NCLEX-RN EXAM
Actual NCLEX-RN Exam Test Bank
Comprehensive Practice Questions
& Study Guide — New Updated 2026 Edition
Complete Real Questions with Correct Verified Answers
Detailed Rationales (Reliable Answers) | 250 Questions Total
250 9 8 NGN
Questions Sections Client Needs Clinical Judgment
Aligned with the 2026/2027 NCSBN NCLEX-RN Test Plan
Management of Care - Safety & Infection Control - Health Promotion
Psychosocial Integrity - Basic Care & Comfort - Pharmacological Therapies
Reduction of Risk - Physiological Adaptation - NGN Clinical Judgment
Cognitive Level Distribution
Recall 15% | Application 55% | Analysis 30%
Comprehensive Study Guide for NCLEX-RN Success
, How to Use This Study Guide
NCLEX-RN EXAM
This comprehensive test bank contains 250 NCLEX-RN style practice questions organized into nine sections that
mirror the NCSBN Client Needs framework. Each question presents a clinical scenario followed by four options;
Actual NCLEX-RN Exam Test Bank
only one option is correct. The correct answer is marked [CORRECT] immediately after the option, followed by a
Correct Answer line and a detailed Rationale explaining the clinical reasoning, pathophysiology, prioritization,
safety considerations, and test-taking
2026 / 2027strategy. Work through each
Comprehensive question Questions
Practice by attempting your answer first, then
reading the full rationale for both correct and incorrect options to reinforce learning and correct any misconceptions
before exam day. & Study Guide — New Updated 2026 Edition
Priority-setting frameworks used throughout this guide include the ABCs (Airway, Breathing, Circulation),
Maslow’s Hierarchy of Needs, the Nursing Process (ADPIE — Assessment, Diagnosis, Planning, Implementation,
Complete
Evaluation), Least Restrictive Real Questions
intervention, and Acutewith Correct
versus ChronicVerified
/ Urgent Answers
versus Non-urgent prioritization.
Delegation questions follow the five rights of delegation (Right Task, Right Circumstance,
Detailed Rationales (Reliable Answers) | 250 Questions Total Right Person, Right
Direction, Right Supervision) and respect RN, LPN/LVN, and UAP scope of practice. Review each rationale
carefully, as the explanations integrate evidence-based practice, safety standards, legal and ethical principles, and
Next Generation NCLEX (NGN) clinical judgment cues.
250 9 8 NGN
Questions Sections Client Needs Clinical Judgment
Aligned with the 2026/2027 NCSBN NCLEX-RN Test Plan
Management of Care - Safety & Infection Control - Health Promotion
Psychosocial Integrity - Basic Care & Comfort - Pharmacological Therapies
Reduction of Risk - Physiological Adaptation - NGN Clinical Judgment
Cognitive Level Distribution
Recall 15% | Application 55% | Analysis 30%
Comprehensive Study Guide for NCLEX-RN Success
,NCLEX-RN 2026/2027 Comprehensive Test Bank & Study Guide 250 Questions | Detailed Rationales
SECTION 1: Safe and Effective Care Environment — Management
of Care
Advocacy, Client Rights, Delegation, Supervision, Assignment, Ethics, Legal Issues, Advance Directives, HIPAA,
Continuity of Care, Interdisciplinary Collaboration & Case Management
Questions 1 – 45
Q1: A charge nurse is planning client care assignments for the shift. Which client should be assigned to the
most experienced RN?
A. A client admitted 2 days ago with stable chronic heart failure receiving oral furosemide.
B. A client who is 8 hours postoperative hemicolectomy with a new colostomy and requiring frequent
reassessment. [CORRECT]
C. A client with a stage 3 pressure injury needing a dressing change and wound measurement.
D. A client receiving IV antibiotics for cellulitis who is afebrile and ambulatory.
Correct Answer: B
Rationale:
The postoperative hemicolectomy client with a new colostomy is the least stable and requires complex assessment,
frequent monitoring for complications such as bleeding or anastomotic leak, and expert stoma care, which falls within
the RN scope and demands experienced clinical judgment. The stable heart failure, pressure injury, and IV antibiotic
clients have predictable needs appropriate for an LPN/LVN or a less experienced RN under supervision. Assigning the
most acute, least stable client to the most experienced RN reflects the delegation principle of matching client acuity to
staff competency and is consistent with the Five Rights of Delegation. This protects client safety and ensures
complications are recognized early.
