NCLEX-RN + NEW YORK RN LICENSURE
COMPREHENSIVE PRACTICE EXAM | 100 EXAM-
STYLE MULTIPLE-CHOICE QUESTIONS WITH
ANSWERS & RATIONALES
1. A nurse is caring for a client who suddenly develops shortness of breath and
oxygen saturation decreases to 84%. What is the nurse's priority action?
A. Notify the healthcare provider
B. Increase the oxygen flow and assess the airway
C. Document the findings
D. Prepare discharge instructions
Answer: B. Increase the oxygen flow and assess the airway
Rationale: Airway and breathing take priority according to the ABC principle.
Oxygenation must be restored before other interventions.
2. Which electrolyte imbalance places a client at the greatest risk for life-
threatening cardiac dysrhythmias?
A. Mild hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Answer: B. Hyperkalemia
Rationale: Elevated potassium significantly affects cardiac conduction and may
lead to fatal arrhythmias.
3. Which task may the RN safely delegate to an experienced UAP?
A. Assessing pain
B. Teaching insulin administration
C. Ambulating a stable postoperative client
D. Evaluating wound healing
,Answer: C. Ambulating a stable postoperative client
Rationale: Stable, routine, non-assessment tasks may be delegated to UAPs.
4. Which client should the nurse assess first?
A. Client with chronic arthritis reporting pain of 5/10
B. Client with diabetes whose blood glucose is 210 mg/dL
C. Client with chest pain and diaphoresis
D. Client requesting a blanket
Answer: C. Client with chest pain and diaphoresis
Rationale: Possible myocardial infarction requires immediate assessment.
5. Which isolation precaution is required for pulmonary tuberculosis?
A. Contact
B. Droplet
C. Airborne
D. Protective
Answer: C. Airborne
Rationale: Tuberculosis spreads through airborne particles requiring an N95
respirator and negative-pressure room.
6. A nurse notices another nurse preparing the wrong medication dose. What
should the nurse do first?
A. Report the nurse later
B. Stop the medication administration immediately
C. Complete an incident report
D. Notify the supervisor after administration
Answer: B. Stop the medication administration immediately
Rationale: Preventing patient harm is the immediate priority.
7. Which developmental milestone is expected in a 6-month-old infant?
A. Walking independently
B. Rolling over both directions
, C. Speaking three-word sentences
D. Riding a tricycle
Answer: B. Rolling over both directions
Rationale: Rolling over is a normal developmental milestone at approximately 6
months.
8. Which vaccine is contraindicated during pregnancy?
A. Influenza (inactivated)
B. Tdap
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: MMR is a live vaccine and should not be administered during
pregnancy.
9. Which statement demonstrates therapeutic communication?
A. "Everything will be fine."
B. "You shouldn't feel that way."
C. "Tell me more about what concerns you."
D. "Don't worry."
Answer: C. Tell me more about what concerns you.
Rationale: Open-ended questions encourage expression of feelings.
10.A client expresses suicidal thoughts. Which intervention is the priority?
A. Encourage journaling
B. Remove potentially harmful objects
C. Offer television
D. Ask family members to visit
Answer: B. Remove potentially harmful objects
Rationale: Client safety is the highest priority.
COMPREHENSIVE PRACTICE EXAM | 100 EXAM-
STYLE MULTIPLE-CHOICE QUESTIONS WITH
ANSWERS & RATIONALES
1. A nurse is caring for a client who suddenly develops shortness of breath and
oxygen saturation decreases to 84%. What is the nurse's priority action?
A. Notify the healthcare provider
B. Increase the oxygen flow and assess the airway
C. Document the findings
D. Prepare discharge instructions
Answer: B. Increase the oxygen flow and assess the airway
Rationale: Airway and breathing take priority according to the ABC principle.
Oxygenation must be restored before other interventions.
2. Which electrolyte imbalance places a client at the greatest risk for life-
threatening cardiac dysrhythmias?
A. Mild hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Answer: B. Hyperkalemia
Rationale: Elevated potassium significantly affects cardiac conduction and may
lead to fatal arrhythmias.
3. Which task may the RN safely delegate to an experienced UAP?
A. Assessing pain
B. Teaching insulin administration
C. Ambulating a stable postoperative client
D. Evaluating wound healing
,Answer: C. Ambulating a stable postoperative client
Rationale: Stable, routine, non-assessment tasks may be delegated to UAPs.
4. Which client should the nurse assess first?
A. Client with chronic arthritis reporting pain of 5/10
B. Client with diabetes whose blood glucose is 210 mg/dL
C. Client with chest pain and diaphoresis
D. Client requesting a blanket
Answer: C. Client with chest pain and diaphoresis
Rationale: Possible myocardial infarction requires immediate assessment.
5. Which isolation precaution is required for pulmonary tuberculosis?
A. Contact
B. Droplet
C. Airborne
D. Protective
Answer: C. Airborne
Rationale: Tuberculosis spreads through airborne particles requiring an N95
respirator and negative-pressure room.
6. A nurse notices another nurse preparing the wrong medication dose. What
should the nurse do first?
A. Report the nurse later
B. Stop the medication