2021 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.

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Basic Nursing Care

1.	In which of the following ways can the nurse promote the sense of taste for an older adult?
		a. Mix foods together on the dinner tray
		b. Avoid cologne, air fresheners, or room deodorizers
		c. Encourage the client to chew food thoroughly
		d. Discourage the use of salt or seasonings with prepared food
As clients age, their sense of taste may diminish, reducing the joy that comes with eating. A nurse can promote the sense of taste for a client by encouraging him to chew his food thoroughly while eating. This results in longer contact of food with the taste buds and a greater chance of tasting the food. Incorrect answer. Please choose another answer.

2.	Which of the following is classified as a prerenal condition that affects urinary elimination?
		a. Nephrotoxic medications
		b. Pericardial tamponade
		c. Neurogenic bladder
		d. Polycystic kidney disease
A prerenal condition is that which causes reduced urinary elimination due to a diminished blood flow to the kidneys. A condition such as cardiac tamponade affects the heart's ability to pump adequate amounts of blood, thereby reducing blood flow to vital organs throughout the body, including the kidneys. Incorrect answer. Please choose another answer.

3.	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?
		a. Skin has a purple/bluish color
		b. Capillary refill is 1 second
		c. Skin appears blanched at the pressure site
		d. Tenting appears when checking skin turgor
When assessing for signs of developing pressure ulcers in a client with dark skin, decreased circulation may not always be readily apparent. For instance, blanching, the red undertones seen in light-skinned clients, will not always be present. Instead, the skin of an early pressure ulcer may develop a purple or bluish color. Incorrect answer. Please choose another answer.

Management and Practice Directives

4.	At the beginning of the shift, a nurse receives report for her daily assignment. Which of the following situations should the nurse give first priority?
		a. A diabetic client with a blood glucose level of 195 mg/dL
		b. A family member of an elderly client who has questions
		c. A client with COPD with an oxygen saturation of 84%
		d. A client who requires assistance to use the bathroom
When prioritizing needs of clients, the nurse must begin with the unstable client or manage conditions that affect airway, breathing, or circulation first. The client with COPD has a condition that affects breathing and is exhibiting decreased oxygen saturation levels; therefore, this client should be the first priority. Incorrect answer. Please choose another answer.

5.	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?
		a. Call the supervisor and file a complaint against the physical therapy department
		b. Contact the physician to notify him that the orders were not carried out
		c. Assess the client's activity level by assisting with ambulation using a gait belt
		d. Contact the physical therapy department again and repeat the order
Nurses must typically work as part of a larger interdisciplinary team that involves collaboration with other professionals. In order to fulfill the client's needs, communication between disciplines should remain respectful, with clear directions about each discipline's responsibilities. Communication between all parties minimizes confusion about the client's care. Incorrect answer. Please choose another answer.

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6.	The "B" in the SBAR acronym stands for:
		a. Background
		b. Basic
		c. Beginning
		d. Break
The "B" in the SBAR acronym stands for Background. The SBAR is a communication tool used between providers that regulates the type and amount of information given. When contacting a physician, the nurse provides information about the situation, the client's background, the nurse's assessment, and further recommendations. Incorrect answer. Please choose another answer.

Preventing Risks and Complications

7.	Which of the following nursing interventions is appropriate for a client who is suffering from a fever?
		a. Avoid giving the client food
		b. Increase the client's fluid volume
		c. Provide oxygen
		d. All of the above
		e. Both b and c
Interventions for a client who is suffering from a fever include increasing the client's volume of fluid and providing oxygen. A fever increases the body's metabolism, causing the client to breathe at a faster rate and increasing the work of the heart. The client is at risk of fluid loss due to increased respiration and sweating. The increased work of the heart requires more oxygen to maintain perfusion to the tissues. Incorrect answer. Please choose another answer.

8.	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:
		a. Malignant hyperthermia
		b. Heat exhaustion
		c. Heat stroke
		d. Heat cramps
Heat exhaustion occurs when a person has enough diaphoresis that he becomes dehydrated. Intense sweating can cause both fluid and electrolyte imbalances. Untreated heat exhaustion can lead to heat stroke, which results in organ damage, loss of consciousness, or death. Incorrect answer. Please choose another answer.

