NCLEX-RN NEWEST 2026 ACTUAL EXAM| COMPLETE
165 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+| RN NCLEX ACTUAL EXAM 2026 (BRAND NEW!!)
1. A nurse in the emergency department is assessing a client who
presents with sudden onset of severe headache, photophobia,
and nuchal rigidity.
Vital signs: T 102.4°F (39.1°C), HR 118, RR 24, BP 148/90.
Which intervention should the nurse implement FIRST?
A) Administer acetaminophen for fever
B) Prepare for lumbar puncture
C) Start IV antibiotics
D) Place the client on droplet precautions
Answer: D
Rationale: The client has signs of bacterial meningitis. Droplet
precautions should be initiated immediately to prevent
1
,transmission to staff and other patients. Antibiotics and diagnostic
testing follow after infection control measures are in place .
2. A nurse is caring for a client with heart failure who reports
increasing shortness of breath and weight gain of 4 lb in 2 days.
Which action should the nurse take FIRST?
A) Administer PRN furosemide
B) Assess lung sounds
C) Notify the provider
D) Restrict oral fluids
Answer: B
Rationale: Assessment of lung sounds (crackles) is the first step to
confirm fluid overload before implementing diuretic therapy or
notifying the provider .
2
,3. A nurse on a medical-surgical unit receives shift report on four
clients.
Which client should the nurse assess FIRST?
A) Client with pneumonia, SpO₂ 90% on 2 L oxygen
B) Client with diabetes, glucose 250 mg/dL
C) Client with postoperative pain 7/10
D) Client with dementia who is wandering
Answer: A
Rationale: SpO₂ 90% indicates hypoxemia and is the highest
priority (ABCs). The oxygen should be increased or the cause
assessed immediately .
4. A nurse is caring for a client with an epidural infusion. The
client reports sudden severe headache and blurred vision.
Which action should the nurse take FIRST?
A) Assess the epidural insertion site
3
, B) Check the infusion pump settings
C) Notify the anesthesia provider immediately
D) Elevate the head of the bed
Answer: C
Rationale: Sudden severe headache and blurred vision with an
epidural may indicate high spinal blockade (respiratory
compromise) or epidural hematoma. Immediate notification of the
anesthesia provider is critical .
5. A nurse is reviewing laboratory results for a client receiving IV
vancomycin. The trough level is 25 mcg/mL.
Which action should the nurse take?
A) Administer the next dose as scheduled
B) Hold the next dose and notify the provider
C) Increase the infusion rate
D) Request a peak level
4
165 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+| RN NCLEX ACTUAL EXAM 2026 (BRAND NEW!!)
1. A nurse in the emergency department is assessing a client who
presents with sudden onset of severe headache, photophobia,
and nuchal rigidity.
Vital signs: T 102.4°F (39.1°C), HR 118, RR 24, BP 148/90.
Which intervention should the nurse implement FIRST?
A) Administer acetaminophen for fever
B) Prepare for lumbar puncture
C) Start IV antibiotics
D) Place the client on droplet precautions
Answer: D
Rationale: The client has signs of bacterial meningitis. Droplet
precautions should be initiated immediately to prevent
1
,transmission to staff and other patients. Antibiotics and diagnostic
testing follow after infection control measures are in place .
2. A nurse is caring for a client with heart failure who reports
increasing shortness of breath and weight gain of 4 lb in 2 days.
Which action should the nurse take FIRST?
A) Administer PRN furosemide
B) Assess lung sounds
C) Notify the provider
D) Restrict oral fluids
Answer: B
Rationale: Assessment of lung sounds (crackles) is the first step to
confirm fluid overload before implementing diuretic therapy or
notifying the provider .
2
,3. A nurse on a medical-surgical unit receives shift report on four
clients.
Which client should the nurse assess FIRST?
A) Client with pneumonia, SpO₂ 90% on 2 L oxygen
B) Client with diabetes, glucose 250 mg/dL
C) Client with postoperative pain 7/10
D) Client with dementia who is wandering
Answer: A
Rationale: SpO₂ 90% indicates hypoxemia and is the highest
priority (ABCs). The oxygen should be increased or the cause
assessed immediately .
4. A nurse is caring for a client with an epidural infusion. The
client reports sudden severe headache and blurred vision.
Which action should the nurse take FIRST?
A) Assess the epidural insertion site
3
, B) Check the infusion pump settings
C) Notify the anesthesia provider immediately
D) Elevate the head of the bed
Answer: C
Rationale: Sudden severe headache and blurred vision with an
epidural may indicate high spinal blockade (respiratory
compromise) or epidural hematoma. Immediate notification of the
anesthesia provider is critical .
5. A nurse is reviewing laboratory results for a client receiving IV
vancomycin. The trough level is 25 mcg/mL.
Which action should the nurse take?
A) Administer the next dose as scheduled
B) Hold the next dose and notify the provider
C) Increase the infusion rate
D) Request a peak level
4
