Page 1 of 90
NEW NCLEX-RN EXAM 2026 QUESTIONS 2026 – 2027
LATEST VERSION SOLVED QUESTIONS & ANSWERS
10-Point Summary of NCLEX-PN Exam Coverage (Set 2)
1. Safe and Effective Care Environment: Client safety protocols, incident
reporting, handling hazardous materials, surgical asepsis, and emergency
response plans.
2. Health Promotion and Maintenance: Age-appropriate screenings,
immunizations, lifestyle modifications, prenatal care, and developmental
surveillance across the lifespan.
3. Psychosocial Integrity: Stress management, therapeutic communication,
cultural competence, grief counseling, and managing behavioral disturbances in
clients with psychiatric conditions.
4. Physiological Integrity: Basic Care and Comfort: Wound care, ostomy
management, mobility aids, sleep/rest promotion, pain management, and end-
of-life comfort measures.
5. Pharmacological Therapies: Drug calculations, side effect monitoring,
interactions, client teaching, and safe administration routes for common
medications.
6. Reduction of Risk Potential: Recognizing early signs of complications,
managing post-operative risks, interpreting laboratory values, and preventing
pressure injuries.
7. Physiological Adaptation: Managing acute and chronic diseases (e.g.,
cardiovascular, respiratory, endocrine, renal, neurological), and recognizing
changes in client status.
8. Maternal and Newborn Health: Antepartum care, intrapartum stages,
postpartum assessments, neonatal reflexes, and common complications (e.g.,
PPH, eclampsia, neonatal abstinence syndrome).
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9. Pediatric Nursing: Common pediatric illnesses (e.g., RSV, croup, diabetes),
safety for each developmental stage, immunization schedules, and medication
administration in children.
10. Mental Health and Psychiatric Nursing: Mood disorders, psychotic disorders,
substance abuse, eating disorders, crisis intervention, psychopharmacology,
and legal/ethical issues.
NEW 250 NCLEX-PN Practice Questions with Rationales
Category 1: Safe and Effective Care Environment (Questions 1-25)
1. A nurse is preparing to administer a blood transfusion to a client who has a
history of febrile non-hemolytic reactions. Which medication should the nurse
anticipate the healthcare provider will prescribe as a pre-medication to prevent
this type of reaction during the transfusion?
• A. Diphenhydramine and acetaminophen.
• B. Epinephrine and methylprednisolone.
• C. Furosemide and digoxin.
• D. Albuterol and ipratropium.
• Answer: A. Rationale: Febrile non-hemolytic reactions are common and are
caused by antibodies to donor leukocytes. Pre-medicating with an antihistamine
(like diphenhydramine) and an antipyretic (like acetaminophen) can help prevent
or reduce the severity of these reactions. Epinephrine is for anaphylaxis, and
furosemide is for fluid overload.
2. The nurse is caring for a client who is on a continuous heparin infusion. The
healthcare provider prescribes aPTT levels to be drawn every 6 hours. What is the
primary purpose of drawing these frequent aPTT levels for this client?
• A. To monitor the client's liver function and detect hepatotoxicity caused by the
heparin.
• B. To assess the client's kidney function and prevent nephrotoxicity from the
medication.
• C. To ensure the medication is within the therapeutic range to prevent bleeding
or clotting.
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• D. To check the client's serum potassium levels, which can be affected by
heparin.
• Answer: C. Rationale: The aPTT (activated partial thromboplastin time) is the
laboratory test used to monitor the effectiveness of unfractionated heparin. It
must be maintained at 1.5 to 2.5 times the control value to ensure adequate
anticoagulation without causing excessive bleeding.
3. A nurse is preparing to administer an intravenous push medication through a
client's peripheral IV line. Which action is most important for the nurse to take
immediately before injecting the medication to ensure it is administered safely?
• A. Flush the IV line with 10 mL of sterile normal saline.
• B. Assess the client's vital signs and document them.
• C. Confirm the client's identity using two unique identifiers.
• D. Verify that the IV site is patent and free of redness or swelling.
• Answer: D. Rationale: Before administering any IV push medication, the nurse
must assess the IV site for patency (by checking for a blood return) and for any
signs of infiltration or phlebitis (redness, swelling). Administering a vesicant into
a non-patent site can cause severe tissue damage.
4. A client is placed in a negative-pressure isolation room due to a confirmed
diagnosis of active pulmonary tuberculosis. What is the most important action the
nurse must take to ensure the safety of other clients and staff members on the
unit?
• A. Keep the client's door closed at all times to maintain negative air pressure.
• B. Restrict all visitors from entering the client's room.
• C. Ensure that all staff members wear N95 respirator masks when entering the
room.
