NCLEX-RN® All Exam Files – PACKAGE DEAL –
Questions and Answers – 2025/2026 Edition –
Complete Bundle
Section 1: Safe and Effective Care Environment – Management of Care (Q1–Q25)
1. A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The family asks the
nurse to explain what DNR means. Which response by the nurse is most appropriate?
A. "It means we will not provide any treatment to keep the client alive."
B. "It means that if the client stops breathing or the heart stops, we will not perform CPR or
advanced cardiac life support."
C. "I cannot discuss that; you need to talk to the doctor."
D. "It means the client will be allowed to die naturally without any medical care."
Answer: B
Rationale: DNR means that if the client experiences cardiac or respiratory arrest, CPR and ACLS
will not be initiated. It does not mean withholding other treatments such as pain relief,
antibiotics, or hydration.
2. A charge nurse is making assignments for a licensed practical nurse (LPN). Which task is
appropriate to delegate to the LPN?
A. Perform the initial admission assessment on a client with pneumonia
B. Administer a PRN enema to a constipated client
C. Develop the nursing care plan for a client with heart failure
D. Teach a client how to self-administer insulin
Answer: B
Rationale: LPNs can administer medications, including PRN enemas, and perform stable,
routine treatments. Initial assessment and care plan development require RN-level critical
thinking.
3. A nurse is caring for a client who refuses a prescribed blood transfusion. The client is alert
and oriented and understands the consequences of refusal. What is the nurse's priority
action?
A. Administer the transfusion against the client's wishes
B. Document the refusal and notify the healthcare provider
C. Ask the family to convince the client to accept the transfusion
D. Restrain the client and administer the transfusion
Answer: B
Rationale: A competent adult has the right to refuse any treatment, even life-saving treatment.
The nurse must document the refusal and notify the provider.
,4. A nurse is preparing to insert a urinary catheter. The nurse touches the inner surface of the
sterile drape without sterile gloves. What should the nurse do?
A. Continue the procedure quickly to minimize contamination
B. Stop the procedure and obtain a new sterile kit
C. Wipe the area with alcohol and continue
D. Document the contamination and proceed
Answer: B
Rationale: Breaking sterile technique increases the risk of infection. The nurse must stop the
procedure and obtain a new sterile kit.
5. A nurse is preparing to administer a blood transfusion. Which IV solution is compatible for
priming the tubing?
A. 5% Dextrose in water (D5W)
B. Lactated Ringer's (LR)
C. 0.9% normal saline
D. 0.45% normal saline (half-strength)
Answer: C
Rationale: Only 0.9% normal saline is compatible with blood products. Dextrose solutions can
cause hemolysis, and LR contains calcium, which can cause clotting.
6. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Administering oral medications
B. Assessing a client's pain level
C. Assisting a client with ambulation
D. Teaching a client about a new medication
Answer: C
Rationale: Assisting with ambulation is within UAP scope. Medication administration,
assessment, and teaching require a licensed nurse.
7. A nurse is caring for a client who speaks a different language. Which action is most
appropriate?
A. Use a family member as an interpreter
B. Use a trained medical interpreter
C. Speak loudly and slowly
D. Use gestures only
Answer: B
Rationale: A trained medical interpreter ensures accurate communication and confidentiality.
8. A nurse is documenting a client's refusal of medication. Which information is most
important to include?
,A. The client's reason for refusal
B. The client's vital signs
C. The nurse's opinion
D. The client's room number
Answer: A
Rationale: Documenting the client's reason for refusal is essential for legal and clinical
purposes.
9. A nurse is teaching a client about advance directives. Which statement indicates correct
understanding?
A. "Advance directives are only for older adults."
B. "I can change my advance directive at any time."
C. "Advance directives are legally binding in all states."
D. "Only my doctor can make decisions for me."
Answer: B
Rationale: Clients can change advance directives at any time as long as they have decision-
making capacity.
10. A nurse is assessing a client for suspected abuse. Which finding is most concerning?
A. Bruises in various stages of healing
B. A single bruise on the knee
C. Mild anxiety
D. Poor eye contact
Answer: A
Rationale: Bruises in various stages of healing may indicate ongoing physical abuse.
