NCLEX-RN® ACTUAL COMPREHENSIVE
PRACTICE EXAM 2026/2027 | Simulated CAT-Style
Questions with Verified Answers | Aligned to NCSBN
Test Plan | Pass Guarantee Target - A+ Graded
NCLEX-RN® Comprehensive Practice Exam (2026/2027)
Simulated CAT-Style Questions with Answers | Aligned to NCSBN Test Plan | Pass Guarantee
Target
Section 1: Safe and Effective Care Environment - Management of Care (25 questions)
Q1: A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L nasal cannula
B. A client with heart failure who reports a weight gain of 2 lbs in 24 hours
C. A client with a new tracheostomy who has thick, yellow secretions and respiratory rate of 28
[CORRECT]
D. A client with diabetes who has a blood glucose of 180 mg/dL before lunch
Correct Answer: C
Q2: The charge nurse is delegating tasks to the unlicensed assistive personnel (UAP). Which task
is appropriate to delegate?
A. Assessing a postoperative client's incision for signs of infection
B. Feeding a client with dysphagia who requires thickened liquids
C. Obtaining vital signs on a stable client admitted 2 days ago for pneumonia [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration
Correct Answer: C
Q3: A client with terminal cancer states, "I don't want any more chemotherapy. I just want to be
comfortable." The client's family insists on aggressive treatment. What is the nurse's priority
action?
A. Convince the family to respect the client's wishes immediately
B. Notify the healthcare provider and ensure the client's advance directive is reviewed
[CORRECT]
,C. Administer the scheduled chemotherapy as ordered
D. Tell the client to discuss this with the family privately
Correct Answer: B
Q4: [Select All That Apply] A nurse is reviewing the medical record of a client with a suspected
pulmonary embolism. Which findings support this diagnosis? Select all that apply.
A. Sudden onset of dyspnea [CORRECT]
B. Bradycardia
C. Pleuritic chest pain [CORRECT]
D. Hemoptysis [CORRECT]
E. Unilateral leg swelling [CORRECT]
Correct Answers: A, C, D, E
Q5: A client is scheduled for surgery and has signed the informed consent form. In the
preoperative holding area, the client states, "I've changed my mind. I don't want the surgery."
What is the nurse's best response?
A. "You've already signed the consent, so we need to proceed."
B. "Let me get your family to talk to you about this."
C. "You have the right to refuse surgery at any time. I will notify the surgeon." [CORRECT]
D. "Why have you changed your mind?"
Correct Answer: C
Q6: [Prioritization - Drag and Drop] Place the following nursing actions in the order of priority
when caring for a client who has just returned to the unit after abdominal surgery.
A. Assess respiratory status
B. Check vital signs
C. Verify IV line patency and rate
D. Assess the surgical dressing
Correct Order: A, B, C, D
Q7: A nurse receives a telephone prescription from a healthcare provider for a new medication.
What is the priority nursing action?
A. Document the prescription in the client's chart
,B. Read back the prescription to verify accuracy [CORRECT]
C. Administer the medication immediately
D. Ask another nurse to listen to the prescription
Correct Answer: B
Q8: [Select All That Apply] Which actions by the nurse demonstrate appropriate advocacy?
Select all that apply.
A. Supporting a client's decision to refuse treatment [CORRECT]
B. Ensuring a client receives adequate pain medication [CORRECT]
C. Reporting unsafe staffing conditions to administration [CORRECT]
D. Following the family's wishes when they conflict with the client's expressed desires
E. Protecting client confidentiality [CORRECT]
Correct Answers: A, B, C, E
Q9: A client with a history of falls is admitted to the hospital. Which intervention is the priority
for fall prevention?
A. Placing the call light within reach
B. Keeping the bed in the lowest position with wheels locked [CORRECT]
C. Administering sleep medication at bedtime
D. Encouraging family members to stay overnight
Correct Answer: B
Q10: A nurse is supervising a newly licensed nurse who is performing a sterile dressing change.
The nurse observes the new nurse touch the sterile field with a non-sterile glove. What is the
appropriate action?
A. Allow the procedure to continue and discuss it afterward
B. Stop the procedure immediately and have the nurse start over with new sterile supplies
[CORRECT]
C. Have the nurse change gloves and continue
D. Complete the dressing change herself
Correct Answer: B
, Q11: [Delegation] The nurse is caring for a group of clients. Which task should the nurse
delegate to the licensed practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client
B. Administering oral medications to stable clients [CORRECT]
C. Performing the initial assessment on a client with chest pain
D. Teaching a client about colostomy care
Correct Answer: B
Q12: A client is being discharged home with a prescription for warfarin. Which statement by the
client indicates a need for further teaching?
A. "I will have my blood checked regularly."
B. "I can eat as many green leafy vegetables as I want." [CORRECT]
C. "I will use an electric razor to shave."
D. "I will report any unusual bleeding immediately."
Correct Answer: B
Q13: [Select All That Apply] A nurse is participating in a quality improvement project to reduce
medication errors. Which strategies should the nurse recommend? Select all that apply.
A. Implementing barcode medication administration [CORRECT]
B. Using standard abbreviations for all medication orders
C. Performing medication reconciliation at transitions of care [CORRECT]
D. Encouraging double-checks for high-alert medications [CORRECT]
E. Storing look-alike/sound-alike medications separately [CORRECT]
Correct Answers: A, C, D, E
Q14: A nurse receives a report that a client has a do-not-resuscitate (DNR) order. The client stops
breathing. What is the nurse's appropriate action?
