Free NGN NCLEX SATA Practice Questions Test 1

These 36 Next Generation NCLEX-style Select All That Apply (SATA) questions were written to give nursing students realistic, NCLEX exam-level practice across medical-surgical, pharmacology, mental health, maternity, and pediatric nursing content. Each question follows the current NCLEX plus/minus partial-credit scoring model, and every answer choice; correct and incorrect, is explained in detail so you understand the clinical reasoning behind it, not just the answer itself. For more NCLEX practice tests like this, signup to ReviseNclex.com.

How These NGN SATA Questions Are Scored

Next Generation NCLEX SATA questions now use what's called plus/minus (+/-) partial credit scoring. Here's how it works:

You earn one point for every option you correctly select.
You lose one point for every incorrect option you select.
The lowest possible score on any single question is zero - there are no negative scores.
As long as you select more right options than wrong ones, you walk away with partial points instead of none.

36 Free NGN NCLEX SATA Practice Questions

Answered 0 of 36 questions. Correct answers and rationales appear after you submit.

Question 1

The nurse is caring for a client admitted to the intensive care unit with diabetic ketoacidosis (DKA). The client's blood glucose is 450 mg/dL (25 mmol/L) and arterial blood gas reveals a pH of 7.22.

Which of the following nursing actions should the nurse anticipate? Select all that apply.

1. Administer an IV bolus of 0.9% normal saline
2. Initiate a continuous IV insulin infusion
3. Administer IV sodium bicarbonate immediately
4. Monitor serum potassium levels before and during insulin therapy
5. Administer subcutaneous regular insulin every 4 hours
6. Assess for Kussmaul respirations
7. Restrict oral and IV fluids until the glucose level normalizes

Question 2

Four hours after a vaginal delivery, the nurse assesses a client and notes a boggy, difficult-to-locate uterine fundus with lochia rubra saturating a perineal pad within 15 minutes.

Which of the following actions should the nurse take? Select all that apply.

1. Perform fundal massage
2. Encourage the client to void, or catheterize if unable
3. Place the client in high-Fowler position
4. Administer oxytocin per protocol
5. Apply an ice pack to the perineum
6. Notify the healthcare provider
7. Place the client in Trendelenburg position

Question 3

The nurse is caring for a client with heart failure who has been taking digoxin for several weeks. The client's most recent serum digoxin level is 2.6 ng/mL (therapeutic range 0.8-2.0 ng/mL).

Which of the following findings should the nurse recognize as consistent with digoxin toxicity? Select all that apply.

1. Visual halos around lights
2. Serum potassium level of 5.8 mEq/L (5.8 mmol/L)
3. Heart rate of 52 beats/min
4. Nausea and vomiting
5. Serum potassium level of 3.0 mEq/L (3.0 mmol/L)
6. Bounding peripheral pulses
7. New-onset confusion in an older adult

Question 4

The nurse is caring for a 6-year-old child with autism spectrum disorder who is nonverbal and becomes visibly distressed with unexpected changes in routine.

Which of the following nursing actions are appropriate? Select all that apply.

1. Use a visual schedule to show the sequence of care activities
2. Speak in a calm, low-pitched voice using simple, concrete language
3. Introduce several new staff members at once to build rapport quickly
4. Provide advance warning before transitioning to a new activity
5. Turn off unnecessary overhead lighting and reduce background noise
6. Insist on eye contact during every interaction to build trust
7. Allow the child to hold a preferred comfort item during procedures

Question 5

The nurse is caring for a client with a chest tube connected to a closed water-seal drainage system following a spontaneous pneumothorax.

Which of the following nursing actions are appropriate? Select all that apply.

1. Keep the drainage system below the level of the client's chest
2. Clamp the chest tube during ambulation
3. Ensure the tubing is free of dependent loops
4. Notify the healthcare provider for continuous bubbling in the water-seal chamber
5. Mark the drainage level and time on the collection chamber each shift
6. Strip the chest tube every 2 hours to promote drainage
7. Encourage coughing and deep-breathing exercises

Question 6

The nurse is assessing a client's peripheral IV site during an infusion of 0.9% normal saline.

Which of the following findings require the nurse to discontinue the IV catheter? Select all that apply.

