NCLEX Practice Questions
This is a free 15-question sampler written in the style of the NCLEX-RN. It covers all four client needs categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity and physiological integrity. It mixes multiple choice, select all that apply and fill in the blank, so answer all 15 questions, then check your score and read the explanation for every one.
A nurse receives report on four clients at the start of the shift. Which client should the nurse assess first?
All 15 questions at a glance
Prefer to read before you play? Every question in the sampler is listed below. Answers and explanations stay collapsed until you open them.
1. A nurse receives report on four clients at the start of the shift. Which client should the nurse assess first?
- A. A client with a fractured femur who rates pain as 7 out of 10
- B. A client with asthma who has new audible wheezing and is using neck muscles to breathe
- C. A client being discharged today who has questions about a new medication
- D. A client one day after surgery with a temperature of 100.8 degrees F
Show answer and explanation
Answer: B. A client with asthma who has new audible wheezing and is using neck muscles to breathe
Airway and breathing come before everything else, and accessory muscle use with new wheezing signals worsening airflow that can deteriorate quickly. Pain, discharge teaching and a low-grade fever on the first postoperative day all need attention, but none of them threatens the airway in the next few minutes.
2. Which task is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
- A. Teaching a newly diagnosed client how to use an insulin pen
- B. Assessing a surgical wound for signs of infection
- C. Helping a stable client with a bed bath and recording intake and output
- D. Writing the plan of care for a client admitted with heart failure
Show answer and explanation
Answer: C. Helping a stable client with a bed bath and recording intake and output
The delegation rule is that assessment, teaching, evaluation and care planning stay with the nurse and cannot be handed off. UAP take routine tasks with predictable outcomes for stable clients, such as hygiene, positioning and recording intake and output.
3. A client is admitted with suspected active pulmonary tuberculosis. Which precautions should the nurse put in place?
- A. Standard precautions in any available room
- B. Contact precautions with gown and gloves in a private room
- C. Droplet precautions with a surgical mask in a private room
- D. Airborne precautions in a negative pressure room, with a fitted N95 respirator for anyone entering
Show answer and explanation
Answer: D. Airborne precautions in a negative pressure room, with a fitted N95 respirator for anyone entering
Tuberculosis spreads by droplet nuclei small enough to stay suspended in the air, so it requires airborne precautions: an airborne infection isolation room kept at negative pressure plus a fitted N95 respirator for staff. The surgical mask goes on the client, not on the nurse, and only when the client has to leave the room.
4. A client with heart failure is receiving intravenous furosemide. Which findings require immediate follow-up? Select all that apply.
Select all that apply.
- A. Serum potassium 2.9 mEq/L
- B. Urine output of 60 mL per hour
- C. New muscle weakness with an irregular pulse
- D. Weight loss of 1 kg since yesterday
- E. The client reports new ringing in the ears
Show answer and explanation
Answer: A. Serum potassium 2.9 mEq/L, C. New muscle weakness with an irregular pulse, E. The client reports new ringing in the ears
Furosemide wastes potassium, so a level of 2.9 mEq/L sits below the usual 3.5 to 5.0 mEq/L range, and new weakness with an irregular pulse suggests hypokalemia is already affecting the heart. New tinnitus points to ototoxicity, while good urine output and steady weight loss are exactly the response the drug is given to produce.
5. A client who was just diagnosed with cancer says, "I do not see the point in starting treatment." Which response by the nurse is most therapeutic?
- A. You should not give up. Many people do very well with treatment.
- B. Tell me more about what you are thinking.
- C. Your family would really want you to try.
- D. I will ask the provider to come and explain your options.
Show answer and explanation
Answer: B. Tell me more about what you are thinking.
An open-ended invitation keeps the conversation open and lets the nurse assess what sits behind the statement, including hopelessness or thoughts of self-harm. False reassurance, appeals to guilt and handing the conversation to someone else all shut the client down before anything is assessed.
6. Complete the sentence.
A client receiving intravenous morphine has a respiratory rate of 7 breaths per minute and is difficult to arouse. The nurse stops the infusion and anticipates giving _____.
Options for blank 1: flumazenil, naloxone, protamine sulfate, vitamin K
Show answer and explanation
Answer: naloxone
Naloxone is the opioid antagonist that reverses respiratory depression, and under the ABCs breathing is treated before anything else on the list. Flumazenil reverses benzodiazepines, protamine sulfate reverses heparin and vitamin K reverses warfarin.
7. Which nursing actions reduce an older adult client's risk of falling in the hospital? Select all that apply.
Select all that apply.