9.	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?
		a. Dorsalis pedis
		b. Popliteal
		c. Posterior tibial
		d. Femoral
The nurse can palpate the posterior tibial pulse to assess circulation to the foot and ankle. The posterior tibial pulse is felt by palpating the inner side of the ankle, behind the medial malleolus. Incorrect answer. Please choose another answer.

Caring for Acute or Chronic Conditions

10.	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?
		a. 70-80 mmHg
		b. 100-120 mmHg
		c. 150-170 mmHg
		d. 200 mmHg
When suctioning the endotracheal tube of an adult client, the nurse should set the suction apparatus at a level no higher than 150 mmHg, with a preferable level between 100 and 120 mmHg. Suction pressure that is too high can contribute to the client's hypoxia. Alternatively, too low of suction pressure may not clear adequate amounts of secretions. Incorrect answer. Please choose another answer.

11.	The nurse caring for Mrs. J is prepared to suction her endotracheal tube. Which of the following interventions will reduce hypoxia during this procedure?
		a. Hyperoxygenate Mrs. J for up to 60 seconds prior to starting
		b. Administer 15 cc of sterile fluid into the tube prior to suctioning
		c. Suction for no longer than 30 seconds at a time
		d. Wait 30 seconds after suctioning before attempting again
Before suctioning a client's endotracheal tube, the nurse should provide extra oxygen for approximately 30 to 60 seconds. Hyperoxygenating a client before suctioning increases oxygen delivery to the tissues and reduces hypoxia that may develop during the procedure. Incorrect answer. Please choose another answer.

12.	Which of the following conditions is a contraindication for performing a diagnostic peritoneal lavage?
		a. A client who is 9 weeks' pregnant
		b. A client with a femur fracture
		c. A morbidly obese client
		d. A client with hypertension
Diagnostic peritoneal lavage is contraindicated in clients who are morbidly obese because excess body fat makes finding essential landmarks for this procedure difficult. Additionally, the equipment used for the procedure may not be large enough to accommodate an obese person. Finally, morbid obesity puts excess strain on the cardiovascular and respiratory systems, such that anesthetic agents used during the procedure could cause further complications. Incorrect answer. Please choose another answer.

Safety

13.	Which of the following is an example of client handling equipment?
		a. Wheelchair
		b. Height-adjustable bed
		c. Shower chair
		d. Call light
Client handling equipment is designed to reduce the stress and workload on nurses who must assist, turn, or lift clients. This equipment decreases the risk of injuries associated with improper lifting. A height-adjustable bed raises the client up to a proper working height for the nurse who must provide assistance. Incorrect answer. Please choose another answer.

14.	Which practice will help to reduce the risk of a needlestick injury?
		a. Only expose the end of the needle once ready to enter the room for the procedure
		b. Always place the cap back on a needle after it has been used
		c. Keep a sharps container nearby where it can be easily accessed
		d. Pass needles between nurses by using the hand-over technique
When administering an injection or using sharps for a procedure, the nurse can minimize safety risks by keeping a sharps container nearby. This provides easy access for quick disposal to prevent the possibility of a needlestick. Needles should never be recapped after use and nurses should always exchange needles from a central area rather than passing them between workers. Incorrect answer. Please choose another answer.

15.	Which of the following is an organizational factor that affects workplace violence directed at nurses?
		a. Clients who have short hospital stays
		b. The presence of security guards
		c. Restricted client areas
		d. Understaffing of nursing personnel
Understaffing of nursing personnel may be an organizational risk associated with workplace violence for nurses. Understaffing involves too few nurses on duty, which may not be enough to meet client needs at the time or may result in longer delays for provision of care. Greater amounts of activity and diminished numbers of nurses to provide care may result in aggression, violence, or anger from clients or families directed toward staff. Incorrect answer. Please choose another answer.

Mental Health

16.	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:
		a. Closed awareness
		b. Mutual pretense
		c. Open awareness
		d. Powerless assessment
Mutual pretense is a form of awareness as a response to death or dying in which those involved avoid discussing the situation. In a case of terminal illness, a client and his family are aware of the diagnosis; but the client may not want to talk about the situation for various reasons, such as saving his family from feelings of grief, fear of the future, or discomfort with talking about feelings. Incorrect answer. Please choose another answer.

