1
2025/2026 NCLEX-RN (Next
Generation Format) – Real Questions
& Answers with Detailed Rationales |
Verified Test Bank | 100% Correct |
A+ Grade
Section 1: Safe and Effective Care Environment (40
Questions, 10 NGN, 35 Scored, 5 Unscored)
Question 1 (Management of Care)
A nurse is delegating tasks for a client with heart failure. Which task can be delegated to a
licensed practical nurse (LPN)?
A) Developing the care plan
B) Administering oral medications
C) Evaluating client outcomes
D) Teaching disease management
Rationale: Per 2025 NCSBN guidelines, LPNs can administer oral medications within their
scope of practice. Developing care plans, evaluating outcomes, and teaching are reserved for
RNs.
Question 2 (Safety and Infection Control)
A client with MRSA is placed on contact precautions. What is the priority action?
A) Wear a surgical mask during care
B) Perform hand hygiene before and after contact
C) Place the client in a shared room
D) Use sterile gloves for all care
Rationale: Hand hygiene is the most effective measure to prevent MRSA transmission. Masks
are not required for contact precautions, shared rooms are inappropriate, and sterile gloves are
unnecessary.
Question 3 (NGN: Case Study, Management of Care)
, 2
Case Study: A nurse is coordinating care for a 68-year-old client admitted with pneumonia. The
client has a history of COPD and is receiving oxygen at 2 L/min via nasal cannula. Which action
demonstrates effective delegation?
A) Assigning the LPN to assess oxygen saturation trends
B) Assigning the CNA to report changes in respiratory status
C) Instructing the RN to perform routine vital signs
D) Delegating client education to the UAP
Rationale: CNAs can report changes in client condition, such as respiratory distress, to the RN.
LPNs cannot assess trends, RNs typically perform higher-level tasks, and UAPs do not provide
education.
Question 4 (Safety and Infection Control)
What is the most appropriate action to prevent needlestick injuries?
A) Recap needles after use
B) Use a sharps container for disposal
C) Store used needles in a sterile tray
D) Dispose of needles in regular trash
Rationale: Using a sharps container prevents needlestick injuries, per OSHA and NCSBN safety
guidelines. Recapping, storing in trays, or using regular trash increases risk.
Question 5 (Management of Care)
A nurse is prioritizing care for multiple clients. Which client should be seen first?
A) A client requesting pain medication
B) A client with a new onset of chest pain
C) A client awaiting discharge instructions
D) A client needing a dressing change
Rationale: Chest pain may indicate a life-threatening condition (e.g., myocardial infarction),
requiring immediate assessment. Other tasks are lower priority.
Question 6 (NGN: Multiple-Select, Safety and Infection Control)
Case Study: A client is admitted with suspected tuberculosis. Select all appropriate infection
control measures.
A) Place in a negative-pressure room
B) Wear an N95 respirator
C) Use standard precautions only
D) Instruct the client to cover their mouth when coughing
E) Allow visitors without restrictions
Correct Answers: A, B, D
Rationale: Tuberculosis requires airborne precautions, including a negative-pressure room, N95
, 3
respirator, and client education on cough etiquette. Standard precautions are insufficient, and
visitor restrictions are necessary.
Question 7 (Management of Care, Unscored)
A nurse is reviewing client assignments. Which assignment violates scope of practice?
A) CNA taking vital signs
B) LPN administering IV push medications
C) UAP performing a sterile dressing change
D) RN developing a care plan
Rationale: UAPs cannot perform sterile procedures like dressing changes, as this exceeds their
scope. Other assignments align with appropriate roles.
Question 8 (Safety and Infection Control)
What is the priority action when a client with C позвонить difficile is admitted?
A) Initiate droplet precautions
B) Use contact precautions and handwashing with soap
C) Wear an N95 respirator
D) Place in a shared room
Rationale: C. difficile requires contact precautions and handwashing with soap and water, as
alcohol-based sanitizers are ineffective against spores.
Question 9 (Management of Care)
A nurse is resolving a conflict between two staff members. What is the best approach?
