NCLEX-RN FINAL EXAM LATEST VERSION WITH
300 QUESTIONS AND CORRECT RATIONALIZED
SOLUTIONS JUST RELEASED THIS YEAR (2026-
2027)
NCLEX-RN FINAL EXAM — COMPREHENSIVE PRACTICE QUESTIONS
SECTION 1: SAFETY AND INFECTION CONTROL
1. A nurse is preparing to administer a blood transfusion to a client with anemia. Which action
is most important to prevent a transfusion reaction?
A) Verify the client's identity using two identifiers and check the blood product against the order
B) Premedicate the client with diphenhydramine
C) Infuse the blood over 4 hours
D) Warm the blood to body temperature before administration
Answer: A
Proper identification using two client identifiers and matching the blood product to the order is
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the most critical step in preventing transfusion reactions. Premedication may reduce allergic
reactions but does not prevent the most serious reactions. Blood should be infused within 4
hours, not over 4 hours, and should never be warmed in a microwave or warm water.
2. A client with a history of latex allergy is scheduled for surgery. Which action should the
nurse take to ensure client safety?
A) Place a sign on the door indicating latex allergy
B) Use only non-latex gloves and equipment
C) Premedicate with antihistamines before surgery
D) All of the above
Answer: D
All measures are essential for clients with latex allergy: signage alerts staff, non-latex equipment
prevents exposure, and premedication may reduce reaction severity if exposure occurs.
3. The nurse is caring for a client on contact precautions for Clostridium difficile infection.
Which action by the nursing assistant requires immediate correction?
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A) Wearing gloves when entering the room
B) Using alcohol-based hand sanitizer after removing gloves
C) Wearing a gown when providing direct care
D) Placing a "Contact Precautions" sign on the door
Answer: B
Alcohol-based hand sanitizer is ineffective against C. difficile spores. The nursing assistant should
wash hands with soap and water after removing gloves. Gloves, gowns, and signage are
appropriate for contact precautions.
4. A nurse is administering a medication via a peripheral IV line. The client reports burning at
the IV site. What is the nurse's priority action?
A) Slow the infusion rate
B) Apply a warm compress to the site
C) Stop the infusion and assess the site
D) Flush the line with normal saline
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Answer: C
Burning at the IV site may indicate infiltration or phlebitis. The nurse should stop the infusion
immediately and assess the site for swelling, redness, or coolness before taking further action.
5. The nurse is teaching a client about fall prevention at home. Which statement by the client
indicates a need for further teaching?
A) "I will remove throw rugs from my home"
B) "I will use nightlights in the hallway and bathroom"
C) "I will keep my walker next to my bed"
D) "I will wear socks without non-slip bottoms when walking"
Answer: D
Socks without non-slip bottoms increase fall risk. The client should wear non-skid footwear. The
other statements reflect appropriate fall prevention strategies.
6. A client is on airborne precautions for active tuberculosis. Which personal protective
equipment is required when entering the room?
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