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NCLEX-PN EXAM QUESTIONS LATEST
VERSION QUESTIONS AND ANSWERS 2026
EDITION
250-question NCLEX-PN
10-Point Summary of NCLEX-PN Exam Coverage
1. Safe and Effective Care Environment: Prioritizing client needs, infection control
(standard/transmission-based precautions), disaster planning, and identifying safety
risks (falls, restraints, fire).
2. Health Promotion and Maintenance: Anticipatory guidance, disease prevention,
growth and development milestones (all ages), client education, and
prenatal/postpartum care.
3. Psychosocial Integrity: Therapeutic communication, coping mechanisms, grief and
loss, crisis intervention, and caring for clients with psychiatric disorders (e.g.,
depression, anxiety, schizophrenia).
4. Physiological Integrity: Basic Care and Comfort: Assisting with activities of daily
living (ADLs), mobility, nutrition/hydration, and providing comfort measures (pain,
palliative care).
5. Pharmacological Therapies: Medication administration (rights), side effects,
adverse reactions, and client teaching for common drug classes (cardiovascular,
respiratory, psychiatric, antibiotics).
6. Reduction of Risk Potential: Monitoring for complications, interpreting diagnostic
tests, and preventing injury in clients at risk (e.g., post-surgical, with electrolyte
imbalances).
7. Physiological Adaptation: Managing acute and chronic conditions (e.g., diabetes,
heart failure, COPD, renal failure), recognizing changes in status, and providing
emergency care.
8. Maternal and Newborn Health: Prenatal care, labor and delivery stages, postpartum
assessment, newborn care, and complications (e.g., preeclampsia, hemorrhage,
newborn jaundice).
9. Pediatric Nursing: Common childhood illnesses, growth and development, safety for
different age groups, and management of pediatric emergencies and chronic
conditions.
10. Mental Health and Psychiatric Nursing: Therapeutic milieu, psychopharmacology,
de-escalation techniques, and management of specific disorders (e.g., bipolar, PTSD,
substance abuse).
250 NCLEX-PN Practice Questions with Rationales
Category 1: Safe and Effective Care Environment (Questions 1-25)
1. When preparing to don sterile gloves for a sterile procedure, which action is most
crucial for the nurse to take first to maintain the sterile field and ensure client safety?
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o A. Select the correct size of gloves.
o B. Ensure the client is positioned comfortably.
o C. Check the integrity and expiration date of the glove package.
o D. Wash hands with antimicrobial soap and water.
o Answer: D. Rationale: While all steps are important, washing hands with
antimicrobial soap or using an alcohol-based hand rub is the first and most
crucial step to reduce the number of microorganisms before entering the sterile
field. Checking the package integrity is also vital, but hand hygiene is the
foundational step.
2. A client who is post-operative is using a patient-controlled analgesia (PCA) pump
with morphine for severe pain. Which nursing action is the highest priority to ensure
the client's safety while using this device?
o A. Encouraging the client to use the pump as often as they need.
o B. Assessing the client's respiratory rate and oxygen saturation levels.
o C. Explaining the pump's function to the client's family members.
o D. Checking the IV site for signs of infiltration or phlebitis.
o Answer: B. Rationale: The highest priority is to monitor for respiratory
depression, a life-threatening side effect of opioid analgesics like morphine.
While checking the IV site and educating the family are important, they are
secondary to the immediate physiological risk of respiratory compromise.
3. A nurse is caring for a client on fall precautions. Which intervention, when
implemented consistently, would be most effective in preventing a client from falling
when they attempt to get out of bed unassisted?
o A. Keeping the side rails up at all times on the bed.
o B. Placing a "Fall Risk" bracelet on the client's wrist.
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o C. Conducting frequent, scheduled rounding on the client.
o D. Placing the call light within easy reach of the client.
o Answer: C. Rationale: Frequent rounding allows the nurse to proactively
address the client's needs (e.g., toileting, repositioning) and anticipate an
attempt to get up, allowing for timely assistance. Side rails can be considered a
restraint, and a bracelet or call light is passive and doesn't prevent the act of
getting up.