11. A nurse is caring for a client with a do-not-resuscitate (DNR) order. Which action is most
appropriate?
A. Initiate CPR if the client stops breathing
B. Respect the DNR order and provide comfort care
C. Ask the family to confirm the DNR order
D. Ignore the DNR order
Answer: B
Rationale: The nurse must respect the DNR order and provide comfort-focused care.
12. A nurse is teaching a client about health promotion. Which instruction is most
appropriate for a client with hypertension?
A. Reduce sodium intake
B. Increase alcohol consumption
C. Decrease physical activity
D. Increase saturated fat intake
, Answer: A
Rationale: Reducing sodium intake is a key lifestyle modification for managing hypertension.
13. A nurse is assessing a community for risk factors for heart disease. Which factor is most
significant?
A. High prevalence of smoking
B. Availability of parks
C. Access to healthcare
D. Education level
Answer: A
Rationale: Smoking is a major modifiable risk factor for heart disease.
14. A nurse is serving as a charge nurse. Which task is appropriate to delegate to a newly
licensed RN?
A. Administering blood products
B. Performing a complex wound dressing change
C. Admitting a stable client
D. Assessing a deteriorating client
Answer: C
Rationale: Admitting a stable client is appropriate for a newly licensed RN. Complex tasks and
deteriorating clients require more experience.
15. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client requesting pain medication
B. A client with a blood pressure of 86/52 mm Hg
C. A client scheduled for discharge
D. A client asking for a blanket
Answer: B
Rationale: Using the ABC framework, the client with hypotension is hemodynamically unstable
and requires immediate assessment.
16. A nurse is preparing to administer a high-alert medication. Which action is most critical to
ensure client safety?
A. Obtaining a second independent check from another qualified nurse
B. Administering the medication slowly over 5 minutes
C. Asking the client if they are allergic to aspirin
D. Checking the client's blood pressure before giving the dose
Answer: A
Rationale: High-alert medications require an independent double-check by another qualified
nurse to verify the Seven Rights before administration.
Questions and Answers – 2025/2026 Edition –
Complete Bundle
Section 1: Safe and Effective Care Environment – Management of Care (Q1–Q25)
1. A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The family asks the
nurse to explain what DNR means. Which response by the nurse is most appropriate?
A. "It means we will not provide any treatment to keep the client alive."
B. "It means that if the client stops breathing or the heart stops, we will not perform CPR or
advanced cardiac life support."
C. "I cannot discuss that; you need to talk to the doctor."
D. "It means the client will be allowed to die naturally without any medical care."
Answer: B
Rationale: DNR means that if the client experiences cardiac or respiratory arrest, CPR and ACLS
will not be initiated. It does not mean withholding other treatments such as pain relief,
antibiotics, or hydration.
2. A charge nurse is making assignments for a licensed practical nurse (LPN). Which task is
appropriate to delegate to the LPN?
A. Perform the initial admission assessment on a client with pneumonia
B. Administer a PRN enema to a constipated client
C. Develop the nursing care plan for a client with heart failure
D. Teach a client how to self-administer insulin
Answer: B
Rationale: LPNs can administer medications, including PRN enemas, and perform stable,
routine treatments. Initial assessment and care plan development require RN-level critical
thinking.
3. A nurse is caring for a client who refuses a prescribed blood transfusion. The client is alert
and oriented and understands the consequences of refusal. What is the nurse's priority
action?
A. Administer the transfusion against the client's wishes
B. Document the refusal and notify the healthcare provider
C. Ask the family to convince the client to accept the transfusion
D. Restrain the client and administer the transfusion
Answer: B
Rationale: A competent adult has the right to refuse any treatment, even life-saving treatment.
The nurse must document the refusal and notify the provider.
,4. A nurse is preparing to insert a urinary catheter. The nurse touches the inner surface of the
sterile drape without sterile gloves. What should the nurse do?
