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NCLEX-RN EXAM REVIEW 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
NCLEX-RN PRACTICE EXAM BLOCK (150 QUESTIONS)
Time Limit: 2 HOURS 30 minutes (1 minute per question average)
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Management of Care &
Safety)
1. A charge nurse is making shift assignments on a busy medical-surgical unit. Which
client is most appropriate to assign to a newly licensed registered nurse who has just
completed orientation?
• A. A 65-year-old client who is 24 hours post-operative from a total knee replacement
and is stable.
• B. A 72-year-old client who has a new diagnosis of heart failure and is receiving IV
diuretics.
• C. A 45-year-old client who is receiving a continuous infusion of heparin for a
pulmonary embolism.
• D. A 58-year-old client who has a chest tube in place following a thoracotomy for
lung cancer.
Correct Answer: A
Rationale: The newly licensed RN should be assigned to a stable client with predictable
outcomes and standard interventions. A client who is 24 hours post-op from a knee
replacement is stable, and the nurse has the foundational knowledge to provide post-operative
care. The other clients are unstable or require specialized care, including clients with heart
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failure on IV diuretics (B), clients receiving heparin infusions (C), and those with chest tubes
(D), which are more appropriate for an experienced RN.
2. A nurse is preparing to administer a medication to a client and notes that the
medication administration record (MAR) has a prescription for a medication that is not
available on the unit. What is the nurse's most appropriate initial action?
• A. Contact the pharmacy to request the medication and document the delay in the
client's chart.
• B. Administer a different medication with a similar therapeutic effect to avoid missing
the dose.
• C. Ask the healthcare provider to change the prescription to a medication that is
available on the unit.
• D. Notify the healthcare provider immediately to clarify the prescription and request
an alternative.
Correct Answer: A
Rationale: The nurse's first action should be to contact the pharmacy to obtain the prescribed
medication to ensure the client receives the correct treatment. If the medication is
unavailable, the nurse should then notify the healthcare provider to discuss alternatives (D).
Administering a different medication (B) is unsafe without a prescription, and asking the
provider to change the order (C) is not the initial step.
3. A nurse is caring for a client who has a prescription for a 24-hour urine collection.
The client asks the nurse why all of their urine needs to be collected. What is the nurse's
best response?
• A. "This test measures how much urine your kidneys produce in a full 24-hour
period."
• B. "The test will help us determine if your kidneys are filtering waste products
properly."
• C. "Collecting all of your urine ensures that the laboratory gets an accurate
measurement of the substances in your urine."
• D. "Your healthcare provider ordered this test to check for the presence of a urinary
tract infection."
Correct Answer: C
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Rationale: The purpose of a 24-hour urine collection is to measure the total excretion of
specific substances, such as creatinine, protein, or electrolytes, over a full day. Collecting all
urine ensures the laboratory has a complete and accurate sample to analyze (C). The other
options are incorrect or incomplete explanations of the test's purpose.
4. A nurse discovers that a colleague has documented a blood glucose result in the
client's electronic health record before the test was actually performed. What is the
nurse's most appropriate initial action?
• A. Report the colleague to the state board of nursing immediately.
• B. Discuss the issue with the colleague privately and remind them of the importance
of accurate documentation.
• C. Document the discrepancy in the client's chart and notify the nurse manager.
• D. Ignore the incident to avoid creating conflict with the colleague.
Correct Answer: B
Rationale: The nurse should first address the issue directly with the colleague in a private,
professional manner to clarify the situation and reinforce the importance of accurate
documentation. If the behavior continues, the nurse should then escalate the issue to the nurse
manager (C). Reporting to the board (A) is premature, and ignoring the incident (D) is unsafe
and unprofessional.
5. A nurse is preparing to insert a nasogastric (NG) tube for gastric decompression.
Which action is most important to ensure proper tube placement before initiating the
feeding?
• A. Auscultate for a "whoosh" sound while injecting air into the tube.
• B. Aspirate gastric contents and check the pH level of the aspirate.
• C. Measure the length of the tube from the client's nose to the earlobe to the xiphoid
process.
• D. Verify the tube placement with an abdominal x-ray.
