Page 1 of 80
NCLEX-RN EXAM 2026 QUESTIONS 2026 – 2027 LATEST
VERSION SOLVED QUESTIONS & ANSWERS
10-Point Summarized Exam Coverage
1. Safe & Effective Care Environment: Management of Care (delegation,
prioritization, case management, legal/ethical issues) & Safety/Infection Control
(emergency plans, restraints, error prevention).
2. Health Promotion & Maintenance: Growth & development (all ages), disease
prevention, screening, immunizations, prenatal/neonatal care, and lifestyle
choices.
3. Psychosocial Integrity: Coping mechanisms, crisis intervention, therapeutic
communication, mental health disorders (depression, schizophrenia, anxiety),
grief, and end-of-life care.
4. Physiological Integrity: Basic Care & Comfort: Hygiene, mobility, nutrition,
sleep, and non-pharmacological comfort interventions.
5. Pharmacological & Parenteral Therapies: Medication administration, dosage
calculations, side effects, contraindications, IV therapy, and blood product
administration.
6. Reduction of Risk Potential: Diagnostic tests, monitoring for complications,
and identifying early signs of deteriorating patient conditions (e.g., labs, vital
signs).
7. Physiological Adaptation: Pathophysiology: Understanding the underlying
disease processes and providing care for acute and chronic conditions (Cardiac,
Respiratory, Neuro, GI, Endocrine, Renal).
8. Maternity & Newborn Care: Antepartum, intrapartum, postpartum care, and
newborn assessment (Apgar, reflexes, transition).
9. Pediatric Nursing: Growth milestones, congenital disorders, common
childhood illnesses, and parent education.
10. Mental Health & Psychiatric Nursing: Therapeutic milieu,
psychopharmacology, personality disorders, mood disorders, and crisis de-
escalation techniques.
, Page 2 of 80
Instructions: Choose the best answer for each question. Rationales are provided after
each question.
Safe & Effective Care Environment (Management of Care & Safety)
1. A registered nurse is delegating tasks to a licensed practical nurse (LPN) and a
nursing assistant. Which client assignment is most appropriate for the LPN to
perform?
• A. Administering a scheduled oral antibiotic to a stable client with pneumonia.
• B. Providing hygiene care and assisting with ambulation for a post-operative
client.
• C. Developing the initial nursing plan of care for a newly admitted client.
• D. Performing a comprehensive admission assessment on a client with chest
pain.
Rationale: LPNs can administer medications to stable clients, as this falls within their
scope of practice. Nursing assistants provide hygiene and ambulation (B). Developing
the care plan (C) and performing the initial comprehensive assessment (D) are the
responsibility of the RN.
2. A nurse is caring for a client who is post-operative and has a new prescription for
a patient-controlled analgesia (PCA) pump. What is the nurse's priority action?
• A. Instruct the client's family on how to press the button if the client is sleeping.
• B. Provide the client with education regarding the use and safety of the PCA
pump.
• C. Assess the client's pain level every four hours to ensure the pump is working.
• D. Ensure that the client understands that only the client should press the dosing
button.
Rationale: The priority is to ensure the client understands proper PCA use, particularly
that only they should press the button to prevent overdose (A, D). Pain assessment
should be more frequent than every 4 hours (C).
3. A charge nurse is organizing a shift assignment for the medical-surgical unit.
Which client should be assigned to the most experienced, senior registered nurse?
• A. A 68-year-old client admitted with a diagnosis of cellulitis and diabetes.
• B. A 45-year-old client with a newly inserted chest tube for a pneumothorax.
• C. A 72-year-old client who is two days post-operative from a hip replacement.
, Page 3 of 80
• D. A 55-year-old client requiring a blood transfusion for severe anemia.
Rationale: A client with a newly inserted chest tube is at high risk for complications like
dislodgement or tension pneumothorax, requiring expert assessment skills and
knowledge. The other clients are more stable and can be managed by less experienced
nurses (A, C, D).
4. A nurse is preparing to administer a blood transfusion to a client. Which action is
most critical to prevent a life-threatening complication?
• A. Verifying the client's identity and blood product compatibility with another
licensed nurse.
• B. Pre-medicating the client with diphenhydramine to prevent an allergic
reaction.
• C. Using a 22-gauge needle to ensure proper flow and minimize vein damage.
• D. Ensuring the blood is infused over four hours to prevent circulatory overload.
Rationale: Verification of client identity and blood product compatibility is the most
critical step to prevent ABO incompatibility, which causes a fatal hemolytic reaction.
Pre-medication (B) may mask early signs of a reaction. A 20-gauge or larger needle is
recommended (C). Infusion should be completed within 4 hours to prevent bacterial
growth, but verification is more critical (D).
5. In the event of a fire in a client's room, the nurse's first priority according to the
RACE protocol is to:
• A. Activate the fire alarm and notify the fire department immediately.
