NCLEX-RN CompREhENsivE EXamiNatioN – NatioNaL CouNCiL of
statE BoaRds of NuRsiNg (NCsBN) – 2026/2027 aCadEmiC YEaR –
100 QuEstioNs aNd aNswERs CovERiNg fivE CoRE domaiNs ||
vERifiEd BY EXpERts .
The following 100 questions are organized into the four major NCLEX-RN
Client Needs categories, aligned with the NCSBN NCLEX-RN Test Plan. Each
question includes four answer choices, the correct answer, and a detailed
rationale grounded in evidence-based nursing practice and the NCLEX-RN
examination blueprint.
Client Needs Category: Safe and Effective Care Environment (Questions 1–25)
Question 1: A nurse is caring for a client who is postoperative following abdominal surgery.
Which action is most important for preventing a pulmonary embolism?
• A) Encourage use of the incentive spirometer every hour
• B) Apply sequential compression devices to the lower extremities
• C) Administer prescribed anticoagulants as ordered
• D) Assist the client to ambulate in the hallway three times daily
CoRRECt aNswER: D
RatioNaLE: Ambulation is the most effective intervention for preventing deep vein thrombosis
and subsequent pulmonary embolism. It promotes venous return and prevents stasis. The other
interventions are also important but ambulation is paramount. This addresses Safety and
Infection Control (Standard Precautions/Transmission-Based Precautions).
Question 2: A nurse is preparing to administer a blood transfusion to a client. Which action is
the priority before beginning the transfusion?
• A) Verify the blood product with another licensed nurse using two client identifiers
• B) Obtain the client's vital signs
• C) Prime the tubing with normal saline
• D) Ask the client about previous transfusion reactions
,CoRRECt aNswER: A
RatioNaLE: Verification of the blood product with another licensed nurse using two client
identifiers is the priority to prevent transfusion errors. All other actions are important but
verification is critical for safety. This addresses Safety and Infection Control (Identifying and
Responding to Client Condition Emergencies).
Question 3: A client on fall precautions is attempting to get out of bed without assistance. What
is the nurse's priority action?
• A) Apply a vest restraint
• B) Place the bed in the lowest position and keep the call light within reach
• C) Ask the client to wait for assistance
• D) Notify the healthcare provider
CoRRECt aNswER: B
RatioNaLE: Maintaining the bed in the lowest position and keeping the call light within reach are
the least restrictive interventions to prevent falls. Restraints should only be used as a last resort.
This addresses Safety and Infection Control (Accident/Injury Prevention).
Question 4: A nurse is caring for a client with a nasogastric tube attached to continuous
suction. Which finding requires immediate intervention?
• A) The client reports nausea
• B) The suction machine is set at 120 mmHg
• C) The client has dry mucous membranes
• D) The tube is draining green fluid
CoRRECt aNswER: B
RatioNaLE: Continuous suction for an NG tube should typically be set at 40-80 mmHg. High
suction can cause damage to the gastric mucosa. The nurse should verify the ordered suction
setting. This addresses Safety and Infection Control (Maintaining a Safe Environment).
Question 5: Which of the following clients should the nurse assess first?
• A) A client with COPD who has an oxygen saturation of 89%
• B) A client with chest pain who reports nausea and is diaphoretic
• C) A client with a urinary tract infection who has a fever of 101.2°F
, • D) A client with a surgical wound who has a dressing saturated with serosanguineous
drainage
CoRRECt aNswER: B
RatioNaLE: The client with chest pain, nausea, and diaphoresis is exhibiting signs of a possible
myocardial infarction and should be assessed first. This is a life-threatening emergency. This
addresses Management of Care (Establishing Priorities).
Question 6: A nurse is teaching a client about the use of a patient-controlled analgesia (PCA)
pump. Which statement indicates the client understands the teaching?
• A) "I will push the button whenever I feel pain."
• B) "My family can push the button for me if I am asleep."
• C) "I should only push the button when the pain is severe."
• D) "I will wait 20 minutes between doses."
CoRRECt aNswER: A
RatioNaLE: The client should be instructed to push the button whenever pain is felt to maintain
a therapeutic level of analgesia. Family members should not push the button due to the risk of
overdose. This addresses Pharmacological and Parenteral Therapies (Analgesics and
Anesthetics).
Question 7: A nurse is preparing to discharge a client who is prescribed warfarin. Which
statement indicates the client understands the medication teaching?
