NCLEX-RN FUNDAMENTALS PRACTICE
EXAMINATION 2026–2027 — COMPREHENSIVE
STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS
1. A nurse is preparing to administer a subcutaneous injection of enoxaparin
to a client. Which technique is correct?
A) Aspirate before injecting
B) Massage the site after injecting
C) Pinch a skin fold on the abdomen and inject at a 90-degree angle
D) Use a 1.5-inch needle in the deltoid muscle
Correct Answer: C
Enoxaparin is given subcutaneously in the abdomen, into a pinched skin fold at a
90-degree angle. Aspiration and massage are not recommended because they can
cause tissue damage and bruising. A 1.5-inch needle is for intramuscular injections
and would be too long for subcutaneous use.
2. A client on droplet precautions asks why staff wear a surgical mask. Which
explanation by the nurse is correct?
A) “The mask protects you from breathing in large respiratory droplets.”
B) “The mask protects you from airborne particles.”
C) “The mask prevents you from touching your face.”
D) “The mask is optional for droplet precautions.”
Correct Answer: A
Droplet precautions require a surgical mask to prevent inhalation of large
respiratory droplets within 3 feet. Airborne precautions require an N95 respirator.
The mask is not optional and does not primarily prevent face touching.
, 3. A nurse is measuring a client’s blood pressure. Which action is essential for
an accurate reading?
A) Use a cuff that is too narrow for the arm
B) Support the arm at heart level and use the correct cuff size
C) Take the reading over clothing
D) Inflate the cuff rapidly to 180 mm Hg for all clients
Correct Answer: B
The arm should be supported at heart level, and the cuff bladder should cover 80%
of the arm circumference. A cuff too narrow or taking the reading over clothing
can cause falsely high readings. Inflating to a fixed value without assessing can be
inaccurate and painful.
4. A client is on a full liquid diet. Which item is appropriate?
A) Oatmeal
B) Strained cream soup
C) Soft-boiled egg
D) Mashed potatoes
Correct Answer: B
A full liquid diet includes liquids and foods that are liquid at room temperature or
melt at body temperature, such as strained cream soup. Oatmeal, soft eggs, and
mashed potatoes are not full liquids.
5. A nurse is preparing to administer a rectal suppository to an adult. Which
position is most appropriate?
A) Prone with legs extended
B) Supine with hips flexed
C) Left lateral with right leg flexed
D) Right lateral with left leg flexed
Correct Answer: C
The left lateral (Sims) position with the right leg flexed facilitates insertion into the
rectum and retention of medication. The other positions are less effective for
suppository administration.
, 6. A client has an oral temperature of 102.2°F (39°C). Which additional
assessment finding is most concerning?
A) Pulse 88 bpm
B) Respiratory rate 16 breaths per minute
C) Blood pressure 90/50 mm Hg
D) Skin warm and dry
Correct Answer: C
A blood pressure of 90/50 in a febrile client may indicate sepsis or hypovolemia
and requires immediate attention. Pulse and respiratory rate are within normal
limits. Warm, dry skin is consistent with fever.
7. A nurse is performing hand hygiene with an alcohol-based hand rub. Which
action is correct?
A) Apply the rub to visibly soiled hands
B) Rub the hands together until the product is dry, covering all surfaces
C) Use a small amount and wipe with a paper towel
D) Wash with soap and water after using the hand rub
Correct Answer: B
Alcohol-based hand rubs should be applied to all hand surfaces and rubbed until
dry. They are not used on visibly soiled hands; soap and water is required. No
paper towel is needed. Washing after is unnecessary.
8. A client is at risk for impaired skin integrity. Which nursing intervention is
most effective for prevention?
A) Massage reddened bony prominences
B) Reposition the client at least every 2 hours
C) Keep the head of the bed elevated 60 degrees
D) Use a donut-shaped cushion for sitting
Correct Answer: B
Frequent repositioning relieves pressure and prevents tissue ischemia. Massaging
reddened areas can cause further damage. Head elevation above 30 degrees
, increases shear on the sacrum. Donut cushions reduce blood flow and are not
recommended.
9. A nurse is documenting a client’s intake and output. The client had IV fluids
800 mL, oral fluids 400 mL, urine output 600 mL, and emesis 300 mL. What
is the total output?
A) 600 mL
B) 800 mL
C) 900 mL
D) 1000 mL
Correct Answer: C
Output includes urine (600 mL) and emesis (300 mL) = 900 mL. Intake is not
included. The other options omit emesis or include intake.
10.A client is receiving oxygen via simple face mask at 6 L/min. Which nursing
action is appropriate?
A) Keep the mask tight against the face at all times
B) Ensure the client can remove the mask to eat and drink
C) Use petroleum jelly around the nose to prevent dryness
D) Maintain the flow rate below 5 L/min
Correct Answer: B
A simple face mask is removed for eating and drinking. It should be set at 6–10
L/min to prevent CO₂ rebreathing. Petroleum jelly is flammable and should not be
used with oxygen. The mask should fit snugly but not be overly tight.
11.A nurse is preparing to administer a medication via a nasogastric tube.
Which action is correct?