4. The nurse is preparing to transfer a client from a bed to a wheelchair using a
mechanical lift. What is the most important safety action the nurse must take prior to
beginning the transfer procedure?
o A. Apply a gait belt around the client's waist.
o B. Ensure the lift's battery is fully charged and the sling is properly attached.
o C. Lower the bed to its lowest position and lock the wheels.
o D. Explain the procedure to the client to gain their cooperation.
o Answer: B. Rationale: Before using any mechanical device, it is critical to
perform a safety check to ensure the equipment is functional and properly
assembled to prevent device failure and injury to the client or staff. Explaining
the procedure and lowering the bed are also important, but equipment safety is
paramount.
5. A nurse discovers a small fire in a client's trash can. According to the RACE acronym
for fire safety, what is the nurse's immediate priority action before attempting to
extinguish the fire?
o A. Rescue any clients in immediate danger from the area.
o B. Activate the nearest fire alarm or call the emergency number.
o C. Attempt to contain the fire by closing the client's door.
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o D. Locate and retrieve the nearest fire extinguisher.
o Answer: A. Rationale: The RACE acronym stands for Rescue, Alarm,
Contain, Extinguish. The first and most critical step is to rescue clients who
are in immediate danger from the fire. Saving lives always takes precedence
over property or extinguishing the fire.
6. The nurse is preparing to administer a prescribed intermittent enteral feeding via a
nasogastric tube. Which action should the nurse take first to confirm the tube is
correctly placed in the stomach before initiating the feeding?
o A. Aspirate gastric contents and check the pH level.
o B. Inject 30 mL of air into the tube while auscultating over the stomach.
o C. Measure the length of the external portion of the tube from the client's nose.
o D. Confirm the placement via an order for an abdominal x-ray from the
healthcare provider.
o Answer: A. Rationale: While an x-ray is the gold standard, it is not performed
at the bedside for every feeding. The most reliable bedside method is to
aspirate gastric contents and check the pH (should be ≤ 4). Auscultation is no
longer recommended as a sole method due to its unreliability.
7. A client on a medical-surgical unit is placed in isolation for Clostridium difficile (C.
diff). Which type of precaution should the nurse implement, and what is the primary
purpose of this specific precautionary measure?
o A. Airborne Precautions, to prevent the spread of infectious respiratory
droplets.
o B. Droplet Precautions, to prevent the spread of infection through coughing or
sneezing.
NCLEX-PN EXAM QUESTIONS LATEST
VERSION QUESTIONS AND ANSWERS 2026
EDITION
250-question NCLEX-PN
10-Point Summary of NCLEX-PN Exam Coverage
1. Safe and Effective Care Environment: Prioritizing client needs, infection control
(standard/transmission-based precautions), disaster planning, and identifying safety
risks (falls, restraints, fire).
2. Health Promotion and Maintenance: Anticipatory guidance, disease prevention,
growth and development milestones (all ages), client education, and
prenatal/postpartum care.
3. Psychosocial Integrity: Therapeutic communication, coping mechanisms, grief and
loss, crisis intervention, and caring for clients with psychiatric disorders (e.g.,
depression, anxiety, schizophrenia).
4. Physiological Integrity: Basic Care and Comfort: Assisting with activities of daily
living (ADLs), mobility, nutrition/hydration, and providing comfort measures (pain,
palliative care).
5. Pharmacological Therapies: Medication administration (rights), side effects,
adverse reactions, and client teaching for common drug classes (cardiovascular,
respiratory, psychiatric, antibiotics).
6. Reduction of Risk Potential: Monitoring for complications, interpreting diagnostic
tests, and preventing injury in clients at risk (e.g., post-surgical, with electrolyte
imbalances).
7. Physiological Adaptation: Managing acute and chronic conditions (e.g., diabetes,
heart failure, COPD, renal failure), recognizing changes in status, and providing
emergency care.
8. Maternal and Newborn Health: Prenatal care, labor and delivery stages, postpartum
assessment, newborn care, and complications (e.g., preeclampsia, hemorrhage,
newborn jaundice).
9. Pediatric Nursing: Common childhood illnesses, growth and development, safety for
different age groups, and management of pediatric emergencies and chronic
conditions.
10. Mental Health and Psychiatric Nursing: Therapeutic milieu, psychopharmacology,
de-escalation techniques, and management of specific disorders (e.g., bipolar, PTSD,
substance abuse).
250 NCLEX-PN Practice Questions with Rationales
Category 1: Safe and Effective Care Environment (Questions 1-25)
1. When preparing to don sterile gloves for a sterile procedure, which action is most
crucial for the nurse to take first to maintain the sterile field and ensure client safety?
