NCLEX-RN Comprehensive Practice Pack (2026)
– Practice Bank
(Original Practice Questions – Not Actual
NCSBN/NCLEX Items)
Instructions:
One best answer per question.
Correct answer: bold.
Rationale: italics.
Fundamentals, Safety & Infection Control (1–25)
1. A nurse is preparing to administer a medication. Which action is the highest priority to prevent
error?
A. Check the medication label once
B. Use two patient identifiers and follow the “rights” of medication administration
C. Ask the patient their room number
D. Prepare all meds for the hallway at once
Answer: B
Rationale: Two identifiers and strict adherence to medication rights prevent errors.
2. Which hand hygiene method is most appropriate when hands are visibly soiled?
A. Alcohol-based hand rub
B. Soap and water wash
C. Wipe with a dry towel
D. Use gloves without hand hygiene
Answer: B
Rationale: Visible soil requires washing with soap and water.
3. A patient is on contact precautions for MRSA. Which PPE is required upon room entry?
A. Gown and gloves
B. N95 respirator only
C. Face shield only
D. No PPE needed
Answer: A
Rationale: Contact precautions require gown and gloves.
, 4. Which action best prevents catheter-associated urinary tract infection (CAUTI)?
A. Keep the drainage bag above the bladder
B. Maintain a closed system and keep the bag below the bladder level
C. Disconnect tubing to empty the bag
D. Irrigate the catheter routinely without orders
Answer: B
Rationale: Closed system and proper bag positioning reduce infection risk.
5. A patient is receiving a blood transfusion. Which action is priority before starting?
A. Start the infusion immediately
B. Verify patient, blood type, unit number, and expiration with another nurse
C. Mix blood with medications
D. Use D5W to prime tubing
Answer: B
Rationale: Two-nurse verification prevents transfusion errors.
6. Which finding suggests a hemolytic transfusion reaction?
A. Mild itching only
B. Fever, chills, back pain, and hypotension
C. Slight rash
D. No symptoms
Answer: B
Rationale: Fever, chills, back pain, and hypotension indicate hemolysis.
7. Priority action for suspected hemolytic transfusion reaction:
A. Slow the infusion
B. Stop the transfusion, maintain IV with NS, notify provider and blood bank
C. Give antipyretics and continue
D. Document and finish the unit
Answer: B
Rationale: Immediate cessation limits further hemolysis.
8. Which intervention is most effective in preventing hospital-acquired infections?
A. Wearing gloves for all client contact
B. Performing hand hygiene before and after each client contact
C. Using isolation gowns for all clients
D. Administering prophylactic antibiotics to all surgical clients
Answer: B
Rationale: Hand hygiene is the single most effective measure.
9. A nurse suspects a colleague is practicing under the influence of alcohol. What is the priority
action?
A. Confront the colleague in front of patients
B. Ignore the behavior unless a mistake occurs
, C. Report the concern to the charge nurse or supervisor immediately
D. Discuss the issue with other staff members first
Answer: C
Rationale: Patient safety is the priority; report through proper channels.
10. Which situation constitutes a breach of client confidentiality?
A. Discussing a client’s case with the care team in a private conference room
B. Talking about a client’s diagnosis in the hospital elevator where visitors can overhear
C. Documenting assessment findings in the electronic health record
D. Calling the pharmacy to verify a medication order
Answer: B
Rationale: PHI must be protected; discussing in public areas is a HIPAA violation.
11. A client refuses a blood transfusion due to religious beliefs. What is the nurse’s best action?
A. Administer the transfusion anyway because it is life-saving
B. Coerce the family to convince the client
C. Respect the client’s decision and notify the provider
D. Document the refusal and leave the room without further discussion
Answer: C
Rationale: Competent adults have the right to refuse treatment.
12. A nurse makes a medication error but the client experiences no harm. What is the appropriate
action?
A. Do not report it because no harm occurred
B. Complete an incident report and notify the provider
C. Tell only the charge nurse and avoid documentation
D. Ask the client not to mention it to anyone
Answer: B
Rationale: All errors must be reported for safety and quality improvement.
13. Which action best protects the nurse from liability in case of a lawsuit?
A. Relying on verbal orders only
B. Documenting care accurately, objectively, and in a timely manner
C. Delegating all assessments to UAP
D. Avoiding difficult clients
Answer: B
Rationale: Accurate, timely, objective documentation is critical legal evidence.
14. A client is placed in restraints due to aggressive behavior. Which requirement must be met?
A. A physician’s order is needed only after 24 hours
B. Restraints can remain in place indefinitely as long as the client is calm
C. A time-limited order and frequent reassessment are required
D. Family consent replaces the need for a provider order
– Practice Bank
(Original Practice Questions – Not Actual
NCSBN/NCLEX Items)
Instructions:
One best answer per question.