A) Ignore the conflict
B) Facilitate open communication
C) Reassign both staff members
D) Discipline both parties
Rationale: Open communication promotes collaboration and resolves conflicts effectively, per
NCSBN guidelines on leadership.
Question 10 (NGN: Ordered Response, Safety and Infection Control)
Case Study: A client develops a surgical site infection. Place the following steps in the correct
order for management.
A) Notify the healthcare provider
B) Obtain a wound culture
C) Administer prescribed antibiotics
D) Assess the wound
, 4
Correct Order: D, B, C, A
Rationale: Assess the wound first, obtain a culture to identify the organism, administer
antibiotics as prescribed, and notify the provider for further orders.
Question 11 (Management of Care)
Which action demonstrates advocacy for a client?
A) Administering medications as ordered
B) Ensuring informed consent is obtained
C) Documenting vital signs
D) Scheduling follow-up appointments
Rationale: Ensuring informed consent protects client autonomy and rights, a key aspect of
advocacy.
Question 12 (Safety and Infection Control)
A nurse spills a cytotoxic drug. What is the priority action?
A) Wipe with a dry cloth
B) Use a spill kit and report the incident
C) Leave the spill unattended
D) Mop with water
Rationale: A spill kit ensures safe cleanup of cytotoxic drugs, and reporting follows safety
protocols. Other actions risk exposure.
Question 13 (Management of Care)
A nurse is assigning a float nurse to a unit. Which client is most appropriate for the float nurse?
A) A client requiring a complex dressing change
B) A stable client needing routine vital signs
C) A client with new-onset seizures
D) A client on mechanical ventilation
Rationale: A stable client requiring routine tasks is appropriate for a float nurse, minimizing risk
due to unfamiliarity with complex care.
Question 14 (NGN: Hot Spot, Safety and Infection Control)
Case Study: A nurse is preparing to enter a client’s room on contact precautions. Identify the
correct sequence of PPE donning on the provided diagram.
Correct Answer: Gown, mask, gloves (indicated on the diagram)
Rationale: Per NCSBN guidelines, don PPE in this order: gown, mask, then gloves to ensure
proper protection.
Question 15 (Management of Care)
2025/2026 NCLEX-RN (Next
Generation Format) – Real Questions
& Answers with Detailed Rationales |
Verified Test Bank | 100% Correct |
A+ Grade
Section 1: Safe and Effective Care Environment (40
Questions, 10 NGN, 35 Scored, 5 Unscored)
Question 1 (Management of Care)
A nurse is delegating tasks for a client with heart failure. Which task can be delegated to a
licensed practical nurse (LPN)?
A) Developing the care plan
B) Administering oral medications
C) Evaluating client outcomes
D) Teaching disease management
Rationale: Per 2025 NCSBN guidelines, LPNs can administer oral medications within their
scope of practice. Developing care plans, evaluating outcomes, and teaching are reserved for
RNs.
Question 2 (Safety and Infection Control)
A client with MRSA is placed on contact precautions. What is the priority action?
A) Wear a surgical mask during care
B) Perform hand hygiene before and after contact
C) Place the client in a shared room
D) Use sterile gloves for all care
Rationale: Hand hygiene is the most effective measure to prevent MRSA transmission. Masks
are not required for contact precautions, shared rooms are inappropriate, and sterile gloves are
unnecessary.
Question 3 (NGN: Case Study, Management of Care)
, 2
Case Study: A nurse is coordinating care for a 68-year-old client admitted with pneumonia. The
client has a history of COPD and is receiving oxygen at 2 L/min via nasal cannula. Which action
demonstrates effective delegation?
A) Assigning the LPN to assess oxygen saturation trends
B) Assigning the CNA to report changes in respiratory status
C) Instructing the RN to perform routine vital signs
D) Delegating client education to the UAP
Rationale: CNAs can report changes in client condition, such as respiratory distress, to the RN.
LPNs cannot assess trends, RNs typically perform higher-level tasks, and UAPs do not provide
education.
Question 4 (Safety and Infection Control)
What is the most appropriate action to prevent needlestick injuries?
