Free NCLEX-RN Practice Questions
105 free NCLEX-RN practice questions with detailed answers and rationales. Sharpen your NCLEX prep across adult health, maternal & newborn, mental health, child health, management of care, pharmacology and fundamentals. Answer the questions, submit your exam, and instantly see your score with full rationales for every item.
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Free NCLEX-RN Adult Health Revision Questions, Answers and Rationale
15 questions • Adult Health
Question 1
The nurse is caring for a client admitted with acute decompensated heart failure. Which assessment finding would the nurse identify as a priority concern?
Question 2
The nurse is preparing to administer digoxin 0.125 mg PO to a client with heart failure and atrial fibrillation. Which assessment finding should prompt the nurse to hold the medication and notify the provider?
Question 3
The nurse is educating a client newly diagnosed with peripheral artery disease (PAD). Which statement by the client indicates a need for further teaching?
Question 4
The nurse is caring for a client with type 1 diabetes who is unresponsive and diaphoretic. The client's blood glucose is 38 mg/dL. Which intervention should the nurse perform first?
Question 5
The nurse is teaching a client newly diagnosed with hypothyroidism who has been prescribed levothyroxine. Which client statement indicates correct understanding?
Question 6
The nurse is caring for a client admitted with Addisonian crisis. Which finding is the nurse's priority concern?
Question 7
The nurse is caring for a client 24 hours post-appendectomy. Which finding should prompt the nurse to notify the healthcare provider immediately?
Question 8
The nurse is caring for a client with liver cirrhosis who is being treated for hepatic encephalopathy. Which medication should the nurse anticipate administering?
Question 9
The nurse is teaching a client with newly diagnosed Crohn's disease. Which statement by the client demonstrates an understanding of dietary management?
Question 10
The nurse is caring for a client receiving a blood transfusion who suddenly develops fever, chills, and back pain 15 minutes after the infusion begins. Which action should the nurse take first?
Question 11
The nurse is caring for a client with sickle cell disease experiencing a vaso-occlusive crisis. Which intervention should the nurse prioritize?
Question 12
The nurse is caring for a client in the emergency department who was bitten by an unknown animal. The wound has been cleaned and sutured. Which intervention should the nurse anticipate?
Question 13
The nurse is reviewing the care plan for a client with neutropenia following chemotherapy. Which intervention is most important to include?
Question 14
The nurse is assessing a client's wound that is healing by secondary intention. Which finding indicates the wound is progressing appropriately?
Question 15
The nurse is providing discharge education to a client with a new colostomy. Which client statement indicates effective teaching?
Free NCLEX-RN Maternal and Newborn Revision Questions, Answers and Rationale
15 questions • Maternal & Newborn
Question 1
The nurse is caring for a client at 32 weeks gestation who presents with a blood pressure of 158/94 mm Hg, 2+ proteinuria, and deep tendon reflexes of 3+. The client reports a headache that "won't go away" and notes swelling in her face and hands. Which of the following interventions should the nurse implement first?
Question 2
The nurse is assessing a newborn who is 12 hours old and was born at 41 weeks gestation via vacuum-assisted delivery. The newborn's parent reports that the baby "hasn't wanted to eat for the past 3 hours and seems really tired." Upon assessment, the nurse notes a high-pitched cry, poor feeding effort, and a yellow-orange skin color visible on the abdomen. Which of the following actions should the nurse take first?
Question 3
A client who is 24 hours postpartum after an uncomplicated vaginal delivery calls the nurse and reports, "I just soaked through an entire pad in about 10 minutes, and I'm passing clots the size of golf balls." The nurse enters the room and finds the client pale and diaphoretic. The fundus is boggy and displaced to the right, and the client's perineal pad is saturated with bright red blood. Which of the following actions should the nurse take first?
Question 4
The nurse is reviewing the electronic fetal monitoring tracing for a client receiving oxytocin for labor augmentation at 39 weeks gestation. The tracing shows a baseline fetal heart rate of 145 beats per minute with moderate variability. The nurse notes repetitive late decelerations occurring with each contraction over the past 15 minutes. Contractions are occurring every 2 minutes and lasting 80 seconds. Which of the following actions should the nurse take?
