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
Q1. The nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess FIRST?
A. A client 2 hours post-op appendectomy with pain rated 6/10
B. A client with heart failure reporting increasing shortness of breath when lying flat
[CORRECT]
C. A client scheduled for discharge who needs medication teaching
D. A client with diabetes requesting a snack before lunch
Correct Answer: B
Q2. [SATA] The nurse is delegating tasks to unlicensed assistive personnel (UAP) on a busy unit.
Which tasks are appropriate to delegate? (Select all that apply.)
A. Measuring vital signs on a stable post-op client [CORRECT]
B. Administering oral medications to a client with dysphagia
C. Assisting a client with ambulation after physical therapy [CORRECT]
D. Performing a sterile dressing change on a surgical wound
E. Feeding a client who is at risk for aspiration [CORRECT]
Correct Answers: A, C, E
Q3. A client is scheduled for an invasive procedure and states, "I don't want this surgery
anymore." What is the nurse's PRIORITY action?
A. Have the client sign an against medical advice (AMA) form
B. Notify the surgeon and ensure the client understands consequences of refusal [CORRECT]
C. Convince the client to proceed with the procedure
D. Document the refusal and continue preoperative preparation
Correct Answer: B
Q4. [Drag & Drop] Place the steps for verifying informed consent in the correct order:
,A. Witness the client signature
B. Confirm the client understands the procedure
C. Verify the correct procedure and site
D. Ensure the provider explained risks and benefits
Correct Order: D, B, C, A
Q5. A nurse discovers that a colleague has been accessing the medical records of neighbors
without clinical justification. What is the nurse's legal responsibility?
A. Confront the colleague directly
B. Report the breach to the privacy officer or supervisor [CORRECT]
C. Document the incident in the client's chart
D. Ignore it unless client harm occurs
Correct Answer: B
Q6. [SATA] Which actions demonstrate the nurse's role as client advocate? (Select all that
apply.)
A. Questioning a medication order that seems inappropriate [CORRECT]
B. Respecting a client's decision to refuse blood products [CORRECT]
C. Ensuring a client receives adequate pain management [CORRECT]
D. Following physician orders without question
E. Sharing client information with family upon request
Correct Answers: A, B, C
Q7. A client with COPD is being discharged home with oxygen therapy. Which referral is MOST
appropriate to ensure continuity of care?
A. Physical therapy for exercise training
B. Home health nursing for assessment and teaching [CORRECT]
C. Social services for financial counseling
D. Occupational therapy for adaptive equipment
Correct Answer: B
,Q8. [Cloze - Calculation] A client is to receive 1,000 mL of 0.9% NaCl over 8 hours. The drip
factor is 15 gtt/mL. The nurse should set the flow rate at ______ gtt/min. (Round to nearest
whole number)
Correct Answer: 31 gtt/min
Q9. During a code blue, the nurse notes that the crash cart defibrillator pads are expired. What is
the BEST immediate action?
A. Use the expired pads; they will likely still work
B. Send someone to retrieve pads from another unit while beginning CPR [CORRECT]
C. Wait for the code team to arrive with equipment
D. Use gel and paddles instead
Correct Answer: B
Q10. [SATA] Which situations require the nurse to complete an incident report? (Select all that
apply.)
A. A client falls while attempting to get to the bathroom [CORRECT]
B. A medication is administered 30 minutes late due to pharmacy delay
C. A visitor slips on a wet floor in the hallway [CORRECT]
D. A client receives the wrong dose of medication [CORRECT]
E. A client complains about the food temperature
Correct Answers: A, C, D
Q11. A new graduate nurse is overwhelmed with assignments. Which task should the nurse
delegate FIRST to a licensed practical nurse (LPN)?
A. Administering a blood transfusion to a stable client
B. Performing wound irrigation and dressing change on a client with a Stage 2 pressure injury
[CORRECT]
C. Assessing a client with new-onset chest pain
D. Teaching discharge instructions to a client with heart failure
Correct Answer: B
Q12. [Chart/Exhibit] Review the following shift report data:
Client A: Post-op day 2 after hip replacement, stable vital signs, pain controlled
, Client B: New admission with chest pain, troponin pending, on telemetry
Client C: Diabetic ketoacidosis, insulin drip, hourly blood glucose checks
Client D: Stable, awaiting discharge, needs final teaching
Which client should the nurse see FIRST at the start of the shift?
A. Client A
B. Client B [CORRECT]
C. Client C
D. Client D
Correct Answer: B
Q13. A client with terminal cancer requests that the nurse not disclose poor prognosis to family
members. What is the nurse's BEST response?
A. Explain that family has a right to know
B. Honor the client's wishes while ensuring the client understands implications [CORRECT]
C. Tell the family anyway, as they need to prepare
D. Ask the physician to break the news to the family
Correct Answer: B
Q14. [SATA] Which actions by the nurse demonstrate ethical practice? (Select all that apply.)
A. Allocating scarce resources based on client need and likelihood of benefit [CORRECT]
B. Accepting a gift from a grateful client family
C. Providing truthful information even when difficult [CORRECT]
D. Respecting cultural differences in healthcare decisions [CORRECT]
E. Covering up a medication error to protect a colleague
Correct Answers: A, C, D
Q15. The nurse is participating in a quality improvement project to reduce catheter-associated
urinary tract infections (CAUTI). Which action demonstrates the nurse's role in quality
improvement?
A. Following the unit's existing protocols without question
B. Collecting data on catheter insertion techniques and outcomes [CORRECT]
PRACTICE EXAM 2026/2027 | Simulated CAT-Style
Questions with Verified Answers | Aligned to NCSBN
Test Plan | Pass Guarantee Target - A+ Graded
Q1. The nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess FIRST?
