NCLEX-RN® PRACTICE EXAM 2026-
2027: QUESTIONS WITH ANSWERS,
RATIONALES, AND CLINICAL
JUDGMENT STRATEGIES
SECTION 1: Management of Care (Questions 1-20)
Question 1
A nurse is caring for a client who has a new diagnosis of terminal cancer.
The client states, "I don't want to be resuscitated if my heart stops." Which
of the following actions should the nurse take FIRST?
A. Notify the provider of the client's request
B. Document the client's request in the medical record
C. Ask the client to sign a do-not-resuscitate (DNR) order
D. Inform the family of the client's decision
Correct Answer: A
Rationale: The nurse should first notify the provider of the client's request
so the provider can discuss the DNR order with the client and obtain a
signed order. The nurse cannot independently implement a DNR order.
Documentation (B) should occur after notifying the provider. The nurse
cannot ask the client to sign a DNR order (C) as this requires a provider's
,order. The client's decision should remain confidential unless the client
gives permission to inform the family (D) .
Question 2
A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which of the following tasks is appropriate to delegate?
A. Administering oral medications
B. Performing a sterile dressing change
C. Measuring and recording intake and output
D. Assessing a client's surgical incision
Correct Answer: C
Rationale: Measuring and recording intake and output is a standard task
that can be delegated to a UAP as it does not require nursing judgment.
Administering medications (A) and performing sterile procedures (B)
require licensed nursing personnel. Assessment (D) requires the clinical
judgment of a registered nurse and cannot be delegated .
Question 3
A charge nurse is assigning client care. Which client should be assigned to
the most experienced RN?
A. A client who is 2 days postoperative following an appendectomy
B. A client with stable chronic obstructive pulmonary disease (COPD)
C. A client who is 1 hour post-cardiac catheterization
D. A client requiring a blood transfusion
Correct Answer: C
,Rationale: The client who is 1 hour post-cardiac catheterization is at
highest risk for complications such as bleeding, hematoma, or vessel
occlusion. This client requires the most experienced RN. The postoperative
appendectomy client (A) and stable COPD client (B) can be assigned to less
experienced nurses. While blood transfusions (D) require monitoring, the
immediate post-procedure cardiac client is the priority for the most
experienced nurse.
Question 4
A nurse is planning care for a client who has a history of falls. Which of the
following interventions is the priority?
A. Place a fall risk identification wristband on the client
B. Instruct the client to call for assistance before getting out of bed
C. Ensure the bed alarm is functioning
D. Keep the client's personal belongings within reach
Correct Answer: B
Rationale: Instructing the client to call for assistance is the most direct
intervention for preventing falls. Client education and engagement is the
priority intervention. While the other interventions are important, they are
supportive measures rather than the primary preventive action .
Question 5
A nurse is preparing a client for a surgical procedure. Which of the
following actions is the nurse's responsibility regarding informed consent?
A. Explain the risks and benefits of the procedure
B. Witness the client's signature on the consent form
, C. Ensure the client is competent to sign the consent
D. Obtain the consent from the client's family member
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the client's
signature, confirming the client is signing voluntarily and appears to
understand what they are signing. Explaining risks and benefits (A) is the
provider's responsibility. Determining competency (C) is a legal
determination made by the provider. The client must consent for
themselves unless they lack capacity and have a designated healthcare
proxy (D).
Question 6
A nurse is caring for a client who has a new prescription for a clear liquid
diet. Which of the following items should the nurse provide?
A. Gelatin
B. Pudding
C. Apple juice
D. Cream of chicken soup
E. Lemon ice
F. A, C, and E
Correct Answer: F
Rationale: Clear liquids include items that are transparent at room
temperature: gelatin, apple juice, and lemon ice. Pudding (B) is a full liquid.
Cream of chicken soup (D) contains solids and is not a clear liquid .
Question 7
2027: QUESTIONS WITH ANSWERS,
RATIONALES, AND CLINICAL
JUDGMENT STRATEGIES
SECTION 1: Management of Care (Questions 1-20)
Question 1
A nurse is caring for a client who has a new diagnosis of terminal cancer.
The client states, "I don't want to be resuscitated if my heart stops." Which
of the following actions should the nurse take FIRST?
A. Notify the provider of the client's request
B. Document the client's request in the medical record
C. Ask the client to sign a do-not-resuscitate (DNR) order
D. Inform the family of the client's decision
Correct Answer: A
Rationale: The nurse should first notify the provider of the client's request
so the provider can discuss the DNR order with the client and obtain a
signed order. The nurse cannot independently implement a DNR order.
Documentation (B) should occur after notifying the provider. The nurse
cannot ask the client to sign a DNR order (C) as this requires a provider's
,order. The client's decision should remain confidential unless the client
gives permission to inform the family (D) .
Question 2
A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which of the following tasks is appropriate to delegate?
A. Administering oral medications
B. Performing a sterile dressing change
C. Measuring and recording intake and output
D. Assessing a client's surgical incision
Correct Answer: C
Rationale: Measuring and recording intake and output is a standard task
that can be delegated to a UAP as it does not require nursing judgment.
Administering medications (A) and performing sterile procedures (B)
require licensed nursing personnel. Assessment (D) requires the clinical
judgment of a registered nurse and cannot be delegated .
Question 3
A charge nurse is assigning client care. Which client should be assigned to
the most experienced RN?
A. A client who is 2 days postoperative following an appendectomy
B. A client with stable chronic obstructive pulmonary disease (COPD)
C. A client who is 1 hour post-cardiac catheterization
D. A client requiring a blood transfusion
Correct Answer: C
,Rationale: The client who is 1 hour post-cardiac catheterization is at
highest risk for complications such as bleeding, hematoma, or vessel
occlusion. This client requires the most experienced RN. The postoperative
appendectomy client (A) and stable COPD client (B) can be assigned to less
experienced nurses. While blood transfusions (D) require monitoring, the
immediate post-procedure cardiac client is the priority for the most
experienced nurse.
Question 4
A nurse is planning care for a client who has a history of falls. Which of the
following interventions is the priority?
A. Place a fall risk identification wristband on the client
B. Instruct the client to call for assistance before getting out of bed
C. Ensure the bed alarm is functioning
D. Keep the client's personal belongings within reach
Correct Answer: B
Rationale: Instructing the client to call for assistance is the most direct
intervention for preventing falls. Client education and engagement is the
priority intervention. While the other interventions are important, they are
supportive measures rather than the primary preventive action .
Question 5
A nurse is preparing a client for a surgical procedure. Which of the
following actions is the nurse's responsibility regarding informed consent?
A. Explain the risks and benefits of the procedure
B. Witness the client's signature on the consent form
, C. Ensure the client is competent to sign the consent
D. Obtain the consent from the client's family member
Correct Answer: B
Rationale: The nurse's role in informed consent is to witness the client's
signature, confirming the client is signing voluntarily and appears to
understand what they are signing. Explaining risks and benefits (A) is the
provider's responsibility. Determining competency (C) is a legal
determination made by the provider. The client must consent for
themselves unless they lack capacity and have a designated healthcare
proxy (D).
Question 6
A nurse is caring for a client who has a new prescription for a clear liquid
diet. Which of the following items should the nurse provide?
A. Gelatin
B. Pudding
C. Apple juice
D. Cream of chicken soup
E. Lemon ice
F. A, C, and E
Correct Answer: F
Rationale: Clear liquids include items that are transparent at room
temperature: gelatin, apple juice, and lemon ice. Pudding (B) is a full liquid.
Cream of chicken soup (D) contains solids and is not a clear liquid .
Question 7
