NCSBN NCLEX-RN Question Bank 9th
Edition by Linda Anne Silvestri and
Angela Elizabeth Silvestri –
Comprehensive Test Bank for 2025/2026
Q1. A newly graduated RN reviews the Pyramid to Success.
Which level is foundational for making safe clinical decisions?
A. Reflection
B. Experience
C. Scientific method
D. Nursing process
Answer: D
Rationale: The nursing process (assessment, diagnosis, planning,
implementation, evaluation) is the foundation of clinical judgment
in the Pyramid to Success. The scientific method, experience, and
reflection build on this foundation but do not replace it.
Q2. A nurse uses the Pyramid to Success to reflect on a
medication error. Which step corresponds to "Reflection"?
A. Assessing patient symptoms
B. Reviewing what went well and what didn't
C. Formulating a nursing diagnosis
D. Implementing a corrective action
Answer: B
Rationale: Reflection involves looking back at actions, identifying
,strengths and areas for improvement. Assessment, diagnosis, and
implementation are earlier process steps.
Q3. Which statement reflects the "Scientific Method" tier of
the Pyramid to Success?
A. "I'll use my past experiences to decide."
B. "I'll test whether elevating the head reduces dyspnea."
C. "I'll ask my mentor how to proceed."
D. "I'll follow hospital policy without variation."
Answer: B
Rationale: The scientific method involves formulating a
hypothesis (elevating the head), testing it, and evaluating results.
Experience, mentorship, and policy adherence are not the
scientific method.
Section 2: Computer Adaptive Testing (CAT)
Q4. In CAT, when a candidate answers correctly, the next item
is:
A. Easier
B. The same level
C. Harder
D. Randomly selected
Answer: C
Rationale: CAT adapts difficulty upward after correct answers to
hone in on ability level. Incorrect responses lead to easier items.
,Q5. CAT stops when:
A. The candidate completes 200 items
B. The candidate's ability estimate is confidently above or below
the passing standard
C. Time expires
D. The candidate requests to stop
Answer: B
Rationale: CAT ends when the algorithm determines with 95%
confidence that the candidate's ability is clearly above or below
the passing standard.
Section 3: Safe and Effective Care Environment
Q6. The nurse employed in a long-term care facility is
planning assignments. The nurse needs to assign four clients
and has a licensed practical nurse and three assistive
personnel (APs) on a nursing team. Which client would the
nurse most appropriately assign to the licensed practical
nurse?
A. A client who requires a bed bath
B. An older client requiring frequent ambulation
C. A client who requires hourly measurement of vital signs
D. A client requiring abdominal wound irrigations and dressing
changes every 3 hours
Answer: D
Rationale: The LPN is skilled in sterile technique and wound care
procedures like irrigations and dressing changes. Bed baths and
, ambulation are appropriate for APs. Vital sign measurement can
be delegated to APs for stable patients.
Q7. The nurse enters a client's room and finds a small fire on
the bedside table. What is the first action?
A. Attempt to extinguish the fire with water
B. Remove the client from the room
C. Activate the fire alarm
D. Call the physician
Answer: B
Rationale: In fire safety (RACE: Rescue, Alarm, Contain,
Extinguish), the first step is to rescue/remove anyone in
immediate danger.
Q8. When using SBAR to communicate with a physician, the
"A" stands for:
A. Assessment
B. Analysis
C. Action
D. Alert
Answer: A
Rationale: SBAR: Situation, Background, Assessment,
Recommendation – this is a structured communication tool for
patient safety.
Q9. A nurse delegates a task to a UAP. Which task is
appropriate?
A. Administering oral medications
B. Measuring vital signs on a stable patient
Edition by Linda Anne Silvestri and
Angela Elizabeth Silvestri –
Comprehensive Test Bank for 2025/2026
Q1. A newly graduated RN reviews the Pyramid to Success.
Which level is foundational for making safe clinical decisions?
A. Reflection
B. Experience
C. Scientific method
D. Nursing process
Answer: D
Rationale: The nursing process (assessment, diagnosis, planning,
implementation, evaluation) is the foundation of clinical judgment
in the Pyramid to Success. The scientific method, experience, and
reflection build on this foundation but do not replace it.
Q2. A nurse uses the Pyramid to Success to reflect on a
medication error. Which step corresponds to "Reflection"?
A. Assessing patient symptoms
B. Reviewing what went well and what didn't
C. Formulating a nursing diagnosis
D. Implementing a corrective action
Answer: B
Rationale: Reflection involves looking back at actions, identifying
,strengths and areas for improvement. Assessment, diagnosis, and
implementation are earlier process steps.
Q3. Which statement reflects the "Scientific Method" tier of
the Pyramid to Success?
A. "I'll use my past experiences to decide."
B. "I'll test whether elevating the head reduces dyspnea."
C. "I'll ask my mentor how to proceed."
D. "I'll follow hospital policy without variation."
Answer: B
Rationale: The scientific method involves formulating a
hypothesis (elevating the head), testing it, and evaluating results.
Experience, mentorship, and policy adherence are not the
scientific method.
Section 2: Computer Adaptive Testing (CAT)
Q4. In CAT, when a candidate answers correctly, the next item
is:
A. Easier
B. The same level
C. Harder
D. Randomly selected
Answer: C
Rationale: CAT adapts difficulty upward after correct answers to
hone in on ability level. Incorrect responses lead to easier items.
,Q5. CAT stops when:
A. The candidate completes 200 items
B. The candidate's ability estimate is confidently above or below
the passing standard
C. Time expires
D. The candidate requests to stop
Answer: B
Rationale: CAT ends when the algorithm determines with 95%
confidence that the candidate's ability is clearly above or below
the passing standard.
Section 3: Safe and Effective Care Environment
Q6. The nurse employed in a long-term care facility is
planning assignments. The nurse needs to assign four clients
and has a licensed practical nurse and three assistive
personnel (APs) on a nursing team. Which client would the
nurse most appropriately assign to the licensed practical
nurse?
A. A client who requires a bed bath
B. An older client requiring frequent ambulation
C. A client who requires hourly measurement of vital signs
D. A client requiring abdominal wound irrigations and dressing
changes every 3 hours
Answer: D
Rationale: The LPN is skilled in sterile technique and wound care
procedures like irrigations and dressing changes. Bed baths and
, ambulation are appropriate for APs. Vital sign measurement can
be delegated to APs for stable patients.
Q7. The nurse enters a client's room and finds a small fire on
the bedside table. What is the first action?
A. Attempt to extinguish the fire with water
B. Remove the client from the room
C. Activate the fire alarm
D. Call the physician
Answer: B
Rationale: In fire safety (RACE: Rescue, Alarm, Contain,
Extinguish), the first step is to rescue/remove anyone in
immediate danger.
Q8. When using SBAR to communicate with a physician, the
"A" stands for:
A. Assessment
B. Analysis
C. Action
D. Alert
Answer: A
Rationale: SBAR: Situation, Background, Assessment,
Recommendation – this is a structured communication tool for
patient safety.
Q9. A nurse delegates a task to a UAP. Which task is
appropriate?
A. Administering oral medications
B. Measuring vital signs on a stable patient