- A. Keep the bed in the lowest position with the wheels locked
- B. Place the call light and personal items within the client's reach
- C. Apply a vest restraint at night so the client stays in bed
- D. Make sure the client wears nonskid footwear when walking
- E. Turn off all lighting at night so the room stays completely dark
Show answer and explanation
Answer: A. Keep the bed in the lowest position with the wheels locked, B. Place the call light and personal items within the client's reach, D. Make sure the client wears nonskid footwear when walking
A low locked bed, items within reach and nonskid footwear are standard fall precautions because they remove the reasons a client climbs out unassisted. Restraints are a last resort and raise the risk of injury rather than lowering it, and a fully dark room makes an unassisted trip to the bathroom more dangerous, so a night light is the safer choice.
8. A nurse teaches a postmenopausal client about lowering the risk of osteoporosis. Which statement shows the teaching was effective?
- A. I will add walking or other weight-bearing exercise on most days of the week.
- B. I should cut dairy out of my diet.
- C. Swimming laps is the best exercise for my bones.
- D. I only need to worry about calcium after I break a bone.
Show answer and explanation
Answer: A. I will add walking or other weight-bearing exercise on most days of the week.
Bone rebuilds in response to load, so weight-bearing exercise such as walking, together with adequate calcium and vitamin D, is the core of prevention. Swimming is good for the heart but does not load the skeleton, and dairy is a useful calcium source rather than something to avoid.
9. A client has a chest tube connected to a water seal drainage system. Which finding requires immediate follow-up?
- A. Continuous bubbling in the water seal chamber
- B. Fluid in the water seal chamber that rises and falls with breathing
- C. 50 mL of serosanguineous drainage over the past 8 hours
- D. A dressing around the insertion site that is dry and intact
Show answer and explanation
Answer: A. Continuous bubbling in the water seal chamber
Continuous bubbling in the water seal chamber means air is entering the system, so the nurse checks the tubing connections and the insertion site right away. Tidaling with respiration, modest serosanguineous drainage and a dry intact dressing are all expected findings.
10. A client is going home on warfarin. Which client statements show that the teaching was effective? Select all that apply.
Select all that apply.
- A. I will keep the amount of green leafy vegetables I eat about the same each week.
- B. I will use a soft toothbrush and an electric razor.
- C. I will take ibuprofen whenever I get a headache.
- D. I will call the clinic if my stools look black or tarry.
- E. I can stop taking it once my INR reaches the target range.
Show answer and explanation
Answer: A. I will keep the amount of green leafy vegetables I eat about the same each week., B. I will use a soft toothbrush and an electric razor., D. I will call the clinic if my stools look black or tarry.
Warfarin blocks vitamin K dependent clotting factors, so a steady weekly vitamin K intake keeps the INR stable, gentle grooming limits bleeding, and black tarry stools are reported because they suggest gastrointestinal bleeding. Ibuprofen adds to the bleeding risk, and the drug is never stopped just because the INR has reached target.
11. Complete the sentence.
Before giving digoxin to an adult client, the nurse counts the apical pulse for one full minute and holds the dose if the rate is below _____ beats per minute.
Options for blank 1: 50, 60, 70, 80
Show answer and explanation
Answer: 60
The standard rule is to hold digoxin and notify the prescriber when an adult's apical pulse is under 60, because the drug already slows conduction through the heart. Nausea, vomiting and visual changes such as yellow or green halos suggest toxicity, and a low potassium level makes toxicity more likely.
12. A client returns to the unit after a bronchoscopy with moderate sedation. Which action must the nurse take before giving the client anything to drink?
- A. Check the client's temperature
- B. Confirm that the gag reflex has returned
- C. Listen for bowel sounds in all four quadrants
- D. Have the client sit up for 30 minutes
Show answer and explanation
Answer: B. Confirm that the gag reflex has returned
The throat is anesthetized for a bronchoscopy, so fluids can pass into the airway until sensation comes back. The client stays NPO until the nurse confirms the gag reflex, which is airway protection taking priority over comfort.
13. A client is having a panic attack and is pacing, breathing rapidly and unable to follow directions. Which action should the nurse take first?
- A. Explore what may have triggered the attack
- B. Stay with the client and speak calmly in short, simple sentences
- C. Leave the client alone in a quiet room until the anxiety passes
- D. Give detailed instructions on diaphragmatic breathing technique
Show answer and explanation
Answer: B. Stay with the client and speak calmly in short, simple sentences
At panic level anxiety the ability to take in information collapses, so the nurse stays present, lowers stimulation and gives short direct sentences. Exploring triggers and teaching breathing techniques only work once the anxiety has come down, and leaving the client alone is unsafe.
14. A charge nurse is making assignments on a medical unit. Which clients are appropriate to assign to a licensed practical nurse (LPN/LVN)? Select all that apply.
Select all that apply.
