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NCLEX PRACTICE CAT AND FINAL EXAM QUESTIONS
ANSWERSA ND RATIONALES ACTUAL TO REAL 2026
SITTING EXAM VERSION
Question 1 (Priority – ABCs)
A nurse receives report on four clients. Who should be assessed
first?
A. Client with BP 130/80, mild headache
B. Client with asthma and SpO₂ 85%
C. Post-op client with pain 6/10
D. Client requesting discharge teaching
Correct Answer: B
Rationale: Low oxygen saturation indicates airway/breathing
compromise – highest priority.
Question 2 (Delegation)
Which task can the nurse safely delegate to a UAP?
A. Feeding a stable post-op client
B. Inserting a Foley catheter
C. Administering oral medications
D. Assessing lung sounds
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Correct Answer: A
Rationale: UAPs can assist with basic care of stable clients.
Question 3 (Safety)
Which client is at greatest risk for falls?
A. 25-year-old with migraine
B. 45-year-old post-appendectomy
C. 80-year-old on sedative medication
D. 60-year-old with controlled hypertension
Correct Answer: C
Rationale: Age + sedatives increase fall risk.
Question 4 (Pharmacology)
Which finding requires immediate intervention after IV
morphine?
A. Pain reduced from 8 to 4
B. Respiratory rate 6/min
C. Mild drowsiness
D. Slight nausea
Correct Answer: B
Rationale: Respiratory depression is life-threatening.
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Question 5 (Infection Control)
Which action best prevents ventilator-associated pneumonia?
A. Hand hygiene
B. Oral care q24h
C. Leaving patient supine
D. Closed suctioning only
Correct Answer: A
Rationale: Hand hygiene is the most effective infection
prevention method.
Question 6 (Priority – Acute vs Chronic)
Which client should be seen first?
A. Chronic arthritis with mild pain
B. New onset chest pain
C. Stable diabetes
D. Routine post-op check
Correct Answer: B
Rationale: Acute chest pain can indicate life-threatening
cardiac event.
Question 7 (Legal/Ethical)
Which action requires filing an incident report?
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A. Client refuses medication
B. Client falls without injury
C. Administering routine meds
D. Changing linens
Correct Answer: B
Rationale: Any accident affecting safety must be documented.
Question 8 (Psychosocial)
Which nurse statement is therapeutic?
A. “Don’t feel that way.”
B. “Everything will be fine.”
C. “Tell me more about your feelings.”
D. “Other people have it worse.”
Correct Answer: C
Rationale: Encourages client to express feelings.
Question 9 (Physiological Adaptation)
Which lab finding requires immediate action?
A. Sodium 140 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 9 mg/dL
D. Glucose 130 mg/dL
NCLEX PRACTICE CAT AND FINAL EXAM QUESTIONS
ANSWERSA ND RATIONALES ACTUAL TO REAL 2026
SITTING EXAM VERSION
Question 1 (Priority – ABCs)
A nurse receives report on four clients. Who should be assessed
first?
A. Client with BP 130/80, mild headache
B. Client with asthma and SpO₂ 85%
C. Post-op client with pain 6/10
D. Client requesting discharge teaching
Correct Answer: B
Rationale: Low oxygen saturation indicates airway/breathing
compromise – highest priority.
Question 2 (Delegation)
Which task can the nurse safely delegate to a UAP?
A. Feeding a stable post-op client
B. Inserting a Foley catheter
C. Administering oral medications
D. Assessing lung sounds
,2
Correct Answer: A
Rationale: UAPs can assist with basic care of stable clients.
Question 3 (Safety)
Which client is at greatest risk for falls?
A. 25-year-old with migraine
B. 45-year-old post-appendectomy
C. 80-year-old on sedative medication
D. 60-year-old with controlled hypertension
Correct Answer: C
Rationale: Age + sedatives increase fall risk.
Question 4 (Pharmacology)
Which finding requires immediate intervention after IV
morphine?
A. Pain reduced from 8 to 4
B. Respiratory rate 6/min
C. Mild drowsiness
D. Slight nausea
Correct Answer: B
Rationale: Respiratory depression is life-threatening.
,3
Question 5 (Infection Control)
Which action best prevents ventilator-associated pneumonia?
A. Hand hygiene
B. Oral care q24h
C. Leaving patient supine
D. Closed suctioning only
Correct Answer: A
Rationale: Hand hygiene is the most effective infection
prevention method.
Question 6 (Priority – Acute vs Chronic)
Which client should be seen first?
A. Chronic arthritis with mild pain
B. New onset chest pain
C. Stable diabetes
D. Routine post-op check
Correct Answer: B
Rationale: Acute chest pain can indicate life-threatening
cardiac event.
Question 7 (Legal/Ethical)
Which action requires filing an incident report?
, 4
A. Client refuses medication
B. Client falls without injury
C. Administering routine meds
D. Changing linens
Correct Answer: B
Rationale: Any accident affecting safety must be documented.
Question 8 (Psychosocial)
Which nurse statement is therapeutic?
A. “Don’t feel that way.”
B. “Everything will be fine.”
C. “Tell me more about your feelings.”
D. “Other people have it worse.”
Correct Answer: C
Rationale: Encourages client to express feelings.
Question 9 (Physiological Adaptation)
Which lab finding requires immediate action?
A. Sodium 140 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 9 mg/dL
D. Glucose 130 mg/dL
