NC S B N V ER I F I ED P R AC T I C E EX A M
Z.ai Educational Series · Nursing Licensure
NCLEX‑RN (NGN)
Test Bank 2026/2027
250 Verified Questions & Answers with Rationales
One full practice exam aligned with the Next Generation NCLEX
Clinical Judgment Model and all eight Client Need categories.
250 8 7 A+
PRA CTICE CLIENT NEED NGN ITEM V ERIFIED
QUESTIONS CATEGORIES TY PES RATIONA LES
Management of Care Safety & Infection Control Health Promotion Psychosocial Integrity
Pharmacology Reduction of Risk Physiological Adaptation
Z.AI · NURSING EDUCATION Edition 2026/2027 · Practice Use Only
,NCLEX-RN (NGN) TEST BANK 2026/2027 Z.ai Educational Series
NCLEX-RN (NGN) Test Bank — Exam Instructions
Welcome to the NCLEX-RN (Next Generation NCLEX) practice exam. This test bank contains 250
verified questions and answers with rationales, organized as one continuous exam. Questions
span all eight NCLEX Client Need categories and include all seven NGN item types. The
structure mirrors the actual NCLEX-RN examination in length, clinical complexity, and Clinical
Judgment Model emphasis, making this a high-yield practice resource.
How to Use This Test Bank
Begin with Question 1 and progress sequentially through Question 250 without reviewing the answer
key. The questions are organized to reflect the actual NCLEX-RN content distribution (Physiological
Adaptation, Pharmacological and Parenteral Therapies, Reduction of Risk Potential, Management of
Care, Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, and
Basic Care and Comfort). After completing all 250 questions, consult the Answer Key and Rationales
section beginning on the page referenced below. Each rationale explains why the correct answer is
right, why key distractors are wrong, and includes a clinical reasoning tip.
Item Types Included
[MCQ] Multiple Choice — single best answer (4 options)
[SATA] Select All That Apply — multiple correct responses
[PRI] Prioritization — order clients or actions by priority
[FIB] Fill-in-the-Blank — numeric calculation
[EXH] Exhibit/Chart — interpretation of clinical data
[DD] Drag-and-Drop / Ordered Response
[CASE] Clinical Judgment — case-based reasoning
NCLEX-RN Examination Overview
The NCLEX-RN is a computerized adaptive test (CAT) administered by Pearson VUE on behalf of the
National Council of State Boards of Nursing (NCSBN). The minimum number of items is 85 and the
maximum is 150, with a 5-hour time limit (inclusive of optional breaks). The NGN format, launched
in April 2023, emphasizes the Clinical Judgment Measurement Model (CJMM) with six cognitive
layers: Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, and
Evaluate Outcomes. Case-based scenarios test multiple layers within a single clinical context.
Scoring & Performance Guidance
Score your exam by counting correct responses. A benchmark of 70-75% correct (175-188 out of 250)
indicates readiness for the NCLEX-RN. Lower scores warrant focused review of weak Client Need
categories. Pay special attention to rationales for questions you answered incorrectly — this is where
the majority of learning occurs. Review rationales for correctly answered questions as well, since
clinical nuances often appear in the distractor analysis. Use the Test-Taking Tip and clinical pearls
embedded in each rationale to build pattern recognition for future questions.
Exam Begins Below
Proceed to Question 1. Do not consult the Answer Key until you have completed all 250 questions.
250 Verified Q&A with Rationales Page 1 Practice Use Only
,NCLEX-RN (NGN) TEST BANK 2026/2027 Z.ai Educational Series
Q1 [MCQ] Management of Care
A registered nurse (RN) on a medical-surgical unit is assigned four clients. Which client should
the RN assess first?
A. A client who is 2 days postoperative from a hip replacement and reports pain rated 6/10.
B. A client with chronic kidney disease whose potassium level is 5.2 mEq/L.
C. A client with heart failure who has new-onset crackles in the lung bases and is dyspneic.
D. A client with diabetes mellitus whose fasting blood glucose is 180 mg/dL.
Q2 [MCQ] Management of Care
A nurse manager is preparing to delegate tasks for the shift. Which task is most appropriate to
delegate to a licensed practical nurse (LPN)?