Q2: An RN delegates ambulation of a stable postoperative client to a UAP. Which statement by the UAP
requires the RN to intervene?
A. I will check the client's identification band before ambulating.
B. I will report any dizziness or shortness of breath to you immediately.
C. The client said the pain is 8/10, but I will walk them anyway since the doctor ordered ambulation.
[CORRECT]
D. I will have the client dangle at the bedside before standing up.
Correct Answer: C
Rationale:
Ambulating a client with uncontrolled pain rated 8/10 is unsafe and exceeds the UAP scope; pain control must be
addressed by the RN before activity to prevent falls, injury, and delayed healing. The UAP should report the pain rather
than proceeding. The other statements reflect correct practice: verifying identity, reporting changes, and dangling before
standing all reduce fall risk. The RN retains accountability for delegation and must intervene to ensure the client
receives analgesia and is reassessed before ambulation, applying the nursing process and safety prioritization.
Aligned with NCSBN NCLEX-RN Test Plan 2026/2027 Page 3
, NCLEX-RN 2026/2027 Comprehensive Test Bank & Study Guide 250 Questions | Detailed Rationales
Q3: A client scheduled for an elective cholecystectomy refuses to sign the informed consent form, stating, "I
changed my mind about the surgery." What is the nurse's best action?
A. Remind the client that the surgeon has already scheduled the operating room and cancellation may incur
charges.
B. Notify the surgeon of the client's decision and document the refusal and the notification. [CORRECT]
C. Explain the risks of not having the surgery to persuade the client to consent.
D. Ask the client's spouse to encourage the client to sign the form.
Correct Answer: B
Rationale:
A competent adult has the legal and ethical right to refuse treatment at any time, even after previously consenting; this
upholds the ethical principle of autonomy. The nurse's role is to advocate for the client by notifying the surgeon so the
provider can address concerns, answer questions, and confirm the decision is informed, and to document the refusal and
notification. Coercing the client, emphasizing financial consequences, or involving family to pressure consent violates
autonomy and informed consent principles. Persuasion based on risks is only appropriate when initiated by the provider
as part of informed refusal counseling, not by the nurse to override the decision.
Q4: A nurse discovers a coworker diverting controlled substances from the medication dispensing system.
Which action should the nurse take first?
A. Confront the coworker privately and demand they return the medication.
B. Report the observation to the nursing supervisor or facility designated official. [CORRECT]
C. Document the observation in the client's medical record.
D. Wait to gather more evidence before taking any action.
Correct Answer: B
Rationale:
Suspicion of substance diversion must be reported promptly through the chain of command or to the facility's
designated official (such as nursing administration or the diversion officer) so a formal investigation can proceed; this
protects client safety and fulfills the nurse's legal and ethical duty. Confronting the coworker directly is unsafe and may
compromise the investigation or lead to retaliation. The client's medical record is not the appropriate place for personnel
observations. Waiting to gather evidence independently delays intervention and risks further client harm; investigation
is the employer's responsibility, not the individual nurse's.
Q5: An older adult client with a terminal illness has a valid DNR (Do-Not-Resuscitate) order. The client goes
into cardiac arrest and a newly hired nurse begins chest compressions. What should the charge nurse do?
A. Allow the compressions to continue since the nurse was acting in good faith.
B. Immediately stop the resuscitation and explain the DNR order to the nurse. [CORRECT]
C. Call a code and let the code team decide whether to continue.
D. Ask the family for permission to stop the resuscitation.
Correct Answer: B
Rationale:
A valid DNR order is a medical order that must be honored; the charge nurse must immediately stop the resuscitation
and educate the new nurse about the order and the client's right to refuse resuscitative measures. Continuing
compressions against a DNR violates the client's autonomy, the advance directive, and facility policy, and could
constitute battery. Calling a code or asking the family delays honoring the order and is inappropriate when a DNR is in
place. The incident should be used as a teaching moment and may warrant review of orientation and DNR identification
processes to prevent recurrence.
