**Master the NCLEX-RN: 100 Practice Questions & Rationales
for 2025/2026 Success**
*Your complete, student-crafted study guide for
Fundamentals, Med-Surg, Pharmacology, and beyond.*
Compiled from student notes and practice resources — not an
official exam.
---
**💫QUESTION 1:**
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which assessment finding
requires the nurse to hold the medication and notify the healthcare provider?
A) Serum potassium of 3.2 mEq/L
B) Blood pressure of 142/88 mmHg
C) Weight gain of 1 lb since yesterday
D) Urine output of 60 mL in the last hour
💫ANSWER✔️✔️: A) Serum potassium of 3.2 mEq/L
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that depletes potassium. A normal potassium is 3.5–5.0
mEq/L; 3.2 is hypokalemia, which increases the risk of cardiac arrhythmias, especially with digoxin use.
Option B is elevated but not a contraindication to furosemide. Option C indicates fluid retention and
supports the need for the drug. Option D is adequate urine output (at least 30 mL/hr). *My tip: "Lasix
loses K+" – always check potassium before giving it.* This nursing exam prep question highlights safe
medication administration. *(SEO: nursing exam prep, study guide, practice questions)*
---
,**💫QUESTION 2:**
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has an arterial
blood gas (ABG) result of pH 7.31, PaCO₂ 58 mmHg, HCO₃ 26 mEq/L. Which intervention should the
nurse prioritize?
A) Administer oxygen at 2 L/min via nasal cannula
B) Encourage pursed-lip breathing
C) Prepare for immediate intubation
D) Administer sodium bicarbonate IV
💫ANSWER✔️✔️: B) Encourage pursed-lip breathing
💫RATIONALE✔️✔️: The ABG shows respiratory acidosis (low pH, high CO₂) with normal bicarbonate – this
is chronic COPD with baseline hypercapnia. Pursed-lip breathing prolongs exhalation, prevents airway
collapse, and helps the client blow off CO₂. Option A is wrong because high-flow oxygen can suppress
the hypoxic drive in COPD clients. Option C is for acute respiratory failure unresponsive to conservative
therapy. Option D treats metabolic acidosis, not respiratory. *I remember: "Pursed lips = prolonged
exhale = CO₂ jailbreak."* This study guide concept is key for respiratory disorders. *(SEO: revision notes,
nursing exam prep, student success)*
---
**💫QUESTION 3:**
A postpartum client reports a painful, red, swollen area on her left calf. The nurse notes warmth and
tenderness upon palpation. What is the nurse's priority action?
A) Massage the affected area to improve circulation
B) Apply a cold compress to reduce swelling
C) Measure the circumference of both calves and notify the provider
D) Encourage ambulation to prevent further stasis
💫ANSWER✔️✔️: C) Measure the circumference of both calves and notify the provider
,💫RATIONALE✔️✔️: This presentation is suspicious for deep vein thrombosis (DVT), a postpartum risk due
to hypercoagulability. Massaging (A) or ambulating (D) can dislodge a clot and cause pulmonary
embolism. Cold compresses (B) are not the priority and do not address the underlying emergency.
Measuring calf circumference provides objective data, and notifying the provider is essential for
diagnostic imaging (Doppler ultrasound). *I always think: "Hot, red, swollen – do NOT rub it; call the doc
instead."* This practice question reinforces maternal-newborn nursing exam prep. *(SEO: nursing exam
prep, practice questions, study guide)*
---
**💫QUESTION 4:**
A client with schizophrenia is exhibiting bizarre mannerisms, echolalia, and waxy flexibility. Which
medication is most commonly prescribed for this acute psychotic episode?
A) Haloperidol (Haldol)
B) Fluoxetine (Prozac)
C) Lorazepam (Ativan)
D) Lithium carbonate
💫ANSWER✔️✔️: A) Haloperidol (Haldol)
💫RATIONALE✔️✔️: Haloperidol is a first-generation antipsychotic used to manage acute psychosis,
including positive symptoms like bizarre behavior and echolalia. Fluoxetine is an SSRI for depression, not
psychosis. Lorazepam is a benzodiazepine for anxiety or agitation but not the primary antipsychotic.