• A) "I will take aspirin for my headaches."
• B) "I will avoid eating green leafy vegetables."
• C) "I will have my blood drawn regularly to check my INR."
• D) "I can stop taking the medication when my symptoms improve."
CoRRECt aNswER: C
RatioNaLE: Regular INR monitoring is essential for clients on warfarin to ensure therapeutic
levels and prevent bleeding or clotting complications. Green leafy vegetables should be
consumed consistently, not avoided entirely. This addresses Pharmacological and Parenteral
Therapies (Anticoagulants).
Question 8: A client is on contact precautions. Which personal protective equipment (PPE)
should the nurse wear when entering the room?
• A) Gloves and gown
, • B) Gloves and mask
• C) Gown and mask
• D) Gloves, gown, and mask
CoRRECt aNswER: A
RatioNaLE: Contact precautions require gloves and a gown. A mask is required for droplet
precautions; airborne precautions require an N95 respirator. This addresses Safety and
Infection Control (Standard Precautions/Transmission-Based Precautions).
Question 9: A nurse is preparing to administer a medication that is a high-alert medication.
Which action is most important?
• A) Check the medication three times before administration
• B) Verify the medication with another nurse
• C) Document the medication administration immediately
• D) Assess the client's vital signs before administration
CoRRECt aNswER: B
RatioNaLE: High-alert medications require independent double-check verification by two nurses
to prevent medication errors. This is a specific safety measure for high-alert medications. This
addresses Pharmacological and Parenteral Therapies (Medication Administration).
Question 10: A client has an advance directive that states "Do Not Resuscitate" (DNR). The
client becomes unresponsive and pulseless. What should the nurse do?
• A) Initiate CPR immediately
• B) Call the healthcare provider for clarification
• C) Respect the DNR order and not initiate CPR
• D) Ask the family for permission to initiate CPR
CoRRECt aNswER: C
RatioNaLE: A valid DNR order must be respected. The nurse should not initiate CPR. If there is
any ambiguity about the DNR order, the healthcare provider should be contacted. This
addresses Management of Care (Legal Rights and Responsibilities).
Question 11: A nurse is caring for a client with a chest tube. Which finding indicates a possible
air leak?
• A) Continuous bubbling in the water seal chamber
statE BoaRds of NuRsiNg (NCsBN) – 2026/2027 aCadEmiC YEaR –
100 QuEstioNs aNd aNswERs CovERiNg fivE CoRE domaiNs ||
vERifiEd BY EXpERts .
The following 100 questions are organized into the four major NCLEX-RN
Client Needs categories, aligned with the NCSBN NCLEX-RN Test Plan. Each
question includes four answer choices, the correct answer, and a detailed
rationale grounded in evidence-based nursing practice and the NCLEX-RN
examination blueprint.
Client Needs Category: Safe and Effective Care Environment (Questions 1–25)
Question 1: A nurse is caring for a client who is postoperative following abdominal surgery.
Which action is most important for preventing a pulmonary embolism?
• A) Encourage use of the incentive spirometer every hour
• B) Apply sequential compression devices to the lower extremities
• C) Administer prescribed anticoagulants as ordered
• D) Assist the client to ambulate in the hallway three times daily
CoRRECt aNswER: D
RatioNaLE: Ambulation is the most effective intervention for preventing deep vein thrombosis
and subsequent pulmonary embolism. It promotes venous return and prevents stasis. The other
interventions are also important but ambulation is paramount. This addresses Safety and
Infection Control (Standard Precautions/Transmission-Based Precautions).
Question 2: A nurse is preparing to administer a blood transfusion to a client. Which action is
the priority before beginning the transfusion?
• A) Verify the blood product with another licensed nurse using two client identifiers
• B) Obtain the client's vital signs
• C) Prime the tubing with normal saline
• D) Ask the client about previous transfusion reactions
,CoRRECt aNswER: A
RatioNaLE: Verification of the blood product with another licensed nurse using two client
identifiers is the priority to prevent transfusion errors. All other actions are important but
verification is critical for safety. This addresses Safety and Infection Control (Identifying and
Responding to Client Condition Emergencies).
Question 3: A client on fall precautions is attempting to get out of bed without assistance. What
is the nurse's priority action?
