Comprehensive NCLEX-RN Exam Questions
and Practice Guide – Latest Review for
Nursing Students
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (Questions 1–15)
Question 1
A charge nurse is making client assignments for the upcoming shift. Which client should be
assigned to the most experienced registered nurse?
A. A client 2 days postoperative appendectomy requesting pain medication
B. A client with a new tracheostomy requiring frequent suctioning
C. A client with cellulitis receiving IV antibiotics
D. A client awaiting discharge following a colonoscopy
Correct Answer: B
Rationale: A client with a new tracheostomy requiring frequent suctioning is the most
unstable and requires the highest level of nursing skill and assessment. New tracheostomy
clients are at risk for airway obstruction, bleeding, and infection. The most experienced RN
should be assigned to the client with the greatest need for complex assessment and
intervention. Options A, C, and D are more stable and predictable in their care needs.
Question 2
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Administering a scheduled oral medication
B. Assessing a client's breath sounds
C. Measuring and recording a client's intake and output
D. Teaching a client about a new prescription
Correct Answer: C
, Rationale: Measuring and recording intake and output is a standard, non-invasive task
within the scope of UAP. Administration of medication (A), assessment (B), and client teaching
(D) require the clinical judgment and knowledge of a licensed nurse and cannot be delegated to
UAP.
Question 3
A nurse is caring for a client who speaks limited English. Which action should the nurse take to
ensure informed consent?
A. Ask the client's family member to translate the consent form
B. Use a certified medical interpreter to explain the procedure
C. Have the client sign the consent form and explain later
D. Provide written materials in the client's language only
Correct Answer: B
Rationale: Informed consent requires that the client fully understands the procedure, risks,
and alternatives. A certified medical interpreter ensures accurate communication. Family
members should not be used as interpreters for consent (A) due to potential for
miscommunication, bias, or confidentiality concerns. Signing before explanation (C) invalidates
informed consent. Written materials alone (D) do not confirm understanding.
Question 4
A nurse is reviewing a client's advance directive. The client has a living will stating no heroic
measures. The client is now unresponsive and in respiratory distress. Which action should the
nurse take?
A. Initiate CPR immediately
B. Follow the living will and withhold intubation
C. Ask the family to make the decision
D. Call the healthcare provider and wait for orders
Correct Answer: B
Rationale: A living will is a legal document that communicates the client's wishes regarding
end-of-life care. If the client has documented no heroic measures, the nurse should respect the
client's autonomy and withhold intubation. Initiating CPR (A) would violate the client's wishes.
,The family (C) cannot override a valid living will in most states. Calling the provider (D) is
appropriate but the living will should guide care.
Question 5
A nurse is preparing to administer blood products. Which action demonstrates proper client
identification?
A. Asking the client to state their name and date of birth
B. Checking the client's armband against the blood bank form with a second nurse
C. Verifying the client's room number
D. Confirming the client's name with the family
Correct Answer: B
Rationale: Blood administration requires a two-nurse verification process comparing the
client's identification band with the blood bank form. This is a critical safety measure to prevent
transfusion reactions. Asking the client (A) is appropriate but not sufficient alone. Room number
(C) is not a reliable identifier. Family confirmation (D) is not a valid identification method.
Question 6
A nurse is caring for a client who is being discharged. Which action is the priority for continuity
of care?
A. Providing written discharge instructions
B. Ensuring the client has a follow-up appointment
C. Verifying the client understands medication regimen
D. All of the above are important, but ensuring understanding of medications is priority
Correct Answer: D
Rationale: All of these actions are important for continuity of care. However, medication
understanding is the priority because medication errors are a leading cause of readmissions.
The nurse must use teach-back to confirm the client understands their medications, dosages,
and side effects before discharge.
Question 7
, A nurse is participating in a quality improvement project. Which action best demonstrates the
nurse's role in quality improvement?
A. Reporting medication errors to the nurse manager
B. Participating in a root cause analysis of a sentinel event
C. Completing incident reports
D. All of the above
Correct Answer: D
Rationale: All of these actions demonstrate the nurse's role in quality improvement.
Reporting errors (A), participating in root cause analysis (B), and completing incident reports (C)
are all essential components of a culture of safety and quality improvement.
Question 8
A nurse is caring for a client who requires an interpreter. Which action should the nurse take?
A. Speak loudly and slowly in English
B. Use a certified interpreter and speak directly to the client
C. Ask a bilingual staff member to interpret
D. Provide written instructions in English
Correct Answer: B
Rationale: The nurse should use a certified interpreter and speak directly to the client, not
to the interpreter. Speaking loudly (A) does not help if the client does not understand English.
Bilingual staff (C) may not be qualified interpreters. Written instructions in English (D) are not
helpful if the client cannot read English.
Question 9
A nurse is preparing to discharge a client who has a new prescription for warfarin. Which
instruction is essential?
