2026 NCLEX Board Exam Practice Test
150 Questions with NGN Formats & Detailed Rationales
Format Multiple Choice, SATA, Ordered Response, Matrix/Grid,
Cloze
Difficulty Mixed (Easy, Moderate, Hard)
Content Areas Safe & Effective Care Environment, Health Promotion &
Maintenance,
Psychosocial Integrity, Physiological Integrity (all
subcategories)
Questions 150
Based On NCSBN NCLEX Test Plan 2026
,Question 1
[Multiple Choice]
Safe and Effective Care Environment: Management of Care
A nurse is caring for a client postop following total hip arthroplasty. Which intervention
prevents VTE?
A. Place a pillow under the knees
B. Apply sequential compression devices
C. Maintain high-Fowler position
D. Restrict oral fluids to 500 mL/day
Correct Answer: B
Rationale:
SCDs promote venous return by intermittent pneumatic compression, reducing stasis
per Virchow triad. Pillow under knees causes compression, high-Fowler alone does not
address stasis. Fluid restriction increases hypercoagulability.
Question
2
[Select All That Apply (SATA)]
Physiological Integrity: Pharmacological and Parenteral Therapies
A nurse reviews meds for a client with new warfarin prescription. Which are
contraindicated or require close monitoring? (Select all that apply)
A. Aspirin
B. Vitamin K-rich foods
C. Acetaminophen
D. Ibuprofen
E. Garlic supplements
F. Omeprazole
Correct Answers: A, D, E
Rationale
:
2
, Aspirin and ibuprofen increase bleeding risk with warfarin. Garlic supplements have
antiplatelet properties that potentiate anticoagulant effect. Vitamin K foods need
consistent intake, not avoidance. Acetaminophen is preferred for pain. Omeprazole
may interact but is not contraindicated.
Question 3
[Multiple Choice]
Physiological Integrity: Physiological Adaptation
A client with heart failure reports increasing dyspnea on exertion and needs to sleep
with three pillows. Which finding is most concerning?
A. Weight gain of 2 kg in 3 days
B. Dry, hacking cough at night
C. 2+ pitting edema in bilateral ankles
D. Jugular venous distention when sitting at 45 degrees
3
, Correct Answer: D
Rationale:
JVD at 45 degrees indicates significantly elevated right atrial pressure and systemic
venous congestion, suggesting advanced HF decompensation. Weight gain is
significant but less immediately alarming. Ankle edema and nocturnal cough are
expected HF findings but JVD at 45 degrees reflects more severe hemodynamic
compromise.
Question
4
[Multiple Choice]
Physiological Integrity: Pharmacological and Parenteral Therapies
A nurse administers digoxin to a client with atrial fibrillation. Which finding requires
the nurse to hold the dose and notify the provider?
A. Heart rate 68 bpm
B. Potassium 3.2 mEq/L
C. Blood pressure 110/70 mmHg
D. Apical pulse irregular but rate 78
Correct Answer: B
Rationale
:
Hypokalemia (K+ 3.2 mEq/L) increases the risk of digoxin toxicity because potassium
competes with digoxin at binding sites. Low potassium enhances digoxin binding to
cardiac cells, increasing the risk of fatal dysrhythmias. Heart rate above 60 bpm does
not warrant holding digoxin.
Question
5
[Multiple Choice]
Safe and Effective Care Environment: Safety and Infection Control
4
150 Questions with NGN Formats & Detailed Rationales
Format Multiple Choice, SATA, Ordered Response, Matrix/Grid,
Cloze
Difficulty Mixed (Easy, Moderate, Hard)
Content Areas Safe & Effective Care Environment, Health Promotion &
Maintenance,
Psychosocial Integrity, Physiological Integrity (all
subcategories)
Questions 150
Based On NCSBN NCLEX Test Plan 2026
,Question 1
[Multiple Choice]
Safe and Effective Care Environment: Management of Care
A nurse is caring for a client postop following total hip arthroplasty. Which intervention
prevents VTE?
A. Place a pillow under the knees
B. Apply sequential compression devices
C. Maintain high-Fowler position
D. Restrict oral fluids to 500 mL/day
Correct Answer: B
Rationale:
SCDs promote venous return by intermittent pneumatic compression, reducing stasis
per Virchow triad. Pillow under knees causes compression, high-Fowler alone does not
address stasis. Fluid restriction increases hypercoagulability.
Question
2
[Select All That Apply (SATA)]
Physiological Integrity: Pharmacological and Parenteral Therapies
A nurse reviews meds for a client with new warfarin prescription. Which are
contraindicated or require close monitoring? (Select all that apply)
A. Aspirin
B. Vitamin K-rich foods
C. Acetaminophen
D. Ibuprofen
E. Garlic supplements
F. Omeprazole
Correct Answers: A, D, E
Rationale
:
2
, Aspirin and ibuprofen increase bleeding risk with warfarin. Garlic supplements have
antiplatelet properties that potentiate anticoagulant effect. Vitamin K foods need
consistent intake, not avoidance. Acetaminophen is preferred for pain. Omeprazole
may interact but is not contraindicated.
Question 3
[Multiple Choice]
Physiological Integrity: Physiological Adaptation
A client with heart failure reports increasing dyspnea on exertion and needs to sleep
with three pillows. Which finding is most concerning?
A. Weight gain of 2 kg in 3 days
B. Dry, hacking cough at night
C. 2+ pitting edema in bilateral ankles
D. Jugular venous distention when sitting at 45 degrees
3
, Correct Answer: D
Rationale:
JVD at 45 degrees indicates significantly elevated right atrial pressure and systemic
venous congestion, suggesting advanced HF decompensation. Weight gain is
significant but less immediately alarming. Ankle edema and nocturnal cough are
expected HF findings but JVD at 45 degrees reflects more severe hemodynamic
compromise.
Question
4
[Multiple Choice]
Physiological Integrity: Pharmacological and Parenteral Therapies
A nurse administers digoxin to a client with atrial fibrillation. Which finding requires
the nurse to hold the dose and notify the provider?
A. Heart rate 68 bpm
B. Potassium 3.2 mEq/L
C. Blood pressure 110/70 mmHg
D. Apical pulse irregular but rate 78
Correct Answer: B
Rationale
:
Hypokalemia (K+ 3.2 mEq/L) increases the risk of digoxin toxicity because potassium
competes with digoxin at binding sites. Low potassium enhances digoxin binding to
cardiac cells, increasing the risk of fatal dysrhythmias. Heart rate above 60 bpm does
not warrant holding digoxin.
Question
5
[Multiple Choice]
Safe and Effective Care Environment: Safety and Infection Control
4
