2024 Edition

Practice Exam for the NCLEX-RN

Take this free practice exam to get a sample of the types of questions that are on the NCLEX-RN exam.

The actual NCLEX exam includes these categories: Basic Nursing Care, Management and Practice Directives, Preventing Risks and Complications, Caring for Acute and Chronic Conditions, Safety, Mental Health, Pharmacology and Growth and Development.

To prepare for your RN licensure exam, see the complete Practice Exam for the NCLEX-RN with 800 questions, written by nursing experts and medical writers, Eileen Johnson, RN, MSN, and medical writer Meg Brannagan, RN, BSN.


Management of Care

1. At the beginning of the shift, a nurse receives a report for her daily assignment. Which of the following situations should the nurse give first priority?
2. A patient is to get an MRI of the abdomen. Which of the following instructions should the nurse give the patient?
3. Which of the following symptoms would support a diagnosis of Crohn's disease?
4. A 50-year-old female is one-day post-op from a total abdominal hysterectomy. The RN is busy with another patient and asks the certified nursing assistant for help. Which of the following is inappropriate delegation by the RN?
5. A doctor visits a patient in the morning prior to a scheduled cholecystectomy to get consent for the procedure. He hands the nurse the consent form prior to leaving the unit. When the nurse steps into the room, the patient has multiple questions regarding the surgery, indicating that everything about the procedure was not disclosed. Which is the appropriate response by the nurse?
6. Mr. W has orders for a physical therapy consult. The nurse contacts the appropriate department but 12 hours later, no one has come to see the client. Which is the most appropriate action of the nurse?
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7. The "B" in the SBAR acronym stands for:

Safety and Infection Control

8. Which of the following is an example of client handling equipment?
9. Which practice will help to reduce the risk of a needlestick injury?
10. Which of the following is an organizational factor that affects workplace violence directed at nurses?
11. Which of the following infectious control methods should be used when caring for a patient with bacterial pneumonia?
12. The nurse notices a CNA using an alcohol-based hand sanitizer after walking out of a room marked as Enteric Contact Precautions. What should the nurse's response be?
13. A newly diagnosed type 1 diabetic presents with a blood glucose of 700, increased ketones, fruity-smelling breath, and rapid deep breathing. An ABG is performed. As the nurse reviews the labs, she notes the following values: pH of 7.25, HCO3 of 17mEq/L, PaCO2 31 mm Hg. Which acid-base imbalance is present?
14. A nurse is advising a patient with Chronic Fatigue Syndrome on infection control procedures. Which of the following statements by the patient indicates that the patient understands the advice?
15. A portion of a building collapses after an earthquake, sending multiple patients to the nearest emergency room. Which of the following patients should be first priority?
16. Which of the following patients would not require a mask to be worn while providing care?
17. A doctor orders restraints on a confused patient who is constantly pulling her NG tube out and has tried several times to remove her catheter. The nurse understands that appropriate use of restraints includes all of the following except:

Health Promotion and Maintenance

18. A patient is not to eat or drink anything 24 hours before a colonoscopy.
19. A nurse is putting together an educational seminar on advance directives. What information would be included in the materials?
20. Which of the following patients should a nurse recognize as having an increased risk of breast cancer while doing breast cancer screening?

Caring for Acute or Chronic Conditions

21. A nurse just started a blood transfusion for a patient with a Hemoglobin of 6. The patient says, "I feel hot, my stomach hurts, and I am having difficulty breathing." What should be the nurses first action?
22. Which of the following statements should the nurse give to a Type 2 Diabetic patient?
23. Which of the following advisements should a patient suffering from GERG receive?
24. Which of the following symptoms would a patient exhibit with hyperthyroidism?
25. A patient has Incentive Spirometry ordered QID x 10 breaths after a cholecystectomy. The patient is asking why they need to perform this action. Which of the following would not be a reason the patient should use the Incentive Spirometer?

