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)
Covers advocacy, rights, delegation, supervision, ethics, legal responsibilities, and quality
improvement.
Q1: A nurse on a medical-surgical unit receives report on four clients. Which client should the
nurse assess first?
A. A client with pneumonia who has a temperature of 101.2°F and is receiving IV antibiotics B.
A client post-appendectomy 2 hours ago with a blood pressure of 90/60 mmHg and heart rate of
118 bpm [CORRECT] C. A client with heart failure who reports feeling short of breath when
walking to the bathroom D. A client with diabetes who has a blood glucose of 180 mg/dL before
lunch
Correct Answer: B
Q2: [Select All That Apply] A nurse is caring for a client with a new diagnosis of tuberculosis.
Which actions by the nurse are appropriate? (Select all that apply.)
A. Place the client in a private room with negative pressure ventilation [CORRECT] B. Wear an
N95 respirator when entering the room [CORRECT] C. Assign the client to a room with another
client who has tuberculosis [CORRECT] D. Wear a standard surgical mask when providing
routine care E. Instruct visitors to wear a surgical mask when visiting
Correct Answers: A, B, C
Q3: A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a postoperative client's incision for signs of infection B. Administering oral
medications to a stable client C. Measuring and recording intake and output for a client with
heart failure [CORRECT] D. Teaching a client with diabetes how to administer insulin
,Correct Answer: C
Q4: [Drag and Drop] Place the steps of the nursing process in the correct order. (Drag options to
correct sequence.)
Options: A. Evaluation B. Planning C. Assessment D. Implementation E. Diagnosis
Correct Order: C, E, B, D, A
Q5: A client is scheduled for surgery and states, "I don't want the surgery anymore. I want to go
home." The nurse notes the client signed the consent form 2 hours ago. What is the nurse's
priority action?
A. Explain the risks of not having the surgery B. Notify the surgeon and document the client's
statement [CORRECT] C. Have the client's family convince them to proceed D. Proceed with
preoperative preparation as scheduled
Correct Answer: B
Q6: [Select All That Apply] Which situations require the nurse to complete an incident report?
(Select all that apply.)
A. A client falls while attempting to get out of bed unassisted [CORRECT] B. A medication is
administered 30 minutes late due to pharmacy delay C. A visitor slips and falls in the hospital
parking garage D. A client receives the wrong dose of medication due to a transcription error
[CORRECT] E. A client develops a nosocomial infection 48 hours after admission
Correct Answers: A, D
Q7: A nurse is caring for a 16-year-old client who is pregnant and requests that her parents not
be informed of her prenatal care. What is the nurse's best action?
A. Inform the parents because the client is a minor B. Respect the client's confidentiality as
permitted by state law [CORRECT] C. Refuse to provide care without parental consent D. Ask
the client's boyfriend to inform the parents
Correct Answer: B
,Q8: [Prioritization - Drag and Drop] The nurse is caring for four clients. Place the clients in
order of priority for assessment. (First to last.)
Options: A. Client with chest pain rated 8/10 B. Client requesting a PRN pain medication for a
headache C. Client with a blood pressure of 210/110 mmHg and headache D. Client who needs
discharge teaching
Correct Order: A, C, B, D
Q9: A nurse is supervising a newly licensed nurse who is preparing to insert a nasogastric tube.
The newly licensed nurse has inserted the tube 55 cm and is about to secure it. What action
should the supervising nurse take?
A. Allow the nurse to secure the tube as placed B. Ask the nurse to verify placement with an X-
ray before use C. Instruct the nurse to withdraw the tube 5-10 cm and check placement
[CORRECT] D. Tell the nurse to remove the tube and start over
Correct Answer: C
Q10: [Select All That Apply] A nurse is participating in quality improvement for the unit. Which
activities are appropriate for the nurse to perform? (Select all that apply.)
A. Collecting data on the incidence of hospital-acquired pressure injuries [CORRECT] B.
Developing policies for the entire hospital system C. Implementing evidence-based practice
protocols on the unit [CORRECT] D. Analyzing root causes of medication errors [CORRECT]
E. Terminating employees who make errors
Correct Answers: A, C, D
Q11: A client with a history of domestic violence confides in the nurse that their partner
threatened to kill them last night. What is the nurse's legal responsibility?
