TEST BANK FOR NCLEX 2026 Study
Guide – Questions & Correct Answers
with solutions (2025-2026)
Q1: A patient with newly diagnosed type 2 diabetes asks about managing high blood
sugar. Which instruction is priority?
a) Administer insulin as prescribed
b) Monitor blood glucose only weekly
c) Avoid all carbohydrates permanently
d) Take insulin only when symptoms occur
Answer: a) Administer insulin as prescribed
Rationale: Consistent insulin or prescribed medications maintain blood glucose control
and prevent complications.
Q2: A patient presents with chest pain and shortness of breath. Which action is the
nurse’s priority?
a) Assess airway, breathing, and circulation (ABC)
b) Offer water
c) Provide blankets
d) Document the complaint
Answer: a) Assess airway, breathing, and circulation (ABC)
Rationale: Life-threatening issues are prioritized first using the ABC framework.
Q3: A patient with a Foley catheter has cloudy urine and fever. What is the first nursing
action?
a) Assess for urinary tract infection and notify provider
b) Remove catheter immediately
c) Restrict fluids
d) Document and continue routine care
, Answer: a) Assess for urinary tract infection and notify provider
Rationale: Early recognition of infection prevents complications such as sepsis.
Q4: Which intervention is most important to prevent aspiration in a patient with
dysphagia?
a) Keep the patient upright at 90 degrees while feeding
b) Feed quickly without supervision
c) Lay the patient flat
d) Give large amounts of liquid at once
Answer: a) Keep the patient upright at 90 degrees while feeding
Rationale: Upright positioning reduces the risk of aspiration.
Q5: A patient on morphine has a respiratory rate of 8/min. What is the priority nursing
action?
a) Hold medication and notify provider
b) Continue the dose
c) Encourage deep breathing
d) Document and monitor
Answer: a) Hold medication and notify provider
Rationale: Morphine can cause respiratory depression; immediate action is required.
Q6: Which patient is at highest risk for pressure ulcers?
a) Bedridden elderly patient
b) Ambulatory adult
c) Outpatient post minor surgery
d) Child with mild illness
Answer: a) Bedridden elderly patient
Rationale: Immobility and fragile skin increase pressure ulcer risk.
Q7: Which task is appropriate to delegate to a UAP?
a) Assist a stable patient with bathing
b) Teach a new patient insulin administration
c) Assess a newly admitted patient
d) Administer IV medications
, Answer: a) Assist a stable patient with bathing
Rationale: UAPs can perform routine care for stable patients safely.
Q8: Which lab result is priority to report for a patient on digoxin?
a) Potassium 3.2 mEq/L
b) Sodium 140 mEq/L
c) WBC 7 x10³/μL
d) Hemoglobin 14 g/dL
Answer: a) Potassium 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity.
Q9: Which sign indicates early hypoxia?
a) Tachypnea and restlessness
b) Bradycardia only
c) Hypertension only
d) Cool, pale skin only
Answer: a) Tachypnea and restlessness
Rationale: Early compensation for low oxygen includes increased respiratory rate
and agitation.
Q10: Patient teaching for a low-sodium diet should include:
a) “Avoid adding extra salt to meals.”
b) “You cannot eat any foods containing sodium.”
c) “Salt restriction is unnecessary.”
d) “Eat salty snacks freely.”
Answer: a) “Avoid adding extra salt to meals.”
Rationale: Reduces fluid retention while still allowing moderate intake from foods.
Q11: Which demonstrates proper hand hygiene?
a) Rub hands with soap for 20 seconds before and after patient contact
b) Rinse hands quickly without soap
c) Wear gloves only
d) Use cold water only
, Answer: a) Rub hands with soap for 20 seconds before and after patient contact
Rationale: Effective handwashing prevents infection.
Q12: A patient with heart failure gains 3 pounds in 2 days. Nursing action:
a) Notify provider and assess for fluid retention
b) Encourage exercise only
c) Ignore unless patient complains
d) Restrict fluids drastically without orders
Answer: a) Notify provider and assess for fluid retention
Rationale: Rapid weight gain indicates fluid overload and may signal worsening heart
failure.
Q13: A patient develops new-onset confusion and agitation. First nursing action:
a) Check blood glucose
b) Provide fluids only
c) Offer a snack
d) Document and continue routine care
Answer: a) Check blood glucose
Rationale: Hypoglycemia is a common reversible cause of confusion.
Q14: Which intervention is priority for a patient with COPD experiencing shortness of
breath?
a) High Fowler’s position and oxygen therapy
b) Encourage ambulation immediately
c) Lay patient flat
d) Restrict fluids
Answer: a) High Fowler’s position and oxygen therapy
Rationale: Upright positioning improves lung expansion; oxygen supports tissue
perfusion.
