1
NGN NCLEX RN EXAM TEST BANK
Actual Exam 2026/2027 Complete Questions
and Verified Answers with Rationales
Graded A Pass Guaranteed - A+ Graded
SECTION 1: MANAGEMENT OF CARE (Questions 1-20)
Q1: The charge nurse is making assignments on a medical-surgical unit. Which client should be
assigned to the most experienced registered nurse (RN)?
A. A 45-year-old with type 2 diabetes requiring blood glucose monitoring and insulin
administration before meals
B. A 62-year-old 3 days post-cholecystectomy with stable vital signs and a Jackson-Pratt drain
C. A 58-year-old with new-onset atrial fibrillation, started on amiodarone IV, with a heart rate of
110-120 bpm. [CORRECT]
D. A 72-year-old with pneumonia receiving IV antibiotics every 12 hours with stable oxygen
saturation
Rationale: The client with new-onset atrial fibrillation on amiodarone IV requires close
monitoring for dysrhythmias, hypotension, and adverse effects, necessitating the clinical
judgment of the most experienced RN (C). The other clients (A, B, D) are stable with predictable
care needs and could be safely assigned to a less experienced RN or LPN under supervision.
Q2: A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Administering oral medications to a client with stable hypertension
C. Measuring and recording intake and output for a client with heart failure [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration
Rationale: Measuring and recording I&O (C) is an appropriate delegation to UAP as it is a
routine, predictable task that does not require nursing judgment or assessment. Assessment (A),
medication administration (B), and client teaching (D) require RN-level clinical judgment and
cannot be delegated to UAP.
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Q3: A client with terminal cancer states, "I don't want any more chemotherapy. I just want to go
home and be comfortable." The nurse recognizes this statement reflects which ethical principle?
A. Beneficence
B. Nonmaleficence
C. Autonomy [CORRECT]
D. Justice
Rationale: Autonomy (C) refers to the client's right to self-determination and make decisions
about their own care, including the right to refuse treatment. Beneficence (A) is doing good,
nonmaleficence (B) is doing no harm, and justice (D) is fairness in distribution of resources.
Q4: During shift report, the outgoing nurse states that a client has a living will and DNR order.
The incoming nurse should take which action first?
A. Verify the DNR order is current and properly documented in the chart [CORRECT]
B. Explain the DNR order to the client's family
C. Place a DNR bracelet on the client's wrist
D. Notify the physician that the client has a DNR order
Rationale: The priority is to verify the DNR order is current and properly documented (A) to
ensure legal and ethical compliance. The order must be valid before any other actions. Family
explanation (B) may be needed but is not the first action. DNR bracelets (C) are not standard
practice, and the physician (D) should already be aware.
Q5: A nurse observes a colleague documenting care that was not provided. According to the
Code of Ethics for Nurses, what is the nurse's responsibility?
A. Ignore the incident to maintain team cohesion
B. Report the observation to the nurse manager [CORRECT]
C. Confront the colleague privately and suggest corrective action
D. Document the incident in the client's chart
Rationale: Falsification of documentation is a serious ethical and legal violation that
compromises client safety and trust. The nurse must report this to the nurse manager (B) as it
represents professional misconduct. Ignoring it (A) violates ethical obligations, private
confrontation (C) is insufficient for this serious issue, and chart documentation (D) is
inappropriate.
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Q6: Which situation requires the nurse to file an incident report?
A. A client refuses to take prescribed medications
B. A client falls while attempting to ambulate to the bathroom [CORRECT]
C. A family member requests a different nurse
D. A client complains about the hospital food
Rationale: Client falls (B) are sentinel events that require incident reporting for quality
improvement and risk management purposes. Medication refusal (A), requests for different
nurses (C), and food complaints (D) are routine occurrences that do not require incident reports.
Q7: A nurse is planning discharge for a client with heart failure. Which action demonstrates
effective continuity of care?
A. Providing the client with a list of medications and scheduling a follow-up appointment
B. Using SBAR to communicate with the receiving home health agency [CORRECT]
C. Telling the client to call the doctor if symptoms worsen
D. Giving the client a brochure about heart failure
Rationale: Using SBAR (Situation, Background, Assessment, Recommendation) for handoff
communication (B) ensures standardized, comprehensive information transfer to the next care
provider. While medication lists (A) and brochures (D) are helpful, structured communication
(B) is the gold standard for continuity. Vague instructions (C) are insufficient.
