NCSBN NCLEX-RN ACTUAL EXAM 2026
50 VERIFIED HIGH-YIELD QUESTIONS WITH DETAILED RATIONALES
Section 1: Legal and Ethical Foundations
1. A nurse forgets to administer a prescribed diuretic and the client develops pulmonary edema. Which
element makes this negligence?
A. Intentional failure to act
B. Unintentional failure to perform a duty
C. Substitution of medication
D. Following incorrect physician order
Correct Answer: B
Rationale: Negligence is an unintentional failure to perform an action that a reasonable nurse would perform. In this case, the
nurse failed to administer a prescribed medication, which is a duty of care, leading to harm.
2. A client asks about a diagnostic test, and the nurse promises to find out and later returns with the
answer. Which ethical principle is demonstrated?
A. Nonmaleficence
B. Veracity
C. Beneficence
D. Fidelity
Correct Answer: D
Rationale: Fidelity refers to keeping promises and maintaining trust. Following through on a commitment to a patient
demonstrates professional integrity.
3. A nurse witnesses a seizure victim in public but does not assist. Why is the nurse not liable for
negligence?
A. No duty to the individual
B. Nurse followed standard care
C. Nurse caused no harm
D. Nurse was off duty
Correct Answer: A
Rationale: Without a nurse-client relationship, there is no legal duty of care. Negligence requires a duty to exist.
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, 4. A nurse neighbor gives aspirin to a client on anticoagulants, leading to bleeding. Which elements of
malpractice are missing?
A. Duty owed
B. Breach of duty
C. Injury
D. Causation
E. Intent
Correct Answer: A, E
Rationale: Malpractice requires duty, breach, causation, and harm. In a neighborly setting, no legal duty was established. Intent
is not required for malpractice.
5. A competent client refuses cancer treatment. Which ethical principle supports the nurse’s action?
A. Justice
B. Fidelity
C. Autonomy
D. Confidentiality
Correct Answer: C
Rationale: Autonomy is the right of individuals to make decisions about their own care.
Section 2: Safety, Delegation, and Clinical Management
6. A nurse is prioritizing care for four clients. Which client should be seen first?
A. Client with mild pain
B. Client with stable fracture
C. Client with difficulty breathing
D. Client awaiting discharge
Correct Answer: C
Rationale: Airway and breathing (ABCs) take absolute priority in clinical emergencies.
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50 VERIFIED HIGH-YIELD QUESTIONS WITH DETAILED RATIONALES
Section 1: Legal and Ethical Foundations
1. A nurse forgets to administer a prescribed diuretic and the client develops pulmonary edema. Which
element makes this negligence?
A. Intentional failure to act
B. Unintentional failure to perform a duty
C. Substitution of medication
D. Following incorrect physician order
Correct Answer: B
Rationale: Negligence is an unintentional failure to perform an action that a reasonable nurse would perform. In this case, the
nurse failed to administer a prescribed medication, which is a duty of care, leading to harm.
2. A client asks about a diagnostic test, and the nurse promises to find out and later returns with the
answer. Which ethical principle is demonstrated?
A. Nonmaleficence
B. Veracity
C. Beneficence
D. Fidelity
Correct Answer: D
Rationale: Fidelity refers to keeping promises and maintaining trust. Following through on a commitment to a patient
demonstrates professional integrity.
3. A nurse witnesses a seizure victim in public but does not assist. Why is the nurse not liable for
negligence?
A. No duty to the individual
B. Nurse followed standard care
C. Nurse caused no harm
D. Nurse was off duty
Correct Answer: A
Rationale: Without a nurse-client relationship, there is no legal duty of care. Negligence requires a duty to exist.
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, 4. A nurse neighbor gives aspirin to a client on anticoagulants, leading to bleeding. Which elements of
malpractice are missing?
A. Duty owed
B. Breach of duty
C. Injury
D. Causation
E. Intent
Correct Answer: A, E
Rationale: Malpractice requires duty, breach, causation, and harm. In a neighborly setting, no legal duty was established. Intent
is not required for malpractice.
5. A competent client refuses cancer treatment. Which ethical principle supports the nurse’s action?
A. Justice
B. Fidelity
C. Autonomy
D. Confidentiality
Correct Answer: C
Rationale: Autonomy is the right of individuals to make decisions about their own care.
Section 2: Safety, Delegation, and Clinical Management
6. A nurse is prioritizing care for four clients. Which client should be seen first?
A. Client with mild pain
B. Client with stable fracture
C. Client with difficulty breathing
D. Client awaiting discharge
Correct Answer: C
Rationale: Airway and breathing (ABCs) take absolute priority in clinical emergencies.
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