NCLEX RN TEST BANK 2025/2026 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A nurse is caring for a client with a newly diagnosed seizure disorder. The provider orders phenytoin.
Which of the following findings indicates a therapeutic response to the medication?
A. Decreased white blood cell count.
B. Absence of seizure activity.
C. Increased urine output.
D. Relief of headaches.
🟢 B. Absence of seizure activity.
🔴 RATIONALE: Phenytoin is an anticonvulsant. A therapeutic response is demonstrated by a reduction or
cessation of seizure activity without significant adverse effects. Monitoring drug levels and clinical response is
essential .
2. A nurse is providing discharge teaching to a client with heart failure. Which of the following statements by
the client indicates a need for further teaching?
A. "I will weigh myself daily and report a gain of 2 pounds in one day."
B. "I can take an over-the-counter antacid for occasional heartburn."
C. "I will limit my fluid intake as prescribed."
D. "I should avoid adding salt to my food when cooking."
,🟢 B. "I can take an over-the-counter antacid for occasional heartburn."
🔴 RATIONALE: Clients with heart failure should avoid over-the-counter medications containing sodium, such
as many antacids, which can worsen fluid retention. All other options reflect appropriate self-management .
3. During a prenatal visit, a client at 36 weeks gestation reports episodes of dizziness when lying on her
back. Which of the following is the most appropriate initial nursing action?
A. Instruct the client to lie on her left side.
B. Advise the client to increase her fluid intake.
C. Obtain an order for a complete blood count (CBC).
D. Assess the client's blood pressure.
🟢 A. Instruct the client to lie on her left side.
🔴 RATIONALE: Supine hypotension syndrome occurs when the gravid uterus compresses the inferior vena
cava. Turning the client to the left lateral position relieves the compression and improves venous return and
cardiac output.
4. A nurse is caring for a client who is post-operative day one following a total hip arthroplasty. Which of the
following actions is a priority to prevent dislocation?
A. Maintain the client in a low Fowler's position.
B. Keep a pillow between the client's legs when turning.
C. Encourage the client to perform ankle pumps.
D. Apply sequential compression devices to the lower extremities.
🟢 B. Keep a pillow between the client's legs when turning.
🔴 RATIONALE: After a total hip arthroplasty, the hip joint is at risk for dislocation. Maintaining abduction by
,keeping a pillow between the legs when turning prevents adduction past midline, which is the most common
mechanism of dislocation .
5. A client with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of "Ineffective
Breathing Pattern." Which of the following is the most appropriate intervention?
A. Teach the client to exhale slowly through pursed lips.
B. Place the client in a high Fowler's position.
C. Administer oxygen at 6 L/min via nasal cannula.
D. Encourage the client to cough and deep breathe.
🟢 A. Teach the client to exhale slowly through pursed lips.
🔴 RATIONALE: Pursed-lip breathing creates back pressure in the airways, which helps keep them open during
exhalation, improving gas exchange and decreasing the work of breathing in clients with COPD .
6. A nurse is preparing to administer a blood transfusion to a client. The client asks, "What if I have a
reaction?" Which of the following responses by the nurse is most appropriate?
A. "A reaction is rare, but I will stay with you for the first few minutes to monitor for any signs."
B. "If you have a reaction, I will stop the transfusion and start an IV of normal saline."
C. "I will give you Benadryl before the transfusion to prevent a reaction."
D. "The blood is carefully screened, so you are unlikely to have a problem."
🟢 B. "If you have a reaction, I will stop the transfusion and start an IV of normal saline."
🔴 RATIONALE: If a transfusion reaction is suspected, the priority is to stop the transfusion immediately and
maintain IV access with normal saline to keep the vein open for potential emergency medications. The response
should reflect this standard protocol.
, 7. A nurse is assessing a client who is 1 day post-partum. The client reports perineal pain and a feeling of
pressure. The nurse observes a localized bluish, bulging area at the perineal site. Which of the following
conditions is most likely?
A. Perineal hematoma.
B. Normal healing process.
C. Wound infection.
D. Erosion of sutures.
🟢 A. Perineal hematoma.
🔴 RATIONALE: A localized bluish, bulging area accompanied by severe pain and pressure at the perineal site is
a classic sign of a perineal hematoma. This is an accumulation of blood in the tissues and requires immediate
evaluation.
8. The nurse is providing education to a client prescribed warfarin. Which of the following statements
indicates the client understands the teaching?
A. "I will need to have my blood drawn regularly to check my clotting levels."
B. "I can take ibuprofen if I get a headache."
C. "I should increase my intake of foods high in vitamin K."
D. "I will take this medication at the same time as my daily aspirin."
🟢 A. "I will need to have my blood drawn regularly to check my clotting levels."
🔴 RATIONALE: Warfarin therapy is monitored closely via the International Normalized Ratio (INR). Regular
blood tests are essential to ensure the dosage is therapeutic and safe .
