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NCLEX-PN FUNDAMENTALS COMPREHENSIVE EXAM
PREP:PRACTICE QUESTIONS WITH ANSWERS AND
DETAILED RATIONALES – COMPLETE STUDY GUIDE,
LATEST 2026 EDITION
This comprehensive practice examination is designed for practical/vocational nursing students
preparing for the NCLEX-PN Fundamentals exam. It provides 150 advanced, exam-style
multiple-choice questions covering essential nursing concepts, including safety and infection
control, basic care and comfort, mobility and immobility, nutrition and hydration, elimination,
vital signs, medication administration, patient education, legal and ethical practice, and cultural
competence. Each question includes a detailed rationale explaining the correct answer and why
alternatives are less suitable. The 2026 edition aligns with the current NCLEX-PN test plan and
NCSBN clinical judgment model. Use this complete review package to assess readiness, identify
knowledge gaps, and build confidence for your licensure examination. Perfect for nursing
students and graduates seeking mastery in fundamentals.
Table of Contents
1. Safety and Infection Control
2. Basic Care and Comfort
3. Mobility and Immobility
4. Nutrition and Hydration
5. Elimination and Bowel/Bladder Management
6. Vital Signs and Health Assessment
7. Medication Administration and Pharmacology Basics
8. Patient Education and Health Promotion
9. Legal, Ethical, and Professional Responsibilities
10. Cultural Competence and End-of-Life Care
,2|Page
1: The nurse is caring for a client on contact precautions for Clostridium difficile infection.
Which action by the nurse requires intervention?
A) Wearing gloves and gown when entering the room
B) Using alcohol-based hand rub after removing gloves
C) Washing hands with soap and water after care
D) Dedicating reusable equipment to the client
Correct Answer: B
C. difficile spores are not killed by alcohol-based hand rubs; soap and water are required. The
other actions are appropriate for contact precautions.
2: A client is admitted with suspected tuberculosis. Which type of isolation is most appropriate?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: C
Tuberculosis is transmitted via airborne droplet nuclei, requiring airborne precautions
including a negative pressure room and N95 respirator. Droplet precautions are for larger
respiratory droplets; contact for direct/indirect contact.
3: The nurse is preparing to insert an indwelling urinary catheter. Which action best prevents
infection?
A) Cleansing the perineum with betadine after insertion
B) Maintaining a closed drainage system
C) Emptying the drainage bag every hour
D) Keeping the drainage bag on the bed
Correct Answer: B
A closed drainage system prevents introduction of microorganisms into the bladder. Cleansing
before insertion is key; frequent emptying and placing bag on bed increase infection risk.
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4: A client has a surgical wound with purulent drainage. The nurse should implement which type
of precautions?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
Correct Answer: B
Purulent drainage may contain infectious organisms requiring contact precautions in addition
to standard precautions. Airborne and droplet are for respiratory pathogens.
5: The nurse is caring for a client with a history of falls. Which environmental modification is
highest priority?
A) Keep the bed in the lowest position with side rails up
B) Place the call light within reach and instruct on use
C) Restrain the client in a chair
D) Use a nightlight and clear clutter
Correct Answer: D
Fall prevention includes adequate lighting and clear pathways. Bed low with side rails up is
not always safe; restraints require orders and are last resort; call light alone not sufficient.
6: A client is being transferred from bed to chair using a mechanical lift. Which action by the
nurse is correct?
A) Use the lift with only one nurse for efficiency
B) Ensure the sling is properly positioned under the client
C) Raise the client high above the bed for clearance
D) Leave the client unattended in the lift briefly
Correct Answer: B
Proper sling placement ensures safety and prevents injury. Mechanical lifts often require two
persons; client should not be raised excessively; never leave unattended in lift.
7: The nurse is performing hand hygiene. Which situation requires washing with soap and water
instead of alcohol-based hand rub?
, 4|Page
A) Before donning sterile gloves
B) After removing gloves following a bed bath
C) When hands are visibly soiled
D) Before touching a client's intact skin
Correct Answer: C
Soap and water are required when hands are visibly dirty or contaminated with spore-forming
organisms. Alcohol rub is acceptable for other listed situations if hands not visibly soiled.
8: A client is on droplet precautions for influenza. The nurse should wear which personal
protective equipment when entering the room?
A) N95 respirator
B) Surgical mask
C) Gown and gloves only
D) Face shield only
Correct Answer: B
Droplet precautions require a surgical mask within 3 feet of the client. N95 is for airborne;
gown and gloves are for contact; face shield alone doesn't protect from droplets.
9: The nurse is caring for a client with a nasogastric tube. Which action prevents aspiration
during feeding?
A) Position the client flat in bed
B) Verify tube placement before each feeding
C) Administer feeding rapidly
D) Check residual after feeding only
Correct Answer: B
Verifying tube placement (pH, measurement, X-ray) before each feeding reduces aspiration
risk. Head of bed should be elevated; feeding slow; residual checked before feeding.
