Page 1 of 66
NCSBN NCLEX EXAM HIGH-YIELD EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
NCSBN NCLEX EXAM: 250 PRACTICE QUESTIONS WITH RATIONALES
10-POINT SUMMARIZED EXAM COVERAGE
QUESTIONS 1-50: SAFE AND EFFECTIVE CARE ENVIRONMENT
1. A nurse is preparing to administer an enteral feeding to a client via a nasogastric
(NG) tube. Which of the following actions should the nurse take first?
A. Check the pH of the gastric aspirate to verify tube placement
B. Flush the tube with 30 mL of water
C. Elevate the head of the bed to 30-45 degrees
D. Warm the feeding formula to room temperature
Correct Answer: A
Rationale: Verifying placement of the NG tube is the priority action before administering
any enteral feeding. Checking the pH of gastric aspirate is an evidence-based method to
confirm tube placement, as gastric contents typically have a pH of 1-4. While elevating the
head of the bed is an important safety measure to prevent aspiration, verifying placement
must occur first to prevent administration of formula into the lungs .
2. The nurse is caring for a client with a wound infection confirmed to be vancomycin-
resistant enterococcus (VRE). Which personal protective equipment (PPE) should the
nurse don before entering the client's room?
A. Gloves and a gown
B. Gloves, gown, and a surgical mask
C. Gloves, gown, and an N95 respirator
D. Gloves and a surgical mask
Correct Answer: A
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Rationale: VRE is transmitted via direct contact with the client or contaminated surfaces.
Contact precautions require the use of gloves and a gown for all interactions that may involve
contact with the client or their environment. A mask is not required unless there is a risk of
splash or the client also has a respiratory infection requiring droplet precautions. Contact
precautions are appropriate for multidrug-resistant organisms such as VRE and MRSA .
3. A home health nurse is assessing an older adult client's home for safety hazards.
Which of the following findings should the nurse identify as the greatest safety risk?
A. The hot water heater is set to 49°C (120°F)
B. A carbon monoxide detector is present on each floor
C. A small space heater is placed 1 foot away from the bed with a blanket draped over it
D. Medications are stored in a clearly labeled, locked cabinet
Correct Answer: C
Rationale: A space heater with a blanket draped over it is a significant fire hazard. Space
heaters should be placed at least 3 feet away from anything that can burn, should never be left
unattended, and should never have anything placed on or near them. The other options
demonstrate safe home practices. Hot water at 49°C (120°F) is the recommended safe
temperature to prevent scalding .
4. A nurse is caring for a client who is confused and has been placed in soft wrist
restraints. Which of the following actions should the nurse take?
A. Remove the restraints every 4 hours to assess skin integrity
B. Tie the restraints to the side rails of the bed
C. Document the client's behavior and the need for restraints every 2 hours
D. Apply restraints tightly enough to prevent any movement
Correct Answer: C
Rationale: The nurse must document the client's behavior and the need for restraints every 2
hours as part of ongoing assessment. Restraints should be removed every 2 hours (not 4
hours) for range of motion and skin assessment. Restraints should be tied to the bed frame,
not side rails, as side rails can move and tighten the restraints. Restraints should be applied
with enough space to allow two fingers to fit between the restraint and the client's wrist to
maintain circulation.
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5. The nurse is caring for a client who is on fall precautions. Which of the following
interventions should the nurse implement?
A. Keep the bed in the lowest position with the side rails up
B. Place a fall risk alert sign above the client's bed
C. Encourage the client to call for assistance before getting out of bed
D. All of the above
Correct Answer: D
Rationale: All of these interventions are appropriate for a client on fall precautions. Keeping
the bed in the lowest position with side rails up (as appropriate) reduces injury risk if the
client falls. A fall risk alert sign notifies all staff of the client's risk. Teaching the client to call
for assistance empowers the client to participate in their safety. Other interventions include
placing the call light within reach, keeping the room free of clutter, and providing non-skid
footwear .
6. A nurse is preparing to administer a controlled substance to a client. Which of the
following actions is the primary purpose of having a second nurse witness the waste of
the unused portion?
A. To ensure the correct dosage was administered
B. To document the medication was given as prescribed
C. To prevent diversion of the controlled substance
D. To calculate the exact amount of medication wasted
Correct Answer: C
Rationale: The primary purpose of having a witness for the waste of controlled substances is
to deter and prevent drug diversion. The witness verifies that the remaining medication was
actually discarded and not taken for personal use or distribution. While it also ensures
accuracy and legal compliance, preventing diversion is the core safety and legal intent. This
is a key nursing responsibility under the Controlled Substances Act .