A. Continue the procedure quickly to minimize contamination
B. Stop the procedure and obtain a new sterile kit
C. Wipe the area with alcohol and continue
D. Document the contamination and proceed
Answer: B
Rationale: Breaking sterile technique increases the risk of infection. The nurse must stop the
procedure and obtain a new sterile kit.
5. A nurse is preparing to administer a blood transfusion. Which IV solution is compatible for
priming the tubing?
A. 5% Dextrose in water (D5W)
B. Lactated Ringer's (LR)
C. 0.9% normal saline
D. 0.45% normal saline (half-strength)
Answer: C
Rationale: Only 0.9% normal saline is compatible with blood products. Dextrose solutions can
cause hemolysis, and LR contains calcium, which can cause clotting.
6. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Administering oral medications
B. Assessing a client's pain level
C. Assisting a client with ambulation
D. Teaching a client about a new medication
Answer: C
Rationale: Assisting with ambulation is within UAP scope. Medication administration,
assessment, and teaching require a licensed nurse.
7. A nurse is caring for a client who speaks a different language. Which action is most
appropriate?
A. Use a family member as an interpreter
B. Use a trained medical interpreter
C. Speak loudly and slowly
D. Use gestures only
Answer: B
Rationale: A trained medical interpreter ensures accurate communication and confidentiality.
8. A nurse is documenting a client's refusal of medication. Which information is most
important to include?
,A. The client's reason for refusal
B. The client's vital signs
C. The nurse's opinion
D. The client's room number
Answer: A
Rationale: Documenting the client's reason for refusal is essential for legal and clinical
purposes.
9. A nurse is teaching a client about advance directives. Which statement indicates correct
understanding?
A. "Advance directives are only for older adults."
B. "I can change my advance directive at any time."
C. "Advance directives are legally binding in all states."
D. "Only my doctor can make decisions for me."
Answer: B
Rationale: Clients can change advance directives at any time as long as they have decision-
making capacity.
10. A nurse is assessing a client for suspected abuse. Which finding is most concerning?
A. Bruises in various stages of healing
B. A single bruise on the knee
C. Mild anxiety
D. Poor eye contact
Answer: A
Rationale: Bruises in various stages of healing may indicate ongoing physical abuse.
11. A nurse is caring for a client with a do-not-resuscitate (DNR) order. Which action is most
appropriate?
A. Initiate CPR if the client stops breathing
B. Respect the DNR order and provide comfort care
C. Ask the family to confirm the DNR order
D. Ignore the DNR order
Answer: B
Rationale: The nurse must respect the DNR order and provide comfort-focused care.
12. A nurse is teaching a client about health promotion. Which instruction is most
appropriate for a client with hypertension?
A. Reduce sodium intake
B. Increase alcohol consumption
C. Decrease physical activity
D. Increase saturated fat intake
, Answer: A
Rationale: Reducing sodium intake is a key lifestyle modification for managing hypertension.
13. A nurse is assessing a community for risk factors for heart disease. Which factor is most
significant?
A. High prevalence of smoking
B. Availability of parks
C. Access to healthcare
D. Education level
Answer: A
Rationale: Smoking is a major modifiable risk factor for heart disease.
14. A nurse is serving as a charge nurse. Which task is appropriate to delegate to a newly
licensed RN?
A. Administering blood products
B. Performing a complex wound dressing change
C. Admitting a stable client
D. Assessing a deteriorating client
Answer: C
Rationale: Admitting a stable client is appropriate for a newly licensed RN. Complex tasks and
deteriorating clients require more experience.
15. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client requesting pain medication
B. A client with a blood pressure of 86/52 mm Hg
C. A client scheduled for discharge
D. A client asking for a blanket
Answer: B
Rationale: Using the ABC framework, the client with hypotension is hemodynamically unstable
and requires immediate assessment.
16. A nurse is preparing to administer a high-alert medication. Which action is most critical to
ensure client safety?
A. Obtaining a second independent check from another qualified nurse
B. Administering the medication slowly over 5 minutes
C. Asking the client if they are allergic to aspirin
D. Checking the client's blood pressure before giving the dose
Answer: A
Rationale: High-alert medications require an independent double-check by another qualified
nurse to verify the Seven Rights before administration.