Correct Answer: D
Rationale: An abdominal x-ray is the gold standard for confirming NG tube placement and is
the most definitive method to ensure the tube is in the stomach and not the lungs. While
auscultation (A) and pH testing (B) are used, they are not as reliable. Measuring the tube (C)
is done before insertion, but x-ray verification is the most important safety step before
feeding.
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6. A nurse is caring for a client who is on a continuous IV infusion of normal saline. The
nurse notes that the IV site is cool, pale, and swollen, and the infusion pump is beeping
with an "occlusion" alarm. What is the nurse's priority action?
• A. Reposition the client's arm and restart the infusion pump.
• B. Discontinue the IV infusion and restart a new IV in the other arm.
• C. Flush the IV with 5 mL of normal saline to restore patency.
• D. Apply a warm compress to the site to promote circulation.
Correct Answer: B
Rationale: The findings of cool, pale, and swollen skin with an occlusion alarm indicate that
the IV has infiltrated, meaning the fluid is leaking into the surrounding tissue rather than the
vein. The nurse must discontinue the IV immediately to prevent further tissue damage and
restart a new IV in a different location. Repositioning (A) and flushing (C) will not resolve
the infiltration, and a warm compress (D) is not the priority.
7. A nurse is teaching a client about the proper use of a cane. Which action by the client
demonstrates correct technique?
• A. The client holds the cane on the weaker side of the body.
• B. The client holds the cane on the stronger side of the body.
• C. The client moves the cane forward at the same time as the weaker leg.
• D. The client advances the cane and the stronger leg together.
Correct Answer: B
Rationale: The cane should be held on the stronger side of the body to provide support and
reduce the weight-bearing load on the weaker leg. The cane and the weaker leg should move
forward together, followed by the stronger leg. Holding the cane on the weaker side (A) is
incorrect, and moving the cane with the stronger leg (D) is also incorrect.
8. A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions is most critical to prevent a fatal transfusion reaction?
• A. Assessing the client's temperature and blood pressure prior to the transfusion.
• B. Premedicating the client with diphenhydramine to prevent allergic reactions.
• C. Verifying the client's identity and blood product compatibility with another
licensed nurse.
• D. Ensuring the blood is infused within 4 hours to prevent bacterial growth.
NCLEX-RN EXAM REVIEW 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
NCLEX-RN PRACTICE EXAM BLOCK (150 QUESTIONS)
Time Limit: 2 HOURS 30 minutes (1 minute per question average)
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Management of Care &
Safety)
1. A charge nurse is making shift assignments on a busy medical-surgical unit. Which
client is most appropriate to assign to a newly licensed registered nurse who has just
completed orientation?
• A. A 65-year-old client who is 24 hours post-operative from a total knee replacement
and is stable.
• B. A 72-year-old client who has a new diagnosis of heart failure and is receiving IV
diuretics.
• C. A 45-year-old client who is receiving a continuous infusion of heparin for a
pulmonary embolism.
• D. A 58-year-old client who has a chest tube in place following a thoracotomy for
lung cancer.
Correct Answer: A
Rationale: The newly licensed RN should be assigned to a stable client with predictable
outcomes and standard interventions. A client who is 24 hours post-op from a knee
replacement is stable, and the nurse has the foundational knowledge to provide post-operative
care. The other clients are unstable or require specialized care, including clients with heart
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failure on IV diuretics (B), clients receiving heparin infusions (C), and those with chest tubes
(D), which are more appropriate for an experienced RN.
2. A nurse is preparing to administer a medication to a client and notes that the
medication administration record (MAR) has a prescription for a medication that is not
available on the unit. What is the nurse's most appropriate initial action?
• A. Contact the pharmacy to request the medication and document the delay in the
client's chart.
• B. Administer a different medication with a similar therapeutic effect to avoid missing
the dose.
• C. Ask the healthcare provider to change the prescription to a medication that is
available on the unit.
• D. Notify the healthcare provider immediately to clarify the prescription and request
an alternative.
Correct Answer: A
Rationale: The nurse's first action should be to contact the pharmacy to obtain the prescribed
medication to ensure the client receives the correct treatment. If the medication is
unavailable, the nurse should then notify the healthcare provider to discuss alternatives (D).
Administering a different medication (B) is unsafe without a prescription, and asking the
provider to change the order (C) is not the initial step.