Q8: Which task can be delegated to a licensed practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client
B. Performing sterile dressing changes on a postoperative wound [CORRECT]
C. Administering IV push medications through a central line
D. Assessing a client with chest pain
Rationale: Sterile dressing changes (B) are within LPN scope in many states when the client is
stable and the procedure is routine. Care planning (A), IV push medications through central lines
(C), and assessment of unstable clients (D) require RN-level judgment and scope of practice.
Q9: A client is being transferred from ICU to the medical-surgical unit. Which action by the
nurse demonstrates appropriate advocacy?
A. Ensuring the client has a private room
B. Questioning the transfer because the client remains on vasopressor medications [CORRECT]
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C. Asking the family if they agree with the transfer
D. Documenting the transfer time in the medical record
Rationale: Advocacy involves protecting client safety by questioning inappropriate orders or
decisions. Questioning the transfer of a client on vasopressors (B) demonstrates appropriate
advocacy as this client likely requires ICU-level care. Room assignment (A), family consultation
(C), and documentation (D) do not represent advocacy in this context.
Q10: During a root cause analysis of a medication error, the team identifies that the nurse was
distracted by multiple alarms while preparing medications. This represents which type of factor?
A. Active failure
B. Latent condition [CORRECT]
C. Violation
D. Slip
Rationale: Environmental factors like alarm fatigue represent latent conditions (B)—systemic
issues that create conditions for errors. Active failures (A) are frontline errors, violations (C) are
deliberate deviations, and slips (D) are attention failures. The alarm environment is a system
design issue.
Q11: A nurse is supervising a newly hired UAP. Which observation requires immediate
intervention?
A. The UAP places a soiled linen bag on the floor
B. The UAP uses a transfer belt when assisting a client to ambulate
C. The UAP performs hand hygiene before and after client contact
D. The UAP takes a manual blood pressure on a client with an automatic cuff order
[CORRECT]
Rationale: The UAP performing a manual BP when an automatic cuff is ordered (D) represents
performing a task outside their scope or without proper authorization. While hand hygiene (C)
and transfer belt use (B) are correct, and linen placement (A) is minor, unauthorized procedures
require immediate intervention.
Q12: Which client situation represents a violation of the client's right to confidentiality?
A. The nurse discusses a client's condition with the interdisciplinary care team
B. The nurse shares client information with the client's spouse without permission
NGN NCLEX RN EXAM TEST BANK
Actual Exam 2026/2027 Complete Questions
and Verified Answers with Rationales
Graded A Pass Guaranteed - A+ Graded
SECTION 1: MANAGEMENT OF CARE (Questions 1-20)
Q1: The charge nurse is making assignments on a medical-surgical unit. Which client should be
assigned to the most experienced registered nurse (RN)?
A. A 45-year-old with type 2 diabetes requiring blood glucose monitoring and insulin
administration before meals
B. A 62-year-old 3 days post-cholecystectomy with stable vital signs and a Jackson-Pratt drain
C. A 58-year-old with new-onset atrial fibrillation, started on amiodarone IV, with a heart rate of
110-120 bpm. [CORRECT]
D. A 72-year-old with pneumonia receiving IV antibiotics every 12 hours with stable oxygen
saturation
Rationale: The client with new-onset atrial fibrillation on amiodarone IV requires close
monitoring for dysrhythmias, hypotension, and adverse effects, necessitating the clinical
judgment of the most experienced RN (C). The other clients (A, B, D) are stable with predictable
care needs and could be safely assigned to a less experienced RN or LPN under supervision.
Q2: A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Administering oral medications to a client with stable hypertension
C. Measuring and recording intake and output for a client with heart failure [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration
Rationale: Measuring and recording I&O (C) is an appropriate delegation to UAP as it is a
routine, predictable task that does not require nursing judgment or assessment. Assessment (A),
medication administration (B), and client teaching (D) require RN-level clinical judgment and
cannot be delegated to UAP.
,2
Q3: A client with terminal cancer states, "I don't want any more chemotherapy. I just want to go
home and be comfortable." The nurse recognizes this statement reflects which ethical principle?
A. Beneficence
B. Nonmaleficence
C. Autonomy [CORRECT]
D. Justice
Rationale: Autonomy (C) refers to the client's right to self-determination and make decisions
about their own care, including the right to refuse treatment. Beneficence (A) is doing good,
nonmaleficence (B) is doing no harm, and justice (D) is fairness in distribution of resources.
Q4: During shift report, the outgoing nurse states that a client has a living will and DNR order.
The incoming nurse should take which action first?
