NCLEX RN EXAM QUESTION BANK {LATEST 2026–
2027 UPDATE} COMPLETE ACTUAL AND
AUTHENTIC EXAM
Questions 1–200 with detailed rationales | Next
Generation NCLEX Style | 100% Pass Guaranteed |
Graded A+
1. A nurse is assessing a client who is 2 hours postoperative following a
thyroidectomy. Which of the following findings should the nurse report to
the provider immediately?
A. Pain at the surgical site
B. Hoarseness of the voice
C. Laryngeal stridor
D. Difficulty swallowing
ANS: C
Explanation: Laryngeal stridor indicates respiratory obstruction due to edema
or hematoma formation, which is a life-threatening complication following
thyroidectomy. Pain (A), hoarseness (B), and difficulty swallowing (D) are
expected findings postoperatively.
2. A nurse is caring for a client who has been prescribed lithium carbonate.
Which of the following findings indicates lithium toxicity?
A. Serum lithium level of 0.8 mEq/L
B. Fine hand tremors
C. Coarse hand tremors and ataxia
D. Increased thirst
Page 1 of 61
,ANS: C
Explanation: Coarse hand tremors and ataxia indicate moderate to severe
lithium toxicity. A serum lithium level of 0.8 mEq/L (A) is within the therapeutic
range (0.6-1.2 mEq/L). Fine hand tremors (B) and increased thirst (D) are
common side effects, not toxicity.
3. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following instructions should the
nurse include?
A. "Increase your intake of leafy green vegetables."
B. "Take aspirin for headaches."
C. "Use an electric razor when shaving."
D. "Double your dose if you miss a dose."
ANS: C
Explanation: Clients on warfarin should use an electric razor to reduce the risk
of bleeding from cuts. Leafy green vegetables (A) are high in vitamin K and
should be consumed consistently, not increased. Aspirin (B) increases bleeding
risk. Doubling doses (D) is dangerous.
4. A nurse is caring for a client who is receiving a blood transfusion and
develops urticaria and pruritus. Which of the following actions should the
nurse take first?
A. Stop the transfusion
B. Administer diphenhydramine
C. Slow the transfusion rate
D. Notify the provider
ANS: A
Explanation: Urticaria and pruritus indicate an allergic transfusion reaction.
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,The first action is to stop the transfusion to prevent further reaction. Then the
nurse should administer diphenhydramine (B) as ordered, notify the provider
(D), and maintain IV access with normal saline.
5. A nurse is assessing a client who has increased intracranial pressure.
Which of the following findings is an early indicator of increased ICP?
A. Decreased level of consciousness
B. Decerebrate posturing
C. Fixed, dilated pupils
D. Cushing's triad
ANS: A
Explanation: Decreased level of consciousness is the earliest and most
sensitive indicator of increased ICP. Decerebrate posturing (B), fixed dilated
pupils (C), and Cushing's triad (D) are late signs.
6. A nurse is preparing to administer digoxin to a client. Which of the
following findings should the nurse report before administering the
medication?
A. Heart rate of 72 bpm
B. Heart rate of 52 bpm
C. Blood pressure of 130/80 mm Hg
D. Serum potassium of 4.0 mEq/L
ANS: B
Explanation: Digoxin should be withheld if the heart rate is below 60 bpm in
adults. A heart rate of 52 bpm indicates bradycardia, which could worsen with
digoxin. The other findings are within normal limits.
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, 7. A nurse is caring for a client who has a new colostomy. Which of the
following findings should the nurse report to the provider?
A. Pink, moist stoma
B. Liquid stool output
C. Dark, dry stoma
D. Slight peristomal edema
ANS: C
Explanation: A dark, dry stoma indicates ischemia and necrosis, requiring
immediate intervention. A pink, moist stoma (A), liquid stool (B), and slight
edema (D) are expected findings.
8. A nurse is assessing a client who has been diagnosed with a urinary tract
infection. Which of the following findings should the nurse expect?
A. Polyuria
B. Suprapubic tenderness
C. Clear urine
D. Hypertension
ANS: B
Explanation: Suprapubic tenderness is a common finding in UTI due to bladder
inflammation. Polyuria (A) is not typical; frequency and urgency are more
common. Clear urine (C) is not expected. Hypertension (D) is not associated.
9. A nurse is preparing to administer heparin subcutaneously. Which of the
following actions should the nurse take?
