1
Saunders Comprehensive Review 8th Edition
NCLEX-RN Practice Exam 100 Questions
Actual Exam 2026/2027 Complete Exam-
Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+
Graded
Part I: Safe and Effective Care Environment – Management of
Care & Safety (Questions 1-20)
Q1: A nurse is caring for a 72-year-old client who was admitted
with pneumonia. The client has an advance directive stating they
do not want intubation or mechanical ventilation. The client's
son approaches the nurse and demands that "everything be
done" for his father because he believes his father didn't
understand what he was signing. What is the nurse's BEST
initial action?
A. Call the hospital administrator to mediate the dispute
B. Explain to the son that the advance directive is a legal
document honoring his father's wishes and offer to contact the
healthcare provider and social worker to facilitate a family
meeting
,2
C. Tell the son that nurses cannot discuss advance directives
with family members without the client present
D. Follow the son's wishes since he is the next of kin
Correct Answer: B
Rationale: The best answer honors the legal validity of the
advance directive while acknowledging the family's concerns
through proper channels. Advance directives are legally binding
documents that reflect the client's autonomous decisions, but
family conflict requires sensitive interdisciplinary intervention
involving the provider, social work, and ethics resources when
needed.
Q2: A charge nurse on a medical-surgical unit is making
assignments for the 7 AM to 3 PM shift. The unit has the
following clients and staff available:
Client A: Postoperative day 1 after total knee replacement,
stable, PCA for pain
Client B: Newly diagnosed with diabetes mellitus, needs
teaching on insulin administration
Client C: Receiving blood transfusion for anemia, first unit
hanging
,3
Client D: Admitted with chest pain, awaiting cardiac
catheterization, telemetry monitoring
Available staff: RN (you), LPN, UAP
Which assignment is MOST appropriate for the LPN?
A. Client A – postoperative assessment and PCA monitoring
B. Client B – diabetes teaching and insulin demonstration
C. Client C – blood transfusion monitoring and vital signs every
15 minutes
D. Client D – telemetry monitoring and preparation for cardiac
catheterization
Correct Answer: C
Rationale: LPNs can monitor blood transfusions including vital
sign assessment within their scope of practice under RN
supervision, as this involves standardized data collection and
recognizing/reporting abnormalities. Client A requires
comprehensive assessment beyond LPN scope; Client B requires
teaching which is RN-level practice; and Client D is
unstable/complex requiring RN judgment.
, 4
Q3: A nurse is preparing to administer a medication to a client
who refuses it, stating "I don't want that pill." The client is alert,
oriented, and has decision-making capacity. What is the nurse's
BEST response?
A. "This medication is ordered by your doctor and you need to
take it."
B. "Tell me more about why you don't want to take this
medication so I can address your concerns."
C. "I'll have to document that you refused and call your doctor
immediately."
D. "If you don't take it, I'll have to use another route."
Correct Answer: B
Rationale: Therapeutic communication using open-ended
exploration respects client autonomy while gathering
information needed to address concerns. An alert, oriented client
with capacity has the right to refuse medication, and the nurse
should first seek to understand the reason—whether it's fear,
side effect concerns, misunderstanding, or a valid clinical
issue—before taking further action.
Q4: Which of the following tasks is appropriate for the nurse to
delegate to unlicensed assistive personnel (UAP)?
Saunders Comprehensive Review 8th Edition
NCLEX-RN Practice Exam 100 Questions
Actual Exam 2026/2027 Complete Exam-
Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+
Graded
Part I: Safe and Effective Care Environment – Management of
Care & Safety (Questions 1-20)
Q1: A nurse is caring for a 72-year-old client who was admitted
with pneumonia. The client has an advance directive stating they
do not want intubation or mechanical ventilation. The client's
son approaches the nurse and demands that "everything be
done" for his father because he believes his father didn't
understand what he was signing. What is the nurse's BEST
initial action?
A. Call the hospital administrator to mediate the dispute
B. Explain to the son that the advance directive is a legal
document honoring his father's wishes and offer to contact the
healthcare provider and social worker to facilitate a family
meeting
,2
C. Tell the son that nurses cannot discuss advance directives
with family members without the client present
D. Follow the son's wishes since he is the next of kin
Correct Answer: B
Rationale: The best answer honors the legal validity of the
advance directive while acknowledging the family's concerns
through proper channels. Advance directives are legally binding
documents that reflect the client's autonomous decisions, but
family conflict requires sensitive interdisciplinary intervention
involving the provider, social work, and ethics resources when
needed.
Q2: A charge nurse on a medical-surgical unit is making
assignments for the 7 AM to 3 PM shift. The unit has the
following clients and staff available:
Client A: Postoperative day 1 after total knee replacement,
stable, PCA for pain
Client B: Newly diagnosed with diabetes mellitus, needs
teaching on insulin administration
Client C: Receiving blood transfusion for anemia, first unit
hanging
,3
Client D: Admitted with chest pain, awaiting cardiac
catheterization, telemetry monitoring
Available staff: RN (you), LPN, UAP
Which assignment is MOST appropriate for the LPN?
A. Client A – postoperative assessment and PCA monitoring
B. Client B – diabetes teaching and insulin demonstration
C. Client C – blood transfusion monitoring and vital signs every
15 minutes
D. Client D – telemetry monitoring and preparation for cardiac
catheterization
Correct Answer: C
Rationale: LPNs can monitor blood transfusions including vital
sign assessment within their scope of practice under RN
supervision, as this involves standardized data collection and
recognizing/reporting abnormalities. Client A requires
comprehensive assessment beyond LPN scope; Client B requires
teaching which is RN-level practice; and Client D is
unstable/complex requiring RN judgment.
, 4
Q3: A nurse is preparing to administer a medication to a client
who refuses it, stating "I don't want that pill." The client is alert,
oriented, and has decision-making capacity. What is the nurse's
BEST response?
A. "This medication is ordered by your doctor and you need to
take it."
B. "Tell me more about why you don't want to take this
medication so I can address your concerns."
C. "I'll have to document that you refused and call your doctor
immediately."
D. "If you don't take it, I'll have to use another route."
Correct Answer: B
Rationale: Therapeutic communication using open-ended
exploration respects client autonomy while gathering
information needed to address concerns. An alert, oriented client
with capacity has the right to refuse medication, and the nurse
should first seek to understand the reason—whether it's fear,
side effect concerns, misunderstanding, or a valid clinical
issue—before taking further action.
Q4: Which of the following tasks is appropriate for the nurse to
delegate to unlicensed assistive personnel (UAP)?
