NCLEX RN ACTUAL EXAM TEST BANK – REAL
& EXACT EXAM QUESTIONS & ANSWERS
(NCLEX 2025/2026) – QUESTIONS
1. A nurse is caring for a client who is postoperative and reports
sudden chest pain and shortness of breath. What is the nurse's priority
action?
A) Administer prescribed PRN pain medication
B) Assess vital signs and notify the provider
C) Encourage deep breathing exercises
D) Apply oxygen and position in high-Fowler's
*D) Apply oxygen and position in high-Fowler's *
Rationale: Sudden chest pain and shortness of breath in a post-operative
client may indicate a pulmonary embolism. The priority is to address
oxygenation (apply oxygen) and position the client to facilitate breathing
(high-Fowler's). Vital signs and notification follow .
2. A nurse is caring for a client with a tracheostomy who has thick
secretions and decreased oxygen saturation. What is the nurse's
priority action?
A) Suction the tracheostomy using sterile technique
B) Increase the FiO₂
C) Deflate the cuff
D) Remove the inner cannula
,*A) Suction the tracheostomy using sterile technique *
Rationale: Thick secretions causing decreased SpO₂ require immediate
suctioning using sterile technique to clear the airway. This addresses the
airway problem directly .
3. A nurse is assessing a client's pain level. The client reports pain as 8
on a 0-10 scale. What is the nurse's priority action?
A) Document the pain level and reassess in 4 hours
B) Administer a PRN analgesic as prescribed
C) Tell the client to try deep breathing exercises
D) Wait to see if the pain subsides
*B) Administer a PRN analgesic as prescribed *
Rationale: Pain of 8/10 requires intervention. The nurse should administer a
prescribed analgesic and reassess pain afterward. Delaying pain relief is
inappropriate .
4. A nurse is preparing to administer an oral medication to a client.
Which action should the nurse take to verify the client's identity?
A) Check the client's room number
B) Ask the client to state their full name and date of birth
C) Check the client's chart only
D) Ask the client's roommate to identify the client
*B) Ask the client to state their full name and date of birth *
Rationale: Two client identifiers should be used, such as the client's full name
and date of birth. Room numbers are not acceptable identifiers. The chart
alone is insufficient; the client's roommate is not a reliable source .
,5. A nurse is caring for a client with Clostridium difficile (C. diff).
Which type of precautions should the nurse implement?
A) Standard precautions
B) Airborne precautions
C) Droplet precautions
D) Contact precautions
*D) Contact precautions *
Rationale: C. difficile is transmitted via the fecal-oral route through contact
with contaminated surfaces. Contact precautions require gloves and gown.
Alcohol-based hand sanitizers are not effective against C. diff spores; soap
and water must be used .
6. A nurse is caring for a client with active tuberculosis (TB). Which
type of precautions should the nurse implement?
A) Standard precautions
B) Airborne precautions
C) Droplet precautions
D) Contact precautions
*B) Airborne precautions *
Rationale: TB is transmitted via airborne droplet nuclei. Airborne precautions
require a negative pressure room, an N95 respirator mask, and keeping the
door closed. The client should wear a surgical mask when leaving the room .
7. A nurse is preparing to perform hand hygiene. When should the
nurse use soap and water instead of alcohol-based hand sanitizer?
, A) When hands are not visibly soiled
B) When caring for a client with C. diff
C) When caring for a client with MRSA
D) When entering a client's room
*B) When caring for a client with C. diff *
Rationale: Alcohol-based hand sanitizers are not effective against C. diff
spores. Soap and water must be used for hand hygiene when caring for
clients with C. diff .
8. A nurse is applying personal protective equipment (PPE). In what
order should the nurse put on PPE?
A) Gown, mask, goggles, gloves
B) Gloves, mask, goggles, gown
C) Mask, goggles, gown, gloves
D) Gown, mask, gloves, goggles
*A) Gown, mask, goggles, gloves *
Rationale: The correct order for donning PPE is: gown first, then mask, then
goggles/face shield, then gloves. The correct order for removing PPE is:
gloves, goggles/face shield, gown, then mask .
9. A nurse is removing PPE. In what order should the nurse remove
PPE?