A. Increase intake of green leafy vegetables
B. Avoid all physical activity
C. Use a soft toothbrush and electric razor
D. Take aspirin for headaches
Correct Answer: C
and Practice Guide – Latest Review for
Nursing Students
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT
Management of Care (Questions 1–15)
Question 1
A charge nurse is making client assignments for the upcoming shift. Which client should be
assigned to the most experienced registered nurse?
A. A client 2 days postoperative appendectomy requesting pain medication
B. A client with a new tracheostomy requiring frequent suctioning
C. A client with cellulitis receiving IV antibiotics
D. A client awaiting discharge following a colonoscopy
Correct Answer: B
Rationale: A client with a new tracheostomy requiring frequent suctioning is the most
unstable and requires the highest level of nursing skill and assessment. New tracheostomy
clients are at risk for airway obstruction, bleeding, and infection. The most experienced RN
should be assigned to the client with the greatest need for complex assessment and
intervention. Options A, C, and D are more stable and predictable in their care needs.
Question 2
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Administering a scheduled oral medication
B. Assessing a client's breath sounds
C. Measuring and recording a client's intake and output
D. Teaching a client about a new prescription
Correct Answer: C
, Rationale: Measuring and recording intake and output is a standard, non-invasive task
within the scope of UAP. Administration of medication (A), assessment (B), and client teaching
(D) require the clinical judgment and knowledge of a licensed nurse and cannot be delegated to
UAP.
Question 3
A nurse is caring for a client who speaks limited English. Which action should the nurse take to
ensure informed consent?
A. Ask the client's family member to translate the consent form
B. Use a certified medical interpreter to explain the procedure
C. Have the client sign the consent form and explain later
D. Provide written materials in the client's language only
Correct Answer: B
Rationale: Informed consent requires that the client fully understands the procedure, risks,
and alternatives. A certified medical interpreter ensures accurate communication. Family
members should not be used as interpreters for consent (A) due to potential for
miscommunication, bias, or confidentiality concerns. Signing before explanation (C) invalidates
informed consent. Written materials alone (D) do not confirm understanding.
Question 4
A nurse is reviewing a client's advance directive. The client has a living will stating no heroic
measures. The client is now unresponsive and in respiratory distress. Which action should the
nurse take?
A. Initiate CPR immediately
B. Follow the living will and withhold intubation
C. Ask the family to make the decision
D. Call the healthcare provider and wait for orders
Correct Answer: B
Rationale: A living will is a legal document that communicates the client's wishes regarding
end-of-life care. If the client has documented no heroic measures, the nurse should respect the
client's autonomy and withhold intubation. Initiating CPR (A) would violate the client's wishes.
,The family (C) cannot override a valid living will in most states. Calling the provider (D) is
appropriate but the living will should guide care.
Question 5
A nurse is preparing to administer blood products. Which action demonstrates proper client
identification?
A. Asking the client to state their name and date of birth
B. Checking the client's armband against the blood bank form with a second nurse
C. Verifying the client's room number
D. Confirming the client's name with the family
Correct Answer: B
Rationale: Blood administration requires a two-nurse verification process comparing the
client's identification band with the blood bank form. This is a critical safety measure to prevent
transfusion reactions. Asking the client (A) is appropriate but not sufficient alone. Room number
(C) is not a reliable identifier. Family confirmation (D) is not a valid identification method.
Question 6
A nurse is caring for a client who is being discharged. Which action is the priority for continuity
of care?
A. Providing written discharge instructions
B. Ensuring the client has a follow-up appointment
C. Verifying the client understands medication regimen
D. All of the above are important, but ensuring understanding of medications is priority
Correct Answer: D
Rationale: All of these actions are important for continuity of care. However, medication
understanding is the priority because medication errors are a leading cause of readmissions.
The nurse must use teach-back to confirm the client understands their medications, dosages,
and side effects before discharge.
Question 7
, A nurse is participating in a quality improvement project. Which action best demonstrates the
nurse's role in quality improvement?
A. Reporting medication errors to the nurse manager
B. Participating in a root cause analysis of a sentinel event
C. Completing incident reports
D. All of the above
Correct Answer: D
Rationale: All of these actions demonstrate the nurse's role in quality improvement.
Reporting errors (A), participating in root cause analysis (B), and completing incident reports (C)
are all essential components of a culture of safety and quality improvement.
Question 8
A nurse is caring for a client who requires an interpreter. Which action should the nurse take?
A. Speak loudly and slowly in English
B. Use a certified interpreter and speak directly to the client
C. Ask a bilingual staff member to interpret
D. Provide written instructions in English
Correct Answer: B
Rationale: The nurse should use a certified interpreter and speak directly to the client, not
to the interpreter. Speaking loudly (A) does not help if the client does not understand English.
Bilingual staff (C) may not be qualified interpreters. Written instructions in English (D) are not
helpful if the client cannot read English.
Question 9
A nurse is preparing to discharge a client who has a new prescription for warfarin. Which
instruction is essential?
A. Increase intake of green leafy vegetables
B. Avoid all physical activity
C. Use a soft toothbrush and electric razor
D. Take aspirin for headaches
Correct Answer: C