A. Aspirate before injecting
B. Massage the site after injection
C. Administer in the abdomen at least 2 inches from the umbilicus
D. Use a 23-gauge, 1.5-inch needle
Page 4 of 61
2027 UPDATE} COMPLETE ACTUAL AND
AUTHENTIC EXAM
Questions 1–200 with detailed rationales | Next
Generation NCLEX Style | 100% Pass Guaranteed |
Graded A+
1. A nurse is assessing a client who is 2 hours postoperative following a
thyroidectomy. Which of the following findings should the nurse report to
the provider immediately?
A. Pain at the surgical site
B. Hoarseness of the voice
C. Laryngeal stridor
D. Difficulty swallowing
ANS: C
Explanation: Laryngeal stridor indicates respiratory obstruction due to edema
or hematoma formation, which is a life-threatening complication following
thyroidectomy. Pain (A), hoarseness (B), and difficulty swallowing (D) are
expected findings postoperatively.
2. A nurse is caring for a client who has been prescribed lithium carbonate.
Which of the following findings indicates lithium toxicity?
A. Serum lithium level of 0.8 mEq/L
B. Fine hand tremors
C. Coarse hand tremors and ataxia
D. Increased thirst
Page 1 of 61
,ANS: C
Explanation: Coarse hand tremors and ataxia indicate moderate to severe
lithium toxicity. A serum lithium level of 0.8 mEq/L (A) is within the therapeutic
range (0.6-1.2 mEq/L). Fine hand tremors (B) and increased thirst (D) are
common side effects, not toxicity.
3. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following instructions should the
nurse include?
A. "Increase your intake of leafy green vegetables."
B. "Take aspirin for headaches."
C. "Use an electric razor when shaving."
D. "Double your dose if you miss a dose."
ANS: C
Explanation: Clients on warfarin should use an electric razor to reduce the risk
of bleeding from cuts. Leafy green vegetables (A) are high in vitamin K and
should be consumed consistently, not increased. Aspirin (B) increases bleeding
risk. Doubling doses (D) is dangerous.
4. A nurse is caring for a client who is receiving a blood transfusion and
develops urticaria and pruritus. Which of the following actions should the
nurse take first?
A. Stop the transfusion
B. Administer diphenhydramine
C. Slow the transfusion rate
D. Notify the provider
ANS: A
Explanation: Urticaria and pruritus indicate an allergic transfusion reaction.
Page 2 of 61
,The first action is to stop the transfusion to prevent further reaction. Then the
nurse should administer diphenhydramine (B) as ordered, notify the provider
(D), and maintain IV access with normal saline.
5. A nurse is assessing a client who has increased intracranial pressure.
Which of the following findings is an early indicator of increased ICP?
A. Decreased level of consciousness
B. Decerebrate posturing
C. Fixed, dilated pupils
D. Cushing's triad
ANS: A
Explanation: Decreased level of consciousness is the earliest and most
sensitive indicator of increased ICP. Decerebrate posturing (B), fixed dilated
pupils (C), and Cushing's triad (D) are late signs.
6. A nurse is preparing to administer digoxin to a client. Which of the
following findings should the nurse report before administering the
medication?
A. Heart rate of 72 bpm
B. Heart rate of 52 bpm
C. Blood pressure of 130/80 mm Hg
D. Serum potassium of 4.0 mEq/L
ANS: B
Explanation: Digoxin should be withheld if the heart rate is below 60 bpm in
adults. A heart rate of 52 bpm indicates bradycardia, which could worsen with
digoxin. The other findings are within normal limits.
Page 3 of 61
, 7. A nurse is caring for a client who has a new colostomy. Which of the
following findings should the nurse report to the provider?
A. Pink, moist stoma
B. Liquid stool output
C. Dark, dry stoma
D. Slight peristomal edema
ANS: C
Explanation: A dark, dry stoma indicates ischemia and necrosis, requiring
immediate intervention. A pink, moist stoma (A), liquid stool (B), and slight
edema (D) are expected findings.
8. A nurse is assessing a client who has been diagnosed with a urinary tract
infection. Which of the following findings should the nurse expect?
A. Polyuria
B. Suprapubic tenderness
C. Clear urine
D. Hypertension
ANS: B
Explanation: Suprapubic tenderness is a common finding in UTI due to bladder
inflammation. Polyuria (A) is not typical; frequency and urgency are more
common. Clear urine (C) is not expected. Hypertension (D) is not associated.
9. A nurse is preparing to administer heparin subcutaneously. Which of the
following actions should the nurse take?
A. Aspirate before injecting
B. Massage the site after injection
C. Administer in the abdomen at least 2 inches from the umbilicus
D. Use a 23-gauge, 1.5-inch needle
Page 4 of 61
