1
NCLEX-RN Ultimate Test Bank 2025–2026 | 100+
Detailed Practice Questions & Rationales | Based on
Saunders 10th Edition
Question 1 – Prioritization / Endocrine
A 24-year-old female client newly diagnosed with Type 1 Diabetes Mellitus is admitted to the medical
unit for glucose stabilization and patient education. During morning rounds, the client reports
dizziness, sweating, and palpitations. Her capillary blood glucose reads 60 mg/dL. The nurse notes the
client is alert but visibly anxious. Which action should the nurse take first?
A. Notify the primary healthcare provider immediately
B. Recheck the blood glucose in 30 minutes
C. Administer 15g of fast-acting carbohydrates
D. Prepare for administration of IV dextrose
✅ Correct Answer: C. Administer 15g of fast-acting carbohydrates
Rationale:
This client is showing classic signs of hypoglycemia (dizziness, sweating, palpitations, anxiety).
According to the "15-15 Rule," the nurse should administer 15g of fast-acting carbs (e.g., orange juice
,2
or glucose tablets) and recheck in 15 minutes. The client is alert and oriented, so oral glucose is
appropriate. IV dextrose is reserved for unconscious patients. Notifying the provider or waiting is
delaying life-saving care.
📚 Reference: Saunders 10th Ed., Ch. 56: Diabetes Management
❓ Question 2 – Infection Control / Delegation
A nurse is caring for four hospitalized clients. The nurse is assigning tasks to an unlicensed assistive
personnel (UAP). Which task is most appropriate for the nurse to delegate to the UAP?
A. Changing the dressing on a stage II pressure ulcer
B. Feeding a client with advanced Parkinson’s disease and dysphagia
C. Collecting a clean-catch urine specimen from a confused elderly client
D. Assisting a stable postoperative client to ambulate for the first time
✅ Correct Answer: D. Assisting a stable postoperative client to ambulate for the first time
Rationale:
The UAP can assist with routine, stable, non-complex care. Assisting a stable client with ambulation
is within the UAP’s scope. Dressing changes and feeding high-risk clients (e.g., dysphagia) require
nursing judgment. Collecting urine from a confused client may result in an inaccurate specimen and
also requires supervision.
📚 Reference: Saunders 10th Ed., Ch. 6: Delegation & Prioritization
,3
❓ Question 3 – Pharmacology / Cardiac
An older adult client with a history of atrial fibrillation is prescribed warfarin. The nurse is reviewing
the client’s medication list during discharge. Which of the following statements made by the client
indicates the need for further teaching?
A. “I will eat more leafy green vegetables to improve my health.”
B. “I will notify my dentist that I take warfarin before my appointment.”
C. “I’ll use an electric razor instead of a blade.”
D. “I will keep all my INR appointments as scheduled.”
✅ Correct Answer: A. “I will eat more leafy green vegetables to improve my health.”
Rationale:
Leafy green vegetables (e.g., spinach, kale) are high in vitamin K, which can interfere with warfarin's
anticoagulant effect. Sudden changes in intake may reduce effectiveness or increase clotting risk. The
other statements demonstrate appropriate understanding of bleeding precautions and INR monitoring.
📚 Reference: Saunders 10th Ed., Ch. 45: Cardiovascular Medications
❓ Question 4 – Safety / Mental Health
A 32-year-old female client with major depressive disorder is admitted for suicidal ideation after a
recent breakup. She reports hopelessness and passive thoughts of self-harm but denies a plan. The
provider orders 15-minute safety checks. During the night shift, the nurse finds the client crying and
curled in bed. What is the priority action?
, 4
A. Notify the provider for a STAT psychiatric consult
B. Ask the client directly if she has thoughts of suicide
C. Provide tissues and therapeutic silence
D. Document behavior and reassess in 15 minutes
✅ Correct Answer: B. Ask the client directly if she has thoughts of suicide
Rationale:
The priority action is direct assessment of suicide risk. Nurses are ethically and legally required to
ask about suicidal thoughts using clear, direct language. Therapeutic silence and observation alone are
not enough. Waiting or delaying intervention risks patient safety.
📚 Reference: Saunders 10th Ed., Ch. 10: Mental Health Nursing
❓ Question 5 – Adult Health / Respiratory
A 68-year-old male with COPD is receiving oxygen therapy via nasal cannula at 4 L/min. The nurse
notes that the client is increasingly somnolent and has a respiratory rate of 8 breaths per minute. What
should the nurse do first?