Question 5
Nurses' Notes 0800: Client is a 28-year-old G2P1 at 38 weeks gestation admitted for induction of labor due to gestational hypertension. Cervix is 2 cm dilated, 50% effaced, fetal station -2. Oxytocin started at 2 milliunits/min. 1200: Oxytocin increased to 12 milliunits/min. Contractions every 2-3 minutes, moderate to strong by palpation. Cervix rechecked: 4 cm dilated, 70% effaced, fetal station -1. Fetal heart rate baseline 135 with moderate variability, no decelerations. 1400: Client reports intense pain and requests epidural anesthesia. Cervical exam deferred per client request due to pain. Fetal heart rate tracing shows baseline 140 with minimal variability and recurrent variable decelerations to 90 beats per minute lasting 45 seconds. The nurse is caring for a client receiving oxytocin for labor induction. Based on the Nurses' Notes, which of the following interventions should the nurse implement first?
Question 6
A client who is 10 hours postpartum after a vacuum-assisted delivery reports increasing perineal pain rated 9/10 despite receiving ibuprofen 800 mg 2 hours ago. The nurse assesses the perineum and notes a large, bulging, bluish discoloration on the left side of the vaginal wall. The client's vital signs are: blood pressure 98/52 mm Hg, heart rate 118 beats/min, respiratory rate 20 breaths/min. Fundus is firm at the umbilicus, and lochia is moderate rubra without clots. Which of the following actions should the nurse take?
Question 7
The nurse is assessing a 30-minute-old newborn born at 35 weeks gestation via spontaneous vaginal delivery. The newborn's respiratory rate is 72 breaths/min with nasal flaring, grunting on expiration, and intercostal retractions. Pulse oximetry is 88% on room air. The newborn is positioned supine in a radiant warmer. Which of the following actions should the nurse take first?
Question 8
A client at 28 weeks gestation calls the labor and delivery unit reporting "I've been having low back pain and mild cramping for the past few hours. I also noticed a small amount of pink discharge when I wiped." The client denies leakage of fluid or vaginal bleeding. She is G1P0 with an uncomplicated pregnancy. Which of the following responses by the nurse is most appropriate?
Question 9
The nurse is providing discharge teaching to a client who is 48 hours postpartum after a cesarean section. The client plans to formula feed her newborn. She asks, "My breasts are really firm and painful. What should I do to feel better?" Which of the following instructions should the nurse include?
Question 10
A client at 34 weeks gestation presents to the obstetric triage unit with complaints of a "gush of fluid" that occurred 2 hours ago. The nurse performs a nitrazine test, which turns blue, and ferning is present on microscopic examination. The client is not contracting and denies pain. Fetal heart rate is 145 beats per minute with moderate variability. Which of the following interventions should the nurse anticipate including in the plan of care?
Question 11
The nurse is caring for a client who is receiving magnesium sulfate for severe preeclampsia. The client's vital signs are: blood pressure 142/88 mm Hg, heart rate 88 beats/min, respiratory rate 14 breaths/min. The nurse assesses deep tendon reflexes and finds them to be absent. Urine output over the past 4 hours is 80 mL. Which of the following actions should the nurse take first?
Question 12
The nurse is assessing a newborn who is 4 hours old. The newborn's mother has gestational diabetes mellitus that was poorly controlled during pregnancy. The newborn is large for gestational age, weighing 9 lb 2 oz (4,150 g). The newborn is jittery, has a weak cry, and is difficult to arouse. Which of the following actions should the nurse take?
Question 13
A client who is 36 weeks pregnant presents to the emergency department with painless, bright red vaginal bleeding that started suddenly 1 hour ago. The client estimates she has saturated one peripad. Fetal heart rate is 155 beats per minute with moderate variability. The client denies contractions, abdominal pain, or trauma. Which of the following interventions should the nurse implement? Select all that apply.
