No email required. Answer each question, then check your answer to see the rationale. Want the PDF version? Download the free sample PDF.
| Exam owner | NCSBN (National Council of State Boards of Nursing) |
|---|---|
| Current test plan | 2026 NCLEX-RN Test Plan, effective April 1, 2026 – March 31, 2029 (client-needs percentages unchanged from the 2023 plan) |
| Format | Computerized adaptive test (CAT), variable length: 85 to 150 items, including 15 unscored pretest items; maximum 5 hours |
| Clinical judgment | Next Generation NCLEX (NGN): 3 unfolding case studies (18 items) plus about 10% stand-alone clinical-judgment items (e.g., bowtie, trend) |
| Item types | Multiple choice, multiple response (SATA), extended multiple response, matrix/grid, drag-and-drop, drop-down (cloze), highlight, bowtie, trend; partial-credit (polytomous) scoring on many NGN items |
| Florida steps | Apply through the Florida Board of Nursing (MQA Online Services), complete Level 2 Livescan fingerprinting, register with Pearson VUE, receive Authorization to Test (ATT), then schedule |
| Fees (verify) | Florida BON application/licensure fee $110; Pearson VUE NCLEX registration $200 (NCSBN has announced the U.S. fee rises to $350 effective Feb. 1, 2027); Livescan fee varies |
| Area | Weight |
|---|---|
| Management of Care | 15–21% |
| Safety and Infection Prevention and Control | 10–16% |
| Health Promotion and Maintenance | 6–12% |
| Psychosocial Integrity | 6–12% |
| Basic Care and Comfort | 6–12% |
| Pharmacological and Parenteral Therapies | 13–19% |
| Reduction of Risk Potential | 9–15% |
| Physiological Adaptation | 11–17% |
Source: NCLEX Test Plans (NCSBN). Always check the official site for updates.
The nurse receives report on four clients. Which client should the nurse assess first?
Answer: A
Neck tightness after thyroidectomy can signal hematoma formation or laryngeal edema threatening the airway (ABCs). The other clients need care but are not at immediate risk of airway compromise.
Which task is appropriate for the RN to delegate to an assistive personnel (AP)?
Answer: D
Assessment, teaching, and evaluation remain RN responsibilities. Measuring and recording I&O for a stable client is a routine, standardized task within the AP's scope.
A client is admitted with suspected pulmonary tuberculosis. Which precautions should the nurse implement?
Answer: C
TB is transmitted by airborne droplet nuclei. Suspected cases require an airborne infection isolation room (negative pressure) and a fit-tested N95 (or higher) respirator for staff.
A client at 30 weeks' gestation asks which position is best for resting. The nurse should recommend which position?
Answer: B
Left lateral positioning reduces compression of the inferior vena cava and aorta by the gravid uterus, improving venous return, cardiac output, and placental perfusion.
A client says, "I have nothing left to live for. My family would be better off without me." What is the nurse's best response?
Answer: B
Asking directly about suicidal thoughts is safe, does not increase risk, and is necessary to assess risk. False reassurance, guilt-inducing statements, and "why" questions block therapeutic communication.
The nurse is caring for a client who is NPO after surgery and reports a dry mouth. Which intervention is most appropriate?
Answer: C
When a client is NPO, nothing should be taken by mouth, including ice chips or candy, unless prescribed. Frequent oral care and lip moisturizer relieve dryness safely.
A client taking digoxin has a serum potassium of 3.1 mEq/L. The nurse understands this places the client at increased risk for which complication?
Answer: A
Hypokalemia increases myocardial sensitivity to digoxin and the risk of toxicity and dysrhythmias. The nurse should hold the dose and notify the provider per protocol.
A client returns from a cardiac catheterization via the right femoral artery. Which finding requires immediate action?
Answer: D
A cool, pale extremity with diminished pulses distal to the puncture site suggests arterial occlusion (thrombus or hematoma compression) and requires immediate notification of the provider.
A client with a chest tube connected to a water-seal drainage system has continuous bubbling in the water-seal chamber. What should the nurse do first?
Answer: C
Continuous bubbling in the water-seal chamber indicates an air leak. The nurse checks connections from the client outward. Prolonged clamping risks tension pneumothorax; intermittent bubbling with exhalation/cough may be expected early with a pneumothorax.
Which findings should the nurse expect in a client with diabetic ketoacidosis (DKA)? (Select all that apply.)
Answer: A, C, E
DKA causes hyperglycemia (usually >250 mg/dL), ketosis with metabolic acidosis, compensatory deep rapid (Kussmaul) breathing, acetone (fruity) breath, and osmotic diuresis leading to dehydration.