A. A client 2 hours post-op appendectomy with pain rated 6/10
B. A client with heart failure reporting increasing shortness of breath when lying flat
[CORRECT]
C. A client scheduled for discharge who needs medication teaching
D. A client with diabetes requesting a snack before lunch
Correct Answer: B
Q2. [SATA] The nurse is delegating tasks to unlicensed assistive personnel (UAP) on a busy unit.
Which tasks are appropriate to delegate? (Select all that apply.)
A. Measuring vital signs on a stable post-op client [CORRECT]
B. Administering oral medications to a client with dysphagia
C. Assisting a client with ambulation after physical therapy [CORRECT]
D. Performing a sterile dressing change on a surgical wound
E. Feeding a client who is at risk for aspiration [CORRECT]
Correct Answers: A, C, E
Q3. A client is scheduled for an invasive procedure and states, "I don't want this surgery
anymore." What is the nurse's PRIORITY action?
A. Have the client sign an against medical advice (AMA) form
B. Notify the surgeon and ensure the client understands consequences of refusal [CORRECT]
C. Convince the client to proceed with the procedure
D. Document the refusal and continue preoperative preparation
Correct Answer: B
Q4. [Drag & Drop] Place the steps for verifying informed consent in the correct order:
,A. Witness the client signature
B. Confirm the client understands the procedure
C. Verify the correct procedure and site
D. Ensure the provider explained risks and benefits
Correct Order: D, B, C, A
Q5. A nurse discovers that a colleague has been accessing the medical records of neighbors
without clinical justification. What is the nurse's legal responsibility?
A. Confront the colleague directly
B. Report the breach to the privacy officer or supervisor [CORRECT]
C. Document the incident in the client's chart
D. Ignore it unless client harm occurs
Correct Answer: B
Q6. [SATA] Which actions demonstrate the nurse's role as client advocate? (Select all that
apply.)
A. Questioning a medication order that seems inappropriate [CORRECT]
B. Respecting a client's decision to refuse blood products [CORRECT]
C. Ensuring a client receives adequate pain management [CORRECT]
D. Following physician orders without question
E. Sharing client information with family upon request
Correct Answers: A, B, C
Q7. A client with COPD is being discharged home with oxygen therapy. Which referral is MOST
appropriate to ensure continuity of care?
A. Physical therapy for exercise training
B. Home health nursing for assessment and teaching [CORRECT]
C. Social services for financial counseling
D. Occupational therapy for adaptive equipment
Correct Answer: B
,Q8. [Cloze - Calculation] A client is to receive 1,000 mL of 0.9% NaCl over 8 hours. The drip
factor is 15 gtt/mL. The nurse should set the flow rate at ______ gtt/min. (Round to nearest
whole number)
Correct Answer: 31 gtt/min
Q9. During a code blue, the nurse notes that the crash cart defibrillator pads are expired. What is
the BEST immediate action?
A. Use the expired pads; they will likely still work
B. Send someone to retrieve pads from another unit while beginning CPR [CORRECT]
C. Wait for the code team to arrive with equipment
D. Use gel and paddles instead
Correct Answer: B
Q10. [SATA] Which situations require the nurse to complete an incident report? (Select all that
apply.)
A. A client falls while attempting to get to the bathroom [CORRECT]
B. A medication is administered 30 minutes late due to pharmacy delay
C. A visitor slips on a wet floor in the hallway [CORRECT]
D. A client receives the wrong dose of medication [CORRECT]
E. A client complains about the food temperature
Correct Answers: A, C, D
Q11. A new graduate nurse is overwhelmed with assignments. Which task should the nurse
delegate FIRST to a licensed practical nurse (LPN)?
A. Administering a blood transfusion to a stable client
B. Performing wound irrigation and dressing change on a client with a Stage 2 pressure injury
[CORRECT]
C. Assessing a client with new-onset chest pain
D. Teaching discharge instructions to a client with heart failure
Correct Answer: B
Q12. [Chart/Exhibit] Review the following shift report data:
Client A: Post-op day 2 after hip replacement, stable vital signs, pain controlled
, Client B: New admission with chest pain, troponin pending, on telemetry
Client C: Diabetic ketoacidosis, insulin drip, hourly blood glucose checks
Client D: Stable, awaiting discharge, needs final teaching
Which client should the nurse see FIRST at the start of the shift?
A. Client A
B. Client B [CORRECT]
C. Client C
D. Client D
Correct Answer: B
Q13. A client with terminal cancer requests that the nurse not disclose poor prognosis to family
members. What is the nurse's BEST response?
A. Explain that family has a right to know
B. Honor the client's wishes while ensuring the client understands implications [CORRECT]
C. Tell the family anyway, as they need to prepare
D. Ask the physician to break the news to the family
Correct Answer: B
Q14. [SATA] Which actions by the nurse demonstrate ethical practice? (Select all that apply.)
A. Allocating scarce resources based on client need and likelihood of benefit [CORRECT]
B. Accepting a gift from a grateful client family
C. Providing truthful information even when difficult [CORRECT]
D. Respecting cultural differences in healthcare decisions [CORRECT]
E. Covering up a medication error to protect a colleague
Correct Answers: A, C, D
Q15. The nurse is participating in a quality improvement project to reduce catheter-associated
urinary tract infections (CAUTI). Which action demonstrates the nurse's role in quality
improvement?
A. Following the unit's existing protocols without question
B. Collecting data on catheter insertion techniques and outcomes [CORRECT]