Question 14
The nurse is caring for a client who is 2 hours postpartum after a vaginal delivery. The client's fundus is firm and midline at the umbilicus. Lochia is moderate rubra with small clots. The client's perineal pad has a 4-inch area of bright red blood. Vital signs are: blood pressure 118/72 mm Hg, heart rate 88 beats/min. The client reports perineal pain rated 6/10. Which of the following actions should the nurse take?
Question 15
The nurse is preparing to administer vitamin K (phytonadione) to a newborn per routine protocol. The newborn's parent asks, "Why does my baby need that shot?" Which of the following responses by the nurse is most appropriate?
Free NCLEX-RN Mental Health Revision Questions, Answers and Rationale
15 questions • Mental Health
Question 1
A nurse on an inpatient psychiatric unit is caring for a client with schizophrenia who is standing in the corner, whispering to themselves. The client suddenly turns and says, "The voice is telling me to punch you." Which of the following responses by the nurse is most appropriate?
Question 2
The nurse is assessing a client in the outpatient clinic who reports, "I can't stop thinking about germs. I wash my hands 30 times a day, and my skin is cracked and bleeding. I know it's not normal, but I can't stop." Which of the following is the client describing?
Question 3
The nurse is providing discharge teaching to a client with bipolar I disorder who is being discharged on lithium. The client asks, "What do I need to know about taking this medication?" Which of the following statements should the nurse include?
Question 4
The nurse is caring for a client with anorexia nervosa who has a BMI of 15.2 kg/m². The client refuses to eat breakfast and states, "I'll get fat if I eat that." Which of the following is the priority nursing action?
Question 5
A client with post-traumatic stress disorder (PTSD) states, "I can't go to the grocery store anymore. The crowds make me feel like I'm back in the war. I have nightmares about the explosion every night." Which of the following findings are consistent with PTSD? Select all that apply.
Question 6
The nurse is assessing a client who reports, "I feel sad every day for the past 3 years. I still function at work, but I don't enjoy anything like I used to. I've never felt this bad before, but it's been constant." Which of the following diagnoses is most consistent with this presentation?
Question 7
A nurse is caring for a client with borderline personality disorder who becomes angry and states, "You're the worst nurse I've ever had. You don't care about anyone. My other nurse was perfect and actually listened to me." Which of the following defense mechanisms is the client demonstrating?
Question 8
The nurse is providing education to the family of a client with Alzheimer's disease who has started wandering at night. Which of the following recommendations should the nurse make first?
Question 9
The nurse is assessing a client who was brought to the emergency department after using cocaine. The client is agitated, has a temperature of 39.5°C (103.1°F), blood pressure 180/110, heart rate 140, and reports chest pain. Which of the following complications is the priority concern?
Question 10
The nurse is caring for a client with major depressive disorder who started taking sertraline 1 week ago. The client reports, "I feel more energy, but I still feel hopeless and I'm thinking about dying." Which of the following is the priority nursing action?
Question 11
The nurse is observing a staff member interacting with a client who has paranoid personality disorder. The staff member whispers to another nurse while the client is present. Which of the following actions by the staff member would require the nurse to intervene?
Question 12
A client with alcohol use disorder is admitted for detoxification. The client's last drink was 72 hours ago. The client is confused, diaphoretic, tremulous, and reports seeing snakes on the floor. Which of the following conditions is the client most likely experiencing?
Question 13
The nurse is providing education to a client with generalized anxiety disorder about non-pharmacological coping strategies. Which of the following statements by the client indicates understanding of the teaching?
Question 14
The nurse is caring for a client with schizophrenia who has been prescribed clozapine for treatment-resistant symptoms. The client reports new onset of fever, sore throat, and fatigue. Which of the following is the priority nursing action?
Question 15
The nurse is assessing a client with bulimia nervosa. Which of the following findings would the nurse most likely observe?
Free NCLEX-RN Child Health Revision Questions, Answers and Rationale
15 questions • Child Health
Question 1
The nurse is caring for a 4-year-old client admitted with a ventricular septal defect (VSD). Which of the following findings would the nurse expect during assessment?
Question 2
A newborn is diagnosed with hypoplastic left heart syndrome (HLHS). The parents ask the nurse what this means for their baby. Which of the following responses by the nurse is most accurate?