A. Begin CPR immediately
B. Call a code blue and start resuscitation
C. Ensure comfort measures and notify the healthcare provider [CORRECT]
D. Ask the family what they want to do
PRACTICE EXAM 2026/2027 | Simulated CAT-Style
Questions with Verified Answers | Aligned to NCSBN
Test Plan | Pass Guarantee Target - A+ Graded
NCLEX-RN® Comprehensive Practice Exam (2026/2027)
Simulated CAT-Style Questions with Answers | Aligned to NCSBN Test Plan | Pass Guarantee
Target
Section 1: Safe and Effective Care Environment - Management of Care (25 questions)
Q1: A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L nasal cannula
B. A client with heart failure who reports a weight gain of 2 lbs in 24 hours
C. A client with a new tracheostomy who has thick, yellow secretions and respiratory rate of 28
[CORRECT]
D. A client with diabetes who has a blood glucose of 180 mg/dL before lunch
Correct Answer: C
Q2: The charge nurse is delegating tasks to the unlicensed assistive personnel (UAP). Which task
is appropriate to delegate?
A. Assessing a postoperative client's incision for signs of infection
B. Feeding a client with dysphagia who requires thickened liquids
C. Obtaining vital signs on a stable client admitted 2 days ago for pneumonia [CORRECT]
D. Teaching a newly diagnosed diabetic client about insulin administration
Correct Answer: C
Q3: A client with terminal cancer states, "I don't want any more chemotherapy. I just want to be
comfortable." The client's family insists on aggressive treatment. What is the nurse's priority
action?
A. Convince the family to respect the client's wishes immediately
B. Notify the healthcare provider and ensure the client's advance directive is reviewed
[CORRECT]
,C. Administer the scheduled chemotherapy as ordered
D. Tell the client to discuss this with the family privately
Correct Answer: B
Q4: [Select All That Apply] A nurse is reviewing the medical record of a client with a suspected
pulmonary embolism. Which findings support this diagnosis? Select all that apply.
A. Sudden onset of dyspnea [CORRECT]
B. Bradycardia
C. Pleuritic chest pain [CORRECT]
D. Hemoptysis [CORRECT]
E. Unilateral leg swelling [CORRECT]
Correct Answers: A, C, D, E
Q5: A client is scheduled for surgery and has signed the informed consent form. In the
preoperative holding area, the client states, "I've changed my mind. I don't want the surgery."
What is the nurse's best response?
A. "You've already signed the consent, so we need to proceed."
B. "Let me get your family to talk to you about this."
C. "You have the right to refuse surgery at any time. I will notify the surgeon." [CORRECT]
D. "Why have you changed your mind?"
Correct Answer: C
Q6: [Prioritization - Drag and Drop] Place the following nursing actions in the order of priority
when caring for a client who has just returned to the unit after abdominal surgery.
A. Assess respiratory status
B. Check vital signs
C. Verify IV line patency and rate
D. Assess the surgical dressing
Correct Order: A, B, C, D
Q7: A nurse receives a telephone prescription from a healthcare provider for a new medication.
What is the priority nursing action?
A. Document the prescription in the client's chart
,B. Read back the prescription to verify accuracy [CORRECT]
C. Administer the medication immediately
D. Ask another nurse to listen to the prescription
Correct Answer: B
Q8: [Select All That Apply] Which actions by the nurse demonstrate appropriate advocacy?
Select all that apply.
A. Supporting a client's decision to refuse treatment [CORRECT]
B. Ensuring a client receives adequate pain medication [CORRECT]
C. Reporting unsafe staffing conditions to administration [CORRECT]
D. Following the family's wishes when they conflict with the client's expressed desires
E. Protecting client confidentiality [CORRECT]
Correct Answers: A, B, C, E
Q9: A client with a history of falls is admitted to the hospital. Which intervention is the priority
for fall prevention?
A. Placing the call light within reach
B. Keeping the bed in the lowest position with wheels locked [CORRECT]
C. Administering sleep medication at bedtime
D. Encouraging family members to stay overnight
Correct Answer: B
Q10: A nurse is supervising a newly licensed nurse who is performing a sterile dressing change.
The nurse observes the new nurse touch the sterile field with a non-sterile glove. What is the
appropriate action?
A. Allow the procedure to continue and discuss it afterward
B. Stop the procedure immediately and have the nurse start over with new sterile supplies
[CORRECT]
C. Have the nurse change gloves and continue
D. Complete the dressing change herself
Correct Answer: B
, Q11: [Delegation] The nurse is caring for a group of clients. Which task should the nurse
delegate to the licensed practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client
B. Administering oral medications to stable clients [CORRECT]
C. Performing the initial assessment on a client with chest pain
D. Teaching a client about colostomy care
Correct Answer: B
Q12: A client is being discharged home with a prescription for warfarin. Which statement by the
client indicates a need for further teaching?
A. "I will have my blood checked regularly."
B. "I can eat as many green leafy vegetables as I want." [CORRECT]
C. "I will use an electric razor to shave."
D. "I will report any unusual bleeding immediately."
Correct Answer: B
Q13: [Select All That Apply] A nurse is participating in a quality improvement project to reduce
medication errors. Which strategies should the nurse recommend? Select all that apply.
A. Implementing barcode medication administration [CORRECT]
B. Using standard abbreviations for all medication orders
C. Performing medication reconciliation at transitions of care [CORRECT]
D. Encouraging double-checks for high-alert medications [CORRECT]
E. Storing look-alike/sound-alike medications separately [CORRECT]
Correct Answers: A, C, D, E
Q14: A nurse receives a report that a client has a do-not-resuscitate (DNR) order. The client stops
breathing. What is the nurse's appropriate action?
A. Begin CPR immediately
B. Call a code blue and start resuscitation
C. Ensure comfort measures and notify the healthcare provider [CORRECT]
D. Ask the family what they want to do
