NCLEX NURSING TEST BANK
2026-2027 139 Questions &
Answers with Detailed Explanations
EXAM INFORMATION
Exam: National Council Licensure Examination (NCLEX-RN® / NCLEX-PN®)
Administering Body: National Council of State Boards of Nursing (NCSBN)
Test Plan: 2026 NCLEX-RN® and NCLEX-PN® Test Plans
Format: Next Generation NCLEX (NGN) – Clinical Judgment Measurement Model (NCJMM)
Question Types: Multiple Choice, Select All That Apply (SATA), Bow-Tie, Drag-and-Drop,
Drop-Down, Highlighting, Matrix/Grid, and Unfolding Case Studies
Number of Questions: 139 Practice Questions
Answer Format: Correct answer indicated with detailed rationale
Exam Year: 2026/2027 Updated Standards
ABOUT THE 2026 NCLEX
The NCSBN has approved the 2026 NCLEX-RN and NCLEX-PN Test Plans, which maintain the
same content category percentages as the 2023 test plans. Key features include:
- NGN Integration: All candidates will encounter Next Generation NCLEX (NGN) items that test
clinical judgment through the NCSBN Clinical Judgment Measurement Model (NCJMM)
- Clinical Judgment: Emphasis on recognizing cues, analyzing cues, prioritizing hypotheses,
generating solutions, taking action, and evaluating outcomes
- Item Types: Extended multiple-choice, multiple-response (SATA), ordered response,
fill-in-the-blank, and enhanced hot spot
- Case Studies: Unfolding case studies with multiple questions testing the clinical judgment
process
,EXAM TOPICS COVERED
| Category | Approximate Weight (RN) |
|-|-|
| Management of Care | 17–23% |
| Safety and Infection Control | 9–15% |
| Health Promotion and Maintenance | 6–12% |
| Psychosocial Integrity | 6–12% |
| Basic Care and Comfort | 6–12% |
| Pharmacological and Parenteral Therapies | 11–17% |
| Reduction of Risk Potential | 9–15% |
| Physiological Adaptation | 11–17% |
SECTION 1: MANAGEMENT OF CARE (Questions 1–25)
QUESTION 1
A charge nurse is assigning client care to a registered nurse (RN) and a licensed practical nurse
(LPN). Which client should the charge nurse assign to the RN?
A) A client with a new tracheostomy requiring suctioning every 2 hours
B) A client with diabetes mellitus requiring daily insulin administration
C) A client with a urinary tract infection requiring antibiotic administration
D) A client with a newly placed chest tube requiring assessment
Answer: D) A client with a newly placed chest tube requiring assessment
Rationale: The RN should be assigned to the client with a newly placed chest tube because this
client requires comprehensive assessment and complex monitoring. The RN is responsible for
the initial assessment and ongoing evaluation of unstable or potentially unstable clients. LPNs
can perform tracheostomy suctioning, administer insulin, and administer antibiotics for stable
clients.
QUESTION 2
A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) A client with pneumonia who has a temperature of 38.5°C (101.3°F) and is diaphoretic
B) A client with heart failure who has 2+ pitting edema and reports shortness of breath
,C) A client with diabetes mellitus who has a blood glucose of 65 mg/dL and is confused
D) A client with a fractured femur who is requesting pain medication
Answer: C) A client with diabetes mellitus who has a blood glucose of 65 mg/dL and is confused
Rationale: The client with hypoglycemia (blood glucose 65 mg/dL) and confusion is
experiencing a life-threatening emergency that requires immediate intervention. Hypoglycemia
can lead to seizures, loss of consciousness, and death if not treated promptly. The nurse should
assess this client first, administer fast-acting carbohydrates or IV dextrose, and recheck blood
glucose.
QUESTION 3
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate
to delegate?
