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NCLEX-PN practice questions and answers

20 free questions from our 300-question NCLEX-PN bank, each with the correct answer and a cited explanation. The real exam: 85–150 items (CAT) · 85% NCLEX passing standard · 5-hour limit.

Questions last updated September 18, 2026 · Questions written from the 2026 NCLEX-PN Test Plan (NCSBN) and verified against its clinical judgment framework.

1. Coordinated Care

   1. A client signs a living will but later tells the nurse they want full treatment regardless. How should the nurse respond?

   1. AFollow the living will since it is a legal document
   2. BNotify the physician that the will is now invalid
   3. CDocument the client's new verbal wishes and clarify them with the healthcare team
   4. DIgnore the verbal statement because the document is legally binding

   Answer: C. The nurse should document the new verbal wishes and communicate them to the interdisciplinary team because the client retains the right to make healthcare decisions at any time Option A is incorrect because following an outdated document ignores the client's current wishes. Option D is incorrect because verbal statements take precedence over a previously signed document when the client is competent..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

2. Coordinated Care

   2. A nurse is preparing to transfer a client to a rehabilitation facility. Which action should the nurse take first?

   1. AArrange transportation for the client
   2. BComplete the transfer documentation
   3. CEnsure the receiving facility has accepted the client
   4. DNotify the client's family of the transfer time

   Answer: C. The nurse should first confirm acceptance by the receiving facility to prevent delays or gaps in care before proceeding with other transfer tasks Option A is incorrect because transportation arrangements come after confirming the facility can accept the client. Option D is incorrect because family notification is not the priority before transfer logistics are confirmed..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

3. Coordinated Care

   3. A client refuses a blood transfusion on religious grounds. The nurse notes that the physician has ordered the transfusion. What is the nurse's priority action?

   1. AAdminister the transfusion because it is physician-ordered
   2. BDocument the refusal and report it to the physician immediately
   3. CPersuade the client to change their mind
   4. DContact a patient advocate to override the refusal

   Answer: B. The nurse must document the refusal and notify the physician. The client has the right to refuse treatment, and the nurse advocates for informed decisions. Option A is incorrect because a physician order does not override a competent client's right to refuse. Option C is incorrect because persuading or coercing the client violates autonomy and informed consent. Option D is incorrect because an advocate cannot override a competent client's refusal.

   Source: Safe/Effective Care — Coordinated Care, 18-24%

4. Coordinated Care

   4. A nurse is reviewing the medical record of a newly admitted client. The nurse sees a do-not-resuscitate order. What should the nurse do first?

   1. ANotify the entire nursing staff about the order
   2. BRequest that the physician re-evaluate the client's condition
   3. CPlace a prominent alert on the client's door and chart
   4. DVerify the order is signed and current, then communicate it to the care team

   Answer: D. The nurse should verify the DNR order is valid and then communicate it to the interdisciplinary team to ensure consistent care Option A is incorrect because only relevant staff need to know about the DNR order, not the entire nursing staff. Option C is incorrect because alerts should be placed only after the order is verified and communicated..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

5. Coordinated Care

   5. A nurse is caring for a client who speaks only Spanish. An interpreter is not available. The nurse should use which approach?

   1. AAsk a family member to interpret for the client
   2. BWait until an interpreter becomes available before providing care
   3. CAttempt to communicate with gestures and body language only
   4. DUse a translation app and document it in the chart

   Answer: D. Using a translation app with documentation is appropriate when a qualified interpreter is unavailable. Family members should not interpret due to confidentiality concerns. Option A is incorrect because family members may misinterpret and confidentiality is breached. Option B is incorrect because delaying needed care while waiting is unsafe. Option C is incorrect because gestures alone cannot ensure accurate clinical communication.

   Source: Safe/Effective Care — Coordinated Care, 18-24%

6. Coordinated Care

   6. A nurse is conducting a shift report using bedside handoff. Which element should the nurse include first?

   1. AA full review of the client's medication history
   2. BCurrent vital signs and any changes in condition
   3. CThe results of all diagnostic tests
   4. DA summary of the client's psychosocial needs only

   Answer: B. Bedside handoff should begin with current vital signs and changes in condition to ensure continuity of care and early identification of deterioration Option A is incorrect because a full medication history review is not the priority during bedside handoff. Option C is incorrect because diagnostic test results are not typically included in bedside handoff reports..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

7. Coordinated Care

   7. A nurse discovers that a colleague has been taking medication from a client's prescription. What is the nurse's responsibility?

