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 (Questions 1-25)
Q1: A nurse on a medical-surgical unit receives report on four clients. Which client should the
nurse assess first?
A. Client with pneumonia who has a temperature of 101.2°F (38.4°C) and is due for scheduled
antibiotics in 30 minutes [INCORRECT - Stable, can wait for scheduled medications]
B. Client with heart failure who reports increasing shortness of breath when lying flat and has
bilateral crackles in lung bases [CORRECT]
C. Client post-appendectomy day 2 who is requesting pain medication for a pain rating of 6/10
[INCORRECT - Pain is priority but not life-threatening]
D. Client with diabetes who has a blood glucose of 185 mg/dL before breakfast [INCORRECT -
Elevated but not immediately dangerous]
Correct Answer: B
Q2: [Select All That Apply] A nurse is caring for a client with a new diagnosis of type 2 diabetes
mellitus. Which actions demonstrate client advocacy? (Select all that apply.)
A. Ensuring the client receives education about diabetes management in their preferred language
[CORRECT]
B. Contacting the healthcare provider to request a diabetes educator consult [CORRECT]
C. Telling the client they must follow the prescribed diet exactly as written [INCORRECT - This
is directive, not collaborative advocacy]
D. Supporting the client's decision to refuse insulin therapy after informed refusal is documented
[CORRECT]
E. Explaining to the family that the client's blood sugar is poorly controlled [INCORRECT -
Violates HIPAA without client consent]
,Correct Answers: A, B, D
Q3: A charge nurse is delegating tasks on a busy medical-surgical unit. Which task is most
appropriate to delegate to an unlicensed assistive personnel (UAP)?
A. Assessing a postoperative client's incision for signs of infection [INCORRECT - Assessment
requires nursing judgment]
B. Administering oral medications to a stable client [INCORRECT - Medication administration
is a licensed nurse responsibility]
C. Measuring and recording intake and output for a client with heart failure [CORRECT]
D. Teaching a client about wound care before discharge [INCORRECT - Teaching requires
nursing education and evaluation]
Correct Answer: C
Q4: [Drag and Drop] Place the steps for verifying informed consent in the correct order.
A. Ensure the client voluntarily agrees to the procedure
B. Verify that the client understands the risks, benefits, and alternatives
C. Confirm that the healthcare provider has explained the procedure
D. Witness the client's signature on the consent form
E. Assess the client's decision-making capacity
Correct Order: E, C, B, A, D
Q5: A nurse discovers that a colleague has posted a photo of a client's wound on social media
without identifying information. What is the nurse's priority action?
A. Ignore the post since no identifying information was included [INCORRECT - Still violates
client privacy]
B. Report the incident to the nurse manager or privacy officer [CORRECT]
C. Confront the colleague publicly on the social media post [INCORRECT - Unprofessional and
escalates situation]
D. Suggest the colleague delete the post and take no further action [INCORRECT - Does not
fulfill mandatory reporting obligation]
,Correct Answer: B
Q6: [Select All That Apply] A nurse is participating in a quality improvement project to reduce
hospital-acquired pressure injuries. Which data should be collected? (Select all that apply.)
A. Number of pressure injuries developed during hospitalization [CORRECT]
B. Braden Scale scores on admission for all clients [CORRECT]
C. Staffing ratios on units where pressure injuries occurred [CORRECT]
D. Client satisfaction scores with food service [INCORRECT - Not directly related to pressure
injury development]
E. Documentation of turning schedules and skin assessments [CORRECT]
Correct Answers: A, B, C, E
Q7: A client with terminal cancer states, "I don't want any more chemotherapy. I want to go
home and be with my family." The client's adult children insist the client must continue
treatment. What is the nurse's priority action?
