NCLEX RN 2026 EXAM PREP
200+ Questions (Scenario-Based | With Rationales)
1. A nurse finds a patient unresponsive in bed. What is the first action?
A. Call physician
B. Check airway and breathing
C. Start documentation
D. Give medication
Answer: B
Rationale: Follow ABC priority—airway and breathing first.
2. A patient with heart failure reports shortness of breath. What is priority?
A. Lay flat
B. High Fowler’s position
C. Increase fluids
D. Give food
Answer: B
Rationale: Upright position improves lung expansion.
3. A diabetic patient is sweating and confused. What should the nurse do first?
A. Give insulin
B. Check blood glucose
C. Give water
D. Call family
Answer: B
Rationale: Symptoms suggest hypoglycemia; confirm first.
4. Which patient should be seen first?
A. Mild fever
B. Chest pain
, C. Headache
D. Back pain
Answer: B
Rationale: Possible cardiac emergency.
5. A nurse notices IV site swelling. What is the action?
A. Continue infusion
B. Stop IV
C. Ignore
D. Flush line
Answer: B
Rationale: Indicates infiltration; stop infusion immediately.
6. A patient is choking. What is the priority action?
A. Give water
B. Heimlich maneuver
C. Call doctor
D. Document
Answer: B
Rationale: Immediate airway clearance required.
7. A patient has low BP and fast pulse. What does this indicate?
A. Infection
B. Shock
C. Recovery
D. Normal
Answer: B
Rationale: Classic signs of shock.
8. A medication dose seems incorrect. What should nurse do?
A. Administer
B. Clarify order
C. Ignore
D. Delay care
, Answer: B
Rationale: Prevent medication error.
9. Which patient is priority?
A. Stable fracture
B. Difficulty breathing
C. Mild fever
D. Headache
Answer: B
Rationale: Airway problems are priority.
10. A patient is unconscious. What is priority?
A. Feeding
B. Airway
C. Hygiene
D. Sleep
Answer: B
Rationale: Maintain airway.
11. A patient develops rash after medication. What is action?
A. Continue drug
B. Stop drug
C. Ignore
D. Delay
Answer: B
Rationale: Possible allergic reaction.
12. A patient is vomiting continuously. What is priority?
A. Nutrition
B. Prevent aspiration
C. Sleep
D. Ignore
Answer: B
Rationale: Aspiration risk.
, 13. Which indicates infection?
A. Fever
B. Cold skin
C. Slow pulse
D. Calmness
Answer: A
Rationale: Immune response.
14. A patient falls. What should nurse do first?
A. Document
B. Assess patient
C. Call family
D. Ignore
Answer: B
Rationale: Check for injuries.
15. A patient refuses medication. What is action?
A. Force
B. Respect decision
C. Ignore
D. Delay
Answer: B
Rationale: Respect autonomy.
16. A patient has chest pain and sweating. What is priority?
A. Give food
B. Oxygen
C. Sleep
D. Ignore
Answer: B
Rationale: Possible MI.
17. A nurse sees cyanosis. What does it indicate?
A. Good oxygen
B. Poor oxygen
200+ Questions (Scenario-Based | With Rationales)
1. A nurse finds a patient unresponsive in bed. What is the first action?
A. Call physician
B. Check airway and breathing
C. Start documentation
D. Give medication
Answer: B
Rationale: Follow ABC priority—airway and breathing first.
2. A patient with heart failure reports shortness of breath. What is priority?
A. Lay flat
B. High Fowler’s position
C. Increase fluids
D. Give food
Answer: B
Rationale: Upright position improves lung expansion.
3. A diabetic patient is sweating and confused. What should the nurse do first?
A. Give insulin
B. Check blood glucose
C. Give water
D. Call family
Answer: B
Rationale: Symptoms suggest hypoglycemia; confirm first.
4. Which patient should be seen first?
A. Mild fever
B. Chest pain
, C. Headache
D. Back pain
Answer: B
Rationale: Possible cardiac emergency.
5. A nurse notices IV site swelling. What is the action?
A. Continue infusion
B. Stop IV
C. Ignore
D. Flush line
Answer: B
Rationale: Indicates infiltration; stop infusion immediately.
6. A patient is choking. What is the priority action?
A. Give water
B. Heimlich maneuver
C. Call doctor
D. Document
Answer: B
Rationale: Immediate airway clearance required.
7. A patient has low BP and fast pulse. What does this indicate?
A. Infection
B. Shock
C. Recovery
D. Normal
Answer: B
Rationale: Classic signs of shock.
8. A medication dose seems incorrect. What should nurse do?
A. Administer
B. Clarify order
C. Ignore
D. Delay care
, Answer: B
Rationale: Prevent medication error.
9. Which patient is priority?
A. Stable fracture
B. Difficulty breathing
C. Mild fever
D. Headache
Answer: B
Rationale: Airway problems are priority.
10. A patient is unconscious. What is priority?
A. Feeding
B. Airway
C. Hygiene
D. Sleep
Answer: B
Rationale: Maintain airway.
11. A patient develops rash after medication. What is action?
A. Continue drug
B. Stop drug
C. Ignore
D. Delay
Answer: B
Rationale: Possible allergic reaction.
12. A patient is vomiting continuously. What is priority?
A. Nutrition
B. Prevent aspiration
C. Sleep
D. Ignore
Answer: B
Rationale: Aspiration risk.
, 13. Which indicates infection?
A. Fever
B. Cold skin
C. Slow pulse
D. Calmness
Answer: A
Rationale: Immune response.
14. A patient falls. What should nurse do first?
A. Document
B. Assess patient
C. Call family
D. Ignore
Answer: B
Rationale: Check for injuries.
15. A patient refuses medication. What is action?
A. Force
B. Respect decision
C. Ignore
D. Delay
Answer: B
Rationale: Respect autonomy.
16. A patient has chest pain and sweating. What is priority?
A. Give food
B. Oxygen
C. Sleep
D. Ignore
Answer: B
Rationale: Possible MI.
17. A nurse sees cyanosis. What does it indicate?
A. Good oxygen
B. Poor oxygen