NCLEX-RN PRACTICE EXAMINATION
100 QUESTIONS WITH ANSWERS AND RATIONALES
2026–2027 TESTING CYCLE
SECTION 1: MANAGEMENT OF CARE (Questions 1–20)
Question 1: A nurse is caring for a client who has a new prescription for a blood transfusion.
Which of the following actions should the nurse take FIRST?
Answer: Verify the prescription with the provider and obtain informed consent.
Rationale: The nurse must verify the prescription and ensure informed consent is obtained
before initiating a blood transfusion. Obtaining the blood product and priming the tubing occur
later. Assessing vital signs is important but should be done after consent and verification.
Question 2: A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). Which of the following tasks is appropriate to delegate to
the LPN?
Answer: Administering a scheduled oral medication to a stable client.
Rationale: LPNs can administer oral medications to stable clients. Teaching a client about a
new diagnosis requires RN-level assessment and education. Performing a head-to-toe
assessment requires RN-level assessment. Developing a plan of care is the RN's responsibility.
,Question 3: A nurse is assigned to care for four clients. Which client should the nurse assess
FIRST?
Answer: A client with chest pain who is diaphoretic and reports shortness of breath.
Rationale: The client with chest pain, diaphoresis, and shortness of breath is experiencing a
potential myocardial infarction and requires immediate assessment and intervention. This is a
life-threatening situation. The other clients are stable and can be assessed later.
Question 4: A nurse is preparing a client for discharge. Which of the following actions
demonstrates effective care coordination?
Answer: Providing the client with a list of community resources and follow-up appointments.
Rationale: Effective care coordination includes providing the client with resources and follow-
up appointments to ensure continuity of care. Administering medications and performing a
physical assessment are part of care but do not address coordination. Documenting the client's
response is a component of evaluation, not coordination.
Question 5: A nurse is caring for a client who refuses a prescribed medication. Which of the
following actions should the nurse take?
,Answer: Inform the client of the risks of refusing the medication, document the refusal, and
notify the provider.
Rationale: The nurse must respect the client's right to refuse treatment, inform them of the risks,
document the refusal, and notify the provider. Administering the medication against the client's
will is unethical and illegal. Hiding the medication is deceptive and violates the client's rights.
Question 6: A charge nurse is preparing assignments for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
Answer: A client who is post-operative day one following a craniotomy with an ICP monitor.
Rationale: The 2026 NCLEX-RN test plan places increased emphasis on monitoring internal
devices such as intracranial pressure (ICP) monitors. The client with an ICP monitor requires
specialized assessment and intervention skills. The other clients are stable and can be assigned
to less experienced staff.
Question 7: A nurse is caring for a client who speaks a different language. Which of the
following actions is most appropriate?
Answer: Use a certified medical interpreter to communicate with the client.
Rationale: The 2026 test plan emphasizes the refined focus on the legal and policy-driven use of
interpreter services. Using a certified medical interpreter ensures accurate communication.
, Family members may not accurately interpret medical information. Using gestures or written
materials may not provide complete understanding.
Question 8: A nurse is participating in a root cause analysis following a medication error. What
is the purpose of this process?
Answer: To identify system failures and prevent future errors.
Rationale: Root cause analysis is a process to identify system failures that contributed to an
error, not to assign blame. The goal is to implement changes to prevent recurrence. It is not used
to discipline staff or to review documentation for legal purposes.
Question 9: A nurse is caring for a client who has an advance directive. Which of the following
actions is appropriate?
Answer: Follow the client's wishes as documented in the advance directive.
Rationale: The nurse must respect the client's advance directive. If the client's wishes are
unclear, the nurse should consult the provider or ethics committee. The family does not have the
authority to override the client's documented wishes unless they are the designated healthcare
proxy.
100 QUESTIONS WITH ANSWERS AND RATIONALES
2026–2027 TESTING CYCLE
SECTION 1: MANAGEMENT OF CARE (Questions 1–20)
Question 1: A nurse is caring for a client who has a new prescription for a blood transfusion.
Which of the following actions should the nurse take FIRST?
Answer: Verify the prescription with the provider and obtain informed consent.
Rationale: The nurse must verify the prescription and ensure informed consent is obtained
before initiating a blood transfusion. Obtaining the blood product and priming the tubing occur
later. Assessing vital signs is important but should be done after consent and verification.
Question 2: A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). Which of the following tasks is appropriate to delegate to
the LPN?
Answer: Administering a scheduled oral medication to a stable client.
Rationale: LPNs can administer oral medications to stable clients. Teaching a client about a
new diagnosis requires RN-level assessment and education. Performing a head-to-toe
assessment requires RN-level assessment. Developing a plan of care is the RN's responsibility.
,Question 3: A nurse is assigned to care for four clients. Which client should the nurse assess
FIRST?
Answer: A client with chest pain who is diaphoretic and reports shortness of breath.
Rationale: The client with chest pain, diaphoresis, and shortness of breath is experiencing a
potential myocardial infarction and requires immediate assessment and intervention. This is a
life-threatening situation. The other clients are stable and can be assessed later.
Question 4: A nurse is preparing a client for discharge. Which of the following actions
demonstrates effective care coordination?
Answer: Providing the client with a list of community resources and follow-up appointments.
Rationale: Effective care coordination includes providing the client with resources and follow-
up appointments to ensure continuity of care. Administering medications and performing a
physical assessment are part of care but do not address coordination. Documenting the client's
response is a component of evaluation, not coordination.
Question 5: A nurse is caring for a client who refuses a prescribed medication. Which of the
following actions should the nurse take?
,Answer: Inform the client of the risks of refusing the medication, document the refusal, and
notify the provider.
Rationale: The nurse must respect the client's right to refuse treatment, inform them of the risks,
document the refusal, and notify the provider. Administering the medication against the client's
will is unethical and illegal. Hiding the medication is deceptive and violates the client's rights.
Question 6: A charge nurse is preparing assignments for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
Answer: A client who is post-operative day one following a craniotomy with an ICP monitor.
Rationale: The 2026 NCLEX-RN test plan places increased emphasis on monitoring internal
devices such as intracranial pressure (ICP) monitors. The client with an ICP monitor requires
specialized assessment and intervention skills. The other clients are stable and can be assigned
to less experienced staff.
Question 7: A nurse is caring for a client who speaks a different language. Which of the
following actions is most appropriate?
Answer: Use a certified medical interpreter to communicate with the client.
Rationale: The 2026 test plan emphasizes the refined focus on the legal and policy-driven use of
interpreter services. Using a certified medical interpreter ensures accurate communication.
, Family members may not accurately interpret medical information. Using gestures or written
materials may not provide complete understanding.
Question 8: A nurse is participating in a root cause analysis following a medication error. What
is the purpose of this process?
Answer: To identify system failures and prevent future errors.
Rationale: Root cause analysis is a process to identify system failures that contributed to an
error, not to assign blame. The goal is to implement changes to prevent recurrence. It is not used
to discipline staff or to review documentation for legal purposes.
Question 9: A nurse is caring for a client who has an advance directive. Which of the following
actions is appropriate?
Answer: Follow the client's wishes as documented in the advance directive.
Rationale: The nurse must respect the client's advance directive. If the client's wishes are
unclear, the nurse should consult the provider or ethics committee. The family does not have the
authority to override the client's documented wishes unless they are the designated healthcare
proxy.