Aligned with NCSBN NCLEX-RN Test Plan 2026/2027 Page 4
Actual NCLEX-RN Exam Test Bank
Comprehensive Practice Questions
& Study Guide — New Updated 2026 Edition
Complete Real Questions with Correct Verified Answers
Detailed Rationales (Reliable Answers) | 250 Questions Total
250 9 8 NGN
Questions Sections Client Needs Clinical Judgment
Aligned with the 2026/2027 NCSBN NCLEX-RN Test Plan
Management of Care - Safety & Infection Control - Health Promotion
Psychosocial Integrity - Basic Care & Comfort - Pharmacological Therapies
Reduction of Risk - Physiological Adaptation - NGN Clinical Judgment
Cognitive Level Distribution
Recall 15% | Application 55% | Analysis 30%
Comprehensive Study Guide for NCLEX-RN Success
, How to Use This Study Guide
NCLEX-RN EXAM
This comprehensive test bank contains 250 NCLEX-RN style practice questions organized into nine sections that
mirror the NCSBN Client Needs framework. Each question presents a clinical scenario followed by four options;
Actual NCLEX-RN Exam Test Bank
only one option is correct. The correct answer is marked [CORRECT] immediately after the option, followed by a
Correct Answer line and a detailed Rationale explaining the clinical reasoning, pathophysiology, prioritization,
safety considerations, and test-taking
2026 / 2027strategy. Work through each
Comprehensive question Questions
Practice by attempting your answer first, then
reading the full rationale for both correct and incorrect options to reinforce learning and correct any misconceptions
before exam day. & Study Guide — New Updated 2026 Edition
Priority-setting frameworks used throughout this guide include the ABCs (Airway, Breathing, Circulation),
Maslow’s Hierarchy of Needs, the Nursing Process (ADPIE — Assessment, Diagnosis, Planning, Implementation,
Complete
Evaluation), Least Restrictive Real Questions
intervention, and Acutewith Correct
versus ChronicVerified
/ Urgent Answers
versus Non-urgent prioritization.
Delegation questions follow the five rights of delegation (Right Task, Right Circumstance,
Detailed Rationales (Reliable Answers) | 250 Questions Total Right Person, Right
Direction, Right Supervision) and respect RN, LPN/LVN, and UAP scope of practice. Review each rationale
carefully, as the explanations integrate evidence-based practice, safety standards, legal and ethical principles, and
Next Generation NCLEX (NGN) clinical judgment cues.
250 9 8 NGN
Questions Sections Client Needs Clinical Judgment
Aligned with the 2026/2027 NCSBN NCLEX-RN Test Plan
Management of Care - Safety & Infection Control - Health Promotion
Psychosocial Integrity - Basic Care & Comfort - Pharmacological Therapies
Reduction of Risk - Physiological Adaptation - NGN Clinical Judgment
Cognitive Level Distribution
Recall 15% | Application 55% | Analysis 30%
Comprehensive Study Guide for NCLEX-RN Success
,NCLEX-RN 2026/2027 Comprehensive Test Bank & Study Guide 250 Questions | Detailed Rationales
SECTION 1: Safe and Effective Care Environment — Management
of Care
Advocacy, Client Rights, Delegation, Supervision, Assignment, Ethics, Legal Issues, Advance Directives, HIPAA,
Continuity of Care, Interdisciplinary Collaboration & Case Management
Questions 1 – 45
Q1: A charge nurse is planning client care assignments for the shift. Which client should be assigned to the
most experienced RN?
A. A client admitted 2 days ago with stable chronic heart failure receiving oral furosemide.
B. A client who is 8 hours postoperative hemicolectomy with a new colostomy and requiring frequent
reassessment. [CORRECT]
C. A client with a stage 3 pressure injury needing a dressing change and wound measurement.
D. A client receiving IV antibiotics for cellulitis who is afebrile and ambulatory.
Correct Answer: B
Rationale:
The postoperative hemicolectomy client with a new colostomy is the least stable and requires complex assessment,
frequent monitoring for complications such as bleeding or anastomotic leak, and expert stoma care, which falls within
the RN scope and demands experienced clinical judgment. The stable heart failure, pressure injury, and IV antibiotic
clients have predictable needs appropriate for an LPN/LVN or a less experienced RN under supervision. Assigning the
most acute, least stable client to the most experienced RN reflects the delegation principle of matching client acuity to
staff competency and is consistent with the Five Rights of Delegation. This protects client safety and ensures
complications are recognized early.
