. "Complications
are very rare with this procedure." Correct Answer: C
Q8: [Multiple Response - Select All That Apply] Which actions by the nurse demonstrate
appropriate advocacy? (Select all that apply.) A. Questioning a medication order that appears to
be an overdose [CORRECT] B. Providing an interpreter for a non-English speaking client
[CORRECT] C. Following a physician's order despite client objections D. Ensuring a homeless
client receives discharge planning resources [CORRECT] E. Completing tasks quickly to
maximize efficiency Correct Answers: A, B, D
Q9: A nurse discovers that a colleague has documented assessment findings that were not
actually performed. What is the nurse's legal and ethical responsibility? A. Confront the
colleague privately and ask them to correct it B. Report the incident to the nurse manager
[CORRECT] C. Document the correct findings in the nurse's own notes D. Ignore it unless it
directly affects client safety Correct Answer: B
Q10: [Chart/Exhibit] Review the following client data:
• Vital signs: BP 92/58, HR 118, RR 24, Temp 38.9°C (102°F), SpO2 91%
• Lab values: WBC 16,000, Hgb 8.2, Platelets 85,000
• Client reports: "I feel like I'm going to pass out."
Based on this data, which nursing diagnosis is the priority? A. Risk for infection B. Ineffective
tissue perfusion [CORRECT] C. Impaired gas exchange D. Risk for bleeding Correct Answer: B
Q11: Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse
(LPN/LVN)? A. Developing a plan of care for a newly admitted client B. Teaching a client about
insulin administration C. Administering an enema to a stable client [CORRECT] D. Assessing a
client with chest pain Correct Answer: C
Q12: A client with terminal cancer requests information about hospice care. The nurse's primary
responsibility is to: A. Contact the physician to discuss hospice referral B. Provide information
, and support the client's autonomy in decision-making [CORRECT] C. Encourage the client to
continue curative treatment D. Suggest the client talk with family members first Correct Answer:
B
Q13: [Multiple Response - Select All That Apply] Which situations require the nurse to obtain
informed consent? (Select all that apply.) A. Administration of blood products [CORRECT] B.
Participation in a research study [CORRECT] C. Routine vital signs assessment D. Surgical
procedure [CORRECT] E. Administration of routine oral medications Correct Answers: A, B, D
Q14: The nurse is supervising a newly hired UAP. Which observation requires immediate
intervention? A. The UAP ambulates a client with a gait belt B. The UAP performs perineal care
using clean technique C. The UAP feeds a client who is positioned at 90 degrees D. The UAP
applies restraints to a client without a healthcare provider's order [CORRECT] Correct Answer:
D
Q15: [Cloze - Fill-in-the-Blank] A client weighs 176 lbs. The healthcare provider orders a
medication at 2 mg/kg. How many mg should the nurse administer? _____ mg
Correct Answer: 160 mg
Q16: Which action by the nurse demonstrates appropriate continuity of care during client
transfer from ICU to a medical-surgical unit? A. Providing a verbal report only to expedite the
transfer B. Ensuring all documentation is complete and conducting a bedside handoff report
[CORRECT] C. Allowing the receiving nurse to review the chart independently D. Sending the
client first and faxing the records later Correct Answer: B
Q17: [Drag & Drop - Delegation] Match the following tasks to the appropriate personnel (RN,
LPN/LVN, or UAP).
• A. Inserting a urinary catheter
• B. Measuring vital signs on stable clients
• C. Administering IV push medications
• D. Performing sterile dressing changes
Correct Assignments: A-RN, B-UAP, C-RN, D-RN
Q18: A client with a history of domestic violence confides in the nurse about the abuse. The
nurse's priority action is to: A. Contact the client's spouse to verify the story B. Report the abuse
to the appropriate authorities as mandated by law [CORRECT] C. Advise the client to leave the
abusive situation immediately D. Document the conversation and take no further action Correct
Answer: B
Q19: [Multiple Response - Select All That Apply] Which information is protected under HIPAA
regulations? (Select all that apply.) A. Client's diagnosis [CORRECT] B. Client's room number
PRACTICE EXAM 2026/2027 | Simulated CAT-Style
Questions with Verified Answers | Aligned to NCSBN
Test Plan | Pass Guarantee Target - A+ Graded
Section 1: Safe and Effective Care Environment - Management of Care (25 questions)
Q1: The nurse is caring for four clients. Which client requires immediate assessment by the
registered nurse? A. A client 2 hours post-op appendectomy with pain rated 6/10 B. A client with
heart failure reporting weight gain of 2 lbs in one week C. A client with new onset confusion and
oxygen saturation of 88% [CORRECT] D. A client scheduled for discharge who needs
medication teaching Correct Answer: C
Q2: [Multiple Response - Select All That Apply] The nurse is delegating tasks to an unlicensed
assistive personnel (UAP). Which tasks are appropriate to delegate? (Select all that apply.) A.
Measuring and recording intake and output for a stable client [CORRECT] B. Assisting a client
with ambulation after physical therapy clearance [CORRECT] C. Administering oral
medications to a client with dysphagia D. Performing post-mortem care [CORRECT] E.
Monitoring a client receiving their first dose of chemotherapy Correct Answers: A, B, D
Q3: A client with diabetes mellitus is scheduled for surgery. The surgeon has ordered NPO after
midnight. The client's morning blood glucose is 48 mg/dL. What is the nurse's priority action? A.
Administer the client's scheduled insulin as ordered B. Notify the surgeon and request
clarification of NPO status [CORRECT] C. Give the client orange juice to treat hypoglycemia D.