• B. Confine the fire by closing doors and windows to prevent the spread of smoke.
• C. Rescue the client from the immediate area of the fire and move them to safety.
• D. Extinguish the fire using the appropriate type of fire extinguisher if safe to do
so.
Rationale: The "R" in RACE stands for Rescue, which is the first priority to ensure the
client's immediate safety. Only after rescuing the client should the nurse activate the
alarm (A), confine the fire (B), or attempt to extinguish it (C).
6. A nurse has administered a wrong dose of an opioid medication. After assessing
the client and determining they are stable, the nurse's next best action is to:
• A. Document the error in the client's medical record and notify the provider.
• B. Complete an incident report and place it in the client's chart for legal
purposes.
, Page 4 of 80
• C. Report the incident to the shift manager but not document to avoid liability.
• D. Discuss the error with the client and apologize, ensuring them no harm was
done.
Rationale: The nurse's legal and ethical duty is to document the error in the medical
record and notify the healthcare provider. An incident report is completed but is not part
of the legal medical record (B, D). Reporting to a manager is necessary, but
documentation is paramount (C).
7. A nurse is planning care for a client who is at risk for falls. Which intervention is
the highest priority to include in this client's plan of care?
• A. Placing the client in a room closest to the nurses' station for frequent
observation.
• B. Using side rails to prevent the client from getting out of bed independently.
• C. Encouraging the client to use the call light before attempting to get out of bed.
• D. Ensuring the bed is in the lowest position and the client's essential items are
within reach.
Rationale: Keeping the bed in the lowest position and ensuring call light and personal
items are within reach are direct, environmental interventions to prevent falls.
Restraints or side rails (B) require a specific order. Placing them near the station (A) is
helpful but not a direct intervention. Call light education (C) is important but requires
the client to be compliant.
8. A newly licensed nurse is preparing to insert a urinary catheter. The charge nurse
identifies a need for further teaching regarding sterile technique when the new
nurse does which action?
• A. Places the sterile field and tray on the client's overbed table just above waist
level.
• B. Opens the sterile kit away from their body and allows the outer wrapper to fall
freely.
• C. Dons sterile gloves before opening the sterile kit and preparing the sterile
field.
• D. Maintains gloved hands above the waist and keeps them within their field of
vision.
Rationale: The sterile kit should be opened before sterile gloves are applied to avoid
contaminating the sterile gloves while handling the packaging. The other actions are
correct principles of sterile technique (A, B, D).
NCLEX-RN EXAM 2026 QUESTIONS 2026 – 2027 LATEST
VERSION SOLVED QUESTIONS & ANSWERS
10-Point Summarized Exam Coverage
1. Safe & Effective Care Environment: Management of Care (delegation,
prioritization, case management, legal/ethical issues) & Safety/Infection Control
(emergency plans, restraints, error prevention).
2. Health Promotion & Maintenance: Growth & development (all ages), disease
prevention, screening, immunizations, prenatal/neonatal care, and lifestyle
choices.
3. Psychosocial Integrity: Coping mechanisms, crisis intervention, therapeutic
communication, mental health disorders (depression, schizophrenia, anxiety),
grief, and end-of-life care.
4. Physiological Integrity: Basic Care & Comfort: Hygiene, mobility, nutrition,
sleep, and non-pharmacological comfort interventions.
5. Pharmacological & Parenteral Therapies: Medication administration, dosage
calculations, side effects, contraindications, IV therapy, and blood product
administration.
6. Reduction of Risk Potential: Diagnostic tests, monitoring for complications,
and identifying early signs of deteriorating patient conditions (e.g., labs, vital
signs).
7. Physiological Adaptation: Pathophysiology: Understanding the underlying
disease processes and providing care for acute and chronic conditions (Cardiac,
Respiratory, Neuro, GI, Endocrine, Renal).
8. Maternity & Newborn Care: Antepartum, intrapartum, postpartum care, and
newborn assessment (Apgar, reflexes, transition).
9. Pediatric Nursing: Growth milestones, congenital disorders, common
childhood illnesses, and parent education.
10. Mental Health & Psychiatric Nursing: Therapeutic milieu,
psychopharmacology, personality disorders, mood disorders, and crisis de-
escalation techniques.
, Page 2 of 80
Instructions: Choose the best answer for each question. Rationales are provided after
each question.
Safe & Effective Care Environment (Management of Care & Safety)
1. A registered nurse is delegating tasks to a licensed practical nurse (LPN) and a
nursing assistant. Which client assignment is most appropriate for the LPN to
perform?
• A. Administering a scheduled oral antibiotic to a stable client with pneumonia.
• B. Providing hygiene care and assisting with ambulation for a post-operative
client.
• C. Developing the initial nursing plan of care for a newly admitted client.
• D. Performing a comprehensive admission assessment on a client with chest
pain.