• D. Place a surgical mask on the client whenever they leave the room for tests.
• Answer: C. Rationale: Tuberculosis is transmitted via airborne droplet nuclei
that can remain suspended in the air. An N95 respirator is required for all staff
entering the room to filter out these particles. While the door should be closed,
the N95 is the critical personal protective measure for the staff.
5. A nurse is reviewing the facility's policy on the use of physical restraints. Which
statement accurately reflects a key principle of safe restraint use according to
current standards of practice?
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• A. A PRN (as needed) order for restraints is acceptable for clients who are
agitated.
• B. The primary purpose of restraints is to ensure the client's safety and prevent
falls.
• C. Restraints should be applied tightly enough to prevent the client from
loosening them.
• D. A healthcare provider's order for restraints must be obtained and renewed
every 24 hours.
• Answer: D. Rationale: A physician's order for physical restraints is required and
must be renewed every 24 hours. PRN orders are not permitted. Restraints
should be applied loosely enough to allow for circulation and movement, and
their primary purpose is to prevent harm to the client or others, not just for
convenience.
6. During a routine fire drill on the unit, the nurse is responsible for evacuating a
client who is on a ventilator. Which evacuation method is most appropriate for this
client who is non-ambulatory and requires continuous respiratory support?
• A. Use a blanket drag to quickly move the client away from the fire.
• B. Wait for the fire department to arrive to safely move the client.
• C. Disconnect the ventilator and use a portable Ambu bag to ventilate the client
during evacuation.
• D. Move the client in their bed while continuing the ventilator using a portable
battery pack.
• Answer: C. Rationale: In an emergency evacuation, the priority is to move the
client to safety while maintaining oxygenation. The nurse should disconnect the
ventilator, attach an Ambu bag (manual resuscitation bag) with a source of
oxygen, and ventilate the client manually while evacuating. The bed is too heavy
to move quickly.
7. A nurse is caring for a client who is receiving a continuous epidural infusion for
post-operative pain management. What is the most important piece of emergency
equipment the nurse must keep available at the client's bedside at all times?
• A. A pulse oximeter to monitor oxygen saturation.
• B. An emergency cart with a defibrillator.
• C. Naloxone (Narcan) and resuscitative equipment.
• D. A bag-valve-mask device and suction equipment.
NEW NCLEX-RN EXAM 2026 QUESTIONS 2026 – 2027
LATEST VERSION SOLVED QUESTIONS & ANSWERS
10-Point Summary of NCLEX-PN Exam Coverage (Set 2)
1. Safe and Effective Care Environment: Client safety protocols, incident
reporting, handling hazardous materials, surgical asepsis, and emergency
response plans.
2. Health Promotion and Maintenance: Age-appropriate screenings,
immunizations, lifestyle modifications, prenatal care, and developmental
surveillance across the lifespan.
3. Psychosocial Integrity: Stress management, therapeutic communication,
cultural competence, grief counseling, and managing behavioral disturbances in
clients with psychiatric conditions.
4. Physiological Integrity: Basic Care and Comfort: Wound care, ostomy
management, mobility aids, sleep/rest promotion, pain management, and end-
of-life comfort measures.
5. Pharmacological Therapies: Drug calculations, side effect monitoring,
interactions, client teaching, and safe administration routes for common
medications.
6. Reduction of Risk Potential: Recognizing early signs of complications,
managing post-operative risks, interpreting laboratory values, and preventing
pressure injuries.
7. Physiological Adaptation: Managing acute and chronic diseases (e.g.,
cardiovascular, respiratory, endocrine, renal, neurological), and recognizing
changes in client status.
8. Maternal and Newborn Health: Antepartum care, intrapartum stages,
postpartum assessments, neonatal reflexes, and common complications (e.g.,
PPH, eclampsia, neonatal abstinence syndrome).
, Page 2 of 90
9. Pediatric Nursing: Common pediatric illnesses (e.g., RSV, croup, diabetes),
safety for each developmental stage, immunization schedules, and medication
administration in children.
10. Mental Health and Psychiatric Nursing: Mood disorders, psychotic disorders,
substance abuse, eating disorders, crisis intervention, psychopharmacology,
and legal/ethical issues.
NEW 250 NCLEX-PN Practice Questions with Rationales
Category 1: Safe and Effective Care Environment (Questions 1-25)
1. A nurse is preparing to administer a blood transfusion to a client who has a
history of febrile non-hemolytic reactions. Which medication should the nurse
anticipate the healthcare provider will prescribe as a pre-medication to prevent
this type of reaction during the transfusion?
• A. Diphenhydramine and acetaminophen.