10: A client has an order for "NPO after midnight" for surgery. The nurse should:
A) Allow water until 2 hours before surgery
B) Hold all oral intake including water
NCLEX-PN FUNDAMENTALS COMPREHENSIVE EXAM
PREP:PRACTICE QUESTIONS WITH ANSWERS AND
DETAILED RATIONALES – COMPLETE STUDY GUIDE,
LATEST 2026 EDITION
This comprehensive practice examination is designed for practical/vocational nursing students
preparing for the NCLEX-PN Fundamentals exam. It provides 150 advanced, exam-style
multiple-choice questions covering essential nursing concepts, including safety and infection
control, basic care and comfort, mobility and immobility, nutrition and hydration, elimination,
vital signs, medication administration, patient education, legal and ethical practice, and cultural
competence. Each question includes a detailed rationale explaining the correct answer and why
alternatives are less suitable. The 2026 edition aligns with the current NCLEX-PN test plan and
NCSBN clinical judgment model. Use this complete review package to assess readiness, identify
knowledge gaps, and build confidence for your licensure examination. Perfect for nursing
students and graduates seeking mastery in fundamentals.
Table of Contents
1. Safety and Infection Control
2. Basic Care and Comfort
3. Mobility and Immobility
4. Nutrition and Hydration
5. Elimination and Bowel/Bladder Management
6. Vital Signs and Health Assessment
7. Medication Administration and Pharmacology Basics
8. Patient Education and Health Promotion
9. Legal, Ethical, and Professional Responsibilities
10. Cultural Competence and End-of-Life Care
,2|Page
1: The nurse is caring for a client on contact precautions for Clostridium difficile infection.
Which action by the nurse requires intervention?
A) Wearing gloves and gown when entering the room
B) Using alcohol-based hand rub after removing gloves
C) Washing hands with soap and water after care
D) Dedicating reusable equipment to the client
Correct Answer: B
C. difficile spores are not killed by alcohol-based hand rubs; soap and water are required. The
other actions are appropriate for contact precautions.
2: A client is admitted with suspected tuberculosis. Which type of isolation is most appropriate?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: C
Tuberculosis is transmitted via airborne droplet nuclei, requiring airborne precautions
including a negative pressure room and N95 respirator. Droplet precautions are for larger
respiratory droplets; contact for direct/indirect contact.
3: The nurse is preparing to insert an indwelling urinary catheter. Which action best prevents
infection?
A) Cleansing the perineum with betadine after insertion
B) Maintaining a closed drainage system
C) Emptying the drainage bag every hour
D) Keeping the drainage bag on the bed
Correct Answer: B
A closed drainage system prevents introduction of microorganisms into the bladder. Cleansing
before insertion is key; frequent emptying and placing bag on bed increase infection risk.
,3|Page
4: A client has a surgical wound with purulent drainage. The nurse should implement which type
of precautions?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
Correct Answer: B
Purulent drainage may contain infectious organisms requiring contact precautions in addition
to standard precautions. Airborne and droplet are for respiratory pathogens.
5: The nurse is caring for a client with a history of falls. Which environmental modification is
highest priority?
A) Keep the bed in the lowest position with side rails up
B) Place the call light within reach and instruct on use
C) Restrain the client in a chair
D) Use a nightlight and clear clutter
Correct Answer: D
Fall prevention includes adequate lighting and clear pathways. Bed low with side rails up is
not always safe; restraints require orders and are last resort; call light alone not sufficient.
6: A client is being transferred from bed to chair using a mechanical lift. Which action by the
nurse is correct?
A) Use the lift with only one nurse for efficiency
B) Ensure the sling is properly positioned under the client
C) Raise the client high above the bed for clearance
D) Leave the client unattended in the lift briefly
Correct Answer: B
Proper sling placement ensures safety and prevents injury. Mechanical lifts often require two
persons; client should not be raised excessively; never leave unattended in lift.
7: The nurse is performing hand hygiene. Which situation requires washing with soap and water
instead of alcohol-based hand rub?
, 4|Page
A) Before donning sterile gloves
B) After removing gloves following a bed bath
C) When hands are visibly soiled
D) Before touching a client's intact skin
Correct Answer: C
Soap and water are required when hands are visibly dirty or contaminated with spore-forming
organisms. Alcohol rub is acceptable for other listed situations if hands not visibly soiled.
8: A client is on droplet precautions for influenza. The nurse should wear which personal
protective equipment when entering the room?
A) N95 respirator
B) Surgical mask
C) Gown and gloves only
D) Face shield only
Correct Answer: B
Droplet precautions require a surgical mask within 3 feet of the client. N95 is for airborne;
gown and gloves are for contact; face shield alone doesn't protect from droplets.
9: The nurse is caring for a client with a nasogastric tube. Which action prevents aspiration
during feeding?
A) Position the client flat in bed
B) Verify tube placement before each feeding
C) Administer feeding rapidly
D) Check residual after feeding only
Correct Answer: B
Verifying tube placement (pH, measurement, X-ray) before each feeding reduces aspiration
risk. Head of bed should be elevated; feeding slow; residual checked before feeding.
10: A client has an order for "NPO after midnight" for surgery. The nurse should:
A) Allow water until 2 hours before surgery
B) Hold all oral intake including water