7. The nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of the
following tasks is appropriate for the nurse to delegate to the UAP?
A. Performing a sterile dressing change for a client with a surgical wound
B. Administering a tube feeding to a client with a gastrostomy tube
C. Obtaining vital signs on a client who is stable
D. Teaching a client how to self-administer insulin
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Correct Answer: C
Rationale: Obtaining vital signs on a stable client is within the scope of practice for a UAP.
Sterile dressing changes, tube feeding administration, and client teaching are all nursing
interventions that require the skill and judgment of a licensed nurse (RN or LPN). The RN
retains accountability for delegation and must ensure the UAP is competent to perform the
delegated task .
8. A nurse is providing teaching to a client about home safety measures to prevent falls.
Which of the following statements by the client indicates a need for further teaching?
A. "I will install grab bars in my bathroom by the toilet and shower."
B. "I should remove throw rugs from my home or use a non-slip backing."
C. "I will ensure my hallways and stairways are well-lit."
D. "I will wear my old, loose-fitting slippers for comfort when walking at night."
Correct Answer: D
Rationale: Loose-fitting, worn slippers are a fall hazard. They can easily slip off the feet,
causing the client to trip. Clients should be taught to wear well-fitting, non-slip footwear at
all times to reduce the risk of falls. The other statements all indicate correct understanding of
fall prevention strategies .
9. The nurse is preparing for a disaster drill. In the triage area, which color tag should
be assigned to a client who has major injuries but is expected to survive with treatment?
A. Red (immediate treatment needed)
B. Yellow (urgent but can wait)
C. Green (minor injuries)
D. Black (deceased or expected to die)
Correct Answer: A
Rationale: Red tags are assigned to victims with major injuries who require immediate
treatment and are expected to survive. Yellow tags indicate urgent but can wait (delayed).
Green tags indicate minor injuries (walking wounded). Black tags indicate deceased or those
with injuries so severe they are not expected to survive with available resources. This triage
system helps prioritize care during mass casualty events.
NCSBN NCLEX EXAM HIGH-YIELD EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
NCSBN NCLEX EXAM: 250 PRACTICE QUESTIONS WITH RATIONALES
10-POINT SUMMARIZED EXAM COVERAGE
QUESTIONS 1-50: SAFE AND EFFECTIVE CARE ENVIRONMENT
1. A nurse is preparing to administer an enteral feeding to a client via a nasogastric
(NG) tube. Which of the following actions should the nurse take first?
A. Check the pH of the gastric aspirate to verify tube placement
B. Flush the tube with 30 mL of water
C. Elevate the head of the bed to 30-45 degrees
D. Warm the feeding formula to room temperature
Correct Answer: A
Rationale: Verifying placement of the NG tube is the priority action before administering
any enteral feeding. Checking the pH of gastric aspirate is an evidence-based method to
confirm tube placement, as gastric contents typically have a pH of 1-4. While elevating the
head of the bed is an important safety measure to prevent aspiration, verifying placement
must occur first to prevent administration of formula into the lungs .
2. The nurse is caring for a client with a wound infection confirmed to be vancomycin-
resistant enterococcus (VRE). Which personal protective equipment (PPE) should the
nurse don before entering the client's room?
A. Gloves and a gown
B. Gloves, gown, and a surgical mask
C. Gloves, gown, and an N95 respirator
D. Gloves and a surgical mask
Correct Answer: A
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Rationale: VRE is transmitted via direct contact with the client or contaminated surfaces.
Contact precautions require the use of gloves and a gown for all interactions that may involve
contact with the client or their environment. A mask is not required unless there is a risk of
splash or the client also has a respiratory infection requiring droplet precautions. Contact
precautions are appropriate for multidrug-resistant organisms such as VRE and MRSA .
3. A home health nurse is assessing an older adult client's home for safety hazards.
Which of the following findings should the nurse identify as the greatest safety risk?
A. The hot water heater is set to 49°C (120°F)
B. A carbon monoxide detector is present on each floor
C. A small space heater is placed 1 foot away from the bed with a blanket draped over it
D. Medications are stored in a clearly labeled, locked cabinet
Correct Answer: C
Rationale: A space heater with a blanket draped over it is a significant fire hazard. Space
heaters should be placed at least 3 feet away from anything that can burn, should never be left
unattended, and should never have anything placed on or near them. The other options
demonstrate safe home practices. Hot water at 49°C (120°F) is the recommended safe
temperature to prevent scalding .
