Page 1 of 45
KAPLAN COMPREHENSIVE NCLEX-RN REVIEW EXAM
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NCLEX-RN
Prepare for the Kaplan Comprehensive NCLEX-RN Review Exam with a focused study
resource covering major nursing concepts and key NCLEX-RN content areas. It
supports review of clinical judgment, patient safety, pharmacology, health
assessment, prioritization, nursing interventions, and evidence-based care. Use the
material to reinforce knowledge, identify areas for additional study, and build
confidence for comprehensive NCLEX-RN preparation. This resource is best suited for
NCLEX-RN candidates and nursing students preparing for comprehensive review
assessments.
MULTIPLE CHOICE.
MANAGEMENT OF CARE — PRIORITIZATION & DELEGATION
1. The charge nurse is making assignments on a medical-surgical unit.
Which client should be assigned to the most experienced registered
nurse?
• A) A 45-year-old client with type 2 diabetes mellitus requiring insulin
administration
• B) A 68-year-old client with pneumonia who needs frequent respiratory
assessments
• C) A 72-year-old client 2 hours post-total hip arthroplasty with a
continuous epidural infusion
• D) A 55-year-old client with chronic kidney disease receiving peritoneal
dialysis
Answer: C) A 72-year-old client 2 hours post-total hip arthroplasty with a
continuous epidural infusion
Rationale: The client who is 2 hours post-total hip arthroplasty with a
, Page 2 of 45
continuous epidural infusion requires the most experienced RN due to the
complexity of care, including monitoring for epidural-related
complications such as respiratory depression, hypotension, and
infection. The experienced RN has the clinical judgment to assess and
intervene appropriately. The other clients have more stable conditions.
2. A charge nurse is delegating tasks to unlicensed assistive personnel
(UAP). Which task is appropriate to delegate to the UAP?
• A) Assessing a client's surgical incision for signs of infection
• B) Administering oral medications to a stable client
• C) Assisting a client with ambulation using a gait belt
• D) Performing a sterile wound dressing change
Answer: C) Assisting a client with ambulation using a gait belt
Rationale: Assisting with ambulation is within the UAP's scope of practice
when the client is stable and the UAP has demonstrated competency.
Assessment, medication administration, and sterile procedures require
licensed nursing personnel.
3. A nurse is caring for four patients on a medical-surgical unit. Which
patient should the nurse assess first?
• A) A 42-year-old with chest pain and diaphoresis
• B) A 28-year-old with ankle pain and swelling
• C) A 65-year-old with a temperature of 37.5°C (99.5°F)
• D) A 50-year-old requesting a refill of antihypertensive medication
Answer: A) A 42-year-old with chest pain and diaphoresis
Rationale: Chest pain with diaphoresis indicates a potential acute
myocardial infarction, which is a life-threatening emergency. This patient
requires immediate assessment and intervention. The other patients have
stable, non-urgent conditions.
, Page 3 of 45
4. A nurse receives handoff on four clients. Which client should the nurse
assess first?
• A) A client with chronic kidney disease who reports a new metallic taste
and generalized weakness
• B) A client 6 hours after thyroidectomy who reports tingling around the
mouth and intermittent muscle twitching
• C) A client with pneumonia whose temperature increased from 37.8°C
to 38.4°C over 4 hours
• D) A client with heart failure who has gained 1 kg over the previous 48
hours
Answer: B) A client 6 hours after thyroidectomy who reports tingling
around the mouth and intermittent muscle twitching
Rationale: Perioral tingling and muscle twitching shortly after
thyroidectomy suggest acute hypocalcemia from impaired parathyroid
function. Progressing hypocalcemia can cause laryngospasm, seizures,
and life-threatening airway compromise. This client has the highest
priority.
5. The nurse is caring for a client who is postoperative day 2 following
abdominal surgery. The client's family member reports that the client has
not had a bowel movement since before surgery. Which action should the
nurse take FIRST?
• A) Administer a prescribed stool softener
• B) Assess the client's abdomen for distension and bowel sounds
• C) Request an order for a laxative
• D) Encourage the client to ambulate
Answer: B) Assess the client's abdomen for distension and bowel sounds
Rationale: The first step in the nursing process is assessment. Before
, Page 4 of 45
implementing any intervention, the nurse must assess the client's current
status. Postoperative ileus is a common concern, and assessment
findings will guide appropriate interventions.
6. A charge nurse is making assignments on a medical-surgical unit.
Which client should be assigned to the LPN?
• A) A client with a new tracheostomy requiring frequent suctioning
• B) A client with a stable colostomy requiring routine stoma care
• C) A client with a chest tube and continuous bubbling in the water seal
• D) A client with a blood transfusion reaction
Answer: B) A client with a stable colostomy requiring routine stoma care
Rationale: LPNs can provide routine care for stable patients, such as
stoma care. Patients with new tracheostomies, chest tube complications,
or transfusion reactions require RN-level assessment and intervention.
7. A nurse is delegating tasks to unlicensed assistive personnel (UAP).
Which tasks are appropriate to delegate? (Select all that apply)
• A) Measuring intake and output
• B) Administering oral medications
• C) Assisting a client with ambulation
• D) Performing a sterile dressing change
• E) Obtaining vital signs on a stable client
• F) Feeding a client with dysphagia
Answer: A, C, E
Rationale: UAPs can measure intake and output, assist with ambulation,
and obtain vital signs on stable clients. Medication administration, sterile
dressing changes, and feeding clients with dysphagia require nursing
judgment and should be performed by licensed personnel.