• B. Epinephrine and methylprednisolone.
• C. Furosemide and digoxin.
• D. Albuterol and ipratropium.
• Answer: A. Rationale: Febrile non-hemolytic reactions are common and are
caused by antibodies to donor leukocytes. Pre-medicating with an antihistamine
(like diphenhydramine) and an antipyretic (like acetaminophen) can help prevent
or reduce the severity of these reactions. Epinephrine is for anaphylaxis, and
furosemide is for fluid overload.
2. The nurse is caring for a client who is on a continuous heparin infusion. The
healthcare provider prescribes aPTT levels to be drawn every 6 hours. What is the
primary purpose of drawing these frequent aPTT levels for this client?
• A. To monitor the client's liver function and detect hepatotoxicity caused by the
heparin.
• B. To assess the client's kidney function and prevent nephrotoxicity from the
medication.
• C. To ensure the medication is within the therapeutic range to prevent bleeding
or clotting.
, Page 3 of 90
• D. To check the client's serum potassium levels, which can be affected by
heparin.
• Answer: C. Rationale: The aPTT (activated partial thromboplastin time) is the
laboratory test used to monitor the effectiveness of unfractionated heparin. It
must be maintained at 1.5 to 2.5 times the control value to ensure adequate
anticoagulation without causing excessive bleeding.
3. A nurse is preparing to administer an intravenous push medication through a
client's peripheral IV line. Which action is most important for the nurse to take
immediately before injecting the medication to ensure it is administered safely?
• A. Flush the IV line with 10 mL of sterile normal saline.
• B. Assess the client's vital signs and document them.
• C. Confirm the client's identity using two unique identifiers.
• D. Verify that the IV site is patent and free of redness or swelling.
• Answer: D. Rationale: Before administering any IV push medication, the nurse
must assess the IV site for patency (by checking for a blood return) and for any
signs of infiltration or phlebitis (redness, swelling). Administering a vesicant into
a non-patent site can cause severe tissue damage.
4. A client is placed in a negative-pressure isolation room due to a confirmed
diagnosis of active pulmonary tuberculosis. What is the most important action the
nurse must take to ensure the safety of other clients and staff members on the
unit?
• A. Keep the client's door closed at all times to maintain negative air pressure.
• B. Restrict all visitors from entering the client's room.
• C. Ensure that all staff members wear N95 respirator masks when entering the
room.
• D. Place a surgical mask on the client whenever they leave the room for tests.
• Answer: C. Rationale: Tuberculosis is transmitted via airborne droplet nuclei
that can remain suspended in the air. An N95 respirator is required for all staff
entering the room to filter out these particles. While the door should be closed,
the N95 is the critical personal protective measure for the staff.
5. A nurse is reviewing the facility's policy on the use of physical restraints. Which
statement accurately reflects a key principle of safe restraint use according to
current standards of practice?
, Page 4 of 90
• A. A PRN (as needed) order for restraints is acceptable for clients who are
agitated.
• B. The primary purpose of restraints is to ensure the client's safety and prevent
falls.
• C. Restraints should be applied tightly enough to prevent the client from
loosening them.
• D. A healthcare provider's order for restraints must be obtained and renewed
every 24 hours.
• Answer: D. Rationale: A physician's order for physical restraints is required and
must be renewed every 24 hours. PRN orders are not permitted. Restraints
should be applied loosely enough to allow for circulation and movement, and
their primary purpose is to prevent harm to the client or others, not just for
convenience.
6. During a routine fire drill on the unit, the nurse is responsible for evacuating a
client who is on a ventilator. Which evacuation method is most appropriate for this
client who is non-ambulatory and requires continuous respiratory support?
• A. Use a blanket drag to quickly move the client away from the fire.
• B. Wait for the fire department to arrive to safely move the client.
• C. Disconnect the ventilator and use a portable Ambu bag to ventilate the client
during evacuation.
• D. Move the client in their bed while continuing the ventilator using a portable
battery pack.
• Answer: C. Rationale: In an emergency evacuation, the priority is to move the
client to safety while maintaining oxygenation. The nurse should disconnect the
ventilator, attach an Ambu bag (manual resuscitation bag) with a source of
oxygen, and ventilate the client manually while evacuating. The bed is too heavy
to move quickly.
7. A nurse is caring for a client who is receiving a continuous epidural infusion for
post-operative pain management. What is the most important piece of emergency
equipment the nurse must keep available at the client's bedside at all times?
• A. A pulse oximeter to monitor oxygen saturation.
• B. An emergency cart with a defibrillator.
• C. Naloxone (Narcan) and resuscitative equipment.
• D. A bag-valve-mask device and suction equipment.
