NCLEX RN Actual Exam Test Bank 2026/2027 | 200 Practice
Questions & Detailed Answers | Real Exam Q&A with
Rationales | A+ Graded
DOMAIN I: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1–25)
Question 1
A nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the
following actions should the nurse take to prevent venous thromboembolism?
A) Massage the client's lower extremities
B) Apply sequential compression devices (SCDs)
C) Place pillows under the client's knees
D) Keep the client in a supine position for 24 hours
Answer: B) Apply sequential compression devices (SCDs)
Rationale: SCDs promote venous return and prevent venous stasis, reducing the risk of deep vein
thrombosis (DVT) and pulmonary embolism (PE) in postoperative clients. Massaging the legs can
dislodge clots, pillows under the knees impair venous return, and prolonged immobility increases risk.
Question 2
A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should
the nurse take first?
A) Verify the client's identity using two identifiers
B) Obtain the client's vital signs
C) Prime the IV tubing with normal saline
,D) Document the transfusion
Answer: A) Verify the client's identity using two identifiers
Rationale: The first step in safe blood transfusion administration is verifying the client's identity using
two unique identifiers (e.g., name and date of birth) to prevent transfusion errors. This must be done
with another licensed nurse.
Question 3
A charge nurse is assigning client care to a licensed practical nurse (LPN) and a nursing assistant. Which
of the following tasks should the charge nurse assign to the LPN?
A) Administering oral medications to stable clients
B) Performing a comprehensive admission assessment
C) Developing a client's plan of care
D) Providing client education on a new diagnosis
Answer: A) Administering oral medications to stable clients
Rationale: LPNs can administer oral medications to stable clients. Comprehensive assessments, plan of
care development, and complex client education are the responsibility of the RN.
Question 4
A nurse is caring for a client who is on fall precautions. Which of the following interventions should the
nurse implement?
,A) Keep all side rails up at all times
B) Place the call light within the client's reach
C) Restrain the client to prevent falls
D) Keep the bed in the highest position
Answer: B) Place the call light within the client's reach
Rationale: Placing the call light within reach allows the client to call for assistance before attempting to
get up, reducing fall risk. Side rails should not be fully raised without a prescription, restraints are a last
resort, and beds should be in the lowest position.
Question 5
A nurse is preparing to administer a medication via a nasogastric (NG) tube. Which of the following
actions should the nurse take?
A) Flush the tube with 30 mL of water before and after medication administration
B) Crush all medications, including entericcoated tablets
C) Administer the medication with the client in a supine position
D) Mix all medications together before administration
Answer: A) Flush the tube with 30 mL of water before and after medication administration
Rationale: Flushing the NG tube before and after medication administration prevents clogging and
ensures the medication reaches the stomach. Entericcoated and sustainedrelease medications should
not be crushed.
, Question 6
A nurse is caring for a client who has a prescription for restraints. Which of the following actions should
the nurse take?
A) Apply restraints for a maximum of 4 hours for adults
B) Tie restraints to the side rails of the bed
C) Remove restraints every 2 hours to assess skin and provide range of motion
D) Use restraints as a firstline intervention for agitation
Answer: C) Remove restraints every 2 hours to assess skin and provide range of motion
Rationale: Restraints should be removed every 2 hours for skin assessment, range of motion, and
toileting. Restraints should be tied to the bed frame (not side rails), used only as a last resort, and
prescriptions are timelimited.
Question 7
A charge nurse is delegating tasks to unlicensed assistive personnel (UAP). Which of the following tasks
is appropriate to delegate to a UAP?
A) Assisting a client with ambulation
B) Assessing a client's skin integrity
C) Administering an enema
D) Evaluating the effectiveness of pain medication
Answer: A) Assisting a client with ambulation
Rationale: UAPs can assist with activities of daily living (ADLs), including ambulation. Assessment,
administration of medications/enemas, and evaluation are nursing responsibilities that cannot be
delegated.
