NCLEX-RN Comprehensive Practice
Examination 2026/2027: 100 High-Yield
Questions with Answers, Detailed Rationales,
and Test-Taking Strategies Aligned to the
Latest NGN Test Plan
Description:
Prepare for the NCLEX-RN 2026/2027 with this comprehensive 100-question practice exam.
Covering all eight Client Needs categories—Management of Care, Safety, Health
Promotion, Psychosocial Integrity, Basic Care, Pharmacology, Risk Reduction, and
Physiological Adaptation—each item includes a correct answer, detailed rationale, and test-
taking strategy. Fully aligned with the 2026 NCLEX-RN Test Plan and NGN Clinical
Judgment Model, this test bank features unique, evidence-based questions, a complete answer
key, scoring guide, and section performance analysis. Ideal for nursing students, repeat test-
takers, and exam prep platforms.
Download your 2026/2027 NCLEX-RN study guide today and pass with confidence!
,Examination Overview
This practice examination contains 100 multiple-choice questions aligned with the 2026
NCLEX-RN Test Plan (effective April 1, 2026, through March 31, 2029) and the Next
Generation NCLEX (NGN) Clinical Judgment Measurement Model. Questions are organized
under the eight official Client Needs categories. Each item includes a correct answer, a detailed
rationale, and a test-taking strategy designed to strengthen clinical reasoning. All content reflects
current evidence-based practice, and every question is unique with no duplicated content. Each
item is tagged with its cognitive level and integrated process for targeted review.
Scoring Interpretation Guide
Score Range Interpretation
90–100 Exam-ready; maintain with light review
80–89 Approaching readiness; target weak content areas
70–79 Developing; structured review recommended
Below 70 Comprehensive remediation needed
Recommended Timing: Approximately 1.5 minutes per question; total suggested time of 150
minutes for 100 items.
, NCLEX-RN Practice Test 2026/2027: 100 Questions & Answers
Section 1: Management of Care (Questions 1–15)
Question 1
A registered nurse is planning care for four clients at the beginning of a shift. Which client
should the nurse assess first?
A. A client who is 2 days postoperative following a total hip arthroplasty and reports pain rated
7/10
B. A client with chronic kidney disease whose serum potassium is 5.4 mEq/L
C. A client with heart failure whose oxygen saturation has decreased from 96% to 89% on room
air over the past hour
D. A client admitted with community-acquired pneumonia who has a scheduled chest radiograph
in 30 minutes
Answer: C
Explanation: Using the ABC (Airway, Breathing, Circulation) priority framework and the
acute-versus-chronic distinction, the client with heart failure and a declining oxygen saturation
represents the highest-priority assessment. A 7-point drop in oxygen saturation within one hour
suggests possible pulmonary edema or acute decompensation requiring immediate evaluation
and intervention. Option A represents expected postoperative pain manageable with prescribed
analgesia. Option B reflects a mildly elevated potassium level in the context of chronic kidney
disease that warrants monitoring but is not immediately life-threatening. Option D involves a
routine scheduled diagnostic study. The nurse should assess the client with declining
oxygenation first, then escalate care as indicated.
Strategy: When prioritizing among multiple clients, apply the ABC framework first, then
distinguish acute from chronic findings. A sudden change in a stable client always outranks a
chronic abnormality.
Cognitive Level: Analyze | Integrated Process: Nursing Process
, Question 2
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is most
appropriate for the nurse to delegate?
A. Performing a focused respiratory assessment on a client with new-onset shortness of breath
B. Measuring vital signs and recording intake and output for stable clients
C. Administering oral acetaminophen to a client reporting a mild headache
D. Providing discharge teaching regarding a new prescription for warfarin
Answer: B
Explanation: Delegation follows the Five Rights: right task, right circumstance, right person,
right direction, and right supervision. Measuring vital signs and recording intake and output are
routine, noninvasive tasks within the UAP scope of practice that do not require nursing
judgment. Option A requires RN-level assessment and clinical decision-making. Option C
involves medication administration, which is a nursing function that cannot be delegated to UAP.
Option D requires the teaching expertise and licensure of a registered nurse. The RN retains
accountability for the overall plan of care even when tasks are delegated.
Strategy: Remember that assessment, teaching, evaluation, and medication administration are
never delegated to UAP. If the task requires nursing judgment, it stays with the RN.
Cognitive Level: Apply | Integrated Process: Nursing Process
Question 3
A nurse is caring for a client who has just received a diagnosis of terminal pancreatic cancer. The
client states, "I don't want any heroic measures. I've already told my family." The client then asks
the nurse to help document these wishes. Which action should the nurse take first?