3. A nurse is caring for a client who has a prescription for a 24-hour urine collection.
The client asks the nurse why all of their urine needs to be collected. What is the nurse's
best response?
• A. "This test measures how much urine your kidneys produce in a full 24-hour
period."
• B. "The test will help us determine if your kidneys are filtering waste products
properly."
• C. "Collecting all of your urine ensures that the laboratory gets an accurate
measurement of the substances in your urine."
• D. "Your healthcare provider ordered this test to check for the presence of a urinary
tract infection."
Correct Answer: C
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Rationale: The purpose of a 24-hour urine collection is to measure the total excretion of
specific substances, such as creatinine, protein, or electrolytes, over a full day. Collecting all
urine ensures the laboratory has a complete and accurate sample to analyze (C). The other
options are incorrect or incomplete explanations of the test's purpose.
4. A nurse discovers that a colleague has documented a blood glucose result in the
client's electronic health record before the test was actually performed. What is the
nurse's most appropriate initial action?
• A. Report the colleague to the state board of nursing immediately.
• B. Discuss the issue with the colleague privately and remind them of the importance
of accurate documentation.
• C. Document the discrepancy in the client's chart and notify the nurse manager.
• D. Ignore the incident to avoid creating conflict with the colleague.
Correct Answer: B
Rationale: The nurse should first address the issue directly with the colleague in a private,
professional manner to clarify the situation and reinforce the importance of accurate
documentation. If the behavior continues, the nurse should then escalate the issue to the nurse
manager (C). Reporting to the board (A) is premature, and ignoring the incident (D) is unsafe
and unprofessional.
5. A nurse is preparing to insert a nasogastric (NG) tube for gastric decompression.
Which action is most important to ensure proper tube placement before initiating the
feeding?
• A. Auscultate for a "whoosh" sound while injecting air into the tube.
• B. Aspirate gastric contents and check the pH level of the aspirate.
• C. Measure the length of the tube from the client's nose to the earlobe to the xiphoid
process.
• D. Verify the tube placement with an abdominal x-ray.
Correct Answer: D
Rationale: An abdominal x-ray is the gold standard for confirming NG tube placement and is
the most definitive method to ensure the tube is in the stomach and not the lungs. While
auscultation (A) and pH testing (B) are used, they are not as reliable. Measuring the tube (C)
is done before insertion, but x-ray verification is the most important safety step before
feeding.
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6. A nurse is caring for a client who is on a continuous IV infusion of normal saline. The
nurse notes that the IV site is cool, pale, and swollen, and the infusion pump is beeping
with an "occlusion" alarm. What is the nurse's priority action?
• A. Reposition the client's arm and restart the infusion pump.
• B. Discontinue the IV infusion and restart a new IV in the other arm.
• C. Flush the IV with 5 mL of normal saline to restore patency.
• D. Apply a warm compress to the site to promote circulation.
Correct Answer: B
Rationale: The findings of cool, pale, and swollen skin with an occlusion alarm indicate that
the IV has infiltrated, meaning the fluid is leaking into the surrounding tissue rather than the
vein. The nurse must discontinue the IV immediately to prevent further tissue damage and
restart a new IV in a different location. Repositioning (A) and flushing (C) will not resolve
the infiltration, and a warm compress (D) is not the priority.
7. A nurse is teaching a client about the proper use of a cane. Which action by the client
demonstrates correct technique?
• A. The client holds the cane on the weaker side of the body.
• B. The client holds the cane on the stronger side of the body.
• C. The client moves the cane forward at the same time as the weaker leg.
• D. The client advances the cane and the stronger leg together.
Correct Answer: B
Rationale: The cane should be held on the stronger side of the body to provide support and
reduce the weight-bearing load on the weaker leg. The cane and the weaker leg should move
forward together, followed by the stronger leg. Holding the cane on the weaker side (A) is
incorrect, and moving the cane with the stronger leg (D) is also incorrect.
8. A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions is most critical to prevent a fatal transfusion reaction?
• A. Assessing the client's temperature and blood pressure prior to the transfusion.
• B. Premedicating the client with diphenhydramine to prevent allergic reactions.
• C. Verifying the client's identity and blood product compatibility with another
licensed nurse.
• D. Ensuring the blood is infused within 4 hours to prevent bacterial growth.
