NCLEX-RN Comprehensive Practice Exam
2026–2027|Original Exam With Multiple-Choice
Questions with Detailed Answers And Rationale
1. A nurse is caring for a client who suddenly develops shortness of breath, chest pain, and
an oxygen saturation of 86% after surgery. Which action should the nurse take FIRST?
A. Notify the healthcare provider.
B. Apply oxygen and assess the client's airway and breathing.
C. Obtain a 12-lead ECG.
D. Prepare the client for a chest X-ray.
Correct ANSWER: B. Apply oxygen and assess the client's airway and breathing.
RATIONALE:
B is correct because airway and breathing take priority using the ABCs. Oxygen should be
administered immediately while further assessment and interventions are initiated.
2. Which electrolyte imbalance places a client at the greatest risk for developing life-
threatening cardiac dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 103 mEq/L
D. Calcium 9.2 mg/dL
Correct ANSWER: B. Potassium 2.8 mEq/L
RATIONALE:
B is correct because severe hypokalemia increases the risk of dangerous cardiac dysrhythmias
and requires prompt treatment.
,3. A client with diabetes reports feeling shaky, sweaty, and dizzy. What should the nurse do
FIRST?
A. Administer insulin.
B. Check the client's blood glucose level.
C. Encourage exercise.
D. Restrict oral fluids.
Correct ANSWER: B. Check the client's blood glucose level.
RATIONALE:
B is correct because these symptoms suggest hypoglycemia, which should be confirmed
immediately before further intervention whenever possible.
4. Which assessment finding requires immediate nursing intervention?
A. Temperature 37.3°C (99.1°F)
B. Blood pressure 118/74 mmHg
C. Respiratory rate 8 breaths/min
D. Heart rate 82 beats/min
Correct ANSWER: C. Respiratory rate 8 breaths/min
RATIONALE:
C is correct because a respiratory rate of 8 indicates respiratory depression requiring immediate
assessment and intervention.
5. Which client should the emergency department nurse assess FIRST?
A. A client with a fractured wrist.
B. A client with severe chest pain radiating to the left arm.
C. A client with a sprained ankle.
D. A client requesting a medication refill.
, Correct ANSWER: B. A client with severe chest pain radiating to the left arm.
RATIONALE:
B is correct because these findings may indicate an acute myocardial infarction, which is
potentially life-threatening.
6. A nurse is teaching a client prescribed warfarin. Which statement by the client indicates
the need for further teaching?
A. "I'll use a soft toothbrush."
B. "I'll have my blood tested regularly."
C. "I'll take aspirin for headaches."
D. "I'll report unusual bleeding."
Correct ANSWER: C. "I'll take aspirin for headaches."
RATIONALE:
C is correct because aspirin increases bleeding risk when taken with warfarin unless specifically
prescribed.
7. Which finding is expected in a client with dehydration?
A. Bounding pulse
B. Decreased hematocrit
C. Dry mucous membranes
D. Bradycardia
Correct ANSWER: C. Dry mucous membranes
RATIONALE:
C is correct because dehydration commonly causes dry mucous membranes, poor skin turgor,
and concentrated urine.
2026–2027|Original Exam With Multiple-Choice
Questions with Detailed Answers And Rationale
1. A nurse is caring for a client who suddenly develops shortness of breath, chest pain, and
an oxygen saturation of 86% after surgery. Which action should the nurse take FIRST?
A. Notify the healthcare provider.
B. Apply oxygen and assess the client's airway and breathing.
C. Obtain a 12-lead ECG.
D. Prepare the client for a chest X-ray.
Correct ANSWER: B. Apply oxygen and assess the client's airway and breathing.
RATIONALE:
B is correct because airway and breathing take priority using the ABCs. Oxygen should be
administered immediately while further assessment and interventions are initiated.
2. Which electrolyte imbalance places a client at the greatest risk for developing life-
threatening cardiac dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 103 mEq/L
D. Calcium 9.2 mg/dL
Correct ANSWER: B. Potassium 2.8 mEq/L
RATIONALE:
B is correct because severe hypokalemia increases the risk of dangerous cardiac dysrhythmias
and requires prompt treatment.
,3. A client with diabetes reports feeling shaky, sweaty, and dizzy. What should the nurse do
FIRST?
A. Administer insulin.
B. Check the client's blood glucose level.
C. Encourage exercise.
D. Restrict oral fluids.
Correct ANSWER: B. Check the client's blood glucose level.
RATIONALE:
B is correct because these symptoms suggest hypoglycemia, which should be confirmed
immediately before further intervention whenever possible.
4. Which assessment finding requires immediate nursing intervention?
A. Temperature 37.3°C (99.1°F)
B. Blood pressure 118/74 mmHg
C. Respiratory rate 8 breaths/min
D. Heart rate 82 beats/min
Correct ANSWER: C. Respiratory rate 8 breaths/min
RATIONALE:
C is correct because a respiratory rate of 8 indicates respiratory depression requiring immediate
assessment and intervention.
5. Which client should the emergency department nurse assess FIRST?
A. A client with a fractured wrist.
B. A client with severe chest pain radiating to the left arm.
C. A client with a sprained ankle.
D. A client requesting a medication refill.
, Correct ANSWER: B. A client with severe chest pain radiating to the left arm.
RATIONALE:
B is correct because these findings may indicate an acute myocardial infarction, which is
potentially life-threatening.
6. A nurse is teaching a client prescribed warfarin. Which statement by the client indicates
the need for further teaching?
A. "I'll use a soft toothbrush."
B. "I'll have my blood tested regularly."
C. "I'll take aspirin for headaches."
D. "I'll report unusual bleeding."
Correct ANSWER: C. "I'll take aspirin for headaches."
RATIONALE:
C is correct because aspirin increases bleeding risk when taken with warfarin unless specifically
prescribed.
7. Which finding is expected in a client with dehydration?
A. Bounding pulse
B. Decreased hematocrit
C. Dry mucous membranes
D. Bradycardia
Correct ANSWER: C. Dry mucous membranes
RATIONALE:
C is correct because dehydration commonly causes dry mucous membranes, poor skin turgor,
and concentrated urine.