A. Maintain confidentiality as requested by the client B. Report the threat to law enforcement
and adult protective services [CORRECT] C. Confront the partner during their next visit D.
Suggest the client move to a shelter but take no further action
Correct Answer: B
, Q12: [Cloze - Fill in the Blank] A client is to receive 1,000 mL of 0.9% sodium chloride over 8
hours. The IV tubing delivers 20 gtt/mL. The nurse should set the drip rate at ______ gtt/min.
(Round to nearest whole number.)
Correct Answer: 42 gtt/min
Q13: A nurse is caring for a client who is Jehovah's Witness and requires emergency surgery.
The client refuses blood transfusions based on religious beliefs. What is the nurse's best action?
A. Obtain a court order to administer blood B. Respect the client's refusal and notify the surgeon
[CORRECT] C. Administer blood only if the client's condition deteriorates D. Have the client's
family override the decision
Correct Answer: B
Q14: [Select All That Apply] Which tasks can the nurse delegate to a licensed practical nurse
(LPN)? (Select all that apply.)
A. Administering oral medications to stable clients [CORRECT] B. Performing sterile dressing
changes on a wound with a new drainage system C. Monitoring a client receiving blood for the
first 15 minutes D. Teaching a client about a new diagnosis of diabetes E. Inserting a urinary
catheter [CORRECT]
Correct Answers: A, E
Q15: A nurse is reviewing the medical record of a client with a do-not-resuscitate (DNR) order.
The client stops breathing. What action should the nurse take?
A. Begin CPR immediately B. Call a code blue and initiate resuscitation C. Honor the DNR
order and provide comfort measures only [CORRECT] D. Ask the family if they want to rescind
the DNR order
Correct Answer: C
Q16: [Chart/Exhibit] A nurse is reviewing the electronic health record of a client admitted with
community-acquired pneumonia. Which finding requires immediate follow-up?
Vital Signs:
• 0200: T 99.8°F, HR 88, RR 18, BP 128/76, SpO2 94% on room air
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)
Covers advocacy, rights, delegation, supervision, ethics, legal responsibilities, and quality
improvement.
Q1: A nurse on a medical-surgical unit receives report on four clients. Which client should the
nurse assess first?
A. A client with pneumonia who has a temperature of 101.2°F and is receiving IV antibiotics B.
A client post-appendectomy 2 hours ago with a blood pressure of 90/60 mmHg and heart rate of
118 bpm [CORRECT] C. A client with heart failure who reports feeling short of breath when
walking to the bathroom D. A client with diabetes who has a blood glucose of 180 mg/dL before
lunch
Correct Answer: B
Q2: [Select All That Apply] A nurse is caring for a client with a new diagnosis of tuberculosis.
Which actions by the nurse are appropriate? (Select all that apply.)
A. Place the client in a private room with negative pressure ventilation [CORRECT] B. Wear an
N95 respirator when entering the room [CORRECT] C. Assign the client to a room with another
client who has tuberculosis [CORRECT] D. Wear a standard surgical mask when providing
routine care E. Instruct visitors to wear a surgical mask when visiting
Correct Answers: A, B, C
Q3: A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a postoperative client's incision for signs of infection B. Administering oral
medications to a stable client C. Measuring and recording intake and output for a client with
heart failure [CORRECT] D. Teaching a client with diabetes how to administer insulin
,Correct Answer: C
Q4: [Drag and Drop] Place the steps of the nursing process in the correct order. (Drag options to
correct sequence.)
Options: A. Evaluation B. Planning C. Assessment D. Implementation E. Diagnosis
Correct Order: C, E, B, D, A
Q5: A client is scheduled for surgery and states, "I don't want the surgery anymore. I want to go
home." The nurse notes the client signed the consent form 2 hours ago. What is the nurse's
priority action?
A. Explain the risks of not having the surgery B. Notify the surgeon and document the client's
statement [CORRECT] C. Have the client's family convince them to proceed D. Proceed with
preoperative preparation as scheduled
Correct Answer: B
Q6: [Select All That Apply] Which situations require the nurse to complete an incident report?