Question 3
The nurse is assessing a 6-week-old infant who has been diagnosed with coarctation of the aorta. Which of the following clinical findings would the nurse expect? Select all that apply.
Question 4
The nurse is caring for a 10-year-old client newly diagnosed with hypothyroidism. The client's parent asks about expected symptoms before treatment. Which of the following symptoms would the nurse include in the teaching?
Question 5
The nurse is caring for a 14-year-old client with Addison disease. The client reports nausea, vomiting, and severe abdominal pain after being sick with the flu for 3 days. Which complication does the nurse suspect?
Question 6
The nurse is admitting a 3-week-old male infant with a 5-day history of non-bilious, projectile vomiting after every feeding. The infant appears hungry after vomiting. Which of the following laboratory findings does the nurse anticipate?
Question 7
The nurse is caring for a 2-year-old client with celiac disease. The parent reports the child has been eating normally but continues to have foul-smelling, greasy, bulky stools. Which teaching point should the nurse emphasize?
Question 8
The nurse is assessing a 9-month-old infant during a well-child visit. Which of the following developmental milestones would the nurse expect this infant to have achieved?
Question 9
The nurse is providing anticipatory guidance to parents of a 2-year-old. Which of the following behaviors should the nurse explain as an expected developmental characteristic of toddlers?
Question 10
The nurse is caring for an 8-year-old client with sickle cell disease who is admitted with vaso-occlusive crisis. The client has a temperature of 102.6°F (39.2°C), oxygen saturation of 91%, and reports 9/10 chest pain with dyspnea. Which complication should the nurse be most concerned about?
Question 11
The nurse is planning care for a 4-year-old client admitted with confirmed varicella (chickenpox). Which infection control precautions should the nurse implement?
Question 12
The nurse is reviewing the medical record of a 5-year-old client with a fever, irritability, and a petechial rash on the trunk and extremities. The client has a stiff neck and is photophobic. Which action should the nurse take first?
Question 13
The nurse is caring for a 6-year-old client who has extensive burns covering the face and neck sustained 2 days ago. Which complication should the nurse most closely monitor for in this client?
Question 14
The nurse is providing discharge teaching to the parent of a 4-year-old client diagnosed with tinea capitis (ringworm of the scalp). Which of the following statements indicates correct understanding?
Question 15
The pediatric nurse is assessing a 5-year-old client in a long leg cast applied 6 hours ago for a femur fracture. The child is crying and reports severe pain in the leg that is not relieved by repositioning. The nurse notes pallor of the toes and the child cannot wiggle them. Which action should the nurse take first?
Free NCLEX-RN Management of Care Revision Questions, Answers and Rationale
15 questions • Management of Care
Question 1
The charge nurse is making shift assignments on a medical-surgical unit. Which client should be assigned to the most experienced registered nurse (RN)?
Question 2
The nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP) on a postoperative orthopedic unit. Which task requires the nurse to provide additional supervision?
Question 3
The nurse on a busy telemetry unit must discharge one client to make room for a new admission from the emergency department. Which client is most appropriate for discharge?
Question 4
The registered nurse (RN) is working with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP) on a medical-surgical unit. Which task is most appropriate for the RN to assign to the LPN?
Question 5
The nurse overhears two colleagues discussing a client in the hospital cafeteria. One says, "Can you believe the client in room 412 has HIV? I can't believe they didn't tell us sooner." Which action should the nurse take first?
Question 6
The charge nurse is evaluating a new graduate RN's understanding of delegation principles. Which statement by the new graduate indicates a need for further teaching?
Question 7
The nurse is caring for a client who was involved in a motor vehicle crash and is now brain dead. The client's family is divided about whether to withdraw life support. Which resource should the nurse recommend to help resolve this conflict?
Question 8
The nurse manager is reviewing incident reports from the past month. Which situation requires immediate follow-up and system change?
Question 9
The charge nurse is making assignments for a float RN who typically works on the postpartum unit but has been assigned to the medical-surgical unit due to staffing shortages. Which client is most appropriate to assign to this float nurse?