A. Support the client's autonomy and facilitate a family meeting with the healthcare team
[CORRECT]
B. Convince the client to continue treatment for the family's sake [INCORRECT - Violates client
autonomy]
C. Tell the children that their parent's decision is final [INCORRECT - Nurse should facilitate
communication, not dictate]
D. Ask the healthcare provider to make the decision [INCORRECT - Client has right to make
informed decisions]
Correct Answer: A
Q8: [Cloze - Calculation] A client is prescribed heparin 5,000 units subcutaneously every 12
hours. The available vial contains heparin 10,000 units/mL. How many mL should the nurse
administer? (Record answer using one decimal place.)
Correct Answer: 0.5 mL
, Q9: A nurse is supervising a newly licensed nurse who is caring for a client with a chest tube.
Which observation requires immediate intervention?
A. The chest tube drainage system is below the level of the client's chest [INCORRECT - Correct
placement]
B. The chest tube is secured with a suture and occlusive dressing [INCORRECT - Appropriate
securement]
C. The chest tube is clamped while the client is being turned [CORRECT]
D. The water seal chamber has intermittent bubbling [INCORRECT - Normal with respiration]
Correct Answer: C
Q10: [Select All That Apply] A nurse is caring for a client who is a Jehovah's Witness and
requires surgery. Which actions by the nurse demonstrate cultural sensitivity and ethical
practice? (Select all that apply.)
A. Asking the client about their specific beliefs regarding blood products [CORRECT]
B. Documenting the client's refusal of blood transfusions in the medical record [CORRECT]
C. Telling the client that refusing blood may result in death [INCORRECT - Coercive and
judgmental]
D. Notifying the surgeon and anesthesiologist of the client's preferences [CORRECT]
E. Attempting to convince the client to accept blood if life-threatening bleeding occurs
[INCORRECT - Violates client autonomy]
Correct Answers: A, B, D
Q11: A nurse is caring for four clients. Which task should the nurse delegate to a licensed
practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client [INCORRECT - RN responsibility]
B. Administering enteral feeding through a gastrostomy tube to a stable client [CORRECT]
C. Performing the initial assessment on a client transferred from ICU [INCORRECT - RN
responsibility]
D. Teaching a client about insulin self-administration [INCORRECT - Teaching requires RN
evaluation]
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 (Questions 1-25)
Q1: A nurse on a medical-surgical unit receives report on four clients. Which client should the
nurse assess first?
A. Client with pneumonia who has a temperature of 101.2°F (38.4°C) and is due for scheduled
antibiotics in 30 minutes [INCORRECT - Stable, can wait for scheduled medications]
B. Client with heart failure who reports increasing shortness of breath when lying flat and has
bilateral crackles in lung bases [CORRECT]
C. Client post-appendectomy day 2 who is requesting pain medication for a pain rating of 6/10
[INCORRECT - Pain is priority but not life-threatening]
D. Client with diabetes who has a blood glucose of 185 mg/dL before breakfast [INCORRECT -
Elevated but not immediately dangerous]
Correct Answer: B
Q2: [Select All That Apply] A nurse is caring for a client with a new diagnosis of type 2 diabetes
mellitus. Which actions demonstrate client advocacy? (Select all that apply.)
A. Ensuring the client receives education about diabetes management in their preferred language
[CORRECT]
B. Contacting the healthcare provider to request a diabetes educator consult [CORRECT]
C. Telling the client they must follow the prescribed diet exactly as written [INCORRECT - This
is directive, not collaborative advocacy]
D. Supporting the client's decision to refuse insulin therapy after informed refusal is documented
[CORRECT]
E. Explaining to the family that the client's blood sugar is poorly controlled [INCORRECT -
Violates HIPAA without client consent]
,Correct Answers: A, B, D
Q3: A charge nurse is delegating tasks on a busy medical-surgical unit. Which task is most
appropriate to delegate to an unlicensed assistive personnel (UAP)?
A. Assessing a postoperative client's incision for signs of infection [INCORRECT - Assessment
requires nursing judgment]
B. Administering oral medications to a stable client [INCORRECT - Medication administration
is a licensed nurse responsibility]
C. Measuring and recording intake and output for a client with heart failure [CORRECT]
D. Teaching a client about wound care before discharge [INCORRECT - Teaching requires
nursing education and evaluation]
Correct Answer: C
Q4: [Drag and Drop] Place the steps for verifying informed consent in the correct order.
