NCLEX-RN TEST BANK UPDATE | 100 QUESTIONS
+ ANSWER SHEET ATTACHED ON THE LAST PAGES, 100%
GUARANTEED PASS || COMPLETE A+ GUIDE
NCLEX-RN Test Bank 2026/2027 Update
100 Questions + Answer Key and Comprehensive Rationales
Difficulty: Professional certification / entry-level RN licensure
Format: Multiple choice and Select All That Apply (SATA)
Total: 100 questions
Clinical emphasis: Prioritization, safety, clinical judgment, application and
analysis
Questions 1–25: Fundamentals, Safety, Prioritization & Pharmacology
1. A nurse receives report on four clients. Which client should the nurse assess first?
A. A client with heart failure who has 2+ bilateral ankle edema
B. A client with pneumonia whose oxygen saturation is 88% on 2 L/min nasal cannula
C. A client with diabetes whose premeal glucose is 214 mg/dL
D. A postoperative client reporting incisional pain of 7/10
Correct Answer: B
Rationale:
Why B is right: An oxygen saturation of 88% despite supplemental oxygen indicates impaired
oxygenation and requires immediate assessment. Airway and breathing take priority over less
immediately threatening problems.
Why the others are wrong:
• A: Edema is concerning but is not necessarily an immediate life threat.
• C: Hyperglycemia requires treatment but is less urgent than hypoxemia.
• D: Pain requires treatment, but it does not take priority over compromised oxygenation.
2. A nurse is caring for a client who develops sudden facial drooping, right-arm weakness,
and difficulty speaking. What is the nurse's priority action?
,A. Give oral aspirin
B. Obtain a blood glucose level and activate the stroke response
C. Place the client in Trendelenburg position
D. Encourage the client to ambulate
Correct Answer: B
Rationale:
Why B is right: The findings strongly suggest acute stroke. Rapid recognition, assessment of
glucose to exclude hypoglycemia as a stroke mimic, and activation of the stroke pathway are
essential because time-sensitive treatment may be possible.
Why the others are wrong:
• A: Aspirin should not be given before hemorrhage is excluded and treatment decisions
are made.
• C: Trendelenburg does not treat acute stroke and can compromise respiratory status.
• D: Ambulation is unsafe because of neurological deficits.
3. A client receiving IV potassium chloride reports burning at the IV site. What should the
nurse do first?
A. Increase the infusion rate
B. Assess the IV site and stop the infusion if infiltration or phlebitis is suspected
C. Apply a warm compress while continuing the infusion
D. Flush the IV rapidly with normal saline
Correct Answer: B
Rationale:
Why B is right: IV potassium is irritating and can cause significant tissue injury if extravasated.
The nurse should immediately assess the site and stop the infusion when infiltration or phlebitis
is suspected.
Why the others are wrong:
• A: Increasing the rate increases the risk of injury and dangerous hyperkalemia.
• C: A compress may sometimes be used after assessment, but the infusion must not simply
continue.
• D: Flushing an infiltrated IV can force potassium into tissue.
,4. A client taking warfarin has an INR of 5.8 and no active bleeding. Which action is most
appropriate?
A. Administer the next scheduled dose
B. Hold the medication and notify the prescribing clinician
C. Give aspirin
D. Encourage foods high in vitamin K immediately
Correct Answer: B
Rationale:
Why B is right: An INR of 5.8 represents excessive anticoagulation and increases bleeding risk.
The dose should be withheld and the clinician notified for further management.
Why the others are wrong:
• A: Giving warfarin could further increase anticoagulation.
• C: Aspirin increases bleeding risk.
• D: Dietary vitamin K should not be used as an unsupervised acute reversal strategy.
5. A nurse is preparing to administer insulin lispro. Which action is most important?
A. Administer it 1 hour before meals
B. Ensure the client has food available because the medication acts rapidly
C. Hold it whenever the blood glucose is above 200 mg/dL
D. Mix it with insulin glargine in the same syringe
Correct Answer: B
Rationale:
Why B is right: Lispro is rapid-acting insulin and should generally be administered in relation to
meals so that carbohydrate intake coincides with insulin action.
Why the others are wrong:
• A: Lispro is not routinely given an hour before meals.
• C: Elevated glucose does not automatically mean lispro should be withheld.
• D: Glargine should not be mixed with other insulins in the same syringe.
6. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
7/min. What is the nurse's priority action?
, A. Document the expected effect
B. Administer naloxone according to the prescription/protocol and support ventilation
C. Give another dose of morphine
D. Place the client in a supine position and leave the room
Correct Answer: B
Rationale:
Why B is right: Severe respiratory depression is a potentially life-threatening opioid adverse
effect. Airway and ventilation take priority, and naloxone reverses opioid effects.
Why the others are wrong:
• A: A respiratory rate of 7/min is dangerous, not an expected harmless effect.
• C: Additional opioid would worsen respiratory depression.
• D: The client requires immediate intervention and monitoring.
7. Which findings should cause a nurse to suspect hypoglycemia? Select all that apply.
A. Diaphoresis
B. Tremor
C. Confusion
D. Polyuria
E. Tachycardia
Correct Answers: A, B, C, E
Rationale:
Why the correct answers are right: Hypoglycemia activates the sympathetic nervous system,
producing sweating, tremor, and tachycardia. Neuroglucopenia can produce confusion and
altered mental status.
Why D is wrong: Polyuria is more characteristic of significant hyperglycemia due to osmotic
diuresis.