• A) Apply a vest restraint
• B) Place the bed in the lowest position and keep the call light within reach
• C) Ask the client to wait for assistance
• D) Notify the healthcare provider
CoRRECt aNswER: B
RatioNaLE: Maintaining the bed in the lowest position and keeping the call light within reach are
the least restrictive interventions to prevent falls. Restraints should only be used as a last resort.
This addresses Safety and Infection Control (Accident/Injury Prevention).
Question 4: A nurse is caring for a client with a nasogastric tube attached to continuous
suction. Which finding requires immediate intervention?
• A) The client reports nausea
• B) The suction machine is set at 120 mmHg
• C) The client has dry mucous membranes
• D) The tube is draining green fluid
CoRRECt aNswER: B
RatioNaLE: Continuous suction for an NG tube should typically be set at 40-80 mmHg. High
suction can cause damage to the gastric mucosa. The nurse should verify the ordered suction
setting. This addresses Safety and Infection Control (Maintaining a Safe Environment).
Question 5: Which of the following clients should the nurse assess first?
• A) A client with COPD who has an oxygen saturation of 89%
• B) A client with chest pain who reports nausea and is diaphoretic
• C) A client with a urinary tract infection who has a fever of 101.2°F
, • D) A client with a surgical wound who has a dressing saturated with serosanguineous
drainage
CoRRECt aNswER: B
RatioNaLE: The client with chest pain, nausea, and diaphoresis is exhibiting signs of a possible
myocardial infarction and should be assessed first. This is a life-threatening emergency. This
addresses Management of Care (Establishing Priorities).
Question 6: A nurse is teaching a client about the use of a patient-controlled analgesia (PCA)
pump. Which statement indicates the client understands the teaching?
• A) "I will push the button whenever I feel pain."
• B) "My family can push the button for me if I am asleep."
• C) "I should only push the button when the pain is severe."
• D) "I will wait 20 minutes between doses."
CoRRECt aNswER: A
RatioNaLE: The client should be instructed to push the button whenever pain is felt to maintain
a therapeutic level of analgesia. Family members should not push the button due to the risk of
overdose. This addresses Pharmacological and Parenteral Therapies (Analgesics and
Anesthetics).
Question 7: A nurse is preparing to discharge a client who is prescribed warfarin. Which
statement indicates the client understands the medication teaching?
• A) "I will take aspirin for my headaches."
• B) "I will avoid eating green leafy vegetables."
• C) "I will have my blood drawn regularly to check my INR."
• D) "I can stop taking the medication when my symptoms improve."
CoRRECt aNswER: C
RatioNaLE: Regular INR monitoring is essential for clients on warfarin to ensure therapeutic
levels and prevent bleeding or clotting complications. Green leafy vegetables should be
consumed consistently, not avoided entirely. This addresses Pharmacological and Parenteral
Therapies (Anticoagulants).
Question 8: A client is on contact precautions. Which personal protective equipment (PPE)
should the nurse wear when entering the room?
• A) Gloves and gown
, • B) Gloves and mask
• C) Gown and mask
• D) Gloves, gown, and mask
CoRRECt aNswER: A
RatioNaLE: Contact precautions require gloves and a gown. A mask is required for droplet
precautions; airborne precautions require an N95 respirator. This addresses Safety and
Infection Control (Standard Precautions/Transmission-Based Precautions).
Question 9: A nurse is preparing to administer a medication that is a high-alert medication.
Which action is most important?
• A) Check the medication three times before administration
• B) Verify the medication with another nurse
• C) Document the medication administration immediately
• D) Assess the client's vital signs before administration
CoRRECt aNswER: B
RatioNaLE: High-alert medications require independent double-check verification by two nurses
to prevent medication errors. This is a specific safety measure for high-alert medications. This
addresses Pharmacological and Parenteral Therapies (Medication Administration).
Question 10: A client has an advance directive that states "Do Not Resuscitate" (DNR). The
client becomes unresponsive and pulseless. What should the nurse do?
• A) Initiate CPR immediately
• B) Call the healthcare provider for clarification
• C) Respect the DNR order and not initiate CPR
• D) Ask the family for permission to initiate CPR
CoRRECt aNswER: C
RatioNaLE: A valid DNR order must be respected. The nurse should not initiate CPR. If there is
any ambiguity about the DNR order, the healthcare provider should be contacted. This
addresses Management of Care (Legal Rights and Responsibilities).
Question 11: A nurse is caring for a client with a chest tube. Which finding indicates a possible
air leak?
• A) Continuous bubbling in the water seal chamber
