NCLEX-RN Comprehensive Practice Exam 2026/2027 –
Verified Q&As with Detailed Rationales (Test Bank
Bundle - 120 Questions)
---
**QUESTION 1:**
A nurse is caring for a client with chest pain.
A) Administer nitroglycerin immediately.
B) Obtain a 12-lead ECG first.
C) Notify the physician immediately.
D) Administer morphine sulfate.
> 🎯 **CORRECT ANSWER:** B) Obtain a 12-lead ECG first.
> 💡 **CLINICAL RATIONALE:**
> * ECG identifies STEMI quickly.
> * Needed before nitroglycerin in inferior MI.
> * Guides reperfusion decisions.
---
**QUESTION 2:**
A client develops hives after penicillin infusion.
A) Administer epinephrine IV.
B) Stop the infusion immediately.
C) Slow the infusion rate.
D) Notify the pharmacy.
> 🎯 **CORRECT ANSWER:** B) Stop the infusion immediately.
> 💡 **CLINICAL RATIONALE:**
> * Removes allergen source first.
> * Prevents progression to anaphylaxis.
,> * Priority action in allergic reactions.
---
**QUESTION 3:**
A patient with heart failure has JVD and crackles.
A) Administer furosemide IV.
B) Place in Trendelenburg position.
C) Encourage oral fluid intake.
D) Prepare for pericardiocentesis.
> 🎯 **CORRECT ANSWER:** A) Administer furosemide IV.
> 💡 **CLINICAL RATIONALE:**
> * Crackles and JVD indicate fluid overload.
> * Loop diuretics reduce preload quickly.
> * Improves respiratory status rapidly.
---
**QUESTION 4:**
A post-op client's wound eviscerates.
A) Push organs back using sterile gloves.
B) Cover with saline-moistened sterile gauze.
C) Apply a dry pressure dressing.
D) Elevate the head of the bed.
> 🎯 **CORRECT ANSWER:** B) Cover with saline-moistened sterile gauze.
> 💡 **CLINICAL RATIONALE:**
> * Prevents tissue drying and infection.
> * Organs should never be reinserted.
> * Keeps viscera viable for surgery.
,---
**QUESTION 5:**
A client on warfarin has an INR of 5.0.
A) Administer Vitamin K IM.
B) Hold the next dose of warfarin.
C) Infuse normal saline quickly.
D) Prepare for protamine sulfate.
> 🎯 **CORRECT ANSWER:** B) Hold the next dose of warfarin.
> 💡 **CLINICAL RATIONALE:**
> * INR 5.0 indicates supratherapeutic level.
> * Holding dose prevents further anticoagulation.
> * Vitamin K only given for active bleeding.
---
**QUESTION 6:**
A nurse hears stridor in a child with epiglottitis.
A) Assess tonsils with a tongue depressor.
B) Maintain a patent airway and avoid agitation.
C) Initiate coughing to clear the throat.
D) Place the child supine.
> 🎯 **CORRECT ANSWER:** B) Maintain a patent airway and avoid agitation.
> 💡 **CLINICAL RATIONALE:**
> * Throat manipulation triggers laryngospasm.
> * Stridor signals near-complete airway obstruction.
> * Keep child calm and NPO.
---
**QUESTION 7:**
, A client with DKA is on IV insulin when potassium is 3.1 mEq/L.
A) Stop the insulin infusion.
B) Add potassium to the IV fluids.
C) Administer IV dextrose 50%.
D) Prepare for hemodialysis.
> 🎯 **CORRECT ANSWER:** B) Add potassium to the IV fluids.
> 💡 **CLINICAL RATIONALE:**
> * Insulin shifts K+ intracellularly.
> * Hypokalemia risks cardiac dysrhythmias.
> * Correct K+ before continuing insulin.
---
**QUESTION 8:**
A patient reports sudden sharp chest pain and tracheal deviation.
A) Insert a large-bore IV.
B) Prepare for needle decompression.
C) Administer inhaled albuterol.
D) Obtain a stat chest X-ray.
> 🎯 **CORRECT ANSWER:** B) Prepare for needle decompression.
> 💡 **CLINICAL RATIONALE:**
> * Tracheal deviation indicates tension pneumothorax.
> * Immediate decompression prevents cardiac arrest.
> * Do not delay for X-ray confirmation.
---
**QUESTION 9:**
A confused client tries to climb out of bed.
