NUR 139 – NCLEX PREPARATION] QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Safe and Effective Care Environment
- Health Promotion and Maintenance
- Psychosocial Integrity
- Physiological Integrity
- Pharmacological and Parenteral Therapies
- Reduction of Risk Potential
- Legal and Ethical Nursing Practice
- Clinical Judgment and Prioritization
- Infection Control and Safety
- Leadership and Delegation
Introduction
This comprehensive assessment is designed to evaluate the candidate’s readiness for the NCLEX examination
through rigorous testing of foundational nursing theory, applied clinical judgment, and adherence to professional
standards. Each multiple-choice question and scenario-based item emphasizes real-world decision-making, patient
safety, legal compliance, and ethical practice. The exam integrates core domains such as pharmacological
therapies, risk reduction, psychosocial support, and infection control. By simulating NCLEX-style questions with
verified answers and rationales, this assessment strengthens critical thinking and reinforces evidence-based
nursing actions. Successful completion reflects mastery of entry-level nursing competencies required for safe,
effective licensure.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a client with heart failure who reports sudden shortness of breath and pink, frothy sputum.
Which action should the nurse take first?
A. Administer furosemide as prescribed
B. Place the client in high-Fowler’s position
C. Auscultate breath sounds
D. Apply a non-rebreather mask at 15 L/min
🟢B
🔴 RATIONALE: High-Fowler’s position reduces venous return and decreases pulmonary congestion, improving
ventilation. This is the priority before administering oxygen or medications.
Question 2
A nurse reviews a client’s laboratory results and notes a serum potassium of 5.8 mEq/L. Which medication
should the nurse question before administration?
A. Furosemide
B. Spironolactone
C. Lisinopril
D. Metoprolol
🟢B
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic and can worsen hyperkalemia. The nurse should
question this order to prevent cardiac arrhythmias.
,Question 3
A charge nurse is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate to delegate?
A. Initial admission assessment of a client with pneumonia
B. Administration of a blood transfusion
C. Monitoring a client’s nasogastric tube for output
D. Creating a plan of care for a postoperative client
🟢C
🔴 RATIONALE: Monitoring NG tube output is within LPN scope of practice. Initial assessments, blood
transfusions, and care planning are responsibilities of the RN.
Question 4
A client with major depressive disorder states, “Life isn’t worth living anymore.” What is the nurse’s priority
response?
A. “Why do you feel that way?”
B. “Have you thought about how you would harm yourself?”
C. “You have so much to live for.”
D. “It’s normal to feel sad sometimes.”
🟢B
🔴 RATIONALE: Directly assessing suicidal ideation, including plan and means, is the priority safety intervention
for a client expressing hopelessness.
Question 5
Which finding in a postpartum client 6 hours after vaginal delivery requires immediate intervention?
, A. Fundus firm at the umbilicus
B. Saturation of two perineal pads per hour
C. Moderate lochia rubra
D. Blood pressure 110/70 mm Hg
🟢B
🔴 RATIONALE: Saturation of more than one pad per hour indicates excessive bleeding and possible
postpartum hemorrhage, requiring immediate assessment and intervention.
Question 6
A nurse is preparing to administer digoxin to a client with atrial fibrillation. Which assessment finding requires
withholding the medication?
A. Heart rate 58 beats per minute
B. Blood pressure 130/85 mm Hg
C. Respiratory rate 16 breaths per minute
D. Serum potassium 4.0 mEq/L
🟢A
🔴 RATIONALE: Digoxin is withheld if the apical pulse is below 60 bpm in an adult due to risk of bradycardia
and digoxin toxicity.
Question 7
A client on a mechanical ventilator has an endotracheal tube. Which action best reduces the risk of ventilator-
associated pneumonia?
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Safe and Effective Care Environment
- Health Promotion and Maintenance
- Psychosocial Integrity
- Physiological Integrity
- Pharmacological and Parenteral Therapies
- Reduction of Risk Potential
- Legal and Ethical Nursing Practice
- Clinical Judgment and Prioritization
- Infection Control and Safety
- Leadership and Delegation
Introduction
This comprehensive assessment is designed to evaluate the candidate’s readiness for the NCLEX examination
through rigorous testing of foundational nursing theory, applied clinical judgment, and adherence to professional
standards. Each multiple-choice question and scenario-based item emphasizes real-world decision-making, patient
safety, legal compliance, and ethical practice. The exam integrates core domains such as pharmacological
therapies, risk reduction, psychosocial support, and infection control. By simulating NCLEX-style questions with
verified answers and rationales, this assessment strengthens critical thinking and reinforces evidence-based
nursing actions. Successful completion reflects mastery of entry-level nursing competencies required for safe,
effective licensure.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a client with heart failure who reports sudden shortness of breath and pink, frothy sputum.
Which action should the nurse take first?
A. Administer furosemide as prescribed
B. Place the client in high-Fowler’s position
C. Auscultate breath sounds
D. Apply a non-rebreather mask at 15 L/min
🟢B
🔴 RATIONALE: High-Fowler’s position reduces venous return and decreases pulmonary congestion, improving
ventilation. This is the priority before administering oxygen or medications.
Question 2
A nurse reviews a client’s laboratory results and notes a serum potassium of 5.8 mEq/L. Which medication
should the nurse question before administration?
A. Furosemide
B. Spironolactone
C. Lisinopril
D. Metoprolol
🟢B
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic and can worsen hyperkalemia. The nurse should
question this order to prevent cardiac arrhythmias.
,Question 3
A charge nurse is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate to delegate?
A. Initial admission assessment of a client with pneumonia
B. Administration of a blood transfusion
C. Monitoring a client’s nasogastric tube for output
D. Creating a plan of care for a postoperative client
🟢C
🔴 RATIONALE: Monitoring NG tube output is within LPN scope of practice. Initial assessments, blood
transfusions, and care planning are responsibilities of the RN.
Question 4
A client with major depressive disorder states, “Life isn’t worth living anymore.” What is the nurse’s priority
response?
A. “Why do you feel that way?”
B. “Have you thought about how you would harm yourself?”
C. “You have so much to live for.”
D. “It’s normal to feel sad sometimes.”
🟢B
🔴 RATIONALE: Directly assessing suicidal ideation, including plan and means, is the priority safety intervention
for a client expressing hopelessness.
Question 5
Which finding in a postpartum client 6 hours after vaginal delivery requires immediate intervention?
, A. Fundus firm at the umbilicus
B. Saturation of two perineal pads per hour
C. Moderate lochia rubra
D. Blood pressure 110/70 mm Hg
🟢B
🔴 RATIONALE: Saturation of more than one pad per hour indicates excessive bleeding and possible
postpartum hemorrhage, requiring immediate assessment and intervention.
Question 6
A nurse is preparing to administer digoxin to a client with atrial fibrillation. Which assessment finding requires
withholding the medication?
A. Heart rate 58 beats per minute
B. Blood pressure 130/85 mm Hg
C. Respiratory rate 16 breaths per minute
D. Serum potassium 4.0 mEq/L
🟢A
🔴 RATIONALE: Digoxin is withheld if the apical pulse is below 60 bpm in an adult due to risk of bradycardia
and digoxin toxicity.
Question 7
A client on a mechanical ventilator has an endotracheal tube. Which action best reduces the risk of ventilator-
associated pneumonia?