Lithium is a mood stabilizer for bipolar disorder. *My mnemonic: "Haldol halts hallucinations."* This
mental health nursing question is essential for your NCLEX study guide revision. *(SEO: revision notes,
student success, nursing exam prep)*
---
**💫QUESTION 5:**
The nurse is preparing to administer 500 mL of 0.9% normal saline over 4 hours. The drop factor is 15
gtt/mL. What is the drip rate in drops per minute?
, A) 31 gtt/min
B) 125 gtt/min
C) 21 gtt/min
D) 83 gtt/min
💫ANSWER✔️✔️: A) 31 gtt/min
💫RATIONALE✔️✔️: Formula: (Volume in mL × drop factor) ÷ time in minutes = (500 × 15) ÷ (4 × 60) =
7500 ÷ 240 = 31.25 → 31 gtt/min. Option B is too high; Option C is too low; Option D miscalculates time.
*I double-check by asking: "Does 31 drops per minute seem reasonable for 500 mL over 4 hours?" Yes –
it's a slow infusion.* This dosage calculation is a staple in nursing exam prep and student success guides.
*(SEO: dosage calculations, nursing exam prep, study guide)*
---
**💫QUESTION 6:**
A client with terminal cancer tells the nurse, "I don't want any more chemo. It's making me miserable,
and I just want to go home." Which response by the nurse is most therapeutic?
A) "You should discuss this with your oncologist before making any decisions."
B) "I understand you're feeling overwhelmed. Can you tell me more about what you're thinking?"
C) "But the chemo is prolonging your life – don't give up hope."
D) "Let's wait until your family arrives to talk about this."
💫ANSWER✔️✔️: B) "I understand you're feeling overwhelmed. Can you tell me more about what you're
thinking?"
💫RATIONALE✔️✔️: This response validates the client's feelings and uses open-ended therapeutic
communication to explore concerns. Option A dismisses the client's autonomy. Option C imposes the
nurse's values and false hope. Option D avoids the issue and delays important discussion. *I learned in
clinicals: "Listen first; fix later – but sometimes there's no fix, just presence."* This end-of-life scenario is
a must-know for mental health and fundamentals nursing exam prep. *(SEO: practice questions, student
success, nursing exam prep)*
for 2025/2026 Success**
*Your complete, student-crafted study guide for
Fundamentals, Med-Surg, Pharmacology, and beyond.*
Compiled from student notes and practice resources — not an
official exam.
---
**💫QUESTION 1:**
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which assessment finding
requires the nurse to hold the medication and notify the healthcare provider?
A) Serum potassium of 3.2 mEq/L
B) Blood pressure of 142/88 mmHg
C) Weight gain of 1 lb since yesterday
D) Urine output of 60 mL in the last hour
💫ANSWER✔️✔️: A) Serum potassium of 3.2 mEq/L
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that depletes potassium. A normal potassium is 3.5–5.0
mEq/L; 3.2 is hypokalemia, which increases the risk of cardiac arrhythmias, especially with digoxin use.
Option B is elevated but not a contraindication to furosemide. Option C indicates fluid retention and
supports the need for the drug. Option D is adequate urine output (at least 30 mL/hr). *My tip: "Lasix
loses K+" – always check potassium before giving it.* This nursing exam prep question highlights safe
medication administration. *(SEO: nursing exam prep, study guide, practice questions)*
---
,**💫QUESTION 2:**
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has an arterial
blood gas (ABG) result of pH 7.31, PaCO₂ 58 mmHg, HCO₃ 26 mEq/L. Which intervention should the
nurse prioritize?
A) Administer oxygen at 2 L/min via nasal cannula
B) Encourage pursed-lip breathing
C) Prepare for immediate intubation
D) Administer sodium bicarbonate IV
💫ANSWER✔️✔️: B) Encourage pursed-lip breathing
💫RATIONALE✔️✔️: The ABG shows respiratory acidosis (low pH, high CO₂) with normal bicarbonate – this
is chronic COPD with baseline hypercapnia. Pursed-lip breathing prolongs exhalation, prevents airway
collapse, and helps the client blow off CO₂. Option A is wrong because high-flow oxygen can suppress
the hypoxic drive in COPD clients. Option C is for acute respiratory failure unresponsive to conservative
therapy. Option D treats metabolic acidosis, not respiratory. *I remember: "Pursed lips = prolonged
exhale = CO₂ jailbreak."* This study guide concept is key for respiratory disorders. *(SEO: revision notes,
nursing exam prep, student success)*
---
**💫QUESTION 3:**
A postpartum client reports a painful, red, swollen area on her left calf. The nurse notes warmth and
tenderness upon palpation. What is the nurse's priority action?
