NCLEX-PN Actual Exam 2025 2026

NCLEX-PN Actual Exam 2025 | 2026 – 260 Questions with Correct Detailed Answers and Rationales Verified Answers | Comprehensive Clinical Coverage | Graded A+ | Real-World Exam Simulation Introduction This complete resource includes 260 actual-style NCLEX-PN exam questions updated for the 2025–2026 testing cycle. All answers are verified and supported with clear, clinical rationales to help practical nursing candidates understand the "why" behind each correct choice. Perfect for last-minute review or comprehensive prep, this guide reflects current NCLEX-PN standards and exam structure.

Topics Covered:

• Coordinated Care & Assignment Delegation • Safety and Infection Control • Pharmacological Therapies • Basic Care and Comfort • Health Promotion and Maintenance • Psychosocial Integrity • Reduction of Risk Potential • Physiological Adaptation • Patient Education & Ethical Practice All correct answers are marked in bold and green. Each question includes a concise yet detailed rationale to reinforce clinical judgment, critical thinking, and test-taking strategies.Exam Questions and Answers Question 1 Question: A nurse is assigning tasks to a licensed practical nurse (LPN) and a nursing assistant (NA). Which task can be delegated to the NA?

• Administering oral medications
• Assisting with bathing and grooming
• Performing a sterile dressing change
• Monitoring a patient’s IV infusion rate

Rationale: Assisting with bathing and grooming is within the NA’s scope of practice, focusing on basic care and comfort. Administering medications, sterile procedures, and monitoring IVs require LPN or RN licensure.Question 2 Question: A patient with MRSA is placed on contact precautions. Which action is most important for the nurse to implement?

• Wearing a mask during all patient interactions
• Wearing gloves and a gown when entering the room
• Using an alcohol-based hand sanitizer only 1 / 4

• Placing the patient in a shared room

Rationale: Contact precautions for MRSA require gloves and a gown to prevent direct contact with the patient or contaminated surfaces. A mask is not routinely required unless droplet precautions are also indicated.Question 3 Question: A patient is prescribed digoxin 0.25 mg daily. The nurse notes the patient’s apical pulse is 56 beats per minute. What should the nurse do next?

• Administer the dose as ordered
• Hold the dose and notify the provider
• Administer half the dose
• Recheck the pulse in 1 hour

Rationale: Digoxin is held if the apical pulse is below 60 bpm in adults to prevent toxicity, as bradycardia is a sign of potential overdose. The provider should be notified.Question 4 Question: A patient with diabetes reports feeling shaky and sweaty. What is the nurse’s priority action?

• Administer insulin immediately
• Check the patient’s blood glucose level
• Provide a high-protein snack
• Encourage the patient to rest

Rationale: Shaking and sweating suggest hypoglycemia. Checking blood glucose confirms the diagnosis and guides treatment, such as administering a fast-acting carbohydrate.Question 5 Case Study: A patient post-appendectomy reports severe pain at the surgical site. The nurse observes redness and warmth.

Question: Which conditions should the nurse suspect? Select all that apply.

• Hypoglycemia
• Infection
• Dehydration
• Wound dehiscence

Rationale: Redness, warmth, and severe pain suggest infection or wound dehiscence, common post-surgical complications. Hypoglycemia and dehydration are unrelated to these symptoms.Question 6 Question: A patient with a history of heart failure is prescribed furosemide. What should the nurse monitor for?

• Hyperkalemia
• Hypokalemia
• Hypernatremia
• Hypocalcemia

Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking hypokalemia, which can cause arrhythmias in heart failure patients.Question 7 Question: A nurse is teaching a patient about hand hygiene to prevent infection. Which statement by the patient indicates understanding? 2 / 4

• “I only need to wash my hands after using the bathroom.”
• “I should wash my hands before eating and after touching surfaces.”
• “Hand sanitizer is not effective against germs.”
• “I should wash my hands for 10 seconds.”

Rationale: Hand hygiene before eating and after touching surfaces prevents infection. Hand sanitizer is effective, and washing should last at least 20 seconds.Question 8 Question: A patient with COPD is using an inhaler. Which instruction should the nurse provide?

• Inhale quickly and shallowly
• Inhale slowly and deeply, then hold breath for 10 seconds
• Exhale during inhalation
• Use the inhaler only during an attack

Rationale: Slow, deep inhalation followed by a 10-second breath hold maximizes medication delivery to the lungs in COPD patients.Question 9 Question: A nurse is caring for a patient with a new colostomy. Which action promotes psychosocial integrity?

• Changing the colostomy bag without explanation
• Encouraging the patient to express feelings about the colostomy
• Avoiding discussion of the colostomy
• Restricting family visits

Rationale: Encouraging emotional expression supports psychosocial adjustment to a new colostomy, promoting coping and acceptance.Question 10 Question: A patient is receiving heparin therapy. Which laboratory value should the nurse monitor?

A) INR

• aPTT
• Platelet count
• Hemoglobin

Rationale: Heparin’s anticoagulant effect is monitored via activated partial thromboplastin time (aPTT) to ensure therapeutic levels and prevent bleeding.Question 11 Question: A nurse is assisting a patient with ambulation after hip surgery. Which action reduces the risk of falls?

• Allowing the patient to walk unassisted
• Using a gait belt and ensuring clear pathways
• Encouraging rapid walking to build strength
• Providing only verbal instructions

Rationale: A gait belt and clear pathways provide safety and stability, reducing fall risk in post-surgical patients.Question 12 Question: A patient with hypertension is prescribed lisinopril. What should the nurse teach the patient to report? 3 / 4

• Increased appetite
• Persistent dry cough
• Improved energy levels
• Mild headache

Rationale: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril and should be reported to the provider.Question 13 Question: A nurse is preparing a sterile field for a dressing change. Which action maintains sterility?

• Touching the edges of the sterile drape
• Using sterile gloves to handle supplies
• Placing non-sterile items on the field
• Opening sterile packages away from the field

Rationale: Sterile gloves maintain the sterility of the field and supplies, preventing contamination during a dressing change.Question 14 Question: A patient with type 2 diabetes is learning about diet. Which food should the nurse recommend limiting?

• Fresh vegetables
• Refined sugars
• Lean proteins
• Whole grains

Rationale: Refined sugars cause rapid blood glucose spikes, which should be limited in diabetes management.Question 15 Case Study: A patient with a history of seizures is prescribed phenytoin. The nurse notes gingival hyperplasia.

Question: What should the nurse do? Select all that apply.

• Increase the phenytoin dose
• Report the finding to the provider
• Stop the medication immediately
• Educate the patient on oral hygiene

Rationale: Gingival hyperplasia is a side effect of phenytoin, requiring provider notification and oral hygiene education to manage symptoms.Question 16 Question: A nurse is caring for a patient with a urinary catheter. Which action prevents infection?

• Cleaning the catheter site with alcohol only
• Maintaining a closed drainage system
• Emptying the drainage bag once daily
• Allowing the drainage bag to touch the floor

Rationale: A closed drainage system minimizes bacterial entry, reducing the risk of catheter- associated urinary tract infections.Question 17 Question: A patient with depression expresses feelings of hopelessness. What is the nurse’s

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