NCLEX-RN® Comprehensive Examination
Practice Questions a well detailed practice
exam 2025/2026 graded A+ well written !!!
Version 2.0 | Advanced/Hard Difficulty | 150
Multiple-Choice Questions with Detailed
Rationales
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT — Management of Care (Questions 1-
25)
Question 1
A charge nurse is evaluating the effectiveness of a newly implemented bedside shift report
protocol. Which outcome indicates successful implementation?
A. Decreased patient satisfaction scores
B. Increased time spent in report at the nursing station
C. Improved patient understanding of their plan of care
D. Increased number of medication errors reported
Correct Answer: C
Rationale: Bedside shift report improves communication, patient engagement, and patient
understanding of their care plan. Decreased satisfaction (A) would indicate failure. Increased
report time at the station (B) contradicts bedside report goals. Increased errors (D) would
indicate a problem.
,Question 2
A nurse is caring for a patient who has a living will that specifies "do not resuscitate." The
patient's adult child demands that the healthcare team "do everything possible." What is the
nurse's appropriate response?
A. "I understand your concern, but we must follow the patient's legal directive."
B. "I will contact the hospital ethics committee to review this situation."
C. "We will do everything possible to save your parent's life."
D. "You need to accept your parent's decision and stop arguing."
Correct Answer: A
Rationale: The nurse must advocate for the patient's autonomy and legally documented wishes
while demonstrating empathy for the family's concerns. Option A validates the family's distress
while upholding the patient's rights. Option B may be unnecessary as the directive is clear.
Option C violates the patient's wishes. Option D is unprofessional and dismissive.
Question 3
A charge nurse is assigning staff for the upcoming shift. Which patient should be assigned to a
newly licensed registered nurse who is in their orientation period?
A. A patient with a chest tube and mechanical ventilation
B. A patient requiring continuous renal replacement therapy
C. A patient with diabetes mellitus requiring routine insulin administration
D. A patient with unstable angina on a titratable heparin drip
Correct Answer: C
Rationale: A stable patient with routine insulin administration is appropriate for a new nurse in
orientation. Options A, B, and D involve high-acuity, complex patients requiring experienced
nursing judgment and specialized skills.
Question 4
A nurse is leading a multidisciplinary team meeting to plan care for a patient with complex
needs. Which action best demonstrates effective collaboration?
A. The nurse directs the team to implement their proposed plan without input
B. The nurse facilitates discussion, encourages input from all disciplines, and synthesizes
,recommendations
C. The nurse delegates all planning responsibilities to the physician
D. The nurse waits for each discipline to submit their plan individually
Correct Answer: B
Rationale: Effective collaboration involves facilitating discussion, encouraging input from all
disciplines, and synthesizing recommendations to create a comprehensive plan. Option A is
authoritarian and discourages collaboration. Option C abdicates nursing responsibility. Option D
lacks integration and collaboration.
Question 5
A patient with a new colostomy is being discharged. The patient states, "I'll never be able to
manage this at home. My husband will be disgusted by me." What is the nurse's best response?
A. "You'll get used to it in time. Most people adapt well."
B. "Many people with ostomies live normal, active lives."
C. "I hear your concern. Let's review the ostomy care together, and I can arrange for a home
health nurse to visit."
D. "Your husband should support you through this."
Correct Answer: C
Rationale: This response validates the patient's feelings, provides practical support, and offers
additional resources. Option A dismisses concerns. Option B minimizes feelings. Option D is
judgmental and assumes the husband's response.
Question 6
A nurse is preparing to delegate vital sign measurement to a UAP. Which statement by the nurse
demonstrates appropriate delegation?
A. "Please check the vital signs on the patients in rooms 201-206."
B. "Please take vital signs on all patients and report any abnormal findings to me."
C. "Please take vital signs on rooms 201-206 and notify me immediately if any patient has a
temperature above 100.4°F or a blood pressure below 90/60."
D. "Do you mind checking the vital signs on rooms 201-206?"
Correct Answer: C
, Rationale: Effective delegation includes specific instructions about what to do, what to report,
and when to report. Option A lacks direction about reporting. Option B is vague about abnormal
parameters. Option D is informal and lacks clarity.
Question 7
A charge nurse observes a staff nurse documenting vital signs without actually taking them.
What should the charge nurse do?
A. Ignore the behavior since the patient appears stable
B. Speak privately with the nurse about the importance of accurate documentation
C. File a formal written reprimand immediately
D. Assign the nurse to a different patient assignment
Correct Answer: B
Rationale: The charge nurse should address the issue privately, discuss the importance of
accurate documentation, and provide education. Option A ignores a serious safety issue. Option
C may be excessive as a first step. Option D does not address the behavior.
Question 8
A nurse is caring for a patient who is a member of a religion that prohibits blood transfusions.
The patient is critically ill and requires a blood transfusion. What should the nurse do?
A. Administer the blood transfusion to save the patient's life
B. Respect the patient's religious beliefs and discuss alternative treatments with the healthcare
provider
C. Contact the hospital ethics committee to override the patient's decision
D. Ask the patient's family to convince the patient to accept the transfusion
Correct Answer: B
Rationale: The nurse must respect the patient's religious beliefs and autonomy while exploring
alternative treatments. Option A violates patient autonomy. Option C may be appropriate in
rare cases but should not be the first action. Option D puts the family in an uncomfortable
position.