8. A nurse discovers that a medication error has occurred. What should the nurse do first?
A. Complete the incident report
B. Assess the client
C. Notify the nurse manager
D. Document that another nurse made the error
+ ANSWER SHEET ATTACHED ON THE LAST PAGES, 100%
GUARANTEED PASS || COMPLETE A+ GUIDE
NCLEX-RN Test Bank 2026/2027 Update
100 Questions + Answer Key and Comprehensive Rationales
Difficulty: Professional certification / entry-level RN licensure
Format: Multiple choice and Select All That Apply (SATA)
Total: 100 questions
Clinical emphasis: Prioritization, safety, clinical judgment, application and
analysis
Questions 1–25: Fundamentals, Safety, Prioritization & Pharmacology
1. A nurse receives report on four clients. Which client should the nurse assess first?
A. A client with heart failure who has 2+ bilateral ankle edema
B. A client with pneumonia whose oxygen saturation is 88% on 2 L/min nasal cannula
C. A client with diabetes whose premeal glucose is 214 mg/dL
D. A postoperative client reporting incisional pain of 7/10
Correct Answer: B
Rationale:
Why B is right: An oxygen saturation of 88% despite supplemental oxygen indicates impaired
oxygenation and requires immediate assessment. Airway and breathing take priority over less
immediately threatening problems.
Why the others are wrong:
• A: Edema is concerning but is not necessarily an immediate life threat.
• C: Hyperglycemia requires treatment but is less urgent than hypoxemia.
• D: Pain requires treatment, but it does not take priority over compromised oxygenation.
2. A nurse is caring for a client who develops sudden facial drooping, right-arm weakness,
and difficulty speaking. What is the nurse's priority action?
,A. Give oral aspirin
B. Obtain a blood glucose level and activate the stroke response
C. Place the client in Trendelenburg position
D. Encourage the client to ambulate
Correct Answer: B
Rationale:
Why B is right: The findings strongly suggest acute stroke. Rapid recognition, assessment of
glucose to exclude hypoglycemia as a stroke mimic, and activation of the stroke pathway are
essential because time-sensitive treatment may be possible.
Why the others are wrong:
• A: Aspirin should not be given before hemorrhage is excluded and treatment decisions
are made.
• C: Trendelenburg does not treat acute stroke and can compromise respiratory status.
• D: Ambulation is unsafe because of neurological deficits.
3. A client receiving IV potassium chloride reports burning at the IV site. What should the
nurse do first?
A. Increase the infusion rate
B. Assess the IV site and stop the infusion if infiltration or phlebitis is suspected
C. Apply a warm compress while continuing the infusion
D. Flush the IV rapidly with normal saline
Correct Answer: B
Rationale:
Why B is right: IV potassium is irritating and can cause significant tissue injury if extravasated.
The nurse should immediately assess the site and stop the infusion when infiltration or phlebitis
is suspected.
Why the others are wrong:
• A: Increasing the rate increases the risk of injury and dangerous hyperkalemia.
• C: A compress may sometimes be used after assessment, but the infusion must not simply
continue.
• D: Flushing an infiltrated IV can force potassium into tissue.
,4. A client taking warfarin has an INR of 5.8 and no active bleeding. Which action is most
appropriate?
A. Administer the next scheduled dose
B. Hold the medication and notify the prescribing clinician
C. Give aspirin
D. Encourage foods high in vitamin K immediately
Correct Answer: B
Rationale:
Why B is right: An INR of 5.8 represents excessive anticoagulation and increases bleeding risk.
The dose should be withheld and the clinician notified for further management.
Why the others are wrong:
• A: Giving warfarin could further increase anticoagulation.
• C: Aspirin increases bleeding risk.
• D: Dietary vitamin K should not be used as an unsupervised acute reversal strategy.
5. A nurse is preparing to administer insulin lispro. Which action is most important?
A. Administer it 1 hour before meals
B. Ensure the client has food available because the medication acts rapidly
C. Hold it whenever the blood glucose is above 200 mg/dL
D. Mix it with insulin glargine in the same syringe
Correct Answer: B
Rationale:
Why B is right: Lispro is rapid-acting insulin and should generally be administered in relation to
meals so that carbohydrate intake coincides with insulin action.
Why the others are wrong:
• A: Lispro is not routinely given an hour before meals.
• C: Elevated glucose does not automatically mean lispro should be withheld.
• D: Glargine should not be mixed with other insulins in the same syringe.
6. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
7/min. What is the nurse's priority action?
, A. Document the expected effect
B. Administer naloxone according to the prescription/protocol and support ventilation
C. Give another dose of morphine
D. Place the client in a supine position and leave the room
Correct Answer: B
Rationale:
Why B is right: Severe respiratory depression is a potentially life-threatening opioid adverse
effect. Airway and ventilation take priority, and naloxone reverses opioid effects.
Why the others are wrong:
• A: A respiratory rate of 7/min is dangerous, not an expected harmless effect.
• C: Additional opioid would worsen respiratory depression.
• D: The client requires immediate intervention and monitoring.
7. Which findings should cause a nurse to suspect hypoglycemia? Select all that apply.
A. Diaphoresis
B. Tremor
C. Confusion
D. Polyuria
E. Tachycardia
Correct Answers: A, B, C, E
Rationale:
Why the correct answers are right: Hypoglycemia activates the sympathetic nervous system,
producing sweating, tremor, and tachycardia. Neuroglucopenia can produce confusion and
altered mental status.
Why D is wrong: Polyuria is more characteristic of significant hyperglycemia due to osmotic
diuresis.
8. A nurse discovers that a medication error has occurred. What should the nurse do first?
A. Complete the incident report
B. Assess the client
C. Notify the nurse manager
D. Document that another nurse made the error