1. Coolness of the skin surrounding the insertion site
2. Slowed infusion rate with difficulty flushing the line
3. Swelling and taut skin at the insertion site
4. Warmth and streaking redness along the path of the vein
5. Mild bruising at the insertion site from initial placement
6. Absence of blood return when the catheter is aspirated
7. Client reports a burning sensation and tightness at the site

Question 7

The charge nurse is supervising a newly licensed nurse who is applying a wrist restraint to a confused client who keeps pulling at a nasogastric tube.

Which of the following actions by the newly licensed nurse require follow-up by the charge nurse? Select all that apply.

1. Ties the restraint to the bed's side rail
2. Uses a quick-release knot to secure the restraint
3. Documents restraint application and the client's response every 4 hours
4. Applies the restraint tight enough to prevent any movement of the wrist
5. Assesses circulation, sensation, and skin integrity every 2 hours
6. Removes the restraint and reassesses the need for it every 2 hours
7. Obtains a prescription for the restraint that includes duration and type

Question 8

The nurse is performing an assessment on a term newborn 2 hours after birth.

Which of the following findings would the nurse expect as normal? Select all that apply.

1. Axillary temperature of 98.4°F (36.9°C)
2. Blue discoloration of the hands and feet
3. Yellow tinge to the skin and sclera
4. Heart rate of 150 beats/min
5. Respiratory rate of 68 breaths/min sustained for over an hour
6. A soft, flat fontanel palpated on the top of the head
7. Passage of a dark green, tarry stool

Question 9

The nurse is caring for a client receiving a continuous IV heparin infusion for treatment of a pulmonary embolism.

Which of the following nursing actions are appropriate? Select all that apply.

1. Monitor activated partial thromboplastin time (aPTT) per protocol
2. Keep protamine sulfate readily available
3. Administer intramuscular injections as needed for pain
4. Assess for signs of bleeding, such as blood in the urine or stool
5. Monitor platelet counts throughout therapy
6. Encourage use of a soft-bristled toothbrush
7. Discontinue the infusion immediately if the aPTT is subtherapeutic

Question 10

The nurse is providing discharge teaching to a client newly diagnosed with chronic obstructive pulmonary disease (COPD).

Which of the following statements indicate the teaching was effective? Select all that apply.

1. "I will use pursed-lip breathing when I feel short of breath."
2. "I should increase my oxygen flow rate on my own if I feel more short of breath."
3. "I will get the influenza vaccine every year."
4. "I should eat six small meals a day instead of three large ones."
5. "I will drink at least 2-3 liters of fluid a day unless told otherwise."
6. "I should sleep flat on my back without pillows to open my airway."

Question 11

The nurse witnesses a hospitalized client having a generalized tonic-clonic seizure while in bed.

Which of the following nursing actions are appropriate? Select all that apply.

1. Turn the client onto their side
2. Insert a padded tongue depressor into the client's mouth
3. Loosen restrictive clothing around the client's neck
4. Remove nearby objects that could cause injury
5. Restrain the client's arms and legs to prevent injury
6. Time the duration of the seizure
7. Stay with the client and call for assistance

Question 12

The nurse is caring for a client receiving peritoneal dialysis (PD).

Which of the following findings should the nurse report to the healthcare provider? Select all that apply.

1. Cloudy, opaque dialysate outflow
2. Outflow amount consistently less than inflow amount by 500 mL over several exchanges
3. Clear, pale-yellow dialysate outflow
4. Client reports abdominal pain and rebound tenderness
5. Dialysate solution warmed prior to instillation
6. Low-grade fever of 100.8°F (38.2°C)

Question 13

The nurse is caring for a postoperative client using patient-controlled analgesia (PCA) with IV morphine.

Which of the following nursing actions are appropriate? Select all that apply.

1. Instruct family members not to press the PCA button for the client
2. Assess respiratory rate and sedation level regularly
3. Set a continuous basal rate for all opioid-naive clients using the PCA
4. Have naloxone readily available at the bedside
5. Instruct the client to press the button only when experiencing pain
6. Increase the demand dose without an order if the client reports poor pain control

Question 14

The nurse is caring for a client experiencing an acute manic episode related to bipolar disorder.

Which of the following nursing interventions are appropriate? Select all that apply.

1. Provide a structured, low-stimulation environment
2. Offer finger foods and high-calorie snacks throughout the day
3. Engage the client in competitive group games to channel excess energy
4. Set clear, consistent limits on behavior
5. Redirect the client calmly and firmly from disruptive behaviors
6. Encourage the client to make several major life decisions during the acute phase

Question 15

A home health nurse visiting an 82-year-old client who lives with her adult son notes multiple bruises in varying stages of healing on the client's upper arms. The client appears fearful whenever the son enters the room.

