Nursing Capstone Comprehensive Pre-Test Exam
NCLEX-RN® Readiness Assessment
Questions and Answers with Rationales| Latest Update
Instructions: Read each question carefully and select the best answer. This exam is
designed to help assess readiness for the NCLEX-RN® examination and covers major
content areas including Fundamentals, Pharmacology, Medical-Surgical Nursing,
Maternal-Newborn Nursing, Pediatric Nursing, Mental Health Nursing, Leadership and
Management, Critical Care, and Legal/Ethical Concepts.
,Question 1. A nurse is planning care for four clients. Which client should the nurse
assess first?
A. A client with a chest tube who reports pain at the insertion site
B. A client 2 hours post-op who has not voided since surgery
C. A client with a new onset of stridor and use of accessory muscles
D. A client with a blood glucose of 150 mg/dL before breakfast
Answer: C. A client with a new onset of stridor and use of accessory muscles
Rationale: Stridor and accessory muscle use indicate airway compromise, which takes
priority over pain, urinary retention, or a mildly elevated glucose using the ABC (airway,
breathing, circulation) framework.
Question 2. Using Maslow's hierarchy of needs, which client problem should the nurse
address first?
A. Client expresses fear about an upcoming surgery
B. Client has not had a bowel movement in 3 days
C. Client's oxygen saturation is 88% on room air
D. Client reports feeling isolated from family
Answer: C. Client's oxygen saturation is 88% on room air
Rationale: Physiological needs, including oxygenation, are the base of Maslow's
hierarchy and must be met before safety, elimination, or psychosocial needs.
Question 3. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A. Teaching a client how to self-administer insulin
B. Ambulating a stable client who is 2 days post-op
C. Assessing a new admission's pain level
D. Administering an oral medication to a client with dysphagia
Answer: B. Ambulating a stable client who is 2 days post-op
Rationale: UAPs may perform tasks that do not require nursing judgment, such as
ambulating a stable client. Teaching, assessment, and medication administration require
licensed nursing judgment.
Question 4. Which action best demonstrates the nursing process step of 'evaluation'?
A. Collecting data on a client's respiratory status
, B. Formulating a nursing diagnosis of impaired gas exchange
C. Comparing a client's oxygen saturation after treatment to the goal of >92%
D. Administering a bronchodilator as prescribed
Answer: C. Comparing a client's oxygen saturation after treatment to the goal of >92%
Rationale: Evaluation involves comparing the client's actual outcomes to the expected
outcomes/goals established in the plan of care.
Question 5. A nurse is performing hand hygiene. Which statement indicates the nurse
understands proper technique?
A. 'I will use hot water to kill more bacteria.'
B. 'I should wash for at least 15 seconds with soap and water.'
C. 'Alcohol-based hand rub is preferred unless hands are visibly soiled.'
D. 'I only need to wash my hands after removing gloves.'
Answer: C. 'Alcohol-based hand rub is preferred unless hands are visibly soiled.'
Rationale: Alcohol-based hand rub is the CDC-preferred method for hand hygiene in
most clinical situations unless hands are visibly soiled or after caring for a client with C.
difficile, in which case soap and water is required.
Question 6. A client is on contact precautions. Which personal protective equipment
(PPE) should the nurse don before entering the room?
A. Mask and eye protection only
B. Gown and gloves
C. N95 respirator only
D. No PPE is required, only hand hygiene
Answer: B. Gown and gloves
Rationale: Contact precautions require a gown and gloves to prevent transmission of
organisms spread by direct or indirect contact, such as MRSA or C. difficile.
Question 7. A nurse finds a client on the floor after a fall. What is the nurse's first action?
A. Complete an incident report
B. Notify the healthcare provider
C. Assess the client for injury
D. Document the event in the medical record
Answer: C. Assess the client for injury
, Rationale: The nurse's first priority is always to assess the client for injuries before
notifying the provider, documenting, or completing paperwork.
Question 8. Which client is at greatest risk for developing a pressure injury?
A. A 25-year-old client who is ambulatory after appendectomy
B. An 80-year-old client with limited mobility and incontinence
C. A 40-year-old client on strict bedrest for 24 hours awaiting surgery
D. A 30-year-old client with a fractured arm in a cast
Answer: B. An 80-year-old client with limited mobility and incontinence
Rationale: Advanced age, immobility, and incontinence (moisture) are major risk factors
for pressure injury development, as reflected in tools like the Braden Scale.
Question 9. A nurse is documenting client care. Which entry follows proper
documentation guidelines?
A. 'Client seems to be in a lot of pain today.'
B. 'Client rates pain as 8/10 on 0–10 scale, guarding abdomen.'
C. 'Client is a difficult patient who complains frequently.'
D. 'Client probably did not take medication as prescribed.'
Answer: B. 'Client rates pain as 8/10 on 0–10 scale, guarding abdomen.'
Rationale: Documentation should be objective, factual, and specific. Subjective
judgments or assumptions should be avoided.
Question 10. A nurse is preparing to transfer a client from bed to wheelchair. Which
action is most important prior to the transfer?
A. Raise the bed to the highest position
B. Lock the wheels of the bed and wheelchair
C. Remove the client's non-skid socks
D. Place the wheelchair on the client's weaker side
Answer: B. Lock the wheels of the bed and wheelchair
Rationale: Locking the wheels of both the bed and wheelchair prevents movement
during transfer and reduces fall risk, which is the priority safety action.