A) Assessing the client's pain level
B) Performing a sterile dressing change
C) Assisting a client with ambulation
D) Administering oral medications
Answer: C) Assisting a client with ambulation
Rationale: UAP can assist with activities of daily living (ADLs), including ambulation, feeding,
hygiene, and toileting. Assessment, sterile procedures, medication administration, and client
education cannot be delegated to UAP. The RN remains responsible for the delegated task and
must provide appropriate supervision.
QUESTION 4
A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates understanding?
A) "I should change the appliance only when it leaks."
B) "I should avoid foods that cause gas and odor."
C) "I can resume normal activities once the stoma heals."
D) "I should use alcohol-based products to clean the stoma."
Answer: C) "I can resume normal activities once the stoma heals."
Rationale: Clients with a new colostomy can resume normal activities once the stoma heals.
The appliance should be changed regularly (not only when it leaks), clients can gradually
, reintroduce foods, and mild soap and water should be used to clean the stoma (not
alcohol-based products).
QUESTION 5
A nurse is caring for a client who refuses a prescribed blood transfusion. Which of the following
actions should the nurse take?
A) Administer the transfusion without the client's consent
B) Respect the client's refusal and document it
C) Contact the ethics committee to override the client's decision
D) Ask the family to convince the client
Answer: B) Respect the client's refusal and document it
Rationale: Clients have the right to refuse treatment, including blood transfusions, based on
personal or religious beliefs. The nurse should respect the client's decision, document the
refusal, notify the healthcare provider, and explore alternatives.
QUESTION 6
A nurse is preparing to discharge a client who speaks a different language. Which action should
the nurse take to ensure effective communication?
A) Use a family member as an interpreter
B) Use a certified medical interpreter
C) Speak loudly and slowly
D) Use hand gestures to communicate
Answer: B) Use a certified medical interpreter
Rationale: A certified medical interpreter should be used to ensure accurate communication with
clients who speak a different language. Family members should not be used as interpreters due
to confidentiality concerns and potential misinterpretation. Speaking loudly or using hand
gestures does not ensure accurate communication.
QUESTION 7
A nurse is caring for a client who has a living will. Which of the following statements is true?
A) The living will designates a healthcare proxy
2026-2027 139 Questions &
Answers with Detailed Explanations
EXAM INFORMATION
Exam: National Council Licensure Examination (NCLEX-RN® / NCLEX-PN®)
Administering Body: National Council of State Boards of Nursing (NCSBN)
Test Plan: 2026 NCLEX-RN® and NCLEX-PN® Test Plans
Format: Next Generation NCLEX (NGN) – Clinical Judgment Measurement Model (NCJMM)
Question Types: Multiple Choice, Select All That Apply (SATA), Bow-Tie, Drag-and-Drop,
Drop-Down, Highlighting, Matrix/Grid, and Unfolding Case Studies
Number of Questions: 139 Practice Questions
Answer Format: Correct answer indicated with detailed rationale
Exam Year: 2026/2027 Updated Standards
ABOUT THE 2026 NCLEX
The NCSBN has approved the 2026 NCLEX-RN and NCLEX-PN Test Plans, which maintain the
same content category percentages as the 2023 test plans. Key features include:
- NGN Integration: All candidates will encounter Next Generation NCLEX (NGN) items that test
clinical judgment through the NCSBN Clinical Judgment Measurement Model (NCJMM)
- Clinical Judgment: Emphasis on recognizing cues, analyzing cues, prioritizing hypotheses,
generating solutions, taking action, and evaluating outcomes
- Item Types: Extended multiple-choice, multiple-response (SATA), ordered response,
fill-in-the-blank, and enhanced hot spot
- Case Studies: Unfolding case studies with multiple questions testing the clinical judgment
process
,EXAM TOPICS COVERED
| Category | Approximate Weight (RN) |
|-|-|
| Management of Care | 17–23% |
| Safety and Infection Control | 9–15% |
| Health Promotion and Maintenance | 6–12% |
| Psychosocial Integrity | 6–12% |
| Basic Care and Comfort | 6–12% |
| Pharmacological and Parenteral Therapies | 11–17% |
| Reduction of Risk Potential | 9–15% |
| Physiological Adaptation | 11–17% |
SECTION 1: MANAGEMENT OF CARE (Questions 1–25)
QUESTION 1
A charge nurse is assigning client care to a registered nurse (RN) and a licensed practical nurse
(LPN). Which client should the charge nurse assign to the RN?