4. A nurse is caring for a client who is confused and has been placed in soft wrist
restraints. Which of the following actions should the nurse take?
A. Remove the restraints every 4 hours to assess skin integrity
B. Tie the restraints to the side rails of the bed
C. Document the client's behavior and the need for restraints every 2 hours
D. Apply restraints tightly enough to prevent any movement
Correct Answer: C
Rationale: The nurse must document the client's behavior and the need for restraints every 2
hours as part of ongoing assessment. Restraints should be removed every 2 hours (not 4
hours) for range of motion and skin assessment. Restraints should be tied to the bed frame,
not side rails, as side rails can move and tighten the restraints. Restraints should be applied
with enough space to allow two fingers to fit between the restraint and the client's wrist to
maintain circulation.
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5. The nurse is caring for a client who is on fall precautions. Which of the following
interventions should the nurse implement?
A. Keep the bed in the lowest position with the side rails up
B. Place a fall risk alert sign above the client's bed
C. Encourage the client to call for assistance before getting out of bed
D. All of the above
Correct Answer: D
Rationale: All of these interventions are appropriate for a client on fall precautions. Keeping
the bed in the lowest position with side rails up (as appropriate) reduces injury risk if the
client falls. A fall risk alert sign notifies all staff of the client's risk. Teaching the client to call
for assistance empowers the client to participate in their safety. Other interventions include
placing the call light within reach, keeping the room free of clutter, and providing non-skid
footwear .
6. A nurse is preparing to administer a controlled substance to a client. Which of the
following actions is the primary purpose of having a second nurse witness the waste of
the unused portion?
A. To ensure the correct dosage was administered
B. To document the medication was given as prescribed
C. To prevent diversion of the controlled substance
D. To calculate the exact amount of medication wasted
Correct Answer: C
Rationale: The primary purpose of having a witness for the waste of controlled substances is
to deter and prevent drug diversion. The witness verifies that the remaining medication was
actually discarded and not taken for personal use or distribution. While it also ensures
accuracy and legal compliance, preventing diversion is the core safety and legal intent. This
is a key nursing responsibility under the Controlled Substances Act .
7. The nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of the
following tasks is appropriate for the nurse to delegate to the UAP?
A. Performing a sterile dressing change for a client with a surgical wound
B. Administering a tube feeding to a client with a gastrostomy tube
C. Obtaining vital signs on a client who is stable
D. Teaching a client how to self-administer insulin
, Page 4 of 66
Correct Answer: C
Rationale: Obtaining vital signs on a stable client is within the scope of practice for a UAP.
Sterile dressing changes, tube feeding administration, and client teaching are all nursing
interventions that require the skill and judgment of a licensed nurse (RN or LPN). The RN
retains accountability for delegation and must ensure the UAP is competent to perform the
delegated task .
8. A nurse is providing teaching to a client about home safety measures to prevent falls.
Which of the following statements by the client indicates a need for further teaching?
A. "I will install grab bars in my bathroom by the toilet and shower."
B. "I should remove throw rugs from my home or use a non-slip backing."
C. "I will ensure my hallways and stairways are well-lit."
D. "I will wear my old, loose-fitting slippers for comfort when walking at night."
Correct Answer: D
Rationale: Loose-fitting, worn slippers are a fall hazard. They can easily slip off the feet,
causing the client to trip. Clients should be taught to wear well-fitting, non-slip footwear at
all times to reduce the risk of falls. The other statements all indicate correct understanding of
fall prevention strategies .
9. The nurse is preparing for a disaster drill. In the triage area, which color tag should
be assigned to a client who has major injuries but is expected to survive with treatment?
A. Red (immediate treatment needed)
B. Yellow (urgent but can wait)
C. Green (minor injuries)
D. Black (deceased or expected to die)
Correct Answer: A
Rationale: Red tags are assigned to victims with major injuries who require immediate
treatment and are expected to survive. Yellow tags indicate urgent but can wait (delayed).
Green tags indicate minor injuries (walking wounded). Black tags indicate deceased or those
with injuries so severe they are not expected to survive with available resources. This triage
system helps prioritize care during mass casualty events.