Psychosocial Integrity

26. While preparing for discharge, a patient makes the statement to the nurse, "I'm not sure I will be able to take care of myself at home." Who is the most appropriate team member to report this statement?
27. A patient's spouse died three months ago. The patient says "I would like my friend Tom to have my collection of artwork because I don't need to look at them anymore." Which of the following responses by the nurse would be proper?
28. A patient with a history of schizophrenia says "The medical staff is secretly employed by the CIA to take me out." The nurse should respond as follows:
29. The spouse of a patient in a long term treatment facility asks a nurse for information about the patient's treatment plan. The nurse should respond as follows:
30. A patient is brought to the emergency room by her spouse. The patient's injuries are indicative of physical abuse. Which of the following actions should be taken by the nurse?
31. A patient is scheduled for surgery to have his appendix out due to acute appendicitis. The patient says "I don't think I need surgery now because I feel better." A nurse should respond as follows:
32. Which method should be the last resort in assisting a patient who is experiencing mild anxiety?
33. A client has been diagnosed with a form of terminal cancer and has started receiving hospice care. The nurse notes that both the client and his family avoid talking about the diagnosis. All attempts at discussion result in changing the subject. The nurse recognizes that this family is exhibiting:
34. A nurse is caring for a child whose parents live in a home with several other unrelated children and adults. Some of the people who live in the home have visited and the nurse discovers that this group all shares finances and living conditions. What type of family is this most likely an example of?
35. A fellow nursing student receives a poor grade after failing to perform a clinical procedure correctly. He vents to you, stating "My instructor does not like me. She is always singling me out and does not want me to graduate." This is an example of which defense mechanism?
36. A patient is prescribed lithium for bipolar disorder. Which of the following patient statements is concerning?
37. A nurse is preparing to talk about body changes with a client who just had a bilateral mastectomy. Which of the following actions of the nurse is most appropriate during this discussion?
38. A nurse is attempting to speak with a client about his personal feelings of self-esteem and self-concept. Which of the following questions is most appropriate for assessing a client's personal identity?

Basic Care and Comfort

39. In which of the following ways can the nurse promote the sense of taste for an older adult?
40. All but which of the following medications may cause urinary retention?
41. A woman presents to the labor unit, reporting contractions every five minutes which are getting stronger. She rates her pain 7 out of 10 on the pain scale. Upon assessment, she is 5cm dilated. She declines pharmacologic intervention. Which of the following pain therapies would not be appropriate in this situation?
42. Which of the following is a potential complication from prolonged immobility?
43. Which of the following is classified as a prerenal condition that affects urinary elimination?
44. A nurse is assessing an African American client for risks of a pressure ulcer. Which of the following best describes what the nurse might find with an early pressure ulcer in this client?
45. A nurse is teaching a staff seminar on patient confidentiality. Which of the following statements would be included in the presentation?
46. A patient is suffering from heart failure. Which of the following would be recommended by a nurse as part of the patient's health care plan?
47. A patient has had diarrhea for the past 72 hours. Which of the symptoms would support a diagnosis of hypovolemia?
48. A patient is being discharged with a new diagnosis of Congestive Heart Failure. Which of the following statements made by the patient indicate understanding of the diagnosis?
49. A patient is about to be discharged from the hospital after a diagnosis of congestive heart failure. Which of the following statements from the patient indicates the need for further nutritional teaching?