A) Crush enteric-coated tablets and mix with water
B) Flush the tube before and after each medication with at least 30 mL of
water
C) Mix all medications together in one cup
D) Use hot water to dissolve medications quickly
EXAMINATION 2026–2027 — COMPREHENSIVE
STUDY GUIDE | LATEST UPDATE 2026/2027 | ACTUAL
EXAM PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS
1. A nurse is preparing to administer a subcutaneous injection of enoxaparin
to a client. Which technique is correct?
A) Aspirate before injecting
B) Massage the site after injecting
C) Pinch a skin fold on the abdomen and inject at a 90-degree angle
D) Use a 1.5-inch needle in the deltoid muscle
Correct Answer: C
Enoxaparin is given subcutaneously in the abdomen, into a pinched skin fold at a
90-degree angle. Aspiration and massage are not recommended because they can
cause tissue damage and bruising. A 1.5-inch needle is for intramuscular injections
and would be too long for subcutaneous use.
2. A client on droplet precautions asks why staff wear a surgical mask. Which
explanation by the nurse is correct?
A) “The mask protects you from breathing in large respiratory droplets.”
B) “The mask protects you from airborne particles.”
C) “The mask prevents you from touching your face.”
D) “The mask is optional for droplet precautions.”
Correct Answer: A
Droplet precautions require a surgical mask to prevent inhalation of large
respiratory droplets within 3 feet. Airborne precautions require an N95 respirator.
The mask is not optional and does not primarily prevent face touching.
, 3. A nurse is measuring a client’s blood pressure. Which action is essential for
an accurate reading?
A) Use a cuff that is too narrow for the arm
B) Support the arm at heart level and use the correct cuff size
C) Take the reading over clothing
D) Inflate the cuff rapidly to 180 mm Hg for all clients
Correct Answer: B
The arm should be supported at heart level, and the cuff bladder should cover 80%
of the arm circumference. A cuff too narrow or taking the reading over clothing
can cause falsely high readings. Inflating to a fixed value without assessing can be
inaccurate and painful.
4. A client is on a full liquid diet. Which item is appropriate?
A) Oatmeal
B) Strained cream soup
C) Soft-boiled egg
D) Mashed potatoes
Correct Answer: B
A full liquid diet includes liquids and foods that are liquid at room temperature or
melt at body temperature, such as strained cream soup. Oatmeal, soft eggs, and
mashed potatoes are not full liquids.
5. A nurse is preparing to administer a rectal suppository to an adult. Which
position is most appropriate?
A) Prone with legs extended
B) Supine with hips flexed
C) Left lateral with right leg flexed
D) Right lateral with left leg flexed
Correct Answer: C
The left lateral (Sims) position with the right leg flexed facilitates insertion into the
rectum and retention of medication. The other positions are less effective for
suppository administration.
, 6. A client has an oral temperature of 102.2°F (39°C). Which additional
assessment finding is most concerning?
A) Pulse 88 bpm
B) Respiratory rate 16 breaths per minute
C) Blood pressure 90/50 mm Hg
D) Skin warm and dry
Correct Answer: C
A blood pressure of 90/50 in a febrile client may indicate sepsis or hypovolemia
and requires immediate attention. Pulse and respiratory rate are within normal
limits. Warm, dry skin is consistent with fever.
7. A nurse is performing hand hygiene with an alcohol-based hand rub. Which
action is correct?
A) Apply the rub to visibly soiled hands
B) Rub the hands together until the product is dry, covering all surfaces
C) Use a small amount and wipe with a paper towel
D) Wash with soap and water after using the hand rub
Correct Answer: B
Alcohol-based hand rubs should be applied to all hand surfaces and rubbed until
dry. They are not used on visibly soiled hands; soap and water is required. No
paper towel is needed. Washing after is unnecessary.
8. A client is at risk for impaired skin integrity. Which nursing intervention is
most effective for prevention?
A) Massage reddened bony prominences
B) Reposition the client at least every 2 hours
C) Keep the head of the bed elevated 60 degrees
D) Use a donut-shaped cushion for sitting
Correct Answer: B
Frequent repositioning relieves pressure and prevents tissue ischemia. Massaging
reddened areas can cause further damage. Head elevation above 30 degrees
, increases shear on the sacrum. Donut cushions reduce blood flow and are not
recommended.
9. A nurse is documenting a client’s intake and output. The client had IV fluids
800 mL, oral fluids 400 mL, urine output 600 mL, and emesis 300 mL. What
is the total output?
A) 600 mL
B) 800 mL
C) 900 mL
D) 1000 mL
Correct Answer: C
Output includes urine (600 mL) and emesis (300 mL) = 900 mL. Intake is not
included. The other options omit emesis or include intake.
10.A client is receiving oxygen via simple face mask at 6 L/min. Which nursing
action is appropriate?
A) Keep the mask tight against the face at all times
B) Ensure the client can remove the mask to eat and drink
C) Use petroleum jelly around the nose to prevent dryness
D) Maintain the flow rate below 5 L/min
Correct Answer: B
A simple face mask is removed for eating and drinking. It should be set at 6–10
L/min to prevent CO₂ rebreathing. Petroleum jelly is flammable and should not be
used with oxygen. The mask should fit snugly but not be overly tight.
11.A nurse is preparing to administer a medication via a nasogastric tube.
Which action is correct?
A) Crush enteric-coated tablets and mix with water
B) Flush the tube before and after each medication with at least 30 mL of
water
C) Mix all medications together in one cup
D) Use hot water to dissolve medications quickly