Question 10
The nurse is providing change-of-shift report using the SBAR (Situation, Background, Assessment, Recommendation) format. Which statement best represents the "Recommendation" component?
Question 11
The nurse is caring for a client who has a do-not-resuscitate (DNR) order and is actively dying. The client's family member demands that the nurse "do everything possible" and threatens to sue if the client dies. Which action should the nurse take first?
Question 12
The nurse manager is implementing a new evidence-based protocol for preventing catheter- associated urinary tract infections (CAUTI). Which action best promotes staff adoption of the new protocol?
Question 13
The nurse notes that a colleague administered the wrong dose of insulin to a client. The client is stable with no adverse effects. The colleague says, "Please don't report this. The client is fine, and I'll lose my job." Which action should the nurse take?
Question 14
The charge nurse observes an RN removing personal protective equipment (PPE) after caring for a client on contact precautions. The RN removes the gloves, then the gown, then the mask, and then performs hand hygiene. Which action should the charge nurse take?
Question 15
The nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs as a Jehovah's Witness. The healthcare provider states, "The client will die without this transfusion. Give it anyway." Which action should the nurse take?
Free NCLEX-RN Pharmacology Revision Questions, Answers and Rationale
15 questions • Pharmacology
Question 1
The nurse is caring for a client who has been taking metformin for type 2 diabetes mellitus for 6 months. The client is scheduled for a computed tomography (CT) scan with intravenous contrast later today. Which of the following actions should the nurse take?
Question 2
The nurse is providing discharge teaching to a client who has been prescribed warfarin for atrial fibrillation. The client asks, "What should I do if I forget to take my morning dose?" Which of the following responses by the nurse is most appropriate?
Question 3
The nurse is assessing a client who was started on furosemide 40 mg orally twice daily three days ago for heart failure. The client reports feeling "weak and dizzy" when standing up. Which of the following actions should the nurse take first?
Question 4
The nurse is preparing to administer digoxin 0.25 mg orally to a client with heart failure. The client's apical pulse is 52 beats per minute and irregular. The client denies any chest pain or shortness of breath. Which of the following actions should the nurse take?
Question 5
The nurse is caring for a client who has been taking prednisone 40 mg daily for 2 weeks to treat an exacerbation of ulcerative colitis. The client asks the nurse, "Why is my face looking so round and puffy?" Which of the following responses by the nurse is most accurate?
Question 6
The nurse is teaching a client who has just been prescribed albuterol via metered-dose inhaler for exercise-induced bronchospasm. Which of the following instructions should the nurse include? Select all that apply.
Question 7
The nurse is assessing a client who is receiving a continuous intravenous infusion of magnesium sulfate for management of preeclampsia. The client's deep tendon reflexes are absent, and the respiratory rate is 10 breaths per minute. Which of the following actions should the nurse take first?
Question 8
The nurse is providing discharge teaching to a client who is being discharged with a prescription for amiodarone for the management of atrial fibrillation. Which of the following client statements indicates a need for further teaching?
Question 9
The nurse is caring for a client who has taken an overdose of acetaminophen 2 hours ago in a suicide attempt. The client's serum acetaminophen level is 180 mcg/mL. Which of the following medications should the nurse anticipate administering?
Question 10
The nurse is assessing a client who has been taking levothyroxine for 3 months for hypothyroidism. The client reports feeling anxious, has a heart rate of 110 beats per minute, and has lost 8 pounds (3.6 kg) without trying. Which of the following actions should the nurse take?
Question 11
The nurse is caring for a client who has been prescribed spironolactone for heart failure. The client's laboratory results show a potassium level of 5.8 mEq/L (5.8 mmol/L). Which of the following actions should the nurse take first?
Question 12
The nurse is providing teaching to a client who has been prescribed finasteride for benign prostatic hyperplasia. Which of the following statements by the client indicates correct understanding of the medication?
Question 13
The nurse is caring for a client who has been prescribed fentanyl transdermal patch for chronic cancer pain. The client's caregiver reports that the client is difficult to arouse and has a respiratory rate of 8 breaths per minute. Which of the following actions should the nurse take first?
