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NCSBN Test Bank NCLEX-RN NGN Actual
Exam 2025/2026 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT
1. The charge nurse is making assignments for the day shift. Which client should be assigned to
the licensed practical nurse (LPN)?
A. A client admitted yesterday with diabetic ketoacidosis who is on an insulin drip.
B. A client 2 days post-op following a total hip replacement who requires ambulation.
C. A client newly admitted with chest pain awaiting cardiac catheterization.
D. A client receiving continuous enteral feedings via a nasogastric tube.
Correct Answer: D
Rationale: The scope of practice for an LPN includes providing care for clients with stable,
predictable conditions. Continuous enteral feedings are a standard task that falls within the LPN's
role. A client on an insulin drip (A) requires frequent assessment and titration by an RN. A client
2 days post-op (B) requires assessment of mobility and pain management which is primarily RN
responsibility, though ambulation can sometimes be delegated, the feeding tube is a more stable
task. A client with unstable chest pain (C) requires immediate RN assessment and monitoring.
2. A nurse is witnessing a client sign an informed consent form for a surgical procedure. Which
action by the nurse indicates a need for further teaching regarding informed consent?
A. The nurse verifies that the client understands the procedure described by the surgeon.
B. The nurse witnesses the client’s signature and signs the form as a witness.
C. The nurse explains the risks and benefits of the procedure to the client.
D. The nurse ensures the client is not currently sedated.
Correct Answer: C
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Rationale: It is the physician's or provider's responsibility to explain the risks, benefits, and
alternatives of the procedure to the client. The nurse's role is to witness the signature and verify
that the client understands what was explained by the provider. Explaining the procedure (C)
exceeds the nurse's scope and practices medicine without a license.
3. The nurse is caring for a client who is on contact precautions for Clostridioides difficile (C.
diff). Which action is most important to prevent the spread of infection?
A. Wear a gown and gloves when entering the room.
B. Place the client in a negative pressure room.
C. Use an alcohol-based hand sanitizer upon leaving the room.
D. Wear a N95 respirator when within 3 feet of the client.
Correct Answer: A
Rationale: Contact precautions require the use of gloves and a gown to prevent contact with
infectious agents. C. diff is spread via spores. Alcohol-based hand sanitizers (C) are not effective
against C. diff spores; soap and water are required. Negative pressure rooms (B) and N95
respirators (D) are used for airborne precautions, not contact precautions.
4. A client on the mental health unit is threatening to harm others. The physician orders physical
restraints. Which statement by the nurse reflects understanding of restraint protocols?
A. "I will apply the restraints and check the client in 1 hour."
B. "I will document the client’s behavior and the specific intervention used."
C. "I will tie the restraints to the side rail to keep them secure."
D. "I can delegate the application of the restraints to the unlicensed assistive personnel (UAP)."
Correct Answer: B
Rationale: Documentation is critical in restraint use, including the behavior necessitating the
restraint, alternatives tried, and client monitoring. Restraints must be checked every 15-30
minutes for circulation and skin integrity, not just in 1 hour (A). Restraints should never be tied
to the side rail (C) due to the risk of injury if the rail is lowered; they must be tied to the bed
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frame. Delegating restraint application (D) is inappropriate for UAP as it requires clinical
judgment and assessment.
5. A nurse observes a colleague making a medication error. The client was not harmed. Which
action should the nurse take first?
A. Report the error to the nurse manager immediately.
B. Complete an incident report.
C. Notify the physician.
D. Tell the colleague to report the error.
Correct Answer: B
Rationale: The first priority is client safety, but since the error has already occurred and no harm
is evident, the nurse must follow facility protocol, which usually involves completing an incident
report (internal quality improvement). Reporting to the manager is also important, but the
incident report documents the event objectively. Telling the colleague to report it (D) does not
ensure it happens or protects the client. Notifying the physician (C) is only necessary if the client
requires monitoring or intervention.
6. A nurse is triaging clients in the emergency department after a mass casualty incident. Which
client should be triaged with the "black" tag?