   1. AReport it to the charge nurse or supervisor immediately
   2. BConfront the colleague privately and ask them to return the medication
   3. CIgnore it because it does not affect the nurse directly
   4. DDocument it anonymously without reporting to management

   Answer: A. The nurse has a legal and ethical obligation to report suspected diversion or substance abuse to a supervisor to protect client safety Option B is incorrect because confronting the colleague privately may not stop the diversion and does not fulfill the reporting obligation. Option D is incorrect because anonymous documentation without reporting does not protect client safety..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

8. Coordinated Care

   8. A nurse is preparing discharge instructions for a client with heart failure. The teach-back method is used. The client repeats the information incorrectly. What should the nurse do?

   1. AProvide the information again using the same teaching method
   2. BDocument that teaching was completed and move on
   3. CRe-teach using different methods until the client demonstrates understanding
   4. DAsk the family to review the instructions at home

   Answer: C. The nurse should use alternative teaching methods and repeat until the client accurately demonstrates understanding, ensuring safe self-care after discharge Option A is incorrect because repeating the same failed teaching method is ineffective. Option B is incorrect because documenting incomplete teaching is unsafe and dishonest..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

9. Coordinated Care

   9. A nurse is reviewing advance directives with a client who has designated a healthcare proxy. What does this document mean for the proxy?

   1. AThe proxy can make all financial decisions for the client
   2. BThe proxy may make healthcare decisions only when the client cannot
   3. CThe proxy must be a licensed attorney in the state
   4. DThe proxy takes full control of all medical care immediately upon signing

   Answer: B. A healthcare proxy is legally authorized to make healthcare decisions only when the client is unable to make them independently Option A is incorrect because a healthcare proxy makes healthcare, not financial, decisions. Option C is incorrect because the proxy does not need to be a licensed attorney..

   Source: Safe/Effective Care — Coordinated Care, 18-24%

10. Safety and Infection Control

    10. A nurse is caring for a client in droplet precautions. Which actions should the nurse take? (Select all that apply.)

    1. AWear a surgical mask when within 3 feet of the client
    2. BWear an N95 respirator at all times in the room
    3. CPlace the client in a negative-pressure room
    4. DPerform hand hygiene before and after client contact

    Answer: A. Droplet precautions require a surgical mask when within 3 feet and hand hygiene before and after contact. Option B is incorrect because N95 respirators are reserved for airborne precautions. Option C is incorrect because negative-pressure rooms are for airborne precautions, not droplet Option A is incorrect because N95 respirators are reserved for airborne precautions, not droplet. Option C is incorrect because gown and gloves alone do not protect against droplet transmission..

    Source: Safe/Effective Care — Safety & Infection Control, 10-16%

11. Safety and Infection Control

    11. A nurse accidentally sticks a finger on a used needle after drawing blood from a client. What should the nurse do first?

    1. AFile an incident report and continue working without washing the exposed site first
    2. BWash the area, report to the supervisor, and follow exposure protocol
    3. CNotify the client's physician immediately about the stick
    4. DApply a bandage and return to the task at hand quickly

    Answer: B. The nurse should immediately wash the wound, report to the supervisor, and follow the facility's post-exposure protocol to minimize infection risk Option A is incorrect because filing a report is important but not the first action after exposure. Option C is incorrect because the nurse's own wound care takes priority over notifying the client's physician..

    Source: Safe/Effective Care — Safety & Infection Control, 10-16%

12. Safety and Infection Control

    12. A nurse enters a client's room and notices a fire is smoldering in the oxygen tubing. What is the first action?

    1. APull the fire alarm to evacuate the floor
    2. BRemove the oxygen tubing and extinguish the fire
    3. CCall the fire department
    4. DClose the door to contain the fire

    Answer: B. The first step is to remove the oxygen source and extinguish the fire. RACE protocol begins with Rescue, which includes removing the ignition source Option A is incorrect because pulling the alarm should come after removing the oxygen source and extinguishing. Option C is incorrect because closing the door does not remove the ignition source..

    Source: Safe/Effective Care — Safety & Infection Control, 10-16%

13. Safety and Infection Control

    13. A client with active tuberculosis is admitted to a medical-surgical unit. Which isolation precaution should be initiated?

    1. ADroplet precautions with a surgical mask and private room
    2. BContact precautions with gown, gloves, and dedicated equipment
    3. CAirborne precautions with a negative-pressure room
    4. DStandard precautions only with routine hand hygiene practices

    Answer: C. Tuberculosis requires airborne precautions, including a negative-pressure room and an N95 respirator, because the organism is transmitted via droplet nuclei Option A is incorrect because droplet precautions are insufficient for TB transmission. Option D is incorrect because standard precautions do not prevent airborne pathogen spread..