KAPLAN COMPREHENSIVE NCLEX-RN REVIEW EXAM
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NCLEX-RN
Prepare for the Kaplan Comprehensive NCLEX-RN Review Exam with a focused study
resource covering major nursing concepts and key NCLEX-RN content areas. It
supports review of clinical judgment, patient safety, pharmacology, health
assessment, prioritization, nursing interventions, and evidence-based care. Use the
material to reinforce knowledge, identify areas for additional study, and build
confidence for comprehensive NCLEX-RN preparation. This resource is best suited for
NCLEX-RN candidates and nursing students preparing for comprehensive review
assessments.
MULTIPLE CHOICE.
MANAGEMENT OF CARE — PRIORITIZATION & DELEGATION
1. The charge nurse is making assignments on a medical-surgical unit.
Which client should be assigned to the most experienced registered
nurse?
• A) A 45-year-old client with type 2 diabetes mellitus requiring insulin
administration
• B) A 68-year-old client with pneumonia who needs frequent respiratory
assessments
• C) A 72-year-old client 2 hours post-total hip arthroplasty with a
continuous epidural infusion
• D) A 55-year-old client with chronic kidney disease receiving peritoneal
dialysis
Answer: C) A 72-year-old client 2 hours post-total hip arthroplasty with a
continuous epidural infusion
Rationale: The client who is 2 hours post-total hip arthroplasty with a
, Page 2 of 45
continuous epidural infusion requires the most experienced RN due to the
complexity of care, including monitoring for epidural-related
complications such as respiratory depression, hypotension, and
infection. The experienced RN has the clinical judgment to assess and
intervene appropriately. The other clients have more stable conditions.
2. A charge nurse is delegating tasks to unlicensed assistive personnel
(UAP). Which task is appropriate to delegate to the UAP?
• A) Assessing a client's surgical incision for signs of infection
• B) Administering oral medications to a stable client
• C) Assisting a client with ambulation using a gait belt
• D) Performing a sterile wound dressing change
Answer: C) Assisting a client with ambulation using a gait belt
Rationale: Assisting with ambulation is within the UAP's scope of practice
when the client is stable and the UAP has demonstrated competency.
Assessment, medication administration, and sterile procedures require
licensed nursing personnel.
3. A nurse is caring for four patients on a medical-surgical unit. Which
patient should the nurse assess first?
• A) A 42-year-old with chest pain and diaphoresis
• B) A 28-year-old with ankle pain and swelling
• C) A 65-year-old with a temperature of 37.5°C (99.5°F)
• D) A 50-year-old requesting a refill of antihypertensive medication
Answer: A) A 42-year-old with chest pain and diaphoresis
Rationale: Chest pain with diaphoresis indicates a potential acute
myocardial infarction, which is a life-threatening emergency. This patient
requires immediate assessment and intervention. The other patients have
stable, non-urgent conditions.
, Page 3 of 45
4. A nurse receives handoff on four clients. Which client should the nurse
assess first?
• A) A client with chronic kidney disease who reports a new metallic taste
and generalized weakness
• B) A client 6 hours after thyroidectomy who reports tingling around the
mouth and intermittent muscle twitching
• C) A client with pneumonia whose temperature increased from 37.8°C
to 38.4°C over 4 hours
• D) A client with heart failure who has gained 1 kg over the previous 48
hours
Answer: B) A client 6 hours after thyroidectomy who reports tingling
around the mouth and intermittent muscle twitching
Rationale: Perioral tingling and muscle twitching shortly after
thyroidectomy suggest acute hypocalcemia from impaired parathyroid
function. Progressing hypocalcemia can cause laryngospasm, seizures,
and life-threatening airway compromise. This client has the highest
priority.
5. The nurse is caring for a client who is postoperative day 2 following
abdominal surgery. The client's family member reports that the client has
not had a bowel movement since before surgery. Which action should the
nurse take FIRST?
• A) Administer a prescribed stool softener
• B) Assess the client's abdomen for distension and bowel sounds
• C) Request an order for a laxative
• D) Encourage the client to ambulate
Answer: B) Assess the client's abdomen for distension and bowel sounds
Rationale: The first step in the nursing process is assessment. Before
, Page 4 of 45
implementing any intervention, the nurse must assess the client's current
status. Postoperative ileus is a common concern, and assessment
findings will guide appropriate interventions.
6. A charge nurse is making assignments on a medical-surgical unit.
Which client should be assigned to the LPN?
• A) A client with a new tracheostomy requiring frequent suctioning
• B) A client with a stable colostomy requiring routine stoma care
• C) A client with a chest tube and continuous bubbling in the water seal
• D) A client with a blood transfusion reaction
Answer: B) A client with a stable colostomy requiring routine stoma care
Rationale: LPNs can provide routine care for stable patients, such as
stoma care. Patients with new tracheostomies, chest tube complications,
or transfusion reactions require RN-level assessment and intervention.
7. A nurse is delegating tasks to unlicensed assistive personnel (UAP).
Which tasks are appropriate to delegate? (Select all that apply)
• A) Measuring intake and output
• B) Administering oral medications
• C) Assisting a client with ambulation
• D) Performing a sterile dressing change
• E) Obtaining vital signs on a stable client
• F) Feeding a client with dysphagia
Answer: A, C, E
Rationale: UAPs can measure intake and output, assist with ambulation,
and obtain vital signs on stable clients. Medication administration, sterile
dressing changes, and feeding clients with dysphagia require nursing
judgment and should be performed by licensed personnel.