Which of the following nursing actions are appropriate? Select all that apply.

1. Interview the client privately, without the son present
2. Ask the client directly if she feels safe at home
3. Confront the son immediately about the suspected abuse
4. Document objective findings using precise, factual language
5. Report the suspected abuse to adult protective services
6. Promise the client that this information will remain confidential from all agencies

Question 16

The nurse is administering an intermittent enteral tube feeding through a nasogastric tube.

Which of the following actions are appropriate? Select all that apply.

1. Elevate the head of the bed to at least 30-45 degrees during and after the feeding
2. Check gastric residual volume per facility protocol before the feeding
3. Verify tube placement before administering the feeding
4. Flush the tube with water before and after the feeding
5. Add blue food coloring to the feeding to help detect aspiration
6. Use auscultation of an injected air bolus as the sole method to confirm placement

Question 17

The nurse assessing a postoperative abdominal incision notes separation of the wound edges with visible viscera protruding through the opening.

Which of the following actions should the nurse take immediately? Select all that apply.

1. Cover the area with sterile saline-soaked gauze
2. Notify the healthcare provider immediately
3. Attempt to gently push the protruding tissue back into the wound
4. Position the client in low semi-Fowler position with knees bent
5. Keep the client NPO
6. Apply firm, direct pressure over the exposed viscera

Question 18

The nurse is caring for a client with a blood pressure of 220/130 mmHg who reports a severe headache and blurred vision.

Which of the following nursing actions are priority? Select all that apply.

1. Initiate IV antihypertensive therapy per order
2. Place the client on continuous cardiac monitoring
3. Encourage the client to ambulate to reduce anxiety
4. Assess neurological status frequently
5. Lower the blood pressure to a normal range within 15 minutes
6. Insert an indwelling urinary catheter to monitor output

Question 19

The nurse is caring for a pregnant client at 34 weeks gestation who has been diagnosed with preeclampsia with severe features.

Which of the following findings would the nurse expect? Select all that apply.

1. Blood pressure of 168/112 mmHg
2. Deep tendon reflexes of 4+ with clonus
3. Urine output of 60 mL/hr
4. Epigastric or right upper quadrant pain
5. Platelet count of 90,000/mm3 (90 x 10\^9/L)
6. Visual disturbances such as scotomata

Question 20

The nurse is providing education to the parent of a 9-year-old child newly prescribed methylphenidate for attention-deficit/hyperactivity disorder (ADHD).

Which of the following statements indicate the teaching was effective? Select all that apply.

1. "I will give this medication in the morning."
2. "My child's height and weight will be monitored regularly."
3. "It's normal for my child to have a big increase in appetite with this medication."
4. "I should watch for a racing heart or complaints of chest pain."
5. "If my child has trouble falling asleep, I should give the medication later in the evening."
6. "I will keep a log of my child's behavior for follow-up appointments."

Question 21

The nurse is transfusing a unit of packed red blood cells. Ten minutes into the transfusion, the client reports lower back pain and chills, and the temperature rises from 98.6°F (37°C) to 101.2°F (38.4°C).

Which of the following actions should the nurse take? Select all that apply.

1. Stop the transfusion immediately
2. Keep the IV line open with normal saline using new tubing
3. Increase the infusion rate to complete the transfusion quickly
4. Notify the healthcare provider and the blood bank
5. Recheck vital signs frequently per protocol
6. Return the blood bag and tubing to the blood bank

Question 22

The nurse is teaching a client with peripheral arterial disease (PAD) about self-care at home.

Which of the following statements indicate the teaching was effective? Select all that apply.

1. "I should walk to the point of pain, then rest and continue."
2. "I will elevate my legs above my heart when resting."
3. "I need to inspect my feet daily for cuts or sores."
4. "I should avoid smoking and secondhand smoke."
5. "I will wear tight, compression socks to improve circulation."
6. "I should keep my legs warm, but avoid direct heat sources like heating pads."

Question 23

The nurse is caring for a client admitted to an inpatient psychiatric unit on suicide precautions following a recent attempt.

Which of the following nursing actions are appropriate? Select all that apply.