, Page 2 of 121
o A. Select the correct size of gloves.
o B. Ensure the client is positioned comfortably.
o C. Check the integrity and expiration date of the glove package.
o D. Wash hands with antimicrobial soap and water.
o Answer: D. Rationale: While all steps are important, washing hands with
antimicrobial soap or using an alcohol-based hand rub is the first and most
crucial step to reduce the number of microorganisms before entering the sterile
field. Checking the package integrity is also vital, but hand hygiene is the
foundational step.
2. A client who is post-operative is using a patient-controlled analgesia (PCA) pump
with morphine for severe pain. Which nursing action is the highest priority to ensure
the client's safety while using this device?
o A. Encouraging the client to use the pump as often as they need.
o B. Assessing the client's respiratory rate and oxygen saturation levels.
o C. Explaining the pump's function to the client's family members.
o D. Checking the IV site for signs of infiltration or phlebitis.
o Answer: B. Rationale: The highest priority is to monitor for respiratory
depression, a life-threatening side effect of opioid analgesics like morphine.
While checking the IV site and educating the family are important, they are
secondary to the immediate physiological risk of respiratory compromise.
3. A nurse is caring for a client on fall precautions. Which intervention, when
implemented consistently, would be most effective in preventing a client from falling
when they attempt to get out of bed unassisted?
o A. Keeping the side rails up at all times on the bed.
o B. Placing a "Fall Risk" bracelet on the client's wrist.
, Page 3 of 121
o C. Conducting frequent, scheduled rounding on the client.
o D. Placing the call light within easy reach of the client.
o Answer: C. Rationale: Frequent rounding allows the nurse to proactively
address the client's needs (e.g., toileting, repositioning) and anticipate an
attempt to get up, allowing for timely assistance. Side rails can be considered a
restraint, and a bracelet or call light is passive and doesn't prevent the act of
getting up.
4. The nurse is preparing to transfer a client from a bed to a wheelchair using a
mechanical lift. What is the most important safety action the nurse must take prior to
beginning the transfer procedure?
o A. Apply a gait belt around the client's waist.
o B. Ensure the lift's battery is fully charged and the sling is properly attached.
o C. Lower the bed to its lowest position and lock the wheels.
o D. Explain the procedure to the client to gain their cooperation.
o Answer: B. Rationale: Before using any mechanical device, it is critical to
perform a safety check to ensure the equipment is functional and properly
assembled to prevent device failure and injury to the client or staff. Explaining
the procedure and lowering the bed are also important, but equipment safety is
paramount.
5. A nurse discovers a small fire in a client's trash can. According to the RACE acronym
for fire safety, what is the nurse's immediate priority action before attempting to
extinguish the fire?
o A. Rescue any clients in immediate danger from the area.
o B. Activate the nearest fire alarm or call the emergency number.
o C. Attempt to contain the fire by closing the client's door.
, Page 4 of 121
o D. Locate and retrieve the nearest fire extinguisher.
o Answer: A. Rationale: The RACE acronym stands for Rescue, Alarm,
Contain, Extinguish. The first and most critical step is to rescue clients who
are in immediate danger from the fire. Saving lives always takes precedence
over property or extinguishing the fire.
6. The nurse is preparing to administer a prescribed intermittent enteral feeding via a
nasogastric tube. Which action should the nurse take first to confirm the tube is
correctly placed in the stomach before initiating the feeding?
o A. Aspirate gastric contents and check the pH level.
o B. Inject 30 mL of air into the tube while auscultating over the stomach.
o C. Measure the length of the external portion of the tube from the client's nose.
o D. Confirm the placement via an order for an abdominal x-ray from the
healthcare provider.
o Answer: A. Rationale: While an x-ray is the gold standard, it is not performed
at the bedside for every feeding. The most reliable bedside method is to
aspirate gastric contents and check the pH (should be ≤ 4). Auscultation is no
longer recommended as a sole method due to its unreliability.
7. A client on a medical-surgical unit is placed in isolation for Clostridium difficile (C.
diff). Which type of precaution should the nurse implement, and what is the primary
purpose of this specific precautionary measure?
o A. Airborne Precautions, to prevent the spread of infectious respiratory
droplets.
o B. Droplet Precautions, to prevent the spread of infection through coughing or
sneezing.