A. Increase oxygen flow to 6 L/min
B. Assess for signs of oxygen toxicity
C. Lower the oxygen to 2 L/min and notify the provider
D. Prepare for possible intubation and ventilatory support
✅ Correct Answer: C. Lower the oxygen to 2 L/min and notify the provider
NCLEX-RN Ultimate Test Bank 2025–2026 | 100+
Detailed Practice Questions & Rationales | Based on
Saunders 10th Edition
Question 1 – Prioritization / Endocrine
A 24-year-old female client newly diagnosed with Type 1 Diabetes Mellitus is admitted to the medical
unit for glucose stabilization and patient education. During morning rounds, the client reports
dizziness, sweating, and palpitations. Her capillary blood glucose reads 60 mg/dL. The nurse notes the
client is alert but visibly anxious. Which action should the nurse take first?
A. Notify the primary healthcare provider immediately
B. Recheck the blood glucose in 30 minutes
C. Administer 15g of fast-acting carbohydrates
D. Prepare for administration of IV dextrose
✅ Correct Answer: C. Administer 15g of fast-acting carbohydrates
Rationale:
This client is showing classic signs of hypoglycemia (dizziness, sweating, palpitations, anxiety).
According to the "15-15 Rule," the nurse should administer 15g of fast-acting carbs (e.g., orange juice
,2
or glucose tablets) and recheck in 15 minutes. The client is alert and oriented, so oral glucose is
appropriate. IV dextrose is reserved for unconscious patients. Notifying the provider or waiting is
delaying life-saving care.
📚 Reference: Saunders 10th Ed., Ch. 56: Diabetes Management
❓ Question 2 – Infection Control / Delegation
A nurse is caring for four hospitalized clients. The nurse is assigning tasks to an unlicensed assistive
personnel (UAP). Which task is most appropriate for the nurse to delegate to the UAP?
A. Changing the dressing on a stage II pressure ulcer
B. Feeding a client with advanced Parkinson’s disease and dysphagia
C. Collecting a clean-catch urine specimen from a confused elderly client
D. Assisting a stable postoperative client to ambulate for the first time
✅ Correct Answer: D. Assisting a stable postoperative client to ambulate for the first time
Rationale:
The UAP can assist with routine, stable, non-complex care. Assisting a stable client with ambulation
is within the UAP’s scope. Dressing changes and feeding high-risk clients (e.g., dysphagia) require
nursing judgment. Collecting urine from a confused client may result in an inaccurate specimen and
also requires supervision.
📚 Reference: Saunders 10th Ed., Ch. 6: Delegation & Prioritization
,3
❓ Question 3 – Pharmacology / Cardiac
An older adult client with a history of atrial fibrillation is prescribed warfarin. The nurse is reviewing
the client’s medication list during discharge. Which of the following statements made by the client
indicates the need for further teaching?
A. “I will eat more leafy green vegetables to improve my health.”
B. “I will notify my dentist that I take warfarin before my appointment.”
C. “I’ll use an electric razor instead of a blade.”
D. “I will keep all my INR appointments as scheduled.”
✅ Correct Answer: A. “I will eat more leafy green vegetables to improve my health.”
Rationale:
Leafy green vegetables (e.g., spinach, kale) are high in vitamin K, which can interfere with warfarin's
anticoagulant effect. Sudden changes in intake may reduce effectiveness or increase clotting risk. The
other statements demonstrate appropriate understanding of bleeding precautions and INR monitoring.
📚 Reference: Saunders 10th Ed., Ch. 45: Cardiovascular Medications
❓ Question 4 – Safety / Mental Health
A 32-year-old female client with major depressive disorder is admitted for suicidal ideation after a
recent breakup. She reports hopelessness and passive thoughts of self-harm but denies a plan. The
provider orders 15-minute safety checks. During the night shift, the nurse finds the client crying and
curled in bed. What is the priority action?
, 4
A. Notify the provider for a STAT psychiatric consult
B. Ask the client directly if she has thoughts of suicide
C. Provide tissues and therapeutic silence
D. Document behavior and reassess in 15 minutes
✅ Correct Answer: B. Ask the client directly if she has thoughts of suicide
Rationale:
The priority action is direct assessment of suicide risk. Nurses are ethically and legally required to
ask about suicidal thoughts using clear, direct language. Therapeutic silence and observation alone are
not enough. Waiting or delaying intervention risks patient safety.
📚 Reference: Saunders 10th Ed., Ch. 10: Mental Health Nursing
❓ Question 5 – Adult Health / Respiratory
A 68-year-old male with COPD is receiving oxygen therapy via nasal cannula at 4 L/min. The nurse
notes that the client is increasingly somnolent and has a respiratory rate of 8 breaths per minute. What
should the nurse do first?
A. Increase oxygen flow to 6 L/min
B. Assess for signs of oxygen toxicity
C. Lower the oxygen to 2 L/min and notify the provider
D. Prepare for possible intubation and ventilatory support
✅ Correct Answer: C. Lower the oxygen to 2 L/min and notify the provider