A) Apply wrist restraints immediately.
Verified Q&As with Detailed Rationales (Test Bank
Bundle - 120 Questions)
---
**QUESTION 1:**
A nurse is caring for a client with chest pain.
A) Administer nitroglycerin immediately.
B) Obtain a 12-lead ECG first.
C) Notify the physician immediately.
D) Administer morphine sulfate.
> 🎯 **CORRECT ANSWER:** B) Obtain a 12-lead ECG first.
> 💡 **CLINICAL RATIONALE:**
> * ECG identifies STEMI quickly.
> * Needed before nitroglycerin in inferior MI.
> * Guides reperfusion decisions.
---
**QUESTION 2:**
A client develops hives after penicillin infusion.
A) Administer epinephrine IV.
B) Stop the infusion immediately.
C) Slow the infusion rate.
D) Notify the pharmacy.
> 🎯 **CORRECT ANSWER:** B) Stop the infusion immediately.
> 💡 **CLINICAL RATIONALE:**
> * Removes allergen source first.
> * Prevents progression to anaphylaxis.
,> * Priority action in allergic reactions.
---
**QUESTION 3:**
A patient with heart failure has JVD and crackles.
A) Administer furosemide IV.
B) Place in Trendelenburg position.
C) Encourage oral fluid intake.
D) Prepare for pericardiocentesis.
> 🎯 **CORRECT ANSWER:** A) Administer furosemide IV.
> 💡 **CLINICAL RATIONALE:**
> * Crackles and JVD indicate fluid overload.
> * Loop diuretics reduce preload quickly.
> * Improves respiratory status rapidly.
---
**QUESTION 4:**
A post-op client's wound eviscerates.
A) Push organs back using sterile gloves.
B) Cover with saline-moistened sterile gauze.
C) Apply a dry pressure dressing.
D) Elevate the head of the bed.
> 🎯 **CORRECT ANSWER:** B) Cover with saline-moistened sterile gauze.
> 💡 **CLINICAL RATIONALE:**
> * Prevents tissue drying and infection.
> * Organs should never be reinserted.
> * Keeps viscera viable for surgery.
,---
**QUESTION 5:**
A client on warfarin has an INR of 5.0.
A) Administer Vitamin K IM.
B) Hold the next dose of warfarin.
C) Infuse normal saline quickly.
D) Prepare for protamine sulfate.
> 🎯 **CORRECT ANSWER:** B) Hold the next dose of warfarin.
> 💡 **CLINICAL RATIONALE:**
> * INR 5.0 indicates supratherapeutic level.
> * Holding dose prevents further anticoagulation.
> * Vitamin K only given for active bleeding.
---
**QUESTION 6:**
A nurse hears stridor in a child with epiglottitis.
A) Assess tonsils with a tongue depressor.
B) Maintain a patent airway and avoid agitation.
C) Initiate coughing to clear the throat.
D) Place the child supine.
> 🎯 **CORRECT ANSWER:** B) Maintain a patent airway and avoid agitation.
> 💡 **CLINICAL RATIONALE:**
> * Throat manipulation triggers laryngospasm.
> * Stridor signals near-complete airway obstruction.
> * Keep child calm and NPO.
---
**QUESTION 7:**
, A client with DKA is on IV insulin when potassium is 3.1 mEq/L.
A) Stop the insulin infusion.
B) Add potassium to the IV fluids.
C) Administer IV dextrose 50%.
D) Prepare for hemodialysis.
> 🎯 **CORRECT ANSWER:** B) Add potassium to the IV fluids.
> 💡 **CLINICAL RATIONALE:**
> * Insulin shifts K+ intracellularly.
> * Hypokalemia risks cardiac dysrhythmias.
> * Correct K+ before continuing insulin.
---
**QUESTION 8:**
A patient reports sudden sharp chest pain and tracheal deviation.
A) Insert a large-bore IV.
B) Prepare for needle decompression.
C) Administer inhaled albuterol.
D) Obtain a stat chest X-ray.
> 🎯 **CORRECT ANSWER:** B) Prepare for needle decompression.
> 💡 **CLINICAL RATIONALE:**
> * Tracheal deviation indicates tension pneumothorax.
> * Immediate decompression prevents cardiac arrest.
> * Do not delay for X-ray confirmation.
---
**QUESTION 9:**
A confused client tries to climb out of bed.
A) Apply wrist restraints immediately.