Document the finding and continue with pre-op preparations Correct Answer: B
Q4: [Cloze - Fill-in-the-Blank] A client is receiving heparin infusion at 1,000 units/hour. The
pharmacy supplies heparin 25,000 units in 500 mL D5W. At what rate (mL/hour) should the
infusion pump be set? _____ mL/hour
Correct Answer: 20 mL/hour
Q5: The charge nurse is making assignments for the shift. Which client is most appropriate to
assign to a float nurse from the pediatric unit? A. A 45-year-old client admitted for exacerbation
of asthma [CORRECT] B. An 82-year-old client with new onset atrial fibrillation C. A 38-year-
old client 1 day post-op coronary artery bypass graft D. A 65-year-old client with acute kidney
injury requiring dialysis Correct Answer: A
Q6: [Drag & Drop - Prioritization] Place the following nursing actions in order of priority when
caring for a client who has fallen and is complaining of severe hip pain.
, • A. Assess neurovascular status of affected extremity
• B. Notify the healthcare provider
• C. Immobilize the affected limb
• D. Administer pain medication as ordered
Correct Order: C, A, B, D
Q7: A client is being prepared for a colonoscopy. The client states, "I don't want this procedure.
My neighbor had complications." What is the nurse's most appropriate response? A. "You don't
have to have the procedure if you don't want to." B. "Your doctor knows what's best for you." C.
"Tell me more about your concerns regarding the procedure." [CORRECT] D. "Complications
are very rare with this procedure." Correct Answer: C
Q8: [Multiple Response - Select All That Apply] Which actions by the nurse demonstrate
appropriate advocacy? (Select all that apply.) A. Questioning a medication order that appears to
be an overdose [CORRECT] B. Providing an interpreter for a non-English speaking client
[CORRECT] C. Following a physician's order despite client objections D. Ensuring a homeless
client receives discharge planning resources [CORRECT] E. Completing tasks quickly to
maximize efficiency Correct Answers: A, B, D
Q9: A nurse discovers that a colleague has documented assessment findings that were not
actually performed. What is the nurse's legal and ethical responsibility? A. Confront the
colleague privately and ask them to correct it B. Report the incident to the nurse manager
[CORRECT] C. Document the correct findings in the nurse's own notes D. Ignore it unless it
directly affects client safety Correct Answer: B
Q10: [Chart/Exhibit] Review the following client data:
• Vital signs: BP 92/58, HR 118, RR 24, Temp 38.9°C (102°F), SpO2 91%
• Lab values: WBC 16,000, Hgb 8.2, Platelets 85,000
• Client reports: "I feel like I'm going to pass out."
Based on this data, which nursing diagnosis is the priority? A. Risk for infection B. Ineffective
tissue perfusion [CORRECT] C. Impaired gas exchange D. Risk for bleeding Correct Answer: B
Q11: Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse
(LPN/LVN)? A. Developing a plan of care for a newly admitted client B. Teaching a client about
insulin administration C. Administering an enema to a stable client [CORRECT] D. Assessing a
client with chest pain Correct Answer: C
Q12: A client with terminal cancer requests information about hospice care. The nurse's primary
responsibility is to: A. Contact the physician to discuss hospice referral B. Provide information
, and support the client's autonomy in decision-making [CORRECT] C. Encourage the client to
continue curative treatment D. Suggest the client talk with family members first Correct Answer:
B
Q13: [Multiple Response - Select All That Apply] Which situations require the nurse to obtain
informed consent? (Select all that apply.) A. Administration of blood products [CORRECT] B.
Participation in a research study [CORRECT] C. Routine vital signs assessment D. Surgical
procedure [CORRECT] E. Administration of routine oral medications Correct Answers: A, B, D
Q14: The nurse is supervising a newly hired UAP. Which observation requires immediate
intervention? A. The UAP ambulates a client with a gait belt B. The UAP performs perineal care
using clean technique C. The UAP feeds a client who is positioned at 90 degrees D. The UAP
applies restraints to a client without a healthcare provider's order [CORRECT] Correct Answer:
D
Q15: [Cloze - Fill-in-the-Blank] A client weighs 176 lbs. The healthcare provider orders a
medication at 2 mg/kg. How many mg should the nurse administer? _____ mg
Correct Answer: 160 mg
Q16: Which action by the nurse demonstrates appropriate continuity of care during client
transfer from ICU to a medical-surgical unit? A. Providing a verbal report only to expedite the
transfer B. Ensuring all documentation is complete and conducting a bedside handoff report
[CORRECT] C. Allowing the receiving nurse to review the chart independently D. Sending the
client first and faxing the records later Correct Answer: B
Q17: [Drag & Drop - Delegation] Match the following tasks to the appropriate personnel (RN,
LPN/LVN, or UAP).
• A. Inserting a urinary catheter
• B. Measuring vital signs on stable clients
• C. Administering IV push medications
• D. Performing sterile dressing changes
Correct Assignments: A-RN, B-UAP, C-RN, D-RN
Q18: A client with a history of domestic violence confides in the nurse about the abuse. The
nurse's priority action is to: A. Contact the client's spouse to verify the story B. Report the abuse
to the appropriate authorities as mandated by law [CORRECT] C. Advise the client to leave the
abusive situation immediately D. Document the conversation and take no further action Correct
Answer: B
Q19: [Multiple Response - Select All That Apply] Which information is protected under HIPAA
regulations? (Select all that apply.) A. Client's diagnosis [CORRECT] B. Client's room number
