NCLEX RN ACTUAL EXAM TEST BANK – REAL &
EXACT EXAM QUESTIONS & ANSWERS (NCLEX
2025/2026) – QUESTIONS 1-250
SECTION 1: PRIORITIZATION, ABCs, AND NURSING
PROCESS
1. When selecting an NCLEX answer or determining the order of
priority, what rule should you remember and what is the exception?
A) Use the ABC rule (Airway, Breathing, Circulation). The exception is in
actual CPR, use C-A-B for CPR
B) Use the CAB rule (Circulation, Airway, Breathing). The exception is in
actual CPR, use A-B-C
C) Always prioritize pain management first
D) Always prioritize client comfort first
*A) Use the ABC rule (Airway, Breathing, Circulation). The exception is
in actual CPR, use C-A-B for CPR *
Rationale: The ABC rule is the primary prioritization framework for NCLEX.
Airway is always first, followed by Breathing, then Circulation. The exception
is during actual CPR, where the American Heart Association recommends C-
A-B (Compressions first) to improve perfusion. Maslow's Hierarchy of Needs is
also helpful for prioritization .
,2. A nurse is caring for four clients. Which client should the nurse
assess first?
A) A client with pneumonia who has an oxygen saturation of 92% on 2 L
nasal cannula
B) A client with heart failure who has crackles and an oxygen saturation of
88%
C) A client with diabetes who has a blood glucose of 180 mg/dL
D) A client with a wound infection who has a temperature of 100.4°F
*B) A client with heart failure who has crackles and an oxygen
saturation of 88% *
Rationale: The client with heart failure and an SpO2 of 88% is unstable and
requires immediate intervention. This client has a breathing problem that
needs urgent attention. The other clients have more stable findings .
3. A nurse is using Maslow's Hierarchy of Needs to prioritize care.
Which client need should the nurse address first?
A) The client's need for social interaction
B) The client's need for pain relief
C) The client's need for adequate oxygenation
D) The client's need for self-esteem
*C) The client's need for adequate oxygenation *
Rationale: Maslow's Hierarchy of Needs prioritizes basic physiological needs
(air, food, water, shelter, sleep) first. Oxygenation is a physiological need and
takes priority over safety, love/belonging, self-esteem, and self-actualization .
,4. A nurse is caring for a client who is post-operative 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 .
5. 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 .
, SECTION 2: INFECTION CONTROL AND SAFETY
6. 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 .
7. 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 *
EXACT EXAM QUESTIONS & ANSWERS (NCLEX
2025/2026) – QUESTIONS 1-250
SECTION 1: PRIORITIZATION, ABCs, AND NURSING
PROCESS
1. When selecting an NCLEX answer or determining the order of
priority, what rule should you remember and what is the exception?
A) Use the ABC rule (Airway, Breathing, Circulation). The exception is in
actual CPR, use C-A-B for CPR
B) Use the CAB rule (Circulation, Airway, Breathing). The exception is in
actual CPR, use A-B-C
C) Always prioritize pain management first
D) Always prioritize client comfort first
*A) Use the ABC rule (Airway, Breathing, Circulation). The exception is
in actual CPR, use C-A-B for CPR *
Rationale: The ABC rule is the primary prioritization framework for NCLEX.
Airway is always first, followed by Breathing, then Circulation. The exception
is during actual CPR, where the American Heart Association recommends C-
A-B (Compressions first) to improve perfusion. Maslow's Hierarchy of Needs is
also helpful for prioritization .
,2. A nurse is caring for four clients. Which client should the nurse
assess first?
A) A client with pneumonia who has an oxygen saturation of 92% on 2 L
nasal cannula
B) A client with heart failure who has crackles and an oxygen saturation of
88%
C) A client with diabetes who has a blood glucose of 180 mg/dL
D) A client with a wound infection who has a temperature of 100.4°F
*B) A client with heart failure who has crackles and an oxygen
saturation of 88% *
Rationale: The client with heart failure and an SpO2 of 88% is unstable and
requires immediate intervention. This client has a breathing problem that
needs urgent attention. The other clients have more stable findings .
3. A nurse is using Maslow's Hierarchy of Needs to prioritize care.
Which client need should the nurse address first?
A) The client's need for social interaction
B) The client's need for pain relief
C) The client's need for adequate oxygenation
D) The client's need for self-esteem
*C) The client's need for adequate oxygenation *
Rationale: Maslow's Hierarchy of Needs prioritizes basic physiological needs
(air, food, water, shelter, sleep) first. Oxygenation is a physiological need and
takes priority over safety, love/belonging, self-esteem, and self-actualization .
,4. A nurse is caring for a client who is post-operative 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 .
5. 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 .
, SECTION 2: INFECTION CONTROL AND SAFETY
6. 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 .
7. 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 *