Pharmacological and Parenteral Therapies

50. A patient, who weighs 200 pounds, has a prescription for a Dopamine Drip at 5 mcg/kg/min. There is 400 mg per 500 ml D5W on hand. The nurse should administer __________ milliliters to the patient each hour.
51. A patient, who weighs 143 pounds, has a prescription for Garamycin at two mg/kg, IV, every eight hours. There is 100 mg in 50 ml solution on hand. The nurse should administer ____ milliliters to the patient with each dose.
52. A patient has a prescription for Tylenol at 650mg every 6 hours. A nurse only has 325mg pills of Tylenol available. How many pills would be administered every 6 hours?
53. The patient has only one IV site with a continuous infusion of Lactated Ringers solution. The provider has prescribed Ceftriaxone 100 mg in Normal Saline 50 ml to be given IV now. What should be the nurse's first action?
54. Which of the following lab tests would be considered Point of Care testing?
55. The nurse enters the room of a patient complaining of lower back pain after a left hip replacement surgery. Which non-pharmacological intervention would not be appropriate?
56. A nurse working in the telemetry unit receives a call that a patient's EKG rhythm has transitioned into Atrial Fibrillation. Which medication is the patient likely to receive long-term in relation to this diagnosis?
57. A drug form in which medication particles are instilled into a liquid and combined through agitation of the solution is called:
58. A nurse is educating a female client about progesterone. Which of the following information is appropriate to include in this teaching?
59. A patient is receiving a transfusion of packed red blood cells, which was started just prior to shift change. Approximately 30 minutes after the infusion has started, the patient complains of chest pain, chills and dyspnea. The RN notes that D5W is hanging with the blood and immediately recognizes the symptoms as a hemolytic reaction. Which is the first action the nurse should take?
60. Which of the following is the antidote to warfarin toxicity?
61. A patient is receiving an insulin infusion at 2 units/hour. The most recent blood glucose is 220. The RN reviews the infusion protocol and notes the following: If Glucose 150-200 = infuse at 2 units/hour; Glucose 201-250 = infuse at 4 units/hour; Glucose 251-300 = infuse at 6 units/hour. Based on the most recent glucose reading, the nurse should increase the infusion by how many units/hour?
62. Protonix 20mg IV BID has been ordered for a patient and is scheduled for 0900 and 2100. The pharmacy sends a vial of Protonix that reads 40mg/mL. How many mL will the patient receive for his 0900 dose?
63. Following a dose of medication, a client develops inflamed mucous membranes and nasal discharge. What type of minor reaction is this client experiencing?
64. Mr. Y is receiving medication through a catheter that has been placed into the subarachnoid space of his spinal column. What route of medication administration is this called?

Reduction of Risk Potential

65. Which of the following nursing interventions is appropriate for a client who is suffering from a fever?
66. Which of the following complications is associated with premature rupture of membranes in the pregnant client?
67. A pregnant woman has just completed her one-hour glucose screening at 26 weeks. The nurse reviews her labs and notes a value of 160. The nurse anticipates that the physician will:
68. A patient on a medical-surgical floor calls out, complaining of chest pain. An EKG is performed. Which of the following is considered abnormal?
69. A nurse is assessing a patient who had a bowel resection. Which of the following is a concern for a surgical complication?
70. A client has started sweating profusely due to intense heat. His overall fluid volume is low and he has developed electrolyte imbalance. This client is most likely suffering from:
71. A nurse is attempting to assess a client's pulse in his foot. She palpates the pulse on the anterior aspect of his ankle, below the lower end of the medial malleolus. Which type of pulse is this nurse taking?
72. Mrs. J is in the adult ICU on a ventilator. The nurse caring for her recognizes that her endotracheal tube needs suctioning. Based on the nurse's understanding of this procedure, what level of pressure should the nurse apply while suctioning?
73. The nurse caring for Mrs. J is prepared to suction her endotracheal tube. Which of the following interventions will reduce hypoxia during this procedure?
74. Which of the following conditions is a contraindication for performing a diagnostic peritoneal lavage?
75. Which of the following would alert the nurse to respiratory distress in the newborn?
76. A nurse is making a Home Health visit at a home of an elderly couple. The wife states regarding her husband, the patient, "He always sits in that chair all day long." Which of the following should the nurse consider the patient at risk for?
77. A patient is having a tonic-clonic seizure. A nurse should take which of the following steps?

Physiological Adaptation

78. A nurse is changing the dressing for a post-op Bilateral Knee Amputation patient. The nurse notes the patient refuses to look at the limb while the dressing is being changed but asks the nurse about their personal life instead. Which nursing care plan should the nurse implement for the patient related to this action?
79. Which of the following would be an expected finding in an age assessment of a 2 year old?
80. A nurse is instructing a patient on the use of a walker. Which of the following would be included in the instructions?