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Next Generation NCLEX-RN®
Comprehensive Review Examination
150 Multiple-Choice Questions for
Practical/Vocational Nursing Candidates
Content Alignment: Based on the 2026 NCSBN NCLEX Test Plan incorporating the Clinical Judgment Measurement Model (CJMM
SAFE AND EFFECTIVE CARE ENVIRONMENT — Management of Care / Coordinated Care (17-
23% of Exam)
Question 1
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A) A client with diabetes mellitus requesting pain medication for a foot ulcer
B) A client with pneumonia who has an oxygen saturation of 89% on 2 L/min nasal cannula
C) A client with a new colostomy requesting assistance with ostomy care
D) A client with hypertension requesting a glass of water
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CorreCt Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) prioritization framework, the client
with an oxygen saturation of 89% requires immediate assessment as this indicates
compromised gas exchange. The other clients have needs that are important but not
immediately life-threatening.
Question 2
A charge nurse is making shift assignments. Which client should be assigned to the most
experienced registered nurse?
A) A client scheduled for discharge teaching on insulin self-administration
B) A client with a chest tube who is 2 days post-operative from a lobectomy
C) A client requiring a wound dressing change for a stage 2 pressure injury
D) A client needing assistance with ambulation following total knee replacement
CorreCt Answer: B
Rationale: The client with a chest tube requires the most experienced nurse due to the
complexity of care, potential for complications (e.g., pneumothorax, infection), and the need for
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advanced assessment skills. Stable clients with routine care needs can be assigned to less
experienced staff.
Question 3
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A) Administering oral medications
B) Assessing a client's pain level
C) Assisting a client with ambulation using a gait belt
D) Evaluating the effectiveness of a client's breathing treatment
CorreCt Answer: C
Rationale: Assisting with ambulation using a gait belt is a standard, predictable task that can be
delegated to UAP. Medication administration, assessment, and evaluation of treatment
effectiveness require nursing judgment and cannot be delegated.
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Question 4
A client with terminal cancer tells the nurse, "I don't want to be resuscitated if my heart stops."
Which action should the nurse take first?
A) Place a "Do Not Resuscitate" (DNR) order in the client's chart
B) Notify the healthcare provider of the client's wishes
C) Ask the client to sign a living will document
D) Contact the client's family to discuss the decision
CorreCt Answer: B
Rationale: The nurse must first notify the healthcare provider so that an official DNR order can
be written. The nurse cannot place a DNR order independently. While advance directives are
important, the immediate priority is communication with the provider.
Question 5
A nurse is caring for a client who is scheduled for surgery. The client asks, "What are the risks of
this procedure?" Which response by the nurse is most appropriate?
A) "You should discuss that with your surgeon before the procedure."
B) "There are always risks with any surgery, but you'll be fine."
Next Generation NCLEX-RN®
Comprehensive Review Examination
150 Multiple-Choice Questions for
Practical/Vocational Nursing Candidates
Content Alignment: Based on the 2026 NCSBN NCLEX Test Plan incorporating the Clinical Judgment Measurement Model (CJMM
SAFE AND EFFECTIVE CARE ENVIRONMENT — Management of Care / Coordinated Care (17-
23% of Exam)
Question 1
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A) A client with diabetes mellitus requesting pain medication for a foot ulcer
B) A client with pneumonia who has an oxygen saturation of 89% on 2 L/min nasal cannula
C) A client with a new colostomy requesting assistance with ostomy care
D) A client with hypertension requesting a glass of water
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CorreCt Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) prioritization framework, the client
with an oxygen saturation of 89% requires immediate assessment as this indicates
compromised gas exchange. The other clients have needs that are important but not
immediately life-threatening.
Question 2
A charge nurse is making shift assignments. Which client should be assigned to the most
experienced registered nurse?
A) A client scheduled for discharge teaching on insulin self-administration
B) A client with a chest tube who is 2 days post-operative from a lobectomy
C) A client requiring a wound dressing change for a stage 2 pressure injury
D) A client needing assistance with ambulation following total knee replacement
CorreCt Answer: B
Rationale: The client with a chest tube requires the most experienced nurse due to the
complexity of care, potential for complications (e.g., pneumothorax, infection), and the need for
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advanced assessment skills. Stable clients with routine care needs can be assigned to less
experienced staff.
Question 3
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A) Administering oral medications
B) Assessing a client's pain level
C) Assisting a client with ambulation using a gait belt
D) Evaluating the effectiveness of a client's breathing treatment
CorreCt Answer: C
Rationale: Assisting with ambulation using a gait belt is a standard, predictable task that can be
delegated to UAP. Medication administration, assessment, and evaluation of treatment
effectiveness require nursing judgment and cannot be delegated.
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Question 4
A client with terminal cancer tells the nurse, "I don't want to be resuscitated if my heart stops."
Which action should the nurse take first?
A) Place a "Do Not Resuscitate" (DNR) order in the client's chart
B) Notify the healthcare provider of the client's wishes
C) Ask the client to sign a living will document
D) Contact the client's family to discuss the decision
CorreCt Answer: B
Rationale: The nurse must first notify the healthcare provider so that an official DNR order can
be written. The nurse cannot place a DNR order independently. While advance directives are
important, the immediate priority is communication with the provider.
Question 5
A nurse is caring for a client who is scheduled for surgery. The client asks, "What are the risks of
this procedure?" Which response by the nurse is most appropriate?
A) "You should discuss that with your surgeon before the procedure."
B) "There are always risks with any surgery, but you'll be fine."
