Free NCLEX-RN Practice Exam 2026 | 50+
Questions with Expert Rationales
Description:
Prepare for your NCLEX-RN with our updated 2026 practice test featuring 50+ clinical scenario
questions covering fundamental nursing concepts, medication safety, and patient
prioritization. Each question includes detailed expert explanations to help you understand the
reasoning behind correct answers. This comprehensive review tool addresses key areas like
infection control, delegation, and patient education that consistently appear on the NCLEX.
Perfect for nursing students seeking to identify knowledge gaps and build confidence before
exam day.
Ready to boost your NCLEX score? Download your free practice test now and approach exam day
with confidence!
, NCLEX Practice Exam: 50+ Questions & Rationales (2026 Guide)
1. A nurse is providing education to a client who reports persistent insomnia. Which of the
following non-pharmacological recommendations should the nurse prioritize?
a. Drink a warm glass of milk before bed.
b. Maintain a consistent time to wake up each day.
c. Watch television in bed to become drowsy.
d. Use sleeping pills for a minimum of two weeks.
Answer: b. Maintain a consistent time to wake up each day.
Explanation: Regulating the wake-up time, even on weekends, is a cornerstone of sleep hygiene
as it helps to stabilize the body's circadian rhythm. This consistency makes it easier to fall asleep
and wake up naturally. The other options are either not recommended (watching TV in bed,
which is stimulating) or involve pharmacological intervention that should not be a first-line
recommendation.
2. A nurse is caring for a client with an infectious diarrheal illness confirmed to be caused by
Shigella. Which transmission-based precaution is essential for the nurse to implement?
a. Don an N95 respirator upon entering the room.
b. Wear a gown and gloves during direct client contact.
c. Place the client in a room with negative-pressure airflow.
d. Use dedicated blood pressure equipment left in the room.
Answer: b. Wear a gown and gloves during direct client contact.
Explanation: Shigella is spread through the fecal-oral route. Direct contact with the client or
contaminated surfaces can lead to transmission. Gowns and gloves are required as part of
Contact Precautions to prevent soiling clothing and contaminating hands with infectious
material. Airborne precautions (N95, negative pressure) are not indicated for Shigella.
3. When assessing a client's report of increased pain, which question best assesses the quality of the
pain sensation?
a. "On a scale of 0 to 10, how bad is your pain?"
b. "What were you doing when the pain started?"
, c. "Would you describe the pain as sharp, burning, or aching?"
d. "Does anything you do make the pain better or worse?"
Answer: c. "Would you describe the pain as sharp, burning, or aching?"
Explanation: The "quality" of pain refers to its characteristic sensation. Asking the client to
describe it (e.g., sharp, dull, burning, throbbing) directly assesses this component. The other
options assess intensity (a), onset/provocation (b), and relieving/aggravating factors (d).
4. A client with a documented latex allergy is scheduled for surgery. Which action is most critical
for the nurse to take in the preoperative area?
a. Administer a prophylactic antihistamine.
b. Ensure the use of latex-free supplies and equipment.
c. Apply a steroid cream to potential contact areas.
d. Wrap monitoring cords with stockinette and tape them in place.
Answer: b. Ensure the use of latex-free supplies and equipment.
Explanation: The primary and most effective intervention for a latex allergy is complete
avoidance of latex-containing products. This includes gloves, catheters, anesthesia supplies, and
other equipment. While stockinette can be a barrier, it is a secondary measure and does not
replace the imperative of a latex-free environment.
5. A nurse reviews a client's lab results and notes a sodium level of 125 mEq/L. Which clinical
manifestation is the nurse most likely to observe?
a. Extreme thirst and dry mucous membranes
b. Abdominal cramping and nausea
c. Muscle twitching and hyperreflexia
d. Bradycardia and hypotension
Answer: b. Abdominal cramping and nausea
Explanation: Hyponatremia (low sodium) often manifests with gastrointestinal symptoms such
as abdominal cramping, nausea, and vomiting. Thirst and dry membranes are more common in
hypernatremia. Neurological symptoms like headache and confusion are also common with
significant hyponatremia, but GI symptoms are a key early indicator.