A) Recap needles after use
B) Use a sharps container for disposal
C) Store used needles in a sterile tray
D) Dispose of needles in regular trash
Rationale: Using a sharps container prevents needlestick injuries, per OSHA and NCSBN safety
guidelines. Recapping, storing in trays, or using regular trash increases risk.
Question 5 (Management of Care)
A nurse is prioritizing care for multiple clients. Which client should be seen first?
A) A client requesting pain medication
B) A client with a new onset of chest pain
C) A client awaiting discharge instructions
D) A client needing a dressing change
Rationale: Chest pain may indicate a life-threatening condition (e.g., myocardial infarction),
requiring immediate assessment. Other tasks are lower priority.
Question 6 (NGN: Multiple-Select, Safety and Infection Control)
Case Study: A client is admitted with suspected tuberculosis. Select all appropriate infection
control measures.
A) Place in a negative-pressure room
B) Wear an N95 respirator
C) Use standard precautions only
D) Instruct the client to cover their mouth when coughing
E) Allow visitors without restrictions
Correct Answers: A, B, D
Rationale: Tuberculosis requires airborne precautions, including a negative-pressure room, N95
, 3
respirator, and client education on cough etiquette. Standard precautions are insufficient, and
visitor restrictions are necessary.
Question 7 (Management of Care, Unscored)
A nurse is reviewing client assignments. Which assignment violates scope of practice?
A) CNA taking vital signs
B) LPN administering IV push medications
C) UAP performing a sterile dressing change
D) RN developing a care plan
Rationale: UAPs cannot perform sterile procedures like dressing changes, as this exceeds their
scope. Other assignments align with appropriate roles.
Question 8 (Safety and Infection Control)
What is the priority action when a client with C позвонить difficile is admitted?
A) Initiate droplet precautions
B) Use contact precautions and handwashing with soap
C) Wear an N95 respirator
D) Place in a shared room
Rationale: C. difficile requires contact precautions and handwashing with soap and water, as
alcohol-based sanitizers are ineffective against spores.
Question 9 (Management of Care)
A nurse is resolving a conflict between two staff members. What is the best approach?
A) Ignore the conflict
B) Facilitate open communication
C) Reassign both staff members
D) Discipline both parties
Rationale: Open communication promotes collaboration and resolves conflicts effectively, per
NCSBN guidelines on leadership.
Question 10 (NGN: Ordered Response, Safety and Infection Control)
Case Study: A client develops a surgical site infection. Place the following steps in the correct
order for management.
A) Notify the healthcare provider
B) Obtain a wound culture
C) Administer prescribed antibiotics
D) Assess the wound
, 4
Correct Order: D, B, C, A
Rationale: Assess the wound first, obtain a culture to identify the organism, administer
antibiotics as prescribed, and notify the provider for further orders.
Question 11 (Management of Care)
Which action demonstrates advocacy for a client?
A) Administering medications as ordered
B) Ensuring informed consent is obtained
C) Documenting vital signs
D) Scheduling follow-up appointments
Rationale: Ensuring informed consent protects client autonomy and rights, a key aspect of
advocacy.
Question 12 (Safety and Infection Control)
A nurse spills a cytotoxic drug. What is the priority action?
A) Wipe with a dry cloth
B) Use a spill kit and report the incident
C) Leave the spill unattended
D) Mop with water
Rationale: A spill kit ensures safe cleanup of cytotoxic drugs, and reporting follows safety
protocols. Other actions risk exposure.
Question 13 (Management of Care)
A nurse is assigning a float nurse to a unit. Which client is most appropriate for the float nurse?
A) A client requiring a complex dressing change
B) A stable client needing routine vital signs
C) A client with new-onset seizures
D) A client on mechanical ventilation
Rationale: A stable client requiring routine tasks is appropriate for a float nurse, minimizing risk
due to unfamiliarity with complex care.
Question 14 (NGN: Hot Spot, Safety and Infection Control)
Case Study: A nurse is preparing to enter a client’s room on contact precautions. Identify the
correct sequence of PPE donning on the provided diagram.
Correct Answer: Gown, mask, gloves (indicated on the diagram)
Rationale: Per NCSBN guidelines, don PPE in this order: gown, mask, then gloves to ensure
proper protection.
Question 15 (Management of Care)