NCLEX-RN® Readiness Assessment
Questions and Answers with Rationales| Latest Update
Instructions: Read each question carefully and select the best answer. This exam is
designed to help assess readiness for the NCLEX-RN® examination and covers major
content areas including Fundamentals, Pharmacology, Medical-Surgical Nursing,
Maternal-Newborn Nursing, Pediatric Nursing, Mental Health Nursing, Leadership and
Management, Critical Care, and Legal/Ethical Concepts.
,Question 1. A nurse is planning care for four clients. Which client should the nurse
assess first?
A. A client with a chest tube who reports pain at the insertion site
B. A client 2 hours post-op who has not voided since surgery
C. A client with a new onset of stridor and use of accessory muscles
D. A client with a blood glucose of 150 mg/dL before breakfast
Answer: C. A client with a new onset of stridor and use of accessory muscles
Rationale: Stridor and accessory muscle use indicate airway compromise, which takes
priority over pain, urinary retention, or a mildly elevated glucose using the ABC (airway,
breathing, circulation) framework.
Question 2. Using Maslow's hierarchy of needs, which client problem should the nurse
address first?
A. Client expresses fear about an upcoming surgery
B. Client has not had a bowel movement in 3 days
C. Client's oxygen saturation is 88% on room air
D. Client reports feeling isolated from family
Answer: C. Client's oxygen saturation is 88% on room air
Rationale: Physiological needs, including oxygenation, are the base of Maslow's
hierarchy and must be met before safety, elimination, or psychosocial needs.
Question 3. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A. Teaching a client how to self-administer insulin
B. Ambulating a stable client who is 2 days post-op
C. Assessing a new admission's pain level
D. Administering an oral medication to a client with dysphagia
Answer: B. Ambulating a stable client who is 2 days post-op
Rationale: UAPs may perform tasks that do not require nursing judgment, such as
ambulating a stable client. Teaching, assessment, and medication administration require
licensed nursing judgment.
Question 4. Which action best demonstrates the nursing process step of 'evaluation'?
A. Collecting data on a client's respiratory status
, B. Formulating a nursing diagnosis of impaired gas exchange
C. Comparing a client's oxygen saturation after treatment to the goal of >92%
D. Administering a bronchodilator as prescribed
Answer: C. Comparing a client's oxygen saturation after treatment to the goal of >92%
Rationale: Evaluation involves comparing the client's actual outcomes to the expected
outcomes/goals established in the plan of care.
Question 5. A nurse is performing hand hygiene. Which statement indicates the nurse
understands proper technique?
A. 'I will use hot water to kill more bacteria.'
B. 'I should wash for at least 15 seconds with soap and water.'
C. 'Alcohol-based hand rub is preferred unless hands are visibly soiled.'
D. 'I only need to wash my hands after removing gloves.'
Answer: C. 'Alcohol-based hand rub is preferred unless hands are visibly soiled.'
Rationale: Alcohol-based hand rub is the CDC-preferred method for hand hygiene in
most clinical situations unless hands are visibly soiled or after caring for a client with C.
difficile, in which case soap and water is required.
Question 6. A client is on contact precautions. Which personal protective equipment
(PPE) should the nurse don before entering the room?
A. Mask and eye protection only
B. Gown and gloves
C. N95 respirator only
D. No PPE is required, only hand hygiene
Answer: B. Gown and gloves
Rationale: Contact precautions require a gown and gloves to prevent transmission of
organisms spread by direct or indirect contact, such as MRSA or C. difficile.
Question 7. A nurse finds a client on the floor after a fall. What is the nurse's first action?
A. Complete an incident report
B. Notify the healthcare provider
C. Assess the client for injury
D. Document the event in the medical record
Answer: C. Assess the client for injury
, Rationale: The nurse's first priority is always to assess the client for injuries before
notifying the provider, documenting, or completing paperwork.
Question 8. Which client is at greatest risk for developing a pressure injury?
A. A 25-year-old client who is ambulatory after appendectomy
B. An 80-year-old client with limited mobility and incontinence
C. A 40-year-old client on strict bedrest for 24 hours awaiting surgery
D. A 30-year-old client with a fractured arm in a cast
Answer: B. An 80-year-old client with limited mobility and incontinence
Rationale: Advanced age, immobility, and incontinence (moisture) are major risk factors
for pressure injury development, as reflected in tools like the Braden Scale.
Question 9. A nurse is documenting client care. Which entry follows proper
documentation guidelines?
A. 'Client seems to be in a lot of pain today.'
B. 'Client rates pain as 8/10 on 0–10 scale, guarding abdomen.'
C. 'Client is a difficult patient who complains frequently.'
D. 'Client probably did not take medication as prescribed.'
Answer: B. 'Client rates pain as 8/10 on 0–10 scale, guarding abdomen.'
Rationale: Documentation should be objective, factual, and specific. Subjective
judgments or assumptions should be avoided.
Question 10. A nurse is preparing to transfer a client from bed to wheelchair. Which
action is most important prior to the transfer?
A. Raise the bed to the highest position
B. Lock the wheels of the bed and wheelchair
C. Remove the client's non-skid socks
D. Place the wheelchair on the client's weaker side
Answer: B. Lock the wheels of the bed and wheelchair
Rationale: Locking the wheels of both the bed and wheelchair prevents movement
during transfer and reduces fall risk, which is the priority safety action.
