NCLEX-RN Readiness Assessment
Practice Test Questions And
Answers Plus Rationales | Instant
Pdf Download 2026
Section 1: Safe and Effective Care Environment (Management of
Care, Safety & Infection Control)
1. A nurse is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is most appropriate for the UAP?
A. Assess a post-operative patient’s incision site
B. Reinforce teaching about insulin injection technique
C. Obtain a clean-catch urine specimen
D. Evaluate the effectiveness of a pain medication
Answer: C. Obtain a clean-catch urine specimen
Rationale: UAPs can perform non-invasive, routine tasks with stable
patients, such as collecting specimens. Assessment, teaching, and
evaluation must be done by licensed nurses.
,2. A charge nurse is making assignments for a medical-surgical unit.
Which patient should be assigned to a float nurse from the
postpartum unit?
A. A patient with pneumonia requiring IV antibiotics
B. A patient with a newly placed tracheostomy
C. A patient with a fractured hip needing assistance with ambulation
D. A patient with chest tubes for a hemopneumothorax
Answer: C. A patient with a fractured hip needing assistance with
ambulation
Rationale: The float nurse from postpartum is likely skilled in basic care,
mobility assistance, and stable patients. Options A, B, and D require
specialized skills (respiratory, complex monitoring).
3. A nurse is caring for a patient with active tuberculosis. Which
type of precautions should the nurse implement?
A. Contact Precautions
B. Droplet Precautions
C. Airborne Precautions
D. Standard Precautions alone
Answer: C. Airborne Precautions
Rationale: TB is transmitted via airborne droplet nuclei. Airborne
Precautions require an N95 respirator, negative pressure room, and the
patient wearing a surgical mask when transported.
,4. A client with a history of falls is confused and attempting to get
out of bed. The nurse applies wrist restraints. Which action is most
important?
A. Tie the restraints to the side rail of the bed
B. Remove restraints every 2 hours for range of motion
C. Obtain a telephone order from the provider within 4 hours
D. Document the patient’s behavior every shift
Answer: B. Remove restraints every 2 hours for range of motion
Rationale: Restraints require removal every 2 hours (or per facility
policy) to assess skin integrity, provide ROM, and meet basic needs.
Restraints must never be tied to side rails (only to bed frame).
5. A nurse receives a verbal order from a provider over the
telephone. What is the nurse’s priority action?
A. Implement the order immediately
B. Repeat the order back to the provider
C. Ask another nurse to listen to the order
D. Document the order in the patient’s chart
Answer: B. Repeat the order back to the provider
Rationale: To prevent errors, the nurse should read back all verbal or
telephone orders to verify accuracy (ISMP guidelines).
6. Which of the following patients should the nurse see first?
A. A patient with diabetes and a blood glucose of 65 mg/dL who is alert
and talking
, B. A patient post-appendectomy with a fever of 100.4°F (38°C)
C. A patient with heart failure and oxygen saturation of 88% on room air
D. A patient with a urinary tract infection who is requesting pain
medication
Answer: C. A patient with heart failure and oxygen saturation of 88% on
room air
Rationale: This patient is hypoxic (O2 sat <90%) and requires immediate
intervention. Airway and breathing take priority.
7. A nurse is preparing to administer a blood transfusion. Which IV
solution is most appropriate to use as a primed line?
A. Lactated Ringer’s solution
B. 5% Dextrose in water (D5W)
C. 0.9% Normal saline
D. 0.45% Normal saline
Answer: C. 0.9% Normal saline
Rationale: Only normal saline is compatible with blood products.
Dextrose solutions can cause hemolysis and clumping.
8. A patient is on a continuous heparin infusion. The nurse notes a
large hematoma at the IV site. Which action should the nurse take
first?
A. Stop the heparin infusion
B. Apply pressure to the site
Practice Test Questions And
Answers Plus Rationales | Instant
Pdf Download 2026
Section 1: Safe and Effective Care Environment (Management of
Care, Safety & Infection Control)
1. A nurse is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is most appropriate for the UAP?
A. Assess a post-operative patient’s incision site
B. Reinforce teaching about insulin injection technique
C. Obtain a clean-catch urine specimen
D. Evaluate the effectiveness of a pain medication
Answer: C. Obtain a clean-catch urine specimen
Rationale: UAPs can perform non-invasive, routine tasks with stable
patients, such as collecting specimens. Assessment, teaching, and
evaluation must be done by licensed nurses.
,2. A charge nurse is making assignments for a medical-surgical unit.
Which patient should be assigned to a float nurse from the
postpartum unit?
A. A patient with pneumonia requiring IV antibiotics
B. A patient with a newly placed tracheostomy
C. A patient with a fractured hip needing assistance with ambulation
D. A patient with chest tubes for a hemopneumothorax
Answer: C. A patient with a fractured hip needing assistance with
ambulation
Rationale: The float nurse from postpartum is likely skilled in basic care,
mobility assistance, and stable patients. Options A, B, and D require
specialized skills (respiratory, complex monitoring).
3. A nurse is caring for a patient with active tuberculosis. Which
type of precautions should the nurse implement?
A. Contact Precautions
B. Droplet Precautions
C. Airborne Precautions
D. Standard Precautions alone
Answer: C. Airborne Precautions
Rationale: TB is transmitted via airborne droplet nuclei. Airborne
Precautions require an N95 respirator, negative pressure room, and the
patient wearing a surgical mask when transported.
,4. A client with a history of falls is confused and attempting to get
out of bed. The nurse applies wrist restraints. Which action is most
important?
A. Tie the restraints to the side rail of the bed
B. Remove restraints every 2 hours for range of motion
C. Obtain a telephone order from the provider within 4 hours
D. Document the patient’s behavior every shift
Answer: B. Remove restraints every 2 hours for range of motion
Rationale: Restraints require removal every 2 hours (or per facility
policy) to assess skin integrity, provide ROM, and meet basic needs.
Restraints must never be tied to side rails (only to bed frame).
5. A nurse receives a verbal order from a provider over the
telephone. What is the nurse’s priority action?
A. Implement the order immediately
B. Repeat the order back to the provider
C. Ask another nurse to listen to the order
D. Document the order in the patient’s chart
Answer: B. Repeat the order back to the provider
Rationale: To prevent errors, the nurse should read back all verbal or
telephone orders to verify accuracy (ISMP guidelines).
6. Which of the following patients should the nurse see first?
A. A patient with diabetes and a blood glucose of 65 mg/dL who is alert
and talking
, B. A patient post-appendectomy with a fever of 100.4°F (38°C)
C. A patient with heart failure and oxygen saturation of 88% on room air
D. A patient with a urinary tract infection who is requesting pain
medication
Answer: C. A patient with heart failure and oxygen saturation of 88% on
room air
Rationale: This patient is hypoxic (O2 sat <90%) and requires immediate
intervention. Airway and breathing take priority.
7. A nurse is preparing to administer a blood transfusion. Which IV
solution is most appropriate to use as a primed line?
A. Lactated Ringer’s solution
B. 5% Dextrose in water (D5W)
C. 0.9% Normal saline
D. 0.45% Normal saline
Answer: C. 0.9% Normal saline
Rationale: Only normal saline is compatible with blood products.
Dextrose solutions can cause hemolysis and clumping.
8. A patient is on a continuous heparin infusion. The nurse notes a
large hematoma at the IV site. Which action should the nurse take
first?
A. Stop the heparin infusion
B. Apply pressure to the site