A. Verify the DNR order is current and properly documented in the chart [CORRECT]
B. Explain the DNR order to the client's family
C. Place a DNR bracelet on the client's wrist
D. Notify the physician that the client has a DNR order
Rationale: The priority is to verify the DNR order is current and properly documented (A) to
ensure legal and ethical compliance. The order must be valid before any other actions. Family
explanation (B) may be needed but is not the first action. DNR bracelets (C) are not standard
practice, and the physician (D) should already be aware.
Q5: A nurse observes a colleague documenting care that was not provided. According to the
Code of Ethics for Nurses, what is the nurse's responsibility?
A. Ignore the incident to maintain team cohesion
B. Report the observation to the nurse manager [CORRECT]
C. Confront the colleague privately and suggest corrective action
D. Document the incident in the client's chart
Rationale: Falsification of documentation is a serious ethical and legal violation that
compromises client safety and trust. The nurse must report this to the nurse manager (B) as it
represents professional misconduct. Ignoring it (A) violates ethical obligations, private
confrontation (C) is insufficient for this serious issue, and chart documentation (D) is
inappropriate.
,3
Q6: Which situation requires the nurse to file an incident report?
A. A client refuses to take prescribed medications
B. A client falls while attempting to ambulate to the bathroom [CORRECT]
C. A family member requests a different nurse
D. A client complains about the hospital food
Rationale: Client falls (B) are sentinel events that require incident reporting for quality
improvement and risk management purposes. Medication refusal (A), requests for different
nurses (C), and food complaints (D) are routine occurrences that do not require incident reports.
Q7: A nurse is planning discharge for a client with heart failure. Which action demonstrates
effective continuity of care?
A. Providing the client with a list of medications and scheduling a follow-up appointment
B. Using SBAR to communicate with the receiving home health agency [CORRECT]
C. Telling the client to call the doctor if symptoms worsen
D. Giving the client a brochure about heart failure
Rationale: Using SBAR (Situation, Background, Assessment, Recommendation) for handoff
communication (B) ensures standardized, comprehensive information transfer to the next care
provider. While medication lists (A) and brochures (D) are helpful, structured communication
(B) is the gold standard for continuity. Vague instructions (C) are insufficient.
Q8: Which task can be delegated to a licensed practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client
B. Performing sterile dressing changes on a postoperative wound [CORRECT]
C. Administering IV push medications through a central line
D. Assessing a client with chest pain
Rationale: Sterile dressing changes (B) are within LPN scope in many states when the client is
stable and the procedure is routine. Care planning (A), IV push medications through central lines
(C), and assessment of unstable clients (D) require RN-level judgment and scope of practice.
Q9: A client is being transferred from ICU to the medical-surgical unit. Which action by the
nurse demonstrates appropriate advocacy?
A. Ensuring the client has a private room
B. Questioning the transfer because the client remains on vasopressor medications [CORRECT]
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C. Asking the family if they agree with the transfer
D. Documenting the transfer time in the medical record
Rationale: Advocacy involves protecting client safety by questioning inappropriate orders or
decisions. Questioning the transfer of a client on vasopressors (B) demonstrates appropriate
advocacy as this client likely requires ICU-level care. Room assignment (A), family consultation
(C), and documentation (D) do not represent advocacy in this context.
Q10: During a root cause analysis of a medication error, the team identifies that the nurse was
distracted by multiple alarms while preparing medications. This represents which type of factor?
A. Active failure
B. Latent condition [CORRECT]
C. Violation
D. Slip
Rationale: Environmental factors like alarm fatigue represent latent conditions (B)—systemic
issues that create conditions for errors. Active failures (A) are frontline errors, violations (C) are
deliberate deviations, and slips (D) are attention failures. The alarm environment is a system
design issue.
Q11: A nurse is supervising a newly hired UAP. Which observation requires immediate
intervention?
A. The UAP places a soiled linen bag on the floor
B. The UAP uses a transfer belt when assisting a client to ambulate
C. The UAP performs hand hygiene before and after client contact
D. The UAP takes a manual blood pressure on a client with an automatic cuff order
[CORRECT]
Rationale: The UAP performing a manual BP when an automatic cuff is ordered (D) represents
performing a task outside their scope or without proper authorization. While hand hygiene (C)
and transfer belt use (B) are correct, and linen placement (A) is minor, unauthorized procedures
require immediate intervention.
Q12: Which client situation represents a violation of the client's right to confidentiality?
A. The nurse discusses a client's condition with the interdisciplinary care team
B. The nurse shares client information with the client's spouse without permission