1. Remove shoelaces, belts, and sharp objects from the client's room
2. Assign the client to a room near the nurses' station
3. Allow the client to keep personal medications at the bedside
4. Conduct room checks at unpredictable, irregular intervals
5. Encourage the client to verbalize thoughts and feelings
6. Ask the client directly if they are having thoughts of suicide

Question 24

The nurse is caring for a severely malnourished client who began enteral nutritional support 24 hours ago after a prolonged period of NPO status.

Which of the following findings should alert the nurse to possible refeeding syndrome? Select all that apply.

1. Serum phosphorus level of 1.2 mg/dL (0.39 mmol/L) (reference range 2.5-4.5 mg/dL \[0.81-1.45 mmol/L\])
2. New-onset peripheral edema
3. Serum potassium level of 4.0 mEq/L (4.0 mmol/L)
4. Client reports increasing shortness of breath
5. Serum magnesium level of 1.0 mg/dL (0.41 mmol/L) (reference range 1.5-2.5 mg/dL \[0.62-1.03 mmol/L\])
6. Irregular heart rhythm noted on telemetry

Question 25

The nurse is conducting a 2-week postpartum follow-up visit and interviews the client about her mood.

Which of the following client statements suggest postpartum depression rather than the expected \"baby blues\"? Select all that apply.

1. "I cried a few times during my first week home, but I feel fine now."
2. "I don't feel connected to my baby at all, and it's been two weeks."
3. "I'm so exhausted I can barely get out of bed most days."
4. "I have thoughts of hurting myself or my baby sometimes."
5. "I felt weepy for a couple of days right after delivery."
6. "I've lost interest in things I used to enjoy, and it's not getting better."

Question 26

The nurse is performing a dressing change for a client's central venous catheter (CVC).

Which of the following actions are appropriate? Select all that apply.

1. Wear a mask and sterile gloves, using sterile technique
2. Clean the site with chlorhexidine using a back-and-forth friction motion
3. Allow the antiseptic solution to air dry completely before applying the dressing
4. Change a transparent semipermeable dressing every 5-7 days or when soiled
5. Change a gauze dressing every 5-7 days
6. Date and time the new dressing after application

Question 27

The nurse is caring for a client undergoing chemotherapy whose absolute neutrophil count (ANC) is 400/mm3 (0.4 x 10\^9/L).

Which of the following instructions should the nurse include in the client\'s plan of care? Select all that apply.

1. Avoid fresh flowers and standing water in the room
2. Eat only well-cooked foods; avoid raw fruits and vegetables
3. Take the client's temperature rectally to obtain the most accurate reading
4. Restrict visitors who are ill or recently received a live vaccine
5. Encourage frequent hand hygiene by the client, staff, and visitors
6. Report a temperature of 100.4°F (38°C) or higher immediately

Question 28

The nurse is caring for a client admitted for alcohol withdrawal, 18 hours since the last drink.

Which of the following findings would the nurse expect? Select all that apply.

Question 29

The nurse is performing suctioning on a client with a tracheostomy.

Which of the following actions are appropriate? Select all that apply.

1. Hyperoxygenate the client before and after suctioning
2. Apply suction while inserting the catheter into the tracheostomy
3. Limit each suction pass to 10-15 seconds or less
4. Apply intermittent suction while withdrawing the catheter in a rotating motion
5. Insert the catheter until resistance is met, then advance an additional 2 inches (5 cm)
6. Allow the client to rest between suction passes

Question 30

The nurse is providing discharge teaching to the parent of a 4-year-old child with a viral illness and a fever of 101.5°F (38.6°C).

Which of the following statements indicate the teaching was effective? Select all that apply.

1. "I can alternate acetaminophen and ibuprofen if the fever doesn't come down."
2. "I should give my child aspirin if the fever gets very high."
3. "I will dress my child in lightweight clothing."
4. "I should offer small amounts of clear fluids frequently."
5. "I will call the doctor if my child has a fever above 104°F (40°C) or the fever lasts more than 3 days."
6. "I will encourage rest but don't need to restrict normal activity if my child feels okay."

Question 31

The nurse is teaching a client newly prescribed oral alendronate for osteoporosis.

Which of the following statements indicate the teaching was effective? Select all that apply.

1. "I will take this medication first thing in the morning on an empty stomach."
2. "I will lie back down for 30 minutes after taking this medication to help it absorb."
3. "I should take this with a full glass of plain water."
4. "I need to remain upright for at least 30 minutes after taking this medication."
5. "I will report any new jaw pain or difficulty healing after dental work."
6. "I can take my calcium supplement at the same time as this medication."