A) Massage the affected area to improve circulation
B) Apply a cold compress to reduce swelling
C) Measure the circumference of both calves and notify the provider
D) Encourage ambulation to prevent further stasis
💫ANSWER✔️✔️: C) Measure the circumference of both calves and notify the provider
,💫RATIONALE✔️✔️: This presentation is suspicious for deep vein thrombosis (DVT), a postpartum risk due
to hypercoagulability. Massaging (A) or ambulating (D) can dislodge a clot and cause pulmonary
embolism. Cold compresses (B) are not the priority and do not address the underlying emergency.
Measuring calf circumference provides objective data, and notifying the provider is essential for
diagnostic imaging (Doppler ultrasound). *I always think: "Hot, red, swollen – do NOT rub it; call the doc
instead."* This practice question reinforces maternal-newborn nursing exam prep. *(SEO: nursing exam
prep, practice questions, study guide)*
---
**💫QUESTION 4:**
A client with schizophrenia is exhibiting bizarre mannerisms, echolalia, and waxy flexibility. Which
medication is most commonly prescribed for this acute psychotic episode?
A) Haloperidol (Haldol)
B) Fluoxetine (Prozac)
C) Lorazepam (Ativan)
D) Lithium carbonate
💫ANSWER✔️✔️: A) Haloperidol (Haldol)
💫RATIONALE✔️✔️: Haloperidol is a first-generation antipsychotic used to manage acute psychosis,
including positive symptoms like bizarre behavior and echolalia. Fluoxetine is an SSRI for depression, not
psychosis. Lorazepam is a benzodiazepine for anxiety or agitation but not the primary antipsychotic.
Lithium is a mood stabilizer for bipolar disorder. *My mnemonic: "Haldol halts hallucinations."* This
mental health nursing question is essential for your NCLEX study guide revision. *(SEO: revision notes,
student success, nursing exam prep)*
---
**💫QUESTION 5:**
The nurse is preparing to administer 500 mL of 0.9% normal saline over 4 hours. The drop factor is 15
gtt/mL. What is the drip rate in drops per minute?
, A) 31 gtt/min
B) 125 gtt/min
C) 21 gtt/min
D) 83 gtt/min
💫ANSWER✔️✔️: A) 31 gtt/min
💫RATIONALE✔️✔️: Formula: (Volume in mL × drop factor) ÷ time in minutes = (500 × 15) ÷ (4 × 60) =
7500 ÷ 240 = 31.25 → 31 gtt/min. Option B is too high; Option C is too low; Option D miscalculates time.
*I double-check by asking: "Does 31 drops per minute seem reasonable for 500 mL over 4 hours?" Yes –
it's a slow infusion.* This dosage calculation is a staple in nursing exam prep and student success guides.
*(SEO: dosage calculations, nursing exam prep, study guide)*
---
**💫QUESTION 6:**
A client with terminal cancer tells the nurse, "I don't want any more chemo. It's making me miserable,
and I just want to go home." Which response by the nurse is most therapeutic?
A) "You should discuss this with your oncologist before making any decisions."
B) "I understand you're feeling overwhelmed. Can you tell me more about what you're thinking?"
C) "But the chemo is prolonging your life – don't give up hope."
D) "Let's wait until your family arrives to talk about this."
💫ANSWER✔️✔️: B) "I understand you're feeling overwhelmed. Can you tell me more about what you're
thinking?"
💫RATIONALE✔️✔️: This response validates the client's feelings and uses open-ended therapeutic
communication to explore concerns. Option A dismisses the client's autonomy. Option C imposes the
nurse's values and false hope. Option D avoids the issue and delays important discussion. *I learned in
clinicals: "Listen first; fix later – but sometimes there's no fix, just presence."* This end-of-life scenario is
a must-know for mental health and fundamentals nursing exam prep. *(SEO: practice questions, student
success, nursing exam prep)*