17.	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?
		a. Provide a room that offers minimal distractions
		b. Ask closed-ended questions to allow the client to think about her situation
		c. Write detailed notes during the conversation to track important information
		d. Ask personal questions about the client's background to determine how the procedure has affected her self-concept
When preparing to talk with a client about a difficult subject, the nurse can provide an environment that is private and that offers minimal distractions. This gives the client an opportunity to open up about personal feelings without being interrupted, and may provide more open communication between the nurse and client. Incorrect answer. Please choose another answer.

18.	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?
		a. "What is your educational background?"
		b. "Are your parents still living?"
		c. "What do you like about your life right now?"
		d. "Where do you see yourself in 10 years?"
When assessing a client's personal identity, the nurse should focus on questions that determine how the client feels about himself. This may mean asking questions that help him identify his personal strengths and weaknesses, as well as how he thinks others see him. Incorrect answer. Please choose another answer.

Pharmacology

19.	A drug form in which medication particles are instilled into a liquid and combined through agitation of the solution is called:
		a. Suspension
		b. Elixir
		c. Syrup
		d. Tincture
A suspension is a type of medicine that combines medication particles with a liquid solution. When not administered, medication particles within the suspension may settle to the bottom, requiring the nurse to shake the solution to mix. Suspensions are typically given as oral solutions. Incorrect answer. Please choose another answer.

20.	Following a dose of medication, a client develops inflamed mucous membranes and nasal discharge. What type of minor reaction is this client experiencing?
		a. Urticaria
		b. Pruritis
		c. Hives
		d. Rhinitis
Rhinitis may occur as a mild reaction following some types of medication administration. Rhinitis involves itchy or inflamed mucous membranes, particularly around the eyes, nose and mouth. The client may also develop swelling of the nasal passages or clear discharge. Incorrect answer. Please choose another answer.

21.	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?
		a. Intrapleural
		b. Intraosseous
		c. Intrathecal
		d. Intraperitoneal
Medications administered through the intrathecal route are given through a catheter that has been placed into the subarachnoid space of the spinal column. These medications are given into cerebrospinal fluid, often for pain control. Placement of an intrathecal catheter is typically done by a trained physician or advanced-practice nurse. Incorrect answer. Please choose another answer.

Growth and Development

22.	Which of the following complications is associated with premature rupture of membranes in the pregnant client?
		a. Vaginal or cervical lacerations
		b. Shoulder dystocia
		c. Uterine rupture
		d. Chorioamnionitis
Premature rupture of membranes occurs when the amniotic sac of a pregnant client has ruptured before the onset of labor. The client may be at increased risk of chorioamnionitis, which occurs as inflammation of the membranes of the placenta. Infection may develop when bacteria ascend into the uterus without the protection of the intact amniotic sac. Incorrect answer. Please choose another answer.

23.	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?
		a. Blended family
		b. Communal family
		c. Foster family
		d. Extended family
A communal family is a group classified as a non-traditional family. In this situation, adults who are not related may live and work with other adults and their children all together in a household. The communal family may share expenses, food, and childcare in the same way as a traditional family. Incorrect answer. Please choose another answer.

24.	A nurse is educating a female client about progesterone. Which of the following information is appropriate to include in this teaching?
		a. Progesterone helps the body to maintain pregnancy
		b. Progesterone stimulates the breasts to secrete milk
		c. Progesterone causes uterine contractions during delivery
		d. Progesterone causes development of masculine characteristics in women
Progesterone is a hormone that is produced by the ovaries in women. Progesterone affects the tissue of the endometrium by developing the lining of the uterus in support of embryo implantation. In pregnant women, progesterone nourishes the uterine lining and limits uterine contractions to prevent miscarriage. Incorrect answer. Please choose another answer.

Quality starts with who wrote the material.

Our practice exam writer

Eileen Johnson, RN, MSN

is a registered nurse and medical writer who has worked in nursing for over 20 years. Eileen was an item writer for the Board of Certification of Emergency Nursing.

Alene Burke, RN, MSN

is a registered nurse since 1976. She is a multidisciplinary nursing educator who has taught nurses for the last 25 years and developed college level curriculum.

Chelsea Homich, RN, MSN

is a nurse educator at the Pittsburgh Technical Institute where she teaches nursing students foundational nursing courses.

Meg Brannagan, RN, BSN

is a medical writer, specializing in courses and curriculum designed for practicing nurses. She has practiced clinical nursing and medical writing for over 12 years.

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