    Source: Safe/Effective Care — Safety & Infection Control, 10-16%

14. Safety and Infection Control

    14. A nurse is caring for a client who requires restraints. Which documentation is essential?

    1. AThe type of restraint, time applied, and the client's response
    2. BOnly that restraints were applied
    3. CThe physician's order and nothing else
    4. DThat the client was verbally notified of the restraint

    Answer: A. Documentation must include the type of restraint, time of application, assessments of circulation and skin integrity, and the client's response Option A is incorrect because documenting only that restraints were applied is insufficient for legal compliance. Option C is incorrect because the physician's order alone does not satisfy documentation requirements..

    Source: Safe/Effective Care — Safety & Infection Control, 10-16%

15. Safety and Infection Control

    15. A nurse is teaching a client about safe sharps disposal at home. Which statements should the nurse include? (Select all that apply.)

    1. AUse a puncture-resistant container for used needles
    2. BPlace sharps in a regular plastic bag
    3. CSeal the container when it is three-quarters full
    4. DBreak needles before disposing them

    Answer: A. Sharps must go in puncture-resistant containers and sealed when three-quarters full to prevent needlestick injuries. Option B is incorrect because regular plastic bags do not prevent injuries from exposed needles. Option D is incorrect because breaking needles is dangerous and creates additional injury risk Option B is incorrect because wrapping needles in newspaper does not prevent needlestick injuries. Option D is incorrect because breaking needles creates an additional injury hazard..

    Source: Safe/Effective Care — Safety & Infection Control, 10-16%

16. Health Promotion and Maintenance

    16. A parent asks the nurse when their child should receive the first MMR vaccination. What is the correct response?

    1. AAt 6 months of age
    2. BAt school entry around age 5
    3. CAt 2 years of age
    4. DBetween 12 and 15 months of age

    Answer: D. The first MMR vaccine is given between 12 and 15 months, with a booster at 4 to 6 years Option A is incorrect because the MMR vaccine is not given at 6 months. Option C is incorrect because delaying until age 2 leaves the child unprotected during a high-risk period..

    Source: Health Promotion & Maintenance, 6-12%

17. Health Promotion and Maintenance

    17. A nurse is performing a developmental screening on a 9-month-old infant. Which finding would the nurse report to the physician?

    1. ARolling from back to stomach
    2. BSitting without support
    3. CNot babbling or responding to own name
    4. DReaching for a toy with both hands

    Answer: C. Failure to babble or respond to name at 9 months is a developmental delay that warrants further evaluation by the physician Option A is incorrect because rolling from back to stomach is a normal 4-6 month milestone. Option B is incorrect because sitting without support is expected by 6-8 months..

    Source: Health Promotion & Maintenance, 6-12%

18. Health Promotion and Maintenance

    18. A pregnant client at 28 weeks asks about exercise. Which response is most appropriate?

    1. AExercise is not recommended during the third trimester
    2. BWalking and swimming are generally safe during pregnancy
    3. CHeavy weightlifting is the best exercise option
    4. DThe client should only perform bed rest

    Answer: B. Moderate exercises such as walking and swimming are generally safe during pregnancy, unless the provider has specified activity restrictions Option A is incorrect because exercise is generally safe throughout pregnancy with appropriate modifications. Option C is incorrect because heavy weightlifting poses risks to the pregnancy..

    Source: Health Promotion & Maintenance, 6-12%

19. Health Promotion and Maintenance

    19. A nurse is teaching an adolescent about skin cancer prevention. Which instruction is most important?

    1. AApply sunscreen with SPF 15 or higher and avoid tanning beds
    2. BWear sunscreen only during the summer months
    3. CDark-skinned individuals do not need sunscreen
    4. DSunscreen should be applied once in the morning for all-day protection

    Answer: A. All individuals should use broad-spectrum sunscreen with SPF 15 or higher and avoid tanning beds to reduce skin cancer risk Option B is incorrect because UV rays penetrate clouds and can cause damage year-round. Option C is incorrect because all skin types are susceptible to UV damage..

    Source: Health Promotion & Maintenance, 6-12%

20. Health Promotion and Maintenance

    20. A nurse is teaching a postmenopausal client about osteoporosis prevention. Which recommendation is most appropriate?

    1. AIncrease caffeine intake to strengthen bones
    2. BEngage in weight-bearing exercise and take calcium supplements
    3. CAvoid dairy products to prevent kidney stones
    4. DLimit physical activity to protect joints

    Answer: B. Weight-bearing exercise and adequate calcium intake are key strategies for maintaining bone density in postmenopausal women Option A is incorrect because caffeine increases calcium loss and weakens bones. Option C is incorrect because dairy products are a primary calcium source for bone health..

    Source: Health Promotion & Maintenance, 6-12%