NCLEX-RN Practice Exam
With Questions and Answers
+ Rationales
This comprehensive practice exam covers key content areas aligned with the
NCLEX-RN test plan, including Safe and Effective Care Environment, Health
Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity.
Each question includes the Correct Answer and a detailed rationale to reinforce
clinical reasoning.
---
## SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT (Questions 1-20)
### Question 1
A nurse is caring for a client who has a new prescription for a patient-controlled
analgesia (PCA) pump. Which action should the nurse take **first**?
A. Explain the use of the PCA pump to the client and family.
B. Assess the client's pain level using a 0-10 scale.
C. Verify the client's allergy status.
D. Demonstrate how to use the PCA button.
**Correct Answer: C**
,**Rationale:** Safety is the priority. Verifying allergy status prevents a potential
anaphylactic reaction to the analgesic medication. While assessment (B) is
typically the first step in the nursing process, verifying allergies is a specific safety
check that must occur before administering any medication via PCA.
---
### Question 2
A charge nurse is assigning clients to a licensed practical nurse (LPN). Which client
should the charge nurse assign to the LPN?
A. A client with a new tracheostomy requiring frequent suctioning.
B. A client with unstable angina requiring telemetry monitoring.
C. A client with diabetic ketoacidosis receiving an insulin drip.
D. A client with pneumonia requiring an initial respiratory assessment.
**Correct Answer: A**
**Rationale:** LPNs can perform stable, predictable tasks like suctioning a stable
client with an established tracheostomy. Options B and C require RN assessment
and titration of drips. Option D requires initial assessment by an RN.
---
### Question 3
,A nurse is preparing to administer a blood transfusion. Which actions are most
important to prevent a hemolytic reaction? **(Select All That Apply)**
A. Use a 20-gauge or larger IV catheter.
B. Obtain baseline vital signs.
C. Verify the client's identity using two identifiers.
D. Check the blood product expiration date.
E. Remain with the client for the first 15 minutes.
**Correct Answers: C, D**
**Rationale:** Preventing a hemolytic reaction hinges on correct patient-blood
product matching. Verifying identity (C) and checking the expiration date (D) are
critical safety checks. A, B, and E are important for general transfusion safety but
do not directly prevent a hemolytic reaction from mismatched blood.
---
### Question 4
A nurse is preparing to insert an indwelling urinary catheter. Which technique is
essential for preventing a catheter-associated urinary tract infection (CAUTI)?
A. Using sterile technique during insertion.
B. Securing the catheter to the inner thigh.
C. Irrigating the catheter daily with normal saline.
D. Emptying the drainage bag every 12 hours.
, **Correct Answer: A**
**Rationale:** Using sterile technique for insertion is the most critical step in
preventing CAUTI. Securing (B) prevents trauma, irrigation (C) is not routine and
can introduce bacteria, and emptying the bag (D) should be done more frequently
to prevent backflow.
---
### Question 5
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task
is appropriate for the UAP?
A. Feeding a client with dysphagia following a stroke.
B. Measuring the urine output from a client's indwelling catheter.
C. Assessing the skin integrity of a client's sacral wound.
D. Reinforcing teaching about insulin self-administration.
**Correct Answer: B**
**Rationale:** Measuring and recording urine output is a non-invasive, routine
task within the UAP's scope of practice. Feeding a dysphagic client (A) requires
assessment for choking. Assessment (C) and teaching (D) are RN responsibilities.
---
With Questions and Answers
+ Rationales
This comprehensive practice exam covers key content areas aligned with the
NCLEX-RN test plan, including Safe and Effective Care Environment, Health
Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity.
Each question includes the Correct Answer and a detailed rationale to reinforce
clinical reasoning.
---
## SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT (Questions 1-20)
### Question 1
A nurse is caring for a client who has a new prescription for a patient-controlled
analgesia (PCA) pump. Which action should the nurse take **first**?
A. Explain the use of the PCA pump to the client and family.
B. Assess the client's pain level using a 0-10 scale.
C. Verify the client's allergy status.
D. Demonstrate how to use the PCA button.
**Correct Answer: C**
,**Rationale:** Safety is the priority. Verifying allergy status prevents a potential
anaphylactic reaction to the analgesic medication. While assessment (B) is
typically the first step in the nursing process, verifying allergies is a specific safety
check that must occur before administering any medication via PCA.
---
### Question 2
A charge nurse is assigning clients to a licensed practical nurse (LPN). Which client
should the charge nurse assign to the LPN?
A. A client with a new tracheostomy requiring frequent suctioning.
B. A client with unstable angina requiring telemetry monitoring.
C. A client with diabetic ketoacidosis receiving an insulin drip.
D. A client with pneumonia requiring an initial respiratory assessment.
**Correct Answer: A**
**Rationale:** LPNs can perform stable, predictable tasks like suctioning a stable
client with an established tracheostomy. Options B and C require RN assessment
and titration of drips. Option D requires initial assessment by an RN.
---
### Question 3
,A nurse is preparing to administer a blood transfusion. Which actions are most
important to prevent a hemolytic reaction? **(Select All That Apply)**
A. Use a 20-gauge or larger IV catheter.
B. Obtain baseline vital signs.
C. Verify the client's identity using two identifiers.
D. Check the blood product expiration date.
E. Remain with the client for the first 15 minutes.
**Correct Answers: C, D**
**Rationale:** Preventing a hemolytic reaction hinges on correct patient-blood
product matching. Verifying identity (C) and checking the expiration date (D) are
critical safety checks. A, B, and E are important for general transfusion safety but
do not directly prevent a hemolytic reaction from mismatched blood.
---
### Question 4
A nurse is preparing to insert an indwelling urinary catheter. Which technique is
essential for preventing a catheter-associated urinary tract infection (CAUTI)?
A. Using sterile technique during insertion.
B. Securing the catheter to the inner thigh.
C. Irrigating the catheter daily with normal saline.
D. Emptying the drainage bag every 12 hours.
, **Correct Answer: A**
**Rationale:** Using sterile technique for insertion is the most critical step in
preventing CAUTI. Securing (B) prevents trauma, irrigation (C) is not routine and
can introduce bacteria, and emptying the bag (D) should be done more frequently
to prevent backflow.
---
### Question 5
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task
is appropriate for the UAP?
A. Feeding a client with dysphagia following a stroke.
B. Measuring the urine output from a client's indwelling catheter.
C. Assessing the skin integrity of a client's sacral wound.
D. Reinforcing teaching about insulin self-administration.
**Correct Answer: B**
**Rationale:** Measuring and recording urine output is a non-invasive, routine
task within the UAP's scope of practice. Feeding a dysphagic client (A) requires
assessment for choking. Assessment (C) and teaching (D) are RN responsibilities.
---