A) Gown, mask, goggles, gloves
B) Gloves, goggles, gown, mask
C) Mask, goggles, gown, gloves
D) Gown, gloves, mask, goggles
& EXACT EXAM QUESTIONS & ANSWERS
(NCLEX 2025/2026) – QUESTIONS
1. A nurse is caring for a client who is postoperative and reports
sudden chest pain and shortness of breath. What is the nurse's priority
action?
A) Administer prescribed PRN pain medication
B) Assess vital signs and notify the provider
C) Encourage deep breathing exercises
D) Apply oxygen and position in high-Fowler's
*D) Apply oxygen and position in high-Fowler's *
Rationale: Sudden chest pain and shortness of breath in a post-operative
client may indicate a pulmonary embolism. The priority is to address
oxygenation (apply oxygen) and position the client to facilitate breathing
(high-Fowler's). Vital signs and notification follow .
2. A nurse is caring for a client with a tracheostomy who has thick
secretions and decreased oxygen saturation. What is the nurse's
priority action?
A) Suction the tracheostomy using sterile technique
B) Increase the FiO₂
C) Deflate the cuff
D) Remove the inner cannula
,*A) Suction the tracheostomy using sterile technique *
Rationale: Thick secretions causing decreased SpO₂ require immediate
suctioning using sterile technique to clear the airway. This addresses the
airway problem directly .
3. A nurse is assessing a client's pain level. The client reports pain as 8
on a 0-10 scale. What is the nurse's priority action?
A) Document the pain level and reassess in 4 hours
B) Administer a PRN analgesic as prescribed
C) Tell the client to try deep breathing exercises
D) Wait to see if the pain subsides
*B) Administer a PRN analgesic as prescribed *
Rationale: Pain of 8/10 requires intervention. The nurse should administer a
prescribed analgesic and reassess pain afterward. Delaying pain relief is
inappropriate .
4. A nurse is preparing to administer an oral medication to a client.
Which action should the nurse take to verify the client's identity?
A) Check the client's room number
B) Ask the client to state their full name and date of birth
C) Check the client's chart only
D) Ask the client's roommate to identify the client
*B) Ask the client to state their full name and date of birth *
Rationale: Two client identifiers should be used, such as the client's full name
and date of birth. Room numbers are not acceptable identifiers. The chart
alone is insufficient; the client's roommate is not a reliable source .
,5. A nurse is caring for a client with Clostridium difficile (C. diff).
Which type of precautions should the nurse implement?
A) Standard precautions
B) Airborne precautions
C) Droplet precautions
D) Contact precautions
*D) Contact precautions *
Rationale: C. difficile is transmitted via the fecal-oral route through contact
with contaminated surfaces. Contact precautions require gloves and gown.
Alcohol-based hand sanitizers are not effective against C. diff spores; soap
and water must be used .
6. A nurse is caring for a client with active tuberculosis (TB). Which
type of precautions should the nurse implement?
A) Standard precautions
B) Airborne precautions
C) Droplet precautions
D) Contact precautions
*B) Airborne precautions *
Rationale: TB is transmitted via airborne droplet nuclei. Airborne precautions
require a negative pressure room, an N95 respirator mask, and keeping the
door closed. The client should wear a surgical mask when leaving the room .
7. A nurse is preparing to perform hand hygiene. When should the
nurse use soap and water instead of alcohol-based hand sanitizer?
, A) When hands are not visibly soiled
B) When caring for a client with C. diff
C) When caring for a client with MRSA
D) When entering a client's room
*B) When caring for a client with C. diff *
Rationale: Alcohol-based hand sanitizers are not effective against C. diff
spores. Soap and water must be used for hand hygiene when caring for
clients with C. diff .
8. A nurse is applying personal protective equipment (PPE). In what
order should the nurse put on PPE?
A) Gown, mask, goggles, gloves
B) Gloves, mask, goggles, gown
C) Mask, goggles, gown, gloves
D) Gown, mask, gloves, goggles
*A) Gown, mask, goggles, gloves *
Rationale: The correct order for donning PPE is: gown first, then mask, then
goggles/face shield, then gloves. The correct order for removing PPE is:
gloves, goggles/face shield, gown, then mask .
9. A nurse is removing PPE. In what order should the nurse remove
PPE?
A) Gown, mask, goggles, gloves
B) Gloves, goggles, gown, mask
C) Mask, goggles, gown, gloves
D) Gown, gloves, mask, goggles