Question 32

The nurse is caring for a client with a peripherally inserted central catheter (PICC) in the right upper arm.

Which of the following actions are appropriate? Select all that apply.

1. Measure the upper arm circumference at the insertion site with each dressing change
2. Use the PICC line arm for blood pressure measurements when other sites are unavailable
3. Flush the line with normal saline before and after each medication administration
4. Use a 10 mL syringe or larger for flushing the line
5. Avoid strenuous or repetitive use of the arm with the PICC line
6. Apply a tourniquet above the PICC insertion site when drawing blood from that arm

Question 33

The nurse is reviewing the medication administration record of an older adult client identified as high risk for falls.

Which of the following medications should the nurse recognize as increasing the client\'s fall risk? Select all that apply.

Question 34

The nurse is caring for a client with a T4 spinal cord injury who suddenly reports a pounding headache. Assessment reveals a blood pressure of 210/120 mmHg (baseline 100/60 mmHg), flushing and diaphoresis above the level of injury, and bradycardia.

Which of the following nursing actions should the nurse take? Select all that apply.

1. Sit the client upright immediately
2. Loosen any constrictive clothing or devices
3. Check the client for a distended bladder or kinked catheter
4. Lay the client flat with the legs elevated
5. Assess for fecal impaction after other causes are addressed
6. Administer an antihypertensive medication if the trigger is not immediately identified and blood pressure remains elevated

Question 35

The nurse is caring for a newborn receiving phototherapy for hyperbilirubinemia.

Which of the following nursing actions are appropriate? Select all that apply.

1. Cover the newborn's eyes with an opaque eye mask during treatment
2. Keep the newborn fully clothed except for the diaper area during treatment
3. Monitor the newborn's temperature regularly
4. Reposition the newborn frequently to expose all skin surfaces to the light
5. Discontinue breastfeeding for the duration of phototherapy
6. Monitor for signs of dehydration, such as decreased urine output

Question 36

The nurse is providing discharge teaching to a client who underwent gastric bypass surgery 2 days ago.

Which of the following statements indicate the teaching was effective? Select all that apply.

1. "I will eat small meals throughout the day instead of three large ones."
2. "I should drink fluids about 30 minutes before or after meals, not with meals."
3. "I will eat protein first at each meal, before other foods."
4. "I can drink carbonated beverages once I'm feeling better."
5. "I should eat slowly and chew my food thoroughly."
6. "I will take a daily multivitamin and calcium supplement for the rest of my life."

You'll be taken back to the top to see your score, then you can review every question and rationale from Question 1.

Keep Practicing NCLEX-RN Questions

Continue with more free NCLEX-RN practice, or read the full guide to select all that apply questions and the NGN scoring model.

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NCLEX Select All That Apply (SATA) FAQs

1. Are these NCLEX SATA questions from ReviseNclex.com free?

Yes. All NGN NCLEX SATA practice questions on ReviseNclex.com are free to use, including the full rationales for both correct and incorrect answer choices

2. How many SATA questions should I practice before the NCLEX?

There's no single magic number, but most candidates benefit from practicing at least 150–200 SATA questions across different content areas (med-surg, pharmacology, mental health, maternity, and pediatrics) before sitting for the exam, since select all that apply questions appear throughout every content category rather than as a separate section.

3. Do these NCLEX practice tests reflect the current NGN scoring model?

Yes. These questions are written to reflect the Next Generation NCLEX plus/minus partial credit scoring model, so working through the rationales helps you understand not just the right answers, but why each incorrect option costs you points

4. Why do the rationales explain the wrong answers too?

Because understanding why an option is incorrect is just as useful as knowing why one is correct. On the actual NCLEX, wrong options are designed to be plausible, so learning to recognize the reasoning behind a distractor helps you avoid similar traps on test day

5. Can I use these questions to study for both NCLEX-RN and NCLEX-PN?

Yes. SATA and multiple response questions appear on both the NCLEX-RN and NCLEX-PN, and the core strategies for approaching them — evaluating each option independently, applying the nursing process, and avoiding overselection — apply to both exams.

6. How often is new SATA practice content added?

New NGN SATA question sets with rationales are added weekly on ReviseNclex.com, so it's worth checking back or bookmarking the page as you continue your NCLEX prep