(Select all that apply.)
A. A client falls while attempting to get out of bed unassisted [CORRECT] B. A medication is
administered 30 minutes late due to pharmacy delay C. A visitor slips and falls in the hospital
parking garage D. A client receives the wrong dose of medication due to a transcription error
[CORRECT] E. A client develops a nosocomial infection 48 hours after admission
Correct Answers: A, D
Q7: A nurse is caring for a 16-year-old client who is pregnant and requests that her parents not
be informed of her prenatal care. What is the nurse's best action?
A. Inform the parents because the client is a minor B. Respect the client's confidentiality as
permitted by state law [CORRECT] C. Refuse to provide care without parental consent D. Ask
the client's boyfriend to inform the parents
Correct Answer: B
,Q8: [Prioritization - Drag and Drop] The nurse is caring for four clients. Place the clients in
order of priority for assessment. (First to last.)
Options: A. Client with chest pain rated 8/10 B. Client requesting a PRN pain medication for a
headache C. Client with a blood pressure of 210/110 mmHg and headache D. Client who needs
discharge teaching
Correct Order: A, C, B, D
Q9: A nurse is supervising a newly licensed nurse who is preparing to insert a nasogastric tube.
The newly licensed nurse has inserted the tube 55 cm and is about to secure it. What action
should the supervising nurse take?
A. Allow the nurse to secure the tube as placed B. Ask the nurse to verify placement with an X-
ray before use C. Instruct the nurse to withdraw the tube 5-10 cm and check placement
[CORRECT] D. Tell the nurse to remove the tube and start over
Correct Answer: C
Q10: [Select All That Apply] A nurse is participating in quality improvement for the unit. Which
activities are appropriate for the nurse to perform? (Select all that apply.)
A. Collecting data on the incidence of hospital-acquired pressure injuries [CORRECT] B.
Developing policies for the entire hospital system C. Implementing evidence-based practice
protocols on the unit [CORRECT] D. Analyzing root causes of medication errors [CORRECT]
E. Terminating employees who make errors
Correct Answers: A, C, D
Q11: A client with a history of domestic violence confides in the nurse that their partner
threatened to kill them last night. What is the nurse's legal responsibility?
A. Maintain confidentiality as requested by the client B. Report the threat to law enforcement
and adult protective services [CORRECT] C. Confront the partner during their next visit D.
Suggest the client move to a shelter but take no further action
Correct Answer: B
, Q12: [Cloze - Fill in the Blank] A client is to receive 1,000 mL of 0.9% sodium chloride over 8
hours. The IV tubing delivers 20 gtt/mL. The nurse should set the drip rate at ______ gtt/min.
(Round to nearest whole number.)
Correct Answer: 42 gtt/min
Q13: A nurse is caring for a client who is Jehovah's Witness and requires emergency surgery.
The client refuses blood transfusions based on religious beliefs. What is the nurse's best action?
A. Obtain a court order to administer blood B. Respect the client's refusal and notify the surgeon
[CORRECT] C. Administer blood only if the client's condition deteriorates D. Have the client's
family override the decision
Correct Answer: B
Q14: [Select All That Apply] Which tasks can the nurse delegate to a licensed practical nurse
(LPN)? (Select all that apply.)
A. Administering oral medications to stable clients [CORRECT] B. Performing sterile dressing
changes on a wound with a new drainage system C. Monitoring a client receiving blood for the
first 15 minutes D. Teaching a client about a new diagnosis of diabetes E. Inserting a urinary
catheter [CORRECT]
Correct Answers: A, E
Q15: A nurse is reviewing the medical record of a client with a do-not-resuscitate (DNR) order.
The client stops breathing. What action should the nurse take?
A. Begin CPR immediately B. Call a code blue and initiate resuscitation C. Honor the DNR
order and provide comfort measures only [CORRECT] D. Ask the family if they want to rescind
the DNR order
Correct Answer: C
Q16: [Chart/Exhibit] A nurse is reviewing the electronic health record of a client admitted with
community-acquired pneumonia. Which finding requires immediate follow-up?
Vital Signs:
• 0200: T 99.8°F, HR 88, RR 18, BP 128/76, SpO2 94% on room air