A. A client with a fractured femur and pedal pulses present.
B. A client with a head injury and Glasgow Coma Scale of 5.
C. A client with severe burns covering 40% of the body.
D. A client who is awake and anxious with a deep laceration to the arm.
Correct Answer: B
Rationale: In a mass casualty incident, resources are limited. A black tag indicates those who are
deceased or have injuries so extensive that survival is unlikely even with treatment. A GCS of 5
(B) indicates severe brain injury with low survival probability in a disaster setting where
resources are scarce. Fractured femur (A) and severe burns (C) are "immediate" (red) or
"delayed" (yellow) depending on resources. Laceration (D) is "minor" (green).
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7. The nurse manager is implementing a quality improvement project using the Plan-Do-Study-
Act (PDSA) cycle. The team is currently collecting data to evaluate the effectiveness of a new
fall prevention protocol. Which phase of the PDSA cycle is this?
A. Plan
B. Do
C. Study
D. Act
Correct Answer: C
Rationale: The "Study" phase involves analyzing the data collected during the "Do" phase to see
if the plan achieved the desired results. "Plan" (A) is defining the problem. "Do" (B) is
implementing the change. "Act" (D) is standardizing the change or starting over.
8. A client has a nasogastric tube to continuous low suction. The nurse notes that the gastric
secretions have become scant and the client reports nausea. What is the priority action?
A. Increase the suction pressure.
B. Irrigate the tube with 30 mL of normal saline.
C. Check the placement of the nasogastric tube.
D. Clamp the tube for 30 minutes.
Correct Answer: C
Rationale: Scant secretions and nausea are classic signs of a displaced or clogged NG tube. The
first priority is to verify placement (likely via pH testing of aspirate or x-ray) to ensure the tube is
not in the lung or displaced in the esophagus, which could lead to aspiration. Irrigation (B) is
appropriate if the tube is clogged but placement must be confirmed first. Increasing suction (A)
may cause mucosal damage.
9. The home health nurse is teaching a client about home safety. Which statement by the client
indicates a need for further instruction?
NCSBN Test Bank NCLEX-RN NGN Actual
Exam 2025/2026 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT
1. The charge nurse is making assignments for the day shift. Which client should be assigned to
the licensed practical nurse (LPN)?
A. A client admitted yesterday with diabetic ketoacidosis who is on an insulin drip.
B. A client 2 days post-op following a total hip replacement who requires ambulation.
C. A client newly admitted with chest pain awaiting cardiac catheterization.
D. A client receiving continuous enteral feedings via a nasogastric tube.
Correct Answer: D
Rationale: The scope of practice for an LPN includes providing care for clients with stable,
predictable conditions. Continuous enteral feedings are a standard task that falls within the LPN's
role. A client on an insulin drip (A) requires frequent assessment and titration by an RN. A client
2 days post-op (B) requires assessment of mobility and pain management which is primarily RN
responsibility, though ambulation can sometimes be delegated, the feeding tube is a more stable
task. A client with unstable chest pain (C) requires immediate RN assessment and monitoring.
2. A nurse is witnessing a client sign an informed consent form for a surgical procedure. Which
action by the nurse indicates a need for further teaching regarding informed consent?
A. The nurse verifies that the client understands the procedure described by the surgeon.
B. The nurse witnesses the client’s signature and signs the form as a witness.
C. The nurse explains the risks and benefits of the procedure to the client.
D. The nurse ensures the client is not currently sedated.
Correct Answer: C
,2
Rationale: It is the physician's or provider's responsibility to explain the risks, benefits, and
alternatives of the procedure to the client. The nurse's role is to witness the signature and verify
that the client understands what was explained by the provider. Explaining the procedure (C)
exceeds the nurse's scope and practices medicine without a license.
3. The nurse is caring for a client who is on contact precautions for Clostridioides difficile (C.
diff). Which action is most important to prevent the spread of infection?