Questions & Detailed Answers | Real Exam Q&A with
Rationales | A+ Graded
DOMAIN I: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1–25)
Question 1
A nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the
following actions should the nurse take to prevent venous thromboembolism?
A) Massage the client's lower extremities
B) Apply sequential compression devices (SCDs)
C) Place pillows under the client's knees
D) Keep the client in a supine position for 24 hours
Answer: B) Apply sequential compression devices (SCDs)
Rationale: SCDs promote venous return and prevent venous stasis, reducing the risk of deep vein
thrombosis (DVT) and pulmonary embolism (PE) in postoperative clients. Massaging the legs can
dislodge clots, pillows under the knees impair venous return, and prolonged immobility increases risk.
Question 2
A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should
the nurse take first?
A) Verify the client's identity using two identifiers
B) Obtain the client's vital signs
C) Prime the IV tubing with normal saline
,D) Document the transfusion
Answer: A) Verify the client's identity using two identifiers
Rationale: The first step in safe blood transfusion administration is verifying the client's identity using
two unique identifiers (e.g., name and date of birth) to prevent transfusion errors. This must be done
with another licensed nurse.
Question 3
A charge nurse is assigning client care to a licensed practical nurse (LPN) and a nursing assistant. Which
of the following tasks should the charge nurse assign to the LPN?
A) Administering oral medications to stable clients
B) Performing a comprehensive admission assessment
C) Developing a client's plan of care
D) Providing client education on a new diagnosis
Answer: A) Administering oral medications to stable clients
Rationale: LPNs can administer oral medications to stable clients. Comprehensive assessments, plan of
care development, and complex client education are the responsibility of the RN.
Question 4
A nurse is caring for a client who is on fall precautions. Which of the following interventions should the
nurse implement?
,A) Keep all side rails up at all times
B) Place the call light within the client's reach
C) Restrain the client to prevent falls
D) Keep the bed in the highest position
Answer: B) Place the call light within the client's reach
Rationale: Placing the call light within reach allows the client to call for assistance before attempting to
get up, reducing fall risk. Side rails should not be fully raised without a prescription, restraints are a last
resort, and beds should be in the lowest position.
Question 5
A nurse is preparing to administer a medication via a nasogastric (NG) tube. Which of the following
actions should the nurse take?
A) Flush the tube with 30 mL of water before and after medication administration
B) Crush all medications, including entericcoated tablets
C) Administer the medication with the client in a supine position
D) Mix all medications together before administration
Answer: A) Flush the tube with 30 mL of water before and after medication administration
Rationale: Flushing the NG tube before and after medication administration prevents clogging and
ensures the medication reaches the stomach. Entericcoated and sustainedrelease medications should
not be crushed.
, Question 6
A nurse is caring for a client who has a prescription for restraints. Which of the following actions should
the nurse take?
A) Apply restraints for a maximum of 4 hours for adults
B) Tie restraints to the side rails of the bed
C) Remove restraints every 2 hours to assess skin and provide range of motion
D) Use restraints as a firstline intervention for agitation
Answer: C) Remove restraints every 2 hours to assess skin and provide range of motion
Rationale: Restraints should be removed every 2 hours for skin assessment, range of motion, and
toileting. Restraints should be tied to the bed frame (not side rails), used only as a last resort, and
prescriptions are timelimited.
Question 7
A charge nurse is delegating tasks to unlicensed assistive personnel (UAP). Which of the following tasks
is appropriate to delegate to a UAP?
A) Assisting a client with ambulation
B) Assessing a client's skin integrity
C) Administering an enema
D) Evaluating the effectiveness of pain medication
Answer: A) Assisting a client with ambulation
Rationale: UAPs can assist with activities of daily living (ADLs), including ambulation. Assessment,
administration of medications/enemas, and evaluation are nursing responsibilities that cannot be
delegated.