Rationale: LPNs can administer medications to stable clients, as this falls within their
scope of practice. Nursing assistants provide hygiene and ambulation (B). Developing
the care plan (C) and performing the initial comprehensive assessment (D) are the
responsibility of the RN.
2. A nurse is caring for a client who is post-operative and has a new prescription for
a patient-controlled analgesia (PCA) pump. What is the nurse's priority action?
• A. Instruct the client's family on how to press the button if the client is sleeping.
• B. Provide the client with education regarding the use and safety of the PCA
pump.
• C. Assess the client's pain level every four hours to ensure the pump is working.
• D. Ensure that the client understands that only the client should press the dosing
button.
Rationale: The priority is to ensure the client understands proper PCA use, particularly
that only they should press the button to prevent overdose (A, D). Pain assessment
should be more frequent than every 4 hours (C).
3. A charge nurse is organizing a shift assignment for the medical-surgical unit.
Which client should be assigned to the most experienced, senior registered nurse?
• A. A 68-year-old client admitted with a diagnosis of cellulitis and diabetes.
• B. A 45-year-old client with a newly inserted chest tube for a pneumothorax.
• C. A 72-year-old client who is two days post-operative from a hip replacement.
, Page 3 of 80
• D. A 55-year-old client requiring a blood transfusion for severe anemia.
Rationale: A client with a newly inserted chest tube is at high risk for complications like
dislodgement or tension pneumothorax, requiring expert assessment skills and
knowledge. The other clients are more stable and can be managed by less experienced
nurses (A, C, D).
4. A nurse is preparing to administer a blood transfusion to a client. Which action is
most critical to prevent a life-threatening complication?
• A. Verifying the client's identity and blood product compatibility with another
licensed nurse.
• B. Pre-medicating the client with diphenhydramine to prevent an allergic
reaction.
• C. Using a 22-gauge needle to ensure proper flow and minimize vein damage.
• D. Ensuring the blood is infused over four hours to prevent circulatory overload.
Rationale: Verification of client identity and blood product compatibility is the most
critical step to prevent ABO incompatibility, which causes a fatal hemolytic reaction.
Pre-medication (B) may mask early signs of a reaction. A 20-gauge or larger needle is
recommended (C). Infusion should be completed within 4 hours to prevent bacterial
growth, but verification is more critical (D).
5. In the event of a fire in a client's room, the nurse's first priority according to the
RACE protocol is to:
• A. Activate the fire alarm and notify the fire department immediately.
• B. Confine the fire by closing doors and windows to prevent the spread of smoke.
• C. Rescue the client from the immediate area of the fire and move them to safety.
• D. Extinguish the fire using the appropriate type of fire extinguisher if safe to do
so.
Rationale: The "R" in RACE stands for Rescue, which is the first priority to ensure the
client's immediate safety. Only after rescuing the client should the nurse activate the
alarm (A), confine the fire (B), or attempt to extinguish it (C).
6. A nurse has administered a wrong dose of an opioid medication. After assessing
the client and determining they are stable, the nurse's next best action is to:
• A. Document the error in the client's medical record and notify the provider.
• B. Complete an incident report and place it in the client's chart for legal
purposes.
, Page 4 of 80
• C. Report the incident to the shift manager but not document to avoid liability.
• D. Discuss the error with the client and apologize, ensuring them no harm was
done.
Rationale: The nurse's legal and ethical duty is to document the error in the medical
record and notify the healthcare provider. An incident report is completed but is not part
of the legal medical record (B, D). Reporting to a manager is necessary, but
documentation is paramount (C).
7. A nurse is planning care for a client who is at risk for falls. Which intervention is
the highest priority to include in this client's plan of care?
• A. Placing the client in a room closest to the nurses' station for frequent
observation.
• B. Using side rails to prevent the client from getting out of bed independently.
• C. Encouraging the client to use the call light before attempting to get out of bed.
• D. Ensuring the bed is in the lowest position and the client's essential items are
within reach.
Rationale: Keeping the bed in the lowest position and ensuring call light and personal
items are within reach are direct, environmental interventions to prevent falls.
Restraints or side rails (B) require a specific order. Placing them near the station (A) is
helpful but not a direct intervention. Call light education (C) is important but requires
the client to be compliant.
8. A newly licensed nurse is preparing to insert a urinary catheter. The charge nurse
identifies a need for further teaching regarding sterile technique when the new
nurse does which action?
• A. Places the sterile field and tray on the client's overbed table just above waist
level.
• B. Opens the sterile kit away from their body and allows the outer wrapper to fall
freely.
• C. Dons sterile gloves before opening the sterile kit and preparing the sterile
field.
• D. Maintains gloved hands above the waist and keeps them within their field of
vision.
Rationale: The sterile kit should be opened before sterile gloves are applied to avoid
contaminating the sterile gloves while handling the packaging. The other actions are
correct principles of sterile technique (A, B, D).
