NCLEX-RN 2026 Next Generation
Questions with Evidence-Based
Rationales
## Management of Care
**1. A nurse is preparing to discharge a client who requires home
oxygen therapy. Which instruction is most important to include in the
discharge teaching?**
A) "Store oxygen tanks in a closet to keep them out of sight."
B) "Use cotton blankets and bedding to prevent static electricity."
C) "Post 'No Smoking' signs in visible areas throughout the home."
D) "Apply petroleum-based ointment to the nares to prevent drying."
**Correct Answer: C**
**Rationale:** Safety is the priority when a client is using home
oxygen. Oxygen supports combustion, so smoking is a major fire
hazard. "No Smoking" signs are essential to remind the client and
,visitors of this life-threatening risk . Storing tanks in a closet (A)
impedes ventilation; cotton bedding (B) is not as critical as eliminating
ignition sources; petroleum-based ointments (D) are flammable and
should be avoided.
---
**2. A charge nurse is delegating tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate to delegate?**
A) Administering a tube feeding to a client with a gastrostomy tube
B) Measuring the vital signs of a client who returned from surgery 1
hour ago
C) Assessing a client's surgical incision for signs of infection
D) Teaching a client how to perform a glucometer check
**Correct Answer: B**
**Rationale:** Delegation requires assigning the right task to the right
person. Taking vital signs of a stable postoperative client is within the
UAP's scope of practice . Tube feeding administration (A), assessment
(C), and client teaching (D) require nursing judgment and are not
delegable to a UAP.
---
,**3. A client tells the nurse, "I want to stop treatment and go home."
The healthcare provider has been notified, but the client's condition is
deteriorating. What is the nurse's priority action?**
A) Tell the client they cannot leave because they are too ill.
B) Ask the healthcare provider to speak with the client again.
C) Call security to restrain the client for safety.
D) Assess the client's decision-making capacity and understanding of
the situation.
**Correct Answer: D**
**Rationale:** Clients have the right to refuse treatment, but the nurse
must first assess whether the client has the capacity to make that
decision and understands the consequences. This assessment should be
documented and communicated to the healthcare provider . The nurse
should not force treatment or restrain the client unless there is
immediate danger.
---
**4. A nurse is caring for four clients. Which client should the nurse
assess first?**
, A) A client with pneumonia who has a new onset of confusion
B) A client with diabetes who has a blood glucose of 180 mg/dL
C) A client with heart failure who has 1+ pitting edema in the lower
extremities
D) A client with an ileostomy who has a new colostomy bag
**Correct Answer: A**
**Rationale:** The client with new-onset confusion and pneumonia
should be seen first, as this may indicate hypoxia, infection, or sepsis
that requires immediate intervention. The other clients are stable: a
blood glucose of 180 mg/dL (B) is elevated but not critical, 1+ edema (C)
is stable, and a new colostomy bag (D) is a routine care need.
---
**5. A nurse is admitting a client who speaks a different language.
Which action demonstrates culturally competent care?**
A) Using a family member to interpret for the client.
B) Speaking loudly and slowly to ensure the client understands.
C) Arranging for a qualified medical interpreter through the hospital's
language line.
D) Using hand gestures and pictures to communicate.
Questions with Evidence-Based
Rationales
## Management of Care
**1. A nurse is preparing to discharge a client who requires home
oxygen therapy. Which instruction is most important to include in the
discharge teaching?**
A) "Store oxygen tanks in a closet to keep them out of sight."
B) "Use cotton blankets and bedding to prevent static electricity."
C) "Post 'No Smoking' signs in visible areas throughout the home."
D) "Apply petroleum-based ointment to the nares to prevent drying."
**Correct Answer: C**
**Rationale:** Safety is the priority when a client is using home
oxygen. Oxygen supports combustion, so smoking is a major fire
hazard. "No Smoking" signs are essential to remind the client and
,visitors of this life-threatening risk . Storing tanks in a closet (A)
impedes ventilation; cotton bedding (B) is not as critical as eliminating
ignition sources; petroleum-based ointments (D) are flammable and
should be avoided.
---
**2. A charge nurse is delegating tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate to delegate?**
A) Administering a tube feeding to a client with a gastrostomy tube
B) Measuring the vital signs of a client who returned from surgery 1
hour ago
C) Assessing a client's surgical incision for signs of infection
D) Teaching a client how to perform a glucometer check
**Correct Answer: B**
**Rationale:** Delegation requires assigning the right task to the right
person. Taking vital signs of a stable postoperative client is within the
UAP's scope of practice . Tube feeding administration (A), assessment
(C), and client teaching (D) require nursing judgment and are not
delegable to a UAP.
---
,**3. A client tells the nurse, "I want to stop treatment and go home."
The healthcare provider has been notified, but the client's condition is
deteriorating. What is the nurse's priority action?**
A) Tell the client they cannot leave because they are too ill.
B) Ask the healthcare provider to speak with the client again.
C) Call security to restrain the client for safety.
D) Assess the client's decision-making capacity and understanding of
the situation.
**Correct Answer: D**
**Rationale:** Clients have the right to refuse treatment, but the nurse
must first assess whether the client has the capacity to make that
decision and understands the consequences. This assessment should be
documented and communicated to the healthcare provider . The nurse
should not force treatment or restrain the client unless there is
immediate danger.
---
**4. A nurse is caring for four clients. Which client should the nurse
assess first?**
, A) A client with pneumonia who has a new onset of confusion
B) A client with diabetes who has a blood glucose of 180 mg/dL
C) A client with heart failure who has 1+ pitting edema in the lower
extremities
D) A client with an ileostomy who has a new colostomy bag
**Correct Answer: A**
**Rationale:** The client with new-onset confusion and pneumonia
should be seen first, as this may indicate hypoxia, infection, or sepsis
that requires immediate intervention. The other clients are stable: a
blood glucose of 180 mg/dL (B) is elevated but not critical, 1+ edema (C)
is stable, and a new colostomy bag (D) is a routine care need.
---
**5. A nurse is admitting a client who speaks a different language.
Which action demonstrates culturally competent care?**
A) Using a family member to interpret for the client.
B) Speaking loudly and slowly to ensure the client understands.
C) Arranging for a qualified medical interpreter through the hospital's
language line.
D) Using hand gestures and pictures to communicate.