A. Administering the first dose of IV push metoprolol to a client with new-onset atrial fibrillation.
B. Performing initial postoperative assessment on a client who just returned from a coronary artery
bypass graft.
C. Caring for a stable client with a chronic leg ulcer requiring daily wet-to-dry dressing changes.
D. Teaching a newly diagnosed client with type 1 diabetes about insulin self-administration.
Q3 [SATA] Management of Care
A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs.
Which actions by the nurse are appropriate? Select all that apply.
A. Notify the primary health care provider immediately.
B. Document the client's refusal and the nurse's actions in the medical record.
C. Explain the potential consequences of refusing the transfusion.
D. Restrain the client and administer the transfusion as prescribed.
E. Ask the client to sign a refusal-of-treatment form.
Q4 [MCQ] Management of Care
A charge nurse is making assignments for the shift. Which client should be assigned to a float
nurse from the postpartum unit who has not worked on a medical-surgical unit in 3 years?
A. A client with pneumonia who requires frequent respiratory assessments and titration of oxygen.
B. A client who is 1 day postoperative from an appendectomy and is stable.
C. A client with acute pancreatitis who is receiving total parenteral nutrition (TPN) and requires
hourly glucose monitoring.
D. A client with a new diagnosis of sepsis on a norepinephrine drip with arterial line monitoring.
Q5 [MCQ] Management of Care
A nurse discovers that a colleague has been removing opioids from the automated dispensing
cabinet without documentation. Which action should the nurse take first?
A. Confront the colleague directly and demand an explanation.
B. Report the observation to the nurse manager and complete an incident report.
C. Continue observing the colleague to gather more evidence before reporting.
D. Notify the state board of nursing immediately.
Q6 [PRI] Management of Care
250 Verified Q&A with Rationales Page 2 Practice Use Only
, NCLEX-RN (NGN) TEST BANK 2026/2027 Z.ai Educational Series
A nurse receives report on four clients. Using the prioritization framework, place the clients in
order from highest to lowest priority for assessment.
A. A client 4 hours post-angiogram with a femoral puncture site reporting back pain.
B. A client with COPD whose SpO2 dropped from 94% to 88% over the last hour.
C. A client with type 2 diabetes requesting a snack before bedtime.
D. A client with chronic back pain asking for PRN analgesic 30 minutes early.
Q7 [MCQ] Management of Care
A client who is scheduled for an elective cholecystectomy asks the nurse, 'Do I really need this
surgery?' The surgeon has already explained the procedure and obtained informed consent.
What is the nurse's best response?
A. 'Yes, your surgeon has already decided this is the best option for you.'
B. 'What concerns or questions do you have about the surgery?'
C. 'I cannot discuss that; you should speak to your surgeon.'
D. 'If you don't have the surgery, your gallstones will only get worse.'
Q8 [MCQ] Management of Care
A nursing student asks the preceptor about the purpose of HIPAA. Which response by the
preceptor is most accurate?
A. 'HIPAA was created to ensure that all clients have access to health insurance regardless of
pre-existing conditions.'
B. 'HIPAA establishes federal standards to protect individuals' medical records and other personal
health information.'
C. 'HIPAA is a state law that requires nurses to report suspected abuse to authorities.'
D. 'HIPAA is a regulation that governs the dispensing and administration of controlled substances.'
Q9 [SATA] Management of Care
A nurse is planning discharge teaching for a client with limited English proficiency. Which
strategies should the nurse use to ensure effective communication? Select all that apply.
A. Use a certified medical interpreter, not a family member, for translation.
B. Provide written materials in the client's preferred language when available.
C. Speak slowly and loudly to help the client understand.
D. Use pictures and demonstrations to reinforce verbal instructions.
E. Ask the client to teach-back the instructions to verify understanding.
Q10 [MCQ] Management of Care
A nurse notes that another nurse on the unit appears impaired and is preparing to administer
medications. What is the nurse's priority action?