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A nurse is caring for a client with a newly diagnosed seizure disorder. The provider orders phenytoin.
Which of the following findings indicates a therapeutic response to the medication?
A. Decreased white blood cell count.
B. Absence of seizure activity.
C. Increased urine output.
D. Relief of headaches.
🟢 B. Absence of seizure activity.
🔴 RATIONALE: Phenytoin is an anticonvulsant. A therapeutic response is demonstrated by a reduction or
cessation of seizure activity without significant adverse effects. Monitoring drug levels and clinical response is
essential .
2. A nurse is providing discharge teaching to a client with heart failure. Which of the following statements by
the client indicates a need for further teaching?
A. "I will weigh myself daily and report a gain of 2 pounds in one day."
B. "I can take an over-the-counter antacid for occasional heartburn."
C. "I will limit my fluid intake as prescribed."
D. "I should avoid adding salt to my food when cooking."
,🟢 B. "I can take an over-the-counter antacid for occasional heartburn."
🔴 RATIONALE: Clients with heart failure should avoid over-the-counter medications containing sodium, such
as many antacids, which can worsen fluid retention. All other options reflect appropriate self-management .
3. During a prenatal visit, a client at 36 weeks gestation reports episodes of dizziness when lying on her
back. Which of the following is the most appropriate initial nursing action?
A. Instruct the client to lie on her left side.
B. Advise the client to increase her fluid intake.
C. Obtain an order for a complete blood count (CBC).
D. Assess the client's blood pressure.
🟢 A. Instruct the client to lie on her left side.
🔴 RATIONALE: Supine hypotension syndrome occurs when the gravid uterus compresses the inferior vena
cava. Turning the client to the left lateral position relieves the compression and improves venous return and
cardiac output.
4. A nurse is caring for a client who is post-operative day one following a total hip arthroplasty. Which of the
following actions is a priority to prevent dislocation?
A. Maintain the client in a low Fowler's position.
B. Keep a pillow between the client's legs when turning.
C. Encourage the client to perform ankle pumps.
D. Apply sequential compression devices to the lower extremities.
🟢 B. Keep a pillow between the client's legs when turning.
🔴 RATIONALE: After a total hip arthroplasty, the hip joint is at risk for dislocation. Maintaining abduction by
,keeping a pillow between the legs when turning prevents adduction past midline, which is the most common
mechanism of dislocation .
5. A client with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of "Ineffective
Breathing Pattern." Which of the following is the most appropriate intervention?
A. Teach the client to exhale slowly through pursed lips.
B. Place the client in a high Fowler's position.
C. Administer oxygen at 6 L/min via nasal cannula.
D. Encourage the client to cough and deep breathe.
🟢 A. Teach the client to exhale slowly through pursed lips.
🔴 RATIONALE: Pursed-lip breathing creates back pressure in the airways, which helps keep them open during
exhalation, improving gas exchange and decreasing the work of breathing in clients with COPD .
6. A nurse is preparing to administer a blood transfusion to a client. The client asks, "What if I have a
reaction?" Which of the following responses by the nurse is most appropriate?
A. "A reaction is rare, but I will stay with you for the first few minutes to monitor for any signs."
B. "If you have a reaction, I will stop the transfusion and start an IV of normal saline."
C. "I will give you Benadryl before the transfusion to prevent a reaction."
D. "The blood is carefully screened, so you are unlikely to have a problem."
🟢 B. "If you have a reaction, I will stop the transfusion and start an IV of normal saline."
🔴 RATIONALE: If a transfusion reaction is suspected, the priority is to stop the transfusion immediately and
maintain IV access with normal saline to keep the vein open for potential emergency medications. The response
should reflect this standard protocol.
, 7. A nurse is assessing a client who is 1 day post-partum. The client reports perineal pain and a feeling of
pressure. The nurse observes a localized bluish, bulging area at the perineal site. Which of the following
conditions is most likely?
A. Perineal hematoma.
B. Normal healing process.
C. Wound infection.
D. Erosion of sutures.
🟢 A. Perineal hematoma.
🔴 RATIONALE: A localized bluish, bulging area accompanied by severe pain and pressure at the perineal site is
a classic sign of a perineal hematoma. This is an accumulation of blood in the tissues and requires immediate
evaluation.
8. The nurse is providing education to a client prescribed warfarin. Which of the following statements
indicates the client understands the teaching?
A. "I will need to have my blood drawn regularly to check my clotting levels."
B. "I can take ibuprofen if I get a headache."
C. "I should increase my intake of foods high in vitamin K."
D. "I will take this medication at the same time as my daily aspirin."
🟢 A. "I will need to have my blood drawn regularly to check my clotting levels."
🔴 RATIONALE: Warfarin therapy is monitored closely via the International Normalized Ratio (INR). Regular
blood tests are essential to ensure the dosage is therapeutic and safe .