Questions with Expert Rationales
Description:
Prepare for your NCLEX-RN with our updated 2026 practice test featuring 50+ clinical scenario
questions covering fundamental nursing concepts, medication safety, and patient
prioritization. Each question includes detailed expert explanations to help you understand the
reasoning behind correct answers. This comprehensive review tool addresses key areas like
infection control, delegation, and patient education that consistently appear on the NCLEX.
Perfect for nursing students seeking to identify knowledge gaps and build confidence before
exam day.
Ready to boost your NCLEX score? Download your free practice test now and approach exam day
with confidence!
, NCLEX Practice Exam: 50+ Questions & Rationales (2026 Guide)
1. A nurse is providing education to a client who reports persistent insomnia. Which of the
following non-pharmacological recommendations should the nurse prioritize?
a. Drink a warm glass of milk before bed.
b. Maintain a consistent time to wake up each day.
c. Watch television in bed to become drowsy.
d. Use sleeping pills for a minimum of two weeks.
Answer: b. Maintain a consistent time to wake up each day.
Explanation: Regulating the wake-up time, even on weekends, is a cornerstone of sleep hygiene
as it helps to stabilize the body's circadian rhythm. This consistency makes it easier to fall asleep
and wake up naturally. The other options are either not recommended (watching TV in bed,
which is stimulating) or involve pharmacological intervention that should not be a first-line
recommendation.
2. A nurse is caring for a client with an infectious diarrheal illness confirmed to be caused by
Shigella. Which transmission-based precaution is essential for the nurse to implement?
a. Don an N95 respirator upon entering the room.
b. Wear a gown and gloves during direct client contact.
c. Place the client in a room with negative-pressure airflow.
d. Use dedicated blood pressure equipment left in the room.
Answer: b. Wear a gown and gloves during direct client contact.
Explanation: Shigella is spread through the fecal-oral route. Direct contact with the client or
contaminated surfaces can lead to transmission. Gowns and gloves are required as part of
Contact Precautions to prevent soiling clothing and contaminating hands with infectious
material. Airborne precautions (N95, negative pressure) are not indicated for Shigella.
3. When assessing a client's report of increased pain, which question best assesses the quality of the
pain sensation?
a. "On a scale of 0 to 10, how bad is your pain?"
b. "What were you doing when the pain started?"
, c. "Would you describe the pain as sharp, burning, or aching?"
d. "Does anything you do make the pain better or worse?"
Answer: c. "Would you describe the pain as sharp, burning, or aching?"
Explanation: The "quality" of pain refers to its characteristic sensation. Asking the client to
describe it (e.g., sharp, dull, burning, throbbing) directly assesses this component. The other
options assess intensity (a), onset/provocation (b), and relieving/aggravating factors (d).
4. A client with a documented latex allergy is scheduled for surgery. Which action is most critical
for the nurse to take in the preoperative area?
a. Administer a prophylactic antihistamine.
b. Ensure the use of latex-free supplies and equipment.
c. Apply a steroid cream to potential contact areas.
d. Wrap monitoring cords with stockinette and tape them in place.
Answer: b. Ensure the use of latex-free supplies and equipment.
Explanation: The primary and most effective intervention for a latex allergy is complete
avoidance of latex-containing products. This includes gloves, catheters, anesthesia supplies, and
other equipment. While stockinette can be a barrier, it is a secondary measure and does not
replace the imperative of a latex-free environment.
5. A nurse reviews a client's lab results and notes a sodium level of 125 mEq/L. Which clinical
manifestation is the nurse most likely to observe?
a. Extreme thirst and dry mucous membranes
b. Abdominal cramping and nausea
c. Muscle twitching and hyperreflexia
d. Bradycardia and hypotension
Answer: b. Abdominal cramping and nausea
Explanation: Hyponatremia (low sodium) often manifests with gastrointestinal symptoms such
as abdominal cramping, nausea, and vomiting. Thirst and dry membranes are more common in
hypernatremia. Neurological symptoms like headache and confusion are also common with
significant hyponatremia, but GI symptoms are a key early indicator.