A. Wait until the end of the shift and discuss the concern privately.
B. Document the observations and report to the charge nurse immediately.
C. Ask the impaired nurse to take a break and drink some coffee.
D. Confront the nurse in front of the client care team.
Q11 [MCQ] Management of Care
250 Verified Q&A with Rationales Page 3 Practice Use Only
Z.ai Educational Series · Nursing Licensure
NCLEX‑RN (NGN)
Test Bank 2026/2027
250 Verified Questions & Answers with Rationales
One full practice exam aligned with the Next Generation NCLEX
Clinical Judgment Model and all eight Client Need categories.
250 8 7 A+
PRA CTICE CLIENT NEED NGN ITEM V ERIFIED
QUESTIONS CATEGORIES TY PES RATIONA LES
Management of Care Safety & Infection Control Health Promotion Psychosocial Integrity
Pharmacology Reduction of Risk Physiological Adaptation
Z.AI · NURSING EDUCATION Edition 2026/2027 · Practice Use Only
,NCLEX-RN (NGN) TEST BANK 2026/2027 Z.ai Educational Series
NCLEX-RN (NGN) Test Bank — Exam Instructions
Welcome to the NCLEX-RN (Next Generation NCLEX) practice exam. This test bank contains 250
verified questions and answers with rationales, organized as one continuous exam. Questions
span all eight NCLEX Client Need categories and include all seven NGN item types. The
structure mirrors the actual NCLEX-RN examination in length, clinical complexity, and Clinical
Judgment Model emphasis, making this a high-yield practice resource.
How to Use This Test Bank
Begin with Question 1 and progress sequentially through Question 250 without reviewing the answer
key. The questions are organized to reflect the actual NCLEX-RN content distribution (Physiological
Adaptation, Pharmacological and Parenteral Therapies, Reduction of Risk Potential, Management of
Care, Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, and
Basic Care and Comfort). After completing all 250 questions, consult the Answer Key and Rationales
section beginning on the page referenced below. Each rationale explains why the correct answer is
right, why key distractors are wrong, and includes a clinical reasoning tip.
Item Types Included
[MCQ] Multiple Choice — single best answer (4 options)
[SATA] Select All That Apply — multiple correct responses
[PRI] Prioritization — order clients or actions by priority
[FIB] Fill-in-the-Blank — numeric calculation
[EXH] Exhibit/Chart — interpretation of clinical data
[DD] Drag-and-Drop / Ordered Response
[CASE] Clinical Judgment — case-based reasoning
NCLEX-RN Examination Overview
The NCLEX-RN is a computerized adaptive test (CAT) administered by Pearson VUE on behalf of the
National Council of State Boards of Nursing (NCSBN). The minimum number of items is 85 and the
maximum is 150, with a 5-hour time limit (inclusive of optional breaks). The NGN format, launched
in April 2023, emphasizes the Clinical Judgment Measurement Model (CJMM) with six cognitive
layers: Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, and
Evaluate Outcomes. Case-based scenarios test multiple layers within a single clinical context.
Scoring & Performance Guidance
Score your exam by counting correct responses. A benchmark of 70-75% correct (175-188 out of 250)
indicates readiness for the NCLEX-RN. Lower scores warrant focused review of weak Client Need
categories. Pay special attention to rationales for questions you answered incorrectly — this is where
the majority of learning occurs. Review rationales for correctly answered questions as well, since
clinical nuances often appear in the distractor analysis. Use the Test-Taking Tip and clinical pearls
embedded in each rationale to build pattern recognition for future questions.
Exam Begins Below
Proceed to Question 1. Do not consult the Answer Key until you have completed all 250 questions.
250 Verified Q&A with Rationales Page 1 Practice Use Only
,NCLEX-RN (NGN) TEST BANK 2026/2027 Z.ai Educational Series
Q1 [MCQ] Management of Care
A registered nurse (RN) on a medical-surgical unit is assigned four clients. Which client should
the RN assess first?
A. A client who is 2 days postoperative from a hip replacement and reports pain rated 6/10.
B. A client with chronic kidney disease whose potassium level is 5.2 mEq/L.
C. A client with heart failure who has new-onset crackles in the lung bases and is dyspneic.
D. A client with diabetes mellitus whose fasting blood glucose is 180 mg/dL.
Q2 [MCQ] Management of Care
A nurse manager is preparing to delegate tasks for the shift. Which task is most appropriate to
delegate to a licensed practical nurse (LPN)?