Q2: An RN delegates ambulation of a stable postoperative client to a UAP. Which statement by the UAP
requires the RN to intervene?
A. I will check the client's identification band before ambulating.
B. I will report any dizziness or shortness of breath to you immediately.
C. The client said the pain is 8/10, but I will walk them anyway since the doctor ordered ambulation.
[CORRECT]
D. I will have the client dangle at the bedside before standing up.
Correct Answer: C
Rationale:
Ambulating a client with uncontrolled pain rated 8/10 is unsafe and exceeds the UAP scope; pain control must be
addressed by the RN before activity to prevent falls, injury, and delayed healing. The UAP should report the pain rather
than proceeding. The other statements reflect correct practice: verifying identity, reporting changes, and dangling before
standing all reduce fall risk. The RN retains accountability for delegation and must intervene to ensure the client
receives analgesia and is reassessed before ambulation, applying the nursing process and safety prioritization.
Aligned with NCSBN NCLEX-RN Test Plan 2026/2027 Page 3
, NCLEX-RN 2026/2027 Comprehensive Test Bank & Study Guide 250 Questions | Detailed Rationales
Q3: A client scheduled for an elective cholecystectomy refuses to sign the informed consent form, stating, "I
changed my mind about the surgery." What is the nurse's best action?
A. Remind the client that the surgeon has already scheduled the operating room and cancellation may incur
charges.
B. Notify the surgeon of the client's decision and document the refusal and the notification. [CORRECT]
C. Explain the risks of not having the surgery to persuade the client to consent.
D. Ask the client's spouse to encourage the client to sign the form.
Correct Answer: B
Rationale:
A competent adult has the legal and ethical right to refuse treatment at any time, even after previously consenting; this
upholds the ethical principle of autonomy. The nurse's role is to advocate for the client by notifying the surgeon so the
provider can address concerns, answer questions, and confirm the decision is informed, and to document the refusal and
notification. Coercing the client, emphasizing financial consequences, or involving family to pressure consent violates
autonomy and informed consent principles. Persuasion based on risks is only appropriate when initiated by the provider
as part of informed refusal counseling, not by the nurse to override the decision.
Q4: A nurse discovers a coworker diverting controlled substances from the medication dispensing system.
Which action should the nurse take first?
A. Confront the coworker privately and demand they return the medication.
B. Report the observation to the nursing supervisor or facility designated official. [CORRECT]
C. Document the observation in the client's medical record.
D. Wait to gather more evidence before taking any action.
Correct Answer: B
Rationale:
Suspicion of substance diversion must be reported promptly through the chain of command or to the facility's
designated official (such as nursing administration or the diversion officer) so a formal investigation can proceed; this
protects client safety and fulfills the nurse's legal and ethical duty. Confronting the coworker directly is unsafe and may
compromise the investigation or lead to retaliation. The client's medical record is not the appropriate place for personnel
observations. Waiting to gather evidence independently delays intervention and risks further client harm; investigation
is the employer's responsibility, not the individual nurse's.
Q5: An older adult client with a terminal illness has a valid DNR (Do-Not-Resuscitate) order. The client goes
into cardiac arrest and a newly hired nurse begins chest compressions. What should the charge nurse do?
A. Allow the compressions to continue since the nurse was acting in good faith.
B. Immediately stop the resuscitation and explain the DNR order to the nurse. [CORRECT]
C. Call a code and let the code team decide whether to continue.
D. Ask the family for permission to stop the resuscitation.
Correct Answer: B
Rationale:
A valid DNR order is a medical order that must be honored; the charge nurse must immediately stop the resuscitation
and educate the new nurse about the order and the client's right to refuse resuscitative measures. Continuing
compressions against a DNR violates the client's autonomy, the advance directive, and facility policy, and could
constitute battery. Calling a code or asking the family delays honoring the order and is inappropriate when a DNR is in
place. The incident should be used as a teaching moment and may warrant review of orientation and DNR identification
processes to prevent recurrence.
Aligned with NCSBN NCLEX-RN Test Plan 2026/2027 Page 4