Q15: Which is the priority nursing action for a patient with chest tube drainage of 150
mL/hr?
a) Assess for signs of bleeding or complications
b) Clamp the tube
Guide – Questions & Correct Answers
with solutions (2025-2026)
Q1: A patient with newly diagnosed type 2 diabetes asks about managing high blood
sugar. Which instruction is priority?
a) Administer insulin as prescribed
b) Monitor blood glucose only weekly
c) Avoid all carbohydrates permanently
d) Take insulin only when symptoms occur
Answer: a) Administer insulin as prescribed
Rationale: Consistent insulin or prescribed medications maintain blood glucose control
and prevent complications.
Q2: A patient presents with chest pain and shortness of breath. Which action is the
nurse’s priority?
a) Assess airway, breathing, and circulation (ABC)
b) Offer water
c) Provide blankets
d) Document the complaint
Answer: a) Assess airway, breathing, and circulation (ABC)
Rationale: Life-threatening issues are prioritized first using the ABC framework.
Q3: A patient with a Foley catheter has cloudy urine and fever. What is the first nursing
action?
a) Assess for urinary tract infection and notify provider
b) Remove catheter immediately
c) Restrict fluids
d) Document and continue routine care
, Answer: a) Assess for urinary tract infection and notify provider
Rationale: Early recognition of infection prevents complications such as sepsis.
Q4: Which intervention is most important to prevent aspiration in a patient with
dysphagia?
a) Keep the patient upright at 90 degrees while feeding
b) Feed quickly without supervision
c) Lay the patient flat
d) Give large amounts of liquid at once
Answer: a) Keep the patient upright at 90 degrees while feeding
Rationale: Upright positioning reduces the risk of aspiration.
Q5: A patient on morphine has a respiratory rate of 8/min. What is the priority nursing
action?
a) Hold medication and notify provider
b) Continue the dose
c) Encourage deep breathing
d) Document and monitor
Answer: a) Hold medication and notify provider
Rationale: Morphine can cause respiratory depression; immediate action is required.
Q6: Which patient is at highest risk for pressure ulcers?
a) Bedridden elderly patient
b) Ambulatory adult
c) Outpatient post minor surgery
d) Child with mild illness
Answer: a) Bedridden elderly patient
Rationale: Immobility and fragile skin increase pressure ulcer risk.
Q7: Which task is appropriate to delegate to a UAP?
a) Assist a stable patient with bathing
b) Teach a new patient insulin administration
c) Assess a newly admitted patient
d) Administer IV medications
, Answer: a) Assist a stable patient with bathing
Rationale: UAPs can perform routine care for stable patients safely.
Q8: Which lab result is priority to report for a patient on digoxin?
a) Potassium 3.2 mEq/L
b) Sodium 140 mEq/L
c) WBC 7 x10³/μL
d) Hemoglobin 14 g/dL
Answer: a) Potassium 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity.
Q9: Which sign indicates early hypoxia?
a) Tachypnea and restlessness
b) Bradycardia only
c) Hypertension only
d) Cool, pale skin only
Answer: a) Tachypnea and restlessness
Rationale: Early compensation for low oxygen includes increased respiratory rate
and agitation.
Q10: Patient teaching for a low-sodium diet should include:
a) “Avoid adding extra salt to meals.”
b) “You cannot eat any foods containing sodium.”
c) “Salt restriction is unnecessary.”
d) “Eat salty snacks freely.”
Answer: a) “Avoid adding extra salt to meals.”
Rationale: Reduces fluid retention while still allowing moderate intake from foods.
Q11: Which demonstrates proper hand hygiene?
a) Rub hands with soap for 20 seconds before and after patient contact
b) Rinse hands quickly without soap
c) Wear gloves only
d) Use cold water only
, Answer: a) Rub hands with soap for 20 seconds before and after patient contact
Rationale: Effective handwashing prevents infection.
Q12: A patient with heart failure gains 3 pounds in 2 days. Nursing action:
a) Notify provider and assess for fluid retention
b) Encourage exercise only
c) Ignore unless patient complains
d) Restrict fluids drastically without orders
Answer: a) Notify provider and assess for fluid retention
Rationale: Rapid weight gain indicates fluid overload and may signal worsening heart
failure.
Q13: A patient develops new-onset confusion and agitation. First nursing action:
a) Check blood glucose
b) Provide fluids only
c) Offer a snack
d) Document and continue routine care
Answer: a) Check blood glucose
Rationale: Hypoglycemia is a common reversible cause of confusion.
Q14: Which intervention is priority for a patient with COPD experiencing shortness of
breath?
a) High Fowler’s position and oxygen therapy
b) Encourage ambulation immediately
c) Lay patient flat
d) Restrict fluids
Answer: a) High Fowler’s position and oxygen therapy
Rationale: Upright positioning improves lung expansion; oxygen supports tissue
perfusion.
Q15: Which is the priority nursing action for a patient with chest tube drainage of 150
mL/hr?
a) Assess for signs of bleeding or complications
b) Clamp the tube