Correct answer: bold.
Rationale: italics.
Fundamentals, Safety & Infection Control (1–25)
1. A nurse is preparing to administer a medication. Which action is the highest priority to prevent
error?
A. Check the medication label once
B. Use two patient identifiers and follow the “rights” of medication administration
C. Ask the patient their room number
D. Prepare all meds for the hallway at once
Answer: B
Rationale: Two identifiers and strict adherence to medication rights prevent errors.
2. Which hand hygiene method is most appropriate when hands are visibly soiled?
A. Alcohol-based hand rub
B. Soap and water wash
C. Wipe with a dry towel
D. Use gloves without hand hygiene
Answer: B
Rationale: Visible soil requires washing with soap and water.
3. A patient is on contact precautions for MRSA. Which PPE is required upon room entry?
A. Gown and gloves
B. N95 respirator only
C. Face shield only
D. No PPE needed
Answer: A
Rationale: Contact precautions require gown and gloves.
, 4. Which action best prevents catheter-associated urinary tract infection (CAUTI)?
A. Keep the drainage bag above the bladder
B. Maintain a closed system and keep the bag below the bladder level
C. Disconnect tubing to empty the bag
D. Irrigate the catheter routinely without orders
Answer: B
Rationale: Closed system and proper bag positioning reduce infection risk.
5. A patient is receiving a blood transfusion. Which action is priority before starting?
A. Start the infusion immediately
B. Verify patient, blood type, unit number, and expiration with another nurse
C. Mix blood with medications
D. Use D5W to prime tubing
Answer: B
Rationale: Two-nurse verification prevents transfusion errors.
6. Which finding suggests a hemolytic transfusion reaction?
A. Mild itching only
B. Fever, chills, back pain, and hypotension
C. Slight rash
D. No symptoms
Answer: B
Rationale: Fever, chills, back pain, and hypotension indicate hemolysis.
7. Priority action for suspected hemolytic transfusion reaction:
A. Slow the infusion
B. Stop the transfusion, maintain IV with NS, notify provider and blood bank
C. Give antipyretics and continue
D. Document and finish the unit
Answer: B
Rationale: Immediate cessation limits further hemolysis.
8. Which intervention is most effective in preventing hospital-acquired infections?
A. Wearing gloves for all client contact
B. Performing hand hygiene before and after each client contact
C. Using isolation gowns for all clients
D. Administering prophylactic antibiotics to all surgical clients
Answer: B
Rationale: Hand hygiene is the single most effective measure.
9. A nurse suspects a colleague is practicing under the influence of alcohol. What is the priority
action?
A. Confront the colleague in front of patients
B. Ignore the behavior unless a mistake occurs
, C. Report the concern to the charge nurse or supervisor immediately
D. Discuss the issue with other staff members first
Answer: C
Rationale: Patient safety is the priority; report through proper channels.
10. Which situation constitutes a breach of client confidentiality?
A. Discussing a client’s case with the care team in a private conference room
B. Talking about a client’s diagnosis in the hospital elevator where visitors can overhear
C. Documenting assessment findings in the electronic health record
D. Calling the pharmacy to verify a medication order
Answer: B
Rationale: PHI must be protected; discussing in public areas is a HIPAA violation.
11. A client refuses a blood transfusion due to religious beliefs. What is the nurse’s best action?
A. Administer the transfusion anyway because it is life-saving
B. Coerce the family to convince the client
C. Respect the client’s decision and notify the provider
D. Document the refusal and leave the room without further discussion
Answer: C
Rationale: Competent adults have the right to refuse treatment.
12. A nurse makes a medication error but the client experiences no harm. What is the appropriate
action?
A. Do not report it because no harm occurred
B. Complete an incident report and notify the provider
C. Tell only the charge nurse and avoid documentation
D. Ask the client not to mention it to anyone
Answer: B
Rationale: All errors must be reported for safety and quality improvement.
13. Which action best protects the nurse from liability in case of a lawsuit?
A. Relying on verbal orders only
B. Documenting care accurately, objectively, and in a timely manner
C. Delegating all assessments to UAP
D. Avoiding difficult clients
Answer: B
Rationale: Accurate, timely, objective documentation is critical legal evidence.
14. A client is placed in restraints due to aggressive behavior. Which requirement must be met?
A. A physician’s order is needed only after 24 hours
B. Restraints can remain in place indefinitely as long as the client is calm
C. A time-limited order and frequent reassessment are required
D. Family consent replaces the need for a provider order
