[NCLEX-RN PRACTICE EXAM 2] – PRACTICE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
*• Management of Care*
*• Safety and Infection Control*
*• Health Promotion and Maintenance*
*• Psychosocial Integrity*
*• Basic Care and Comfort*
*• Pharmacological and Parenteral Therapies*
*• Reduction of Risk Potential*
*• Physiological Adaptation*
*Introduction*
This comprehensive assessment is designed to simulate the rigorous environment of the NCLEX-RN
licensure examination. The purpose of this exam is to evaluate the entry-level nursing candidate's
ability to provide safe, effective care through the application of clinical judgment and foundational
nursing theory. The questions are structured as multiple-choice and scenario-based items that
mirror real-world clinical dilemmas. Candidates are assessed on their knowledge of regulatory
compliance, ethical standards, and physiological adaptation. Emphasis is placed on critical thinking
and decision-making skills required to prioritize patient needs and ensure optimal health outcomes
across diverse healthcare settings.
1. A nurse is caring for a client with a deep vein thrombosis (DVT) who is receiving a heparin
infusion. Which laboratory result should the nurse prioritize?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
,🟢 C. Activated partial thromboplastin time (aPTT)
🔴 RATIONALE: The aPTT is the specific laboratory test used to monitor the effectiveness and
therapeutic range of heparin therapy. PT and INR are used for warfarin monitoring.
2. A nurse is teaching a client about a new prescription for sublingual nitroglycerin. Which
instruction is most important to include?
A. Swallow the tablet with a full glass of water.
B. Take the medication only if chest pain persists after 10 minutes of rest.
C. Store the medication in its original dark glass bottle.
D. Expect a tingling sensation under the tongue, which indicates the drug is expired.
🟢 C. Store the medication in its original dark glass bottle.
🔴 RATIONALE: Nitroglycerin is sensitive to light and moisture; it must be kept in its original dark
container to maintain potency. It should be taken at the onset of pain and should not be
swallowed.
3. Which of the following clients should the nurse assess first after receiving the change-of-
shift report?
A. A client with a chest tube who has 50 mL of serosanguinous drainage in the last 4 hours.
B. A client with a total hip arthroplasty who is complaining of pain 7/10.
C. A client with pneumonia who has an oxygen saturation of 89% on room air.
D. A client with diabetes whose morning fingerstick glucose was 150 mg/dL.
🟢 C. A client with pneumonia who has an oxygen saturation of 89% on room air.
🔴 RATIONALE: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with
low oxygen saturation (hypoxemia) requires immediate intervention to prevent respiratory
distress.
4. A nurse is preparing to administer a blood transfusion. Which action should the nurse take
first?
,A. Verify the client’s identity and blood type with another nurse.
B. Prime the tubing with 0.45% normal saline.
C. Obtain the client's baseline vital signs.
D. Ensure a 22-gauge IV catheter is patent.
🟢 C. Obtain the client's baseline vital signs.
🔴 RATIONALE: Baseline vital signs must be established before the transfusion starts to provide a
comparison for detecting potential transfusion reactions. Verification with another nurse happens
after the blood is at the bedside.
5. A client with end-stage renal disease (ESRD) has a potassium level of 6.8 mEq/L. Which
cardiac rhythm change is most expected?
A. U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged PR interval
🟢 C. Tall, peaked T waves
🔴 RATIONALE: Hyperkalemia typically manifests on an ECG as tall, peaked T waves. U waves and
ST depression are more common in hypokalemia.
6. The nurse is caring for a client in the manic phase of bipolar disorder. Which meal choice
is most appropriate for this client?
A. Steak, baked potato, and a side salad.
B. Chicken nuggets, an apple, and a carton of milk.
C. Spaghetti with meat sauce and garlic bread.
D. Soup and a sandwich.
🟢 B. Chicken nuggets, an apple, and a carton of milk.
, 🔴 RATIONALE: Clients in a manic phase often have high activity levels and cannot sit still for
long meals. "Finger foods" allow them to maintain nutritional intake while on the move.
7. A nurse is providing discharge teaching to a client following a cholecystectomy. Which
statement by the client indicates an understanding of the teaching?
A. "I should avoid high-fat foods for several weeks."
B. "I will need to stay on a clear liquid diet for one month."
C. "I can resume heavy lifting in 48 hours."
D. "I must notify the doctor if my stools are brown."
🟢 A. "I should avoid high-fat foods for several weeks."
🔴 RATIONALE: After gallbladder removal, the body may have difficulty digesting large amounts
of fat until the bile duct adjusts. Heavy lifting is restricted, and brown stools are normal.
8. A 2-year-old child is admitted with suspected bacterial meningitis. Which type of
precautions should the nurse implement?
A. Contact
B. Droplet
C. Airborne
D. Standard only
🟢 B. Droplet
🔴 RATIONALE: Bacterial meningitis is transmitted through respiratory droplets; therefore,
droplet precautions are required for at least the first 24 hours of antibiotic therapy.
9. The nurse notes that a client’s living will requests no intubation. The client’s spouse
demands the client be intubated during respiratory failure. What is the nurse's best
action?