- A. A stable client with a healing surgical wound who needs a routine dressing change
- B. A newly admitted client who needs the initial admission assessment
- C. A client with pneumonia on oral antibiotics who needs vital signs monitored
- D. A client whose first unit of packed red blood cells needs to be started
- E. A client with a long-term indwelling urinary catheter who needs routine catheter care
Show answer and explanation
Answer: A. A stable client with a healing surgical wound who needs a routine dressing change, C. A client with pneumonia on oral antibiotics who needs vital signs monitored, E. A client with a long-term indwelling urinary catheter who needs routine catheter care
LPNs care for stable clients with predictable outcomes, which covers routine dressing changes, ongoing monitoring and routine catheter care. The initial admission assessment and starting a blood transfusion stay with the RN, since both require nursing judgment on a client whose status is not yet established.
15. Complete the sentence.
To lower the risk of aspiration, the nurse feeds a client who has dysphagia after a stroke while the client is _____.
Options for blank 1: lying flat on the back, sitting fully upright at 90 degrees, side-lying with the head of the bed flat, in a semi-prone position
Show answer and explanation
Answer: sitting fully upright at 90 degrees
Sitting fully upright with a slight chin tuck lets gravity carry food toward the esophagus rather than the airway, and the client stays upright for about 30 minutes after eating. Any reclined position raises the aspiration risk, and aspiration is an airway problem, which makes positioning a top priority rather than a comfort measure.
What the NCLEX-RN actually is
The NCLEX-RN is the licensure exam you take after nursing school, and passing it is what turns a nursing degree into an RN license. It is written by the National Council of State Boards of Nursing and delivered at testing centers. Unlike a course final, it is not built to check whether you memorized a textbook. It checks whether you can practice safely on your first day, which is why so many questions ask what you would do first rather than what something is called.
The exam is computer adaptive. Each answer changes what comes next: get an item right and the next one is harder, miss it and the next one is easier, so the test narrows in on your ability level. That has two practical effects. You cannot skip a question or go back to change an answer, and two candidates sitting side by side almost never see the same test. The number of items varies as well. Everyone answers at least a minimum number, the exam can go up to a maximum, and it stops as soon as it can decide with confidence whether you are above or below the passing standard, or when the time limit is reached. Some items are unscored pretest items you cannot identify. The current minimum, maximum and time limit are set by the NCSBN and have changed over the years, so check the candidate bulletin for the version in effect when you test. The result is pass or fail, not a score.
The Next Generation NCLEX added case studies and several new item types on top of classic multiple choice. A case study gives you an unfolding client scenario with new data at each step, and the item types include extended multiple response, matrix and grid questions, drop-down cloze, highlight, bowtie and trend items. Many of them award partial credit rather than all or nothing. The point of the redesign was clinical judgment: recognizing cues, analyzing them, forming a priority, acting, then evaluating the result.
How to use this sampler
The 15 questions below sample all four client needs categories in miniature: delegation, prioritization and infection control from safe and effective care environment, one health promotion item, one psychosocial item, and the rest from physiological integrity, including basic care and comfort, pharmacological therapies, reduction of risk potential and physiological adaptation. They are application questions, so knowing the definition is rarely enough. This sampler is not adaptive and it is not scored the way the real exam is, so treat it as a diagnostic rather than a prediction.
Prioritization questions deserve their own method, because they are the ones that feel unfair. When a question asks which client the nurse assesses first, or which finding requires immediate follow-up, assume every option describes a real problem. You are not looking for the only thing that matters, you are looking for the thing that will hurt someone soonest. Run the ABCs first: airway, then breathing, then circulation. If nothing is an ABC problem, ask which finding is new, unexpected or unstable, because an expected finding for that diagnosis can wait. Maslow settles the rest, with physical needs before safety and safety before psychosocial needs. Delegation questions run on scope rather than on how busy anyone is: assessment, teaching, evaluation and any unstable client stay with the RN, an LPN takes stable clients with predictable outcomes, and unlicensed assistive personnel take routine tasks like hygiene, positioning and recording intake and output.
Work through all 15 in one sitting without notes, then read every explanation, including the ones you answered correctly. A miss usually points at a category rather than a fact. Two missed pharmacology items mean drug monitoring is the gap, not those two drugs.
How StudyPDF builds full practice tests from your own materials
Fifteen questions can show you where you are shaky. They cannot get you ready for a licensure exam, and generic question banks drift away from the content your own program emphasized.
StudyPDF works from what you already have. Upload your NCLEX review book, lecture slides, care plans or class notes, and Bo, the study agent, builds full-length practice tests from that exact material. Every question is grounded in your pages and every explanation cites where the answer came from, so you can flip straight to the source when the reasoning does not land. You can regenerate fresh tests as often as you want, narrow them to one area such as pharmacology or maternal newborn, and track which concepts you keep missing across attempts. Starting is free.
Written by the StudyPDF team. Last updated 2026-08-19.