A. Administering the first dose of IV push metoprolol to a client with new-onset atrial fibrillation.
B. Performing initial postoperative assessment on a client who just returned from a coronary artery
bypass graft.
C. Caring for a stable client with a chronic leg ulcer requiring daily wet-to-dry dressing changes.
D. Teaching a newly diagnosed client with type 1 diabetes about insulin self-administration.
Q3 [SATA] Management of Care
A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs.
Which actions by the nurse are appropriate? Select all that apply.
A. Notify the primary health care provider immediately.
B. Document the client's refusal and the nurse's actions in the medical record.
C. Explain the potential consequences of refusing the transfusion.
D. Restrain the client and administer the transfusion as prescribed.
E. Ask the client to sign a refusal-of-treatment form.
Q4 [MCQ] Management of Care
A charge nurse is making assignments for the shift. Which client should be assigned to a float
nurse from the postpartum unit who has not worked on a medical-surgical unit in 3 years?
A. A client with pneumonia who requires frequent respiratory assessments and titration of oxygen.
B. A client who is 1 day postoperative from an appendectomy and is stable.
C. A client with acute pancreatitis who is receiving total parenteral nutrition (TPN) and requires
hourly glucose monitoring.
D. A client with a new diagnosis of sepsis on a norepinephrine drip with arterial line monitoring.
Q5 [MCQ] Management of Care
A nurse discovers that a colleague has been removing opioids from the automated dispensing
cabinet without documentation. Which action should the nurse take first?
A. Confront the colleague directly and demand an explanation.
B. Report the observation to the nurse manager and complete an incident report.
C. Continue observing the colleague to gather more evidence before reporting.
D. Notify the state board of nursing immediately.
Q6 [PRI] Management of Care
250 Verified Q&A with Rationales Page 2 Practice Use Only
, NCLEX-RN (NGN) TEST BANK 2026/2027 Z.ai Educational Series
A nurse receives report on four clients. Using the prioritization framework, place the clients in
order from highest to lowest priority for assessment.
A. A client 4 hours post-angiogram with a femoral puncture site reporting back pain.
B. A client with COPD whose SpO2 dropped from 94% to 88% over the last hour.
C. A client with type 2 diabetes requesting a snack before bedtime.
D. A client with chronic back pain asking for PRN analgesic 30 minutes early.
Q7 [MCQ] Management of Care
A client who is scheduled for an elective cholecystectomy asks the nurse, 'Do I really need this
surgery?' The surgeon has already explained the procedure and obtained informed consent.
What is the nurse's best response?
A. 'Yes, your surgeon has already decided this is the best option for you.'
B. 'What concerns or questions do you have about the surgery?'
C. 'I cannot discuss that; you should speak to your surgeon.'
D. 'If you don't have the surgery, your gallstones will only get worse.'
Q8 [MCQ] Management of Care
A nursing student asks the preceptor about the purpose of HIPAA. Which response by the
preceptor is most accurate?
A. 'HIPAA was created to ensure that all clients have access to health insurance regardless of
pre-existing conditions.'
B. 'HIPAA establishes federal standards to protect individuals' medical records and other personal
health information.'
C. 'HIPAA is a state law that requires nurses to report suspected abuse to authorities.'
D. 'HIPAA is a regulation that governs the dispensing and administration of controlled substances.'
Q9 [SATA] Management of Care
A nurse is planning discharge teaching for a client with limited English proficiency. Which
strategies should the nurse use to ensure effective communication? Select all that apply.
A. Use a certified medical interpreter, not a family member, for translation.
B. Provide written materials in the client's preferred language when available.
C. Speak slowly and loudly to help the client understand.
D. Use pictures and demonstrations to reinforce verbal instructions.
E. Ask the client to teach-back the instructions to verify understanding.
Q10 [MCQ] Management of Care
A nurse notes that another nurse on the unit appears impaired and is preparing to administer
medications. What is the nurse's priority action?
A. Wait until the end of the shift and discuss the concern privately.
B. Document the observations and report to the charge nurse immediately.
C. Ask the impaired nurse to take a break and drink some coffee.
D. Confront the nurse in front of the client care team.
Q11 [MCQ] Management of Care
250 Verified Q&A with Rationales Page 3 Practice Use Only
