COMPREHENSIVE NURSING EXAM REVIEW
| 2025/2026 |
75 Questions and Correct Answers
with Rationales
NCLEX-RN Readiness & Institutional Final Assessment
, Table of Contents
Section I: Safe and Effective Care Environment — Questions 1–16 (16 Questions,
~21%)
Section II: Health Promotion and Maintenance — Questions 17–25 (9 Questions,
~12%)
Section III: Psychosocial Integrity — Questions 26–34 (9 Questions, ~12%)
Section IV: Physiological Integrity — Questions 35–65 (31 Questions, ~41%)
Section V: Clinical Judgment & NGN Integration — Questions 66–75 (10 Questions,
~13%)
Quick Reference Table — Key Values, Mnemonics, and Frameworks
, Section I: Safe and Effective Care Environment
Questions 1–16 (16 Questions, ~21%)
This section covers delegation (Five Rights of Delegation), prioritization (ABCs, Maslow), legal/ethical
considerations (Nurse Practice Act, informed consent, HIPAA), infection control (standard and
transmission-based precautions, hand hygiene, PPE), and safety (fall prevention, restraint alternatives,
fire safety, emergency codes).
Q1. A charge nurse is making client assignments for the shift. Which task is MOST appropriate to
delegate to an unlicensed assistive personnel (UAP)?
A. Performing the initial admission assessment of a new client
B. Recording intake and output for a stable postoperative client
C. Evaluating the effectiveness of a new pain management plan
D. Teaching a diabetic client about insulin self-administration
Rationale: Recording intake and output is a routine, repetitive task within the UAP scope of practice for stable
clients. The RN cannot delegate assessment, teaching, or evaluation because these require professional nursing
judgment. The Five Rights of Delegation include right task, right circumstance, right person, right direction, and
right supervision.
Q2. The nurse receives a client assignment that includes four patients. Which client should the nurse
assess FIRST?
A. A client admitted yesterday with abdominal pain awaiting test results
B. A client scheduled for discharge today who needs wound care teaching
C. A client with chronic hypertension requesting a diet menu change
D. A client who had a chest tube removed 2 hours ago and reports sudden dyspnea
Rationale: Sudden dyspnea after chest tube removal may indicate a pneumothorax, which is a life-threatening
emergency requiring immediate assessment. Using the ABC framework (airway-breathing-circulation) and the
principle of assessing the least stable client first, this patient takes priority. Chronic and stable conditions are lower
priority than acute changes.
Q3. The nurse is caring for multiple clients. Which client requires the MOST immediate intervention?
A. A client with a glucose level of 180 mg/dL who is awaiting breakfast
B. A client with a blood pressure of 90/58 mmHg and cool, clammy skin
, C. A client who reports feeling anxious about an upcoming procedure
D. A client with a temperature of 38.2°C (100.8°F) and a new cough
Rationale: A blood pressure of 90/58 mmHg with cool, clammy skin suggests shock or inadequate tissue perfusion,
which is a circulatory emergency. According to Maslow’s hierarchy and the ABC approach, physiologic needs
related to circulation take precedence over psychosocial concerns or less acute physiologic changes. Immediate
intervention is required to prevent deterioration.
Q4. A patient is scheduled for a surgical procedure and asks the nurse to explain the risks. What is the
nurse’s BEST response?
A. Explain all the risks and benefits of the procedure in detail
B. Tell the patient that the surgeon will explain the procedure and risks
C. Provide a written brochure about the procedure for the patient to read
D. Document that the patient refused the nurse’s explanation
Rationale: The physician or surgeon is responsible for obtaining informed consent, which includes explaining the
procedure, risks, benefits, and alternatives. The nurse’s role is to witness the patient signing the consent form and to
verify that the patient understands the information provided. If the patient has unanswered questions, the nurse
should notify the physician.
Q5. A family member calls the nursing unit and asks for information about a relative’s condition. The
patient has not authorized release of information. What should the nurse do?
A. Provide the family member with general information about the patient’s diagnosis
B. Tell the family member to visit the patient in person to get information
C. Inform the family member that no information can be disclosed without patient
authorization
D. Transfer the call to the charge nurse for handling
Rationale: HIPAA protects patient confidentiality, and information cannot be released to anyone without the
patient’s written authorization. The nurse must uphold the patient’s right to privacy regardless of the relationship to
the caller. This is both a legal obligation and an ethical duty under the Nurse Practice Act.
Q6. Which action by the nurse demonstrates correct use of standard precautions?