Question 9
Practice Questions a well detailed practice
exam 2025/2026 graded A+ well written !!!
Version 2.0 | Advanced/Hard Difficulty | 150
Multiple-Choice Questions with Detailed
Rationales
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT — Management of Care (Questions 1-
25)
Question 1
A charge nurse is evaluating the effectiveness of a newly implemented bedside shift report
protocol. Which outcome indicates successful implementation?
A. Decreased patient satisfaction scores
B. Increased time spent in report at the nursing station
C. Improved patient understanding of their plan of care
D. Increased number of medication errors reported
Correct Answer: C
Rationale: Bedside shift report improves communication, patient engagement, and patient
understanding of their care plan. Decreased satisfaction (A) would indicate failure. Increased
report time at the station (B) contradicts bedside report goals. Increased errors (D) would
indicate a problem.
,Question 2
A nurse is caring for a patient who has a living will that specifies "do not resuscitate." The
patient's adult child demands that the healthcare team "do everything possible." What is the
nurse's appropriate response?
A. "I understand your concern, but we must follow the patient's legal directive."
B. "I will contact the hospital ethics committee to review this situation."
C. "We will do everything possible to save your parent's life."
D. "You need to accept your parent's decision and stop arguing."
Correct Answer: A
Rationale: The nurse must advocate for the patient's autonomy and legally documented wishes
while demonstrating empathy for the family's concerns. Option A validates the family's distress
while upholding the patient's rights. Option B may be unnecessary as the directive is clear.
Option C violates the patient's wishes. Option D is unprofessional and dismissive.
Question 3
A charge nurse is assigning staff for the upcoming shift. Which patient should be assigned to a
newly licensed registered nurse who is in their orientation period?
A. A patient with a chest tube and mechanical ventilation
B. A patient requiring continuous renal replacement therapy
C. A patient with diabetes mellitus requiring routine insulin administration
D. A patient with unstable angina on a titratable heparin drip
Correct Answer: C
Rationale: A stable patient with routine insulin administration is appropriate for a new nurse in
orientation. Options A, B, and D involve high-acuity, complex patients requiring experienced
nursing judgment and specialized skills.
Question 4
A nurse is leading a multidisciplinary team meeting to plan care for a patient with complex
needs. Which action best demonstrates effective collaboration?
A. The nurse directs the team to implement their proposed plan without input
B. The nurse facilitates discussion, encourages input from all disciplines, and synthesizes
,recommendations
C. The nurse delegates all planning responsibilities to the physician
D. The nurse waits for each discipline to submit their plan individually
Correct Answer: B
Rationale: Effective collaboration involves facilitating discussion, encouraging input from all
disciplines, and synthesizing recommendations to create a comprehensive plan. Option A is
authoritarian and discourages collaboration. Option C abdicates nursing responsibility. Option D
lacks integration and collaboration.
Question 5
A patient with a new colostomy is being discharged. The patient states, "I'll never be able to
manage this at home. My husband will be disgusted by me." What is the nurse's best response?
A. "You'll get used to it in time. Most people adapt well."
B. "Many people with ostomies live normal, active lives."
C. "I hear your concern. Let's review the ostomy care together, and I can arrange for a home
health nurse to visit."
D. "Your husband should support you through this."
Correct Answer: C
Rationale: This response validates the patient's feelings, provides practical support, and offers
additional resources. Option A dismisses concerns. Option B minimizes feelings. Option D is
judgmental and assumes the husband's response.
Question 6
A nurse is preparing to delegate vital sign measurement to a UAP. Which statement by the nurse
demonstrates appropriate delegation?
A. "Please check the vital signs on the patients in rooms 201-206."
B. "Please take vital signs on all patients and report any abnormal findings to me."
C. "Please take vital signs on rooms 201-206 and notify me immediately if any patient has a
temperature above 100.4°F or a blood pressure below 90/60."
D. "Do you mind checking the vital signs on rooms 201-206?"
Correct Answer: C
, Rationale: Effective delegation includes specific instructions about what to do, what to report,
and when to report. Option A lacks direction about reporting. Option B is vague about abnormal
parameters. Option D is informal and lacks clarity.
Question 7
A charge nurse observes a staff nurse documenting vital signs without actually taking them.
What should the charge nurse do?
A. Ignore the behavior since the patient appears stable
B. Speak privately with the nurse about the importance of accurate documentation
C. File a formal written reprimand immediately
D. Assign the nurse to a different patient assignment
Correct Answer: B
Rationale: The charge nurse should address the issue privately, discuss the importance of
accurate documentation, and provide education. Option A ignores a serious safety issue. Option
C may be excessive as a first step. Option D does not address the behavior.
Question 8
A nurse is caring for a patient who is a member of a religion that prohibits blood transfusions.
The patient is critically ill and requires a blood transfusion. What should the nurse do?
A. Administer the blood transfusion to save the patient's life
B. Respect the patient's religious beliefs and discuss alternative treatments with the healthcare
provider
C. Contact the hospital ethics committee to override the patient's decision
D. Ask the patient's family to convince the patient to accept the transfusion
Correct Answer: B
Rationale: The nurse must respect the patient's religious beliefs and autonomy while exploring
alternative treatments. Option A violates patient autonomy. Option C may be appropriate in
rare cases but should not be the first action. Option D puts the family in an uncomfortable
position.
Question 9