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
*• Management of Care*
*• Safety and Infection Control*
*• Health Promotion and Maintenance*
*• Psychosocial Integrity*
*• Basic Care and Comfort*
*• Pharmacological and Parenteral Therapies*
*• Reduction of Risk Potential*
*• Physiological Adaptation*
*Introduction*
This comprehensive assessment is designed to simulate the rigorous environment of the NCLEX-RN
licensure examination. The purpose of this exam is to evaluate the entry-level nursing candidate's
ability to provide safe, effective care through the application of clinical judgment and foundational
nursing theory. The questions are structured as multiple-choice and scenario-based items that
mirror real-world clinical dilemmas. Candidates are assessed on their knowledge of regulatory
compliance, ethical standards, and physiological adaptation. Emphasis is placed on critical thinking
and decision-making skills required to prioritize patient needs and ensure optimal health outcomes
across diverse healthcare settings.
1. A nurse is caring for a client with a deep vein thrombosis (DVT) who is receiving a heparin
infusion. Which laboratory result should the nurse prioritize?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
,🟢 C. Activated partial thromboplastin time (aPTT)
🔴 RATIONALE: The aPTT is the specific laboratory test used to monitor the effectiveness and
therapeutic range of heparin therapy. PT and INR are used for warfarin monitoring.
2. A nurse is teaching a client about a new prescription for sublingual nitroglycerin. Which
instruction is most important to include?
A. Swallow the tablet with a full glass of water.
B. Take the medication only if chest pain persists after 10 minutes of rest.
C. Store the medication in its original dark glass bottle.
D. Expect a tingling sensation under the tongue, which indicates the drug is expired.
🟢 C. Store the medication in its original dark glass bottle.
🔴 RATIONALE: Nitroglycerin is sensitive to light and moisture; it must be kept in its original dark
container to maintain potency. It should be taken at the onset of pain and should not be
swallowed.
3. Which of the following clients should the nurse assess first after receiving the change-of-
shift report?
A. A client with a chest tube who has 50 mL of serosanguinous drainage in the last 4 hours.
B. A client with a total hip arthroplasty who is complaining of pain 7/10.
C. A client with pneumonia who has an oxygen saturation of 89% on room air.
D. A client with diabetes whose morning fingerstick glucose was 150 mg/dL.
🟢 C. A client with pneumonia who has an oxygen saturation of 89% on room air.
🔴 RATIONALE: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with
low oxygen saturation (hypoxemia) requires immediate intervention to prevent respiratory
distress.
4. A nurse is preparing to administer a blood transfusion. Which action should the nurse take
first?
,A. Verify the client’s identity and blood type with another nurse.
B. Prime the tubing with 0.45% normal saline.
C. Obtain the client's baseline vital signs.
D. Ensure a 22-gauge IV catheter is patent.
🟢 C. Obtain the client's baseline vital signs.
🔴 RATIONALE: Baseline vital signs must be established before the transfusion starts to provide a
comparison for detecting potential transfusion reactions. Verification with another nurse happens
after the blood is at the bedside.
5. A client with end-stage renal disease (ESRD) has a potassium level of 6.8 mEq/L. Which
cardiac rhythm change is most expected?
A. U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged PR interval
🟢 C. Tall, peaked T waves
🔴 RATIONALE: Hyperkalemia typically manifests on an ECG as tall, peaked T waves. U waves and
ST depression are more common in hypokalemia.
6. The nurse is caring for a client in the manic phase of bipolar disorder. Which meal choice
is most appropriate for this client?
A. Steak, baked potato, and a side salad.
B. Chicken nuggets, an apple, and a carton of milk.
C. Spaghetti with meat sauce and garlic bread.
D. Soup and a sandwich.
🟢 B. Chicken nuggets, an apple, and a carton of milk.
, 🔴 RATIONALE: Clients in a manic phase often have high activity levels and cannot sit still for
long meals. "Finger foods" allow them to maintain nutritional intake while on the move.
7. A nurse is providing discharge teaching to a client following a cholecystectomy. Which
statement by the client indicates an understanding of the teaching?
A. "I should avoid high-fat foods for several weeks."
B. "I will need to stay on a clear liquid diet for one month."
C. "I can resume heavy lifting in 48 hours."
D. "I must notify the doctor if my stools are brown."
🟢 A. "I should avoid high-fat foods for several weeks."
🔴 RATIONALE: After gallbladder removal, the body may have difficulty digesting large amounts
of fat until the bile duct adjusts. Heavy lifting is restricted, and brown stools are normal.
8. A 2-year-old child is admitted with suspected bacterial meningitis. Which type of
precautions should the nurse implement?
A. Contact
B. Droplet
C. Airborne
D. Standard only
🟢 B. Droplet
🔴 RATIONALE: Bacterial meningitis is transmitted through respiratory droplets; therefore,
droplet precautions are required for at least the first 24 hours of antibiotic therapy.
9. The nurse notes that a client’s living will requests no intubation. The client’s spouse
demands the client be intubated during respiratory failure. What is the nurse's best
action?