Question 14
The nurse is assessing a client who has been taking phenytoin for 6 months for a seizure disorder. The nurse notes that the client has swollen, bleeding gums and difficulty chewing. Which of the following nursing actions is most appropriate?
Question 15
The nurse is teaching a client who has been prescribed a nicotine transdermal patch for smoking cessation. The client asks, "Can I still smoke while wearing this patch?" Which of the following responses by the nurse is most appropriate?
Free NCLEX-RN Fundamentals Revision Questions, Answers and Rationale
15 questions • Fundamentals
Question 1
The nurse is caring for a client with chronic kidney disease who reports fatigue, muscle weakness, and tingling in the fingers. Laboratory results show serum calcium of 6.8 mg/dL (reference range: 8.5-10.2 mg/dL) and serum phosphorus of 6.0 mg/dL (reference range: 2.5-4.5 mg/dL). Which of the following findings should the nurse expect to assess in this client?
Question 2
The nurse is caring for a client receiving total parenteral nutrition (TPN) through a central line. The pharmacy notifies the nurse that the next TPN bag will be delayed by 3 hours. Which of the following actions should the nurse take first?
Question 3
The nurse is preparing to administer a blood transfusion to a client with a history of multiple previous transfusions. Fifteen minutes after starting the transfusion, the client reports headache and chills. The nurse obtains vital signs: temperature 100.8°F (38.2°C), heart rate 110/min, blood pressure 118/72 mmHg. Which of the following actions should the nurse take first?
Question 4
The charge nurse is observing a new graduate nurse caring for a client with Clostridioides difficile infection. The client has contact precautions in place. Which of the following actions by the new graduate nurse would require the charge nurse to intervene?
Question 5
The nurse is caring for a client who reports chest pain and shortness of breath while receiving a blood transfusion. Vital signs show temperature 99.2°F (37.3°C), heart rate 122/min, blood pressure 88/54 mmHg, respiratory rate 28/min, and pulse oximetry 91% on room air. Which of the following conditions is the client most likely experiencing?
Question 6
The nurse is providing discharge teaching to a client prescribed furosemide for heart failure. The client asks what symptoms should prompt a call to the healthcare provider. Which of the following statements by the client indicates a need for further teaching?
Question 7
The nurse is preparing to insert a nasogastric tube for gastric decompression in a client with a small bowel obstruction. The client is alert and oriented. Which of the following actions should the nurse take to facilitate tube insertion?
Question 8
The nurse is assessing a client who received 2 units of packed red blood cells yesterday. The client now reports severe lower back pain, nausea, and dark urine. Vital signs show temperature 100.4°F (38.0°C), heart rate 108/min, blood pressure 100/62 mmHg. Which of the following laboratory findings would the nurse expect?
Question 9
The nurse is caring for a client receiving continuous enteral tube feeding through a nasogastric tube. The nurse notes that the tube feeding formula has been infusing for 6 hours. Which of the following actions should the nurse take?
Question 10
The nurse is caring for a client with a new colostomy. The client states, "I don't even want to look at it. This is disgusting." Which of the following responses by the nurse is most appropriate?
Question 11
The nurse is caring for a client with a Salem sump nasogastric tube connected to continuous suction. The nurse notes that the client's gastric output has decreased significantly over the past 2 hours. Which of the following actions should the nurse take first?
Question 12
The nurse is preparing to administer a cleansing enema to an adult client. The client asks, "How far will the tube be inserted?" Which of the following responses by the nurse is correct?
Question 13
The nurse is observing a staff member caring for a client with active pulmonary tuberculosis. The client is on airborne precautions. Which of the following actions by the staff member requires immediate intervention?
Question 14
The nurse is caring for a client with a peripherally inserted central catheter (PICC) line. The client reports chest pain and difficulty breathing. The nurse notes that the client appears anxious and the respiratory rate is 32/min. Which of the following actions should the nurse take first?
Question 15
The nurse is providing discharge teaching to a client prescribed warfarin for atrial fibrillation. The client asks what foods should be avoided. Which of the following foods should the nurse instruct the client to eat consistently rather than avoid completely?
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