A. Wearing gloves only when touching blood or body fluids
B. Removing gloves before touching environmental surfaces in the patient’s room
C. Discarding gloves in the regular trash bin after use
| 2025/2026 |
75 Questions and Correct Answers
with Rationales
NCLEX-RN Readiness & Institutional Final Assessment
, Table of Contents
Section I: Safe and Effective Care Environment — Questions 1–16 (16 Questions,
~21%)
Section II: Health Promotion and Maintenance — Questions 17–25 (9 Questions,
~12%)
Section III: Psychosocial Integrity — Questions 26–34 (9 Questions, ~12%)
Section IV: Physiological Integrity — Questions 35–65 (31 Questions, ~41%)
Section V: Clinical Judgment & NGN Integration — Questions 66–75 (10 Questions,
~13%)
Quick Reference Table — Key Values, Mnemonics, and Frameworks
, Section I: Safe and Effective Care Environment
Questions 1–16 (16 Questions, ~21%)
This section covers delegation (Five Rights of Delegation), prioritization (ABCs, Maslow), legal/ethical
considerations (Nurse Practice Act, informed consent, HIPAA), infection control (standard and
transmission-based precautions, hand hygiene, PPE), and safety (fall prevention, restraint alternatives,
fire safety, emergency codes).
Q1. A charge nurse is making client assignments for the shift. Which task is MOST appropriate to
delegate to an unlicensed assistive personnel (UAP)?
A. Performing the initial admission assessment of a new client
B. Recording intake and output for a stable postoperative client
C. Evaluating the effectiveness of a new pain management plan
D. Teaching a diabetic client about insulin self-administration
Rationale: Recording intake and output is a routine, repetitive task within the UAP scope of practice for stable
clients. The RN cannot delegate assessment, teaching, or evaluation because these require professional nursing
judgment. The Five Rights of Delegation include right task, right circumstance, right person, right direction, and
right supervision.
Q2. The nurse receives a client assignment that includes four patients. Which client should the nurse
assess FIRST?
A. A client admitted yesterday with abdominal pain awaiting test results
B. A client scheduled for discharge today who needs wound care teaching
C. A client with chronic hypertension requesting a diet menu change
D. A client who had a chest tube removed 2 hours ago and reports sudden dyspnea
Rationale: Sudden dyspnea after chest tube removal may indicate a pneumothorax, which is a life-threatening
emergency requiring immediate assessment. Using the ABC framework (airway-breathing-circulation) and the
principle of assessing the least stable client first, this patient takes priority. Chronic and stable conditions are lower
priority than acute changes.
Q3. The nurse is caring for multiple clients. Which client requires the MOST immediate intervention?
A. A client with a glucose level of 180 mg/dL who is awaiting breakfast
B. A client with a blood pressure of 90/58 mmHg and cool, clammy skin
, C. A client who reports feeling anxious about an upcoming procedure
D. A client with a temperature of 38.2°C (100.8°F) and a new cough
Rationale: A blood pressure of 90/58 mmHg with cool, clammy skin suggests shock or inadequate tissue perfusion,
which is a circulatory emergency. According to Maslow’s hierarchy and the ABC approach, physiologic needs
related to circulation take precedence over psychosocial concerns or less acute physiologic changes. Immediate
intervention is required to prevent deterioration.
Q4. A patient is scheduled for a surgical procedure and asks the nurse to explain the risks. What is the
nurse’s BEST response?
A. Explain all the risks and benefits of the procedure in detail
B. Tell the patient that the surgeon will explain the procedure and risks
C. Provide a written brochure about the procedure for the patient to read
D. Document that the patient refused the nurse’s explanation
Rationale: The physician or surgeon is responsible for obtaining informed consent, which includes explaining the
procedure, risks, benefits, and alternatives. The nurse’s role is to witness the patient signing the consent form and to
verify that the patient understands the information provided. If the patient has unanswered questions, the nurse
should notify the physician.
Q5. A family member calls the nursing unit and asks for information about a relative’s condition. The
patient has not authorized release of information. What should the nurse do?
A. Provide the family member with general information about the patient’s diagnosis
B. Tell the family member to visit the patient in person to get information
C. Inform the family member that no information can be disclosed without patient
authorization
D. Transfer the call to the charge nurse for handling
Rationale: HIPAA protects patient confidentiality, and information cannot be released to anyone without the
patient’s written authorization. The nurse must uphold the patient’s right to privacy regardless of the relationship to
the caller. This is both a legal obligation and an ethical duty under the Nurse Practice Act.
Q6. Which action by the nurse demonstrates correct use of standard precautions?
A. Wearing gloves only when touching blood or body fluids
B. Removing gloves before touching environmental surfaces in the patient’s room
C. Discarding gloves in the regular trash bin after use