A. Ensure the client voluntarily agrees to the procedure
B. Verify that the client understands the risks, benefits, and alternatives
C. Confirm that the healthcare provider has explained the procedure
D. Witness the client's signature on the consent form
E. Assess the client's decision-making capacity
Correct Order: E, C, B, A, D
Q5: A nurse discovers that a colleague has posted a photo of a client's wound on social media
without identifying information. What is the nurse's priority action?
A. Ignore the post since no identifying information was included [INCORRECT - Still violates
client privacy]
B. Report the incident to the nurse manager or privacy officer [CORRECT]
C. Confront the colleague publicly on the social media post [INCORRECT - Unprofessional and
escalates situation]
D. Suggest the colleague delete the post and take no further action [INCORRECT - Does not
fulfill mandatory reporting obligation]
,Correct Answer: B
Q6: [Select All That Apply] A nurse is participating in a quality improvement project to reduce
hospital-acquired pressure injuries. Which data should be collected? (Select all that apply.)
A. Number of pressure injuries developed during hospitalization [CORRECT]
B. Braden Scale scores on admission for all clients [CORRECT]
C. Staffing ratios on units where pressure injuries occurred [CORRECT]
D. Client satisfaction scores with food service [INCORRECT - Not directly related to pressure
injury development]
E. Documentation of turning schedules and skin assessments [CORRECT]
Correct Answers: A, B, C, E
Q7: A client with terminal cancer states, "I don't want any more chemotherapy. I want to go
home and be with my family." The client's adult children insist the client must continue
treatment. What is the nurse's priority action?
A. Support the client's autonomy and facilitate a family meeting with the healthcare team
[CORRECT]
B. Convince the client to continue treatment for the family's sake [INCORRECT - Violates client
autonomy]
C. Tell the children that their parent's decision is final [INCORRECT - Nurse should facilitate
communication, not dictate]
D. Ask the healthcare provider to make the decision [INCORRECT - Client has right to make
informed decisions]
Correct Answer: A
Q8: [Cloze - Calculation] A client is prescribed heparin 5,000 units subcutaneously every 12
hours. The available vial contains heparin 10,000 units/mL. How many mL should the nurse
administer? (Record answer using one decimal place.)
Correct Answer: 0.5 mL
, Q9: A nurse is supervising a newly licensed nurse who is caring for a client with a chest tube.
Which observation requires immediate intervention?
A. The chest tube drainage system is below the level of the client's chest [INCORRECT - Correct
placement]
B. The chest tube is secured with a suture and occlusive dressing [INCORRECT - Appropriate
securement]
C. The chest tube is clamped while the client is being turned [CORRECT]
D. The water seal chamber has intermittent bubbling [INCORRECT - Normal with respiration]
Correct Answer: C
Q10: [Select All That Apply] A nurse is caring for a client who is a Jehovah's Witness and
requires surgery. Which actions by the nurse demonstrate cultural sensitivity and ethical
practice? (Select all that apply.)
A. Asking the client about their specific beliefs regarding blood products [CORRECT]
B. Documenting the client's refusal of blood transfusions in the medical record [CORRECT]
C. Telling the client that refusing blood may result in death [INCORRECT - Coercive and
judgmental]
D. Notifying the surgeon and anesthesiologist of the client's preferences [CORRECT]
E. Attempting to convince the client to accept blood if life-threatening bleeding occurs
[INCORRECT - Violates client autonomy]
Correct Answers: A, B, D
Q11: A nurse is caring for four clients. Which task should the nurse delegate to a licensed
practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client [INCORRECT - RN responsibility]
B. Administering enteral feeding through a gastrostomy tube to a stable client [CORRECT]
C. Performing the initial assessment on a client transferred from ICU [INCORRECT - RN
responsibility]
D. Teaching a client about insulin self-administration [INCORRECT - Teaching requires RN
evaluation]