A. Notify the health care provider that the client is refusing treatment
B. Ask the client whether an advance directive has been completed
C. Contact the family to verify the client's stated wishes
D. Document the client's statement in the medical record as a verbal refusal
Examination 2026/2027: 100 High-Yield
Questions with Answers, Detailed Rationales,
and Test-Taking Strategies Aligned to the
Latest NGN Test Plan
Description:
Prepare for the NCLEX-RN 2026/2027 with this comprehensive 100-question practice exam.
Covering all eight Client Needs categories—Management of Care, Safety, Health
Promotion, Psychosocial Integrity, Basic Care, Pharmacology, Risk Reduction, and
Physiological Adaptation—each item includes a correct answer, detailed rationale, and test-
taking strategy. Fully aligned with the 2026 NCLEX-RN Test Plan and NGN Clinical
Judgment Model, this test bank features unique, evidence-based questions, a complete answer
key, scoring guide, and section performance analysis. Ideal for nursing students, repeat test-
takers, and exam prep platforms.
Download your 2026/2027 NCLEX-RN study guide today and pass with confidence!
,Examination Overview
This practice examination contains 100 multiple-choice questions aligned with the 2026
NCLEX-RN Test Plan (effective April 1, 2026, through March 31, 2029) and the Next
Generation NCLEX (NGN) Clinical Judgment Measurement Model. Questions are organized
under the eight official Client Needs categories. Each item includes a correct answer, a detailed
rationale, and a test-taking strategy designed to strengthen clinical reasoning. All content reflects
current evidence-based practice, and every question is unique with no duplicated content. Each
item is tagged with its cognitive level and integrated process for targeted review.
Scoring Interpretation Guide
Score Range Interpretation
90–100 Exam-ready; maintain with light review
80–89 Approaching readiness; target weak content areas
70–79 Developing; structured review recommended
Below 70 Comprehensive remediation needed
Recommended Timing: Approximately 1.5 minutes per question; total suggested time of 150
minutes for 100 items.
, NCLEX-RN Practice Test 2026/2027: 100 Questions & Answers
Section 1: Management of Care (Questions 1–15)
Question 1
A registered nurse is planning care for four clients at the beginning of a shift. Which client
should the nurse assess first?
A. A client who is 2 days postoperative following a total hip arthroplasty and reports pain rated
7/10
B. A client with chronic kidney disease whose serum potassium is 5.4 mEq/L
C. A client with heart failure whose oxygen saturation has decreased from 96% to 89% on room
air over the past hour
D. A client admitted with community-acquired pneumonia who has a scheduled chest radiograph
in 30 minutes
Answer: C
Explanation: Using the ABC (Airway, Breathing, Circulation) priority framework and the
acute-versus-chronic distinction, the client with heart failure and a declining oxygen saturation
represents the highest-priority assessment. A 7-point drop in oxygen saturation within one hour
suggests possible pulmonary edema or acute decompensation requiring immediate evaluation
and intervention. Option A represents expected postoperative pain manageable with prescribed
analgesia. Option B reflects a mildly elevated potassium level in the context of chronic kidney
disease that warrants monitoring but is not immediately life-threatening. Option D involves a
routine scheduled diagnostic study. The nurse should assess the client with declining
oxygenation first, then escalate care as indicated.
Strategy: When prioritizing among multiple clients, apply the ABC framework first, then
distinguish acute from chronic findings. A sudden change in a stable client always outranks a
chronic abnormality.
Cognitive Level: Analyze | Integrated Process: Nursing Process
, Question 2
A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is most
appropriate for the nurse to delegate?
A. Performing a focused respiratory assessment on a client with new-onset shortness of breath
B. Measuring vital signs and recording intake and output for stable clients
C. Administering oral acetaminophen to a client reporting a mild headache
D. Providing discharge teaching regarding a new prescription for warfarin
Answer: B
Explanation: Delegation follows the Five Rights: right task, right circumstance, right person,
right direction, and right supervision. Measuring vital signs and recording intake and output are
routine, noninvasive tasks within the UAP scope of practice that do not require nursing
judgment. Option A requires RN-level assessment and clinical decision-making. Option C
involves medication administration, which is a nursing function that cannot be delegated to UAP.
Option D requires the teaching expertise and licensure of a registered nurse. The RN retains
accountability for the overall plan of care even when tasks are delegated.
Strategy: Remember that assessment, teaching, evaluation, and medication administration are
never delegated to UAP. If the task requires nursing judgment, it stays with the RN.
Cognitive Level: Apply | Integrated Process: Nursing Process
Question 3
A nurse is caring for a client who has just received a diagnosis of terminal pancreatic cancer. The
client states, "I don't want any heroic measures. I've already told my family." The client then asks
the nurse to help document these wishes. Which action should the nurse take first?
A. Notify the health care provider that the client is refusing treatment
B. Ask the client whether an advance directive has been completed
C. Contact the family to verify the client's stated wishes
D. Document the client's statement in the medical record as a verbal refusal