A) A client with a new tracheostomy requiring suctioning every 2 hours
B) A client with diabetes mellitus requiring daily insulin administration
C) A client with a urinary tract infection requiring antibiotic administration
D) A client with a newly placed chest tube requiring assessment
Answer: D) A client with a newly placed chest tube requiring assessment
Rationale: The RN should be assigned to the client with a newly placed chest tube because this
client requires comprehensive assessment and complex monitoring. The RN is responsible for
the initial assessment and ongoing evaluation of unstable or potentially unstable clients. LPNs
can perform tracheostomy suctioning, administer insulin, and administer antibiotics for stable
clients.
QUESTION 2
A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) A client with pneumonia who has a temperature of 38.5°C (101.3°F) and is diaphoretic
B) A client with heart failure who has 2+ pitting edema and reports shortness of breath
,C) A client with diabetes mellitus who has a blood glucose of 65 mg/dL and is confused
D) A client with a fractured femur who is requesting pain medication
Answer: C) A client with diabetes mellitus who has a blood glucose of 65 mg/dL and is confused
Rationale: The client with hypoglycemia (blood glucose 65 mg/dL) and confusion is
experiencing a life-threatening emergency that requires immediate intervention. Hypoglycemia
can lead to seizures, loss of consciousness, and death if not treated promptly. The nurse should
assess this client first, administer fast-acting carbohydrates or IV dextrose, and recheck blood
glucose.
QUESTION 3
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate
to delegate?
A) Assessing the client's pain level
B) Performing a sterile dressing change
C) Assisting a client with ambulation
D) Administering oral medications
Answer: C) Assisting a client with ambulation
Rationale: UAP can assist with activities of daily living (ADLs), including ambulation, feeding,
hygiene, and toileting. Assessment, sterile procedures, medication administration, and client
education cannot be delegated to UAP. The RN remains responsible for the delegated task and
must provide appropriate supervision.
QUESTION 4
A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates understanding?
A) "I should change the appliance only when it leaks."
B) "I should avoid foods that cause gas and odor."
C) "I can resume normal activities once the stoma heals."
D) "I should use alcohol-based products to clean the stoma."
Answer: C) "I can resume normal activities once the stoma heals."
Rationale: Clients with a new colostomy can resume normal activities once the stoma heals.
The appliance should be changed regularly (not only when it leaks), clients can gradually
, reintroduce foods, and mild soap and water should be used to clean the stoma (not
alcohol-based products).
QUESTION 5
A nurse is caring for a client who refuses a prescribed blood transfusion. Which of the following
actions should the nurse take?
A) Administer the transfusion without the client's consent
B) Respect the client's refusal and document it
C) Contact the ethics committee to override the client's decision
D) Ask the family to convince the client
Answer: B) Respect the client's refusal and document it
Rationale: Clients have the right to refuse treatment, including blood transfusions, based on
personal or religious beliefs. The nurse should respect the client's decision, document the
refusal, notify the healthcare provider, and explore alternatives.
QUESTION 6
A nurse is preparing to discharge a client who speaks a different language. Which action should
the nurse take to ensure effective communication?
A) Use a family member as an interpreter
B) Use a certified medical interpreter
C) Speak loudly and slowly
D) Use hand gestures to communicate
Answer: B) Use a certified medical interpreter
Rationale: A certified medical interpreter should be used to ensure accurate communication with
clients who speak a different language. Family members should not be used as interpreters due
to confidentiality concerns and potential misinterpretation. Speaking loudly or using hand
gestures does not ensure accurate communication.
QUESTION 7
A nurse is caring for a client who has a living will. Which of the following statements is true?
A) The living will designates a healthcare proxy
