NCLEX-RN 2026 – 150 Practice Questions
with Answers & Detailed Rationales
Question 1
A nurse is caring for a client who has pneumonia and is receiving
oxygen at 2 L/min via nasal cannula. The client becomes increasingly
restless and confused. Which action should the nurse take first?
A. Administer the prescribed sedative.
B. Increase the oxygen flow rate.
C. Assess the client's oxygen saturation.
D. Notify the healthcare provider.
Correct Answer: C. Assess the client's oxygen saturation.
Rationale: Restlessness and confusion can be early manifestations of
hypoxemia. The nurse should first assess oxygen saturation and
respiratory status to determine whether impaired oxygenation is
contributing to the change. Increasing oxygen without assessment may
be inappropriate, while medication or provider notification should
follow the initial assessment.
Question 2
A client with heart failure reports a sudden increase in shortness of
breath and has bilateral crackles. Which prescription should the nurse
anticipate?
,A. Intravenous furosemide
B. Oral potassium supplement
C. Intravenous normal saline
D. Oral antidiarrheal medication
Correct Answer: A. Intravenous furosemide
Rationale: Acute worsening of heart failure with dyspnea and
pulmonary crackles suggests fluid accumulation in the lungs.
Furosemide is a loop diuretic that promotes rapid removal of excess
fluid. Intravenous administration is commonly used when prompt
diuresis is required during acute decompensation.
Question 3
A postoperative client suddenly develops chest pain, dyspnea,
tachycardia, and anxiety. The oxygen saturation is 86%. Which
complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Hypoglycemia
D. Fluid overload
Correct Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea, pleuritic chest discomfort, tachycardia,
hypoxemia, and anxiety are classic findings associated with pulmonary
embolism. Recent surgery increases the risk because of venous stasis
and hypercoagulability. This is an emergency requiring immediate
,oxygen support, assessment, and rapid notification of the healthcare
team.
Question 4
A nurse is assessing a client with hypokalemia. Which finding should
the nurse expect?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Facial flushing
Correct Answer: A. Muscle weakness
Rationale: Hypokalemia can impair neuromuscular function, producing
generalized weakness, fatigue, muscle cramps, and decreased
gastrointestinal motility. Cardiac changes may include flattened T waves
and U waves. Peaked T waves are more characteristic of hyperkalemia,
making muscle weakness the expected finding.
Question 5
A client receiving a blood transfusion develops chills, fever, and low
back pain. What is the nurse's priority action?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Obtain another blood sample.
, Correct Answer: B. Stop the transfusion immediately.
Rationale: Fever, chills, and low back pain during a transfusion may
indicate an acute hemolytic transfusion reaction. The nurse must
immediately stop the transfusion to prevent additional incompatible
blood from entering the circulation. The nurse should then maintain
intravenous access with appropriate fluid and notify the provider and
blood bank.
Question 6
A nurse is teaching a client who has been prescribed warfarin. Which
statement by the client indicates a need for further teaching?
A. "I will have my blood tested regularly."
B. "I will report unusual bleeding."
C. "I should avoid all foods containing vitamin K."
D. "I will take the medication exactly as prescribed."
Correct Answer: C. "I should avoid all foods containing vitamin K."
Rationale: Clients taking warfarin should maintain a consistent intake
of vitamin K rather than completely avoiding it. Large fluctuations in
vitamin K consumption can alter anticoagulant effectiveness. Regular
monitoring of the international normalized ratio and reporting signs of
bleeding are important aspects of safe warfarin therapy.
Question 7
with Answers & Detailed Rationales
Question 1
A nurse is caring for a client who has pneumonia and is receiving
oxygen at 2 L/min via nasal cannula. The client becomes increasingly
restless and confused. Which action should the nurse take first?
A. Administer the prescribed sedative.
B. Increase the oxygen flow rate.
C. Assess the client's oxygen saturation.
D. Notify the healthcare provider.
Correct Answer: C. Assess the client's oxygen saturation.
Rationale: Restlessness and confusion can be early manifestations of
hypoxemia. The nurse should first assess oxygen saturation and
respiratory status to determine whether impaired oxygenation is
contributing to the change. Increasing oxygen without assessment may
be inappropriate, while medication or provider notification should
follow the initial assessment.
Question 2
A client with heart failure reports a sudden increase in shortness of
breath and has bilateral crackles. Which prescription should the nurse
anticipate?
,A. Intravenous furosemide
B. Oral potassium supplement
C. Intravenous normal saline
D. Oral antidiarrheal medication
Correct Answer: A. Intravenous furosemide
Rationale: Acute worsening of heart failure with dyspnea and
pulmonary crackles suggests fluid accumulation in the lungs.
Furosemide is a loop diuretic that promotes rapid removal of excess
fluid. Intravenous administration is commonly used when prompt
diuresis is required during acute decompensation.
Question 3
A postoperative client suddenly develops chest pain, dyspnea,
tachycardia, and anxiety. The oxygen saturation is 86%. Which
complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Hypoglycemia
D. Fluid overload
Correct Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea, pleuritic chest discomfort, tachycardia,
hypoxemia, and anxiety are classic findings associated with pulmonary
embolism. Recent surgery increases the risk because of venous stasis
and hypercoagulability. This is an emergency requiring immediate
,oxygen support, assessment, and rapid notification of the healthcare
team.
Question 4
A nurse is assessing a client with hypokalemia. Which finding should
the nurse expect?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Facial flushing
Correct Answer: A. Muscle weakness
Rationale: Hypokalemia can impair neuromuscular function, producing
generalized weakness, fatigue, muscle cramps, and decreased
gastrointestinal motility. Cardiac changes may include flattened T waves
and U waves. Peaked T waves are more characteristic of hyperkalemia,
making muscle weakness the expected finding.
Question 5
A client receiving a blood transfusion develops chills, fever, and low
back pain. What is the nurse's priority action?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Obtain another blood sample.
, Correct Answer: B. Stop the transfusion immediately.
Rationale: Fever, chills, and low back pain during a transfusion may
indicate an acute hemolytic transfusion reaction. The nurse must
immediately stop the transfusion to prevent additional incompatible
blood from entering the circulation. The nurse should then maintain
intravenous access with appropriate fluid and notify the provider and
blood bank.
Question 6
A nurse is teaching a client who has been prescribed warfarin. Which
statement by the client indicates a need for further teaching?
A. "I will have my blood tested regularly."
B. "I will report unusual bleeding."
C. "I should avoid all foods containing vitamin K."
D. "I will take the medication exactly as prescribed."
Correct Answer: C. "I should avoid all foods containing vitamin K."
Rationale: Clients taking warfarin should maintain a consistent intake
of vitamin K rather than completely avoiding it. Large fluctuations in
vitamin K consumption can alter anticoagulant effectiveness. Regular
monitoring of the international normalized ratio and reporting signs of
bleeding are important aspects of safe warfarin therapy.
Question 7