A. Wear a gown and gloves when entering the room.
B. Place the client in a negative pressure room.
C. Use an alcohol-based hand sanitizer upon leaving the room.
D. Wear a N95 respirator when within 3 feet of the client.
Correct Answer: A
Rationale: Contact precautions require the use of gloves and a gown to prevent contact with
infectious agents. C. diff is spread via spores. Alcohol-based hand sanitizers (C) are not effective
against C. diff spores; soap and water are required. Negative pressure rooms (B) and N95
respirators (D) are used for airborne precautions, not contact precautions.
4. A client on the mental health unit is threatening to harm others. The physician orders physical
restraints. Which statement by the nurse reflects understanding of restraint protocols?
A. "I will apply the restraints and check the client in 1 hour."
B. "I will document the client’s behavior and the specific intervention used."
C. "I will tie the restraints to the side rail to keep them secure."
D. "I can delegate the application of the restraints to the unlicensed assistive personnel (UAP)."
Correct Answer: B
Rationale: Documentation is critical in restraint use, including the behavior necessitating the
restraint, alternatives tried, and client monitoring. Restraints must be checked every 15-30
minutes for circulation and skin integrity, not just in 1 hour (A). Restraints should never be tied
to the side rail (C) due to the risk of injury if the rail is lowered; they must be tied to the bed
,3
frame. Delegating restraint application (D) is inappropriate for UAP as it requires clinical
judgment and assessment.
5. A nurse observes a colleague making a medication error. The client was not harmed. Which
action should the nurse take first?
A. Report the error to the nurse manager immediately.
B. Complete an incident report.
C. Notify the physician.
D. Tell the colleague to report the error.
Correct Answer: B
Rationale: The first priority is client safety, but since the error has already occurred and no harm
is evident, the nurse must follow facility protocol, which usually involves completing an incident
report (internal quality improvement). Reporting to the manager is also important, but the
incident report documents the event objectively. Telling the colleague to report it (D) does not
ensure it happens or protects the client. Notifying the physician (C) is only necessary if the client
requires monitoring or intervention.
6. A nurse is triaging clients in the emergency department after a mass casualty incident. Which
client should be triaged with the "black" tag?
A. A client with a fractured femur and pedal pulses present.
B. A client with a head injury and Glasgow Coma Scale of 5.
C. A client with severe burns covering 40% of the body.
D. A client who is awake and anxious with a deep laceration to the arm.
Correct Answer: B
Rationale: In a mass casualty incident, resources are limited. A black tag indicates those who are
deceased or have injuries so extensive that survival is unlikely even with treatment. A GCS of 5
(B) indicates severe brain injury with low survival probability in a disaster setting where
resources are scarce. Fractured femur (A) and severe burns (C) are "immediate" (red) or
"delayed" (yellow) depending on resources. Laceration (D) is "minor" (green).
, 4
7. The nurse manager is implementing a quality improvement project using the Plan-Do-Study-
Act (PDSA) cycle. The team is currently collecting data to evaluate the effectiveness of a new
fall prevention protocol. Which phase of the PDSA cycle is this?
A. Plan
B. Do
C. Study
D. Act
Correct Answer: C
Rationale: The "Study" phase involves analyzing the data collected during the "Do" phase to see
if the plan achieved the desired results. "Plan" (A) is defining the problem. "Do" (B) is
implementing the change. "Act" (D) is standardizing the change or starting over.
8. A client has a nasogastric tube to continuous low suction. The nurse notes that the gastric
secretions have become scant and the client reports nausea. What is the priority action?
A. Increase the suction pressure.
B. Irrigate the tube with 30 mL of normal saline.
C. Check the placement of the nasogastric tube.
D. Clamp the tube for 30 minutes.
Correct Answer: C
Rationale: Scant secretions and nausea are classic signs of a displaced or clogged NG tube. The
first priority is to verify placement (likely via pH testing of aspirate or x-ray) to ensure the tube is
not in the lung or displaced in the esophagus, which could lead to aspiration. Irrigation (B) is
appropriate if the tube is clogged but placement must be confirmed first. Increasing suction (A)
may cause mucosal damage.
9. The home health nurse is teaching a client about home safety. Which statement by the client
indicates a need for further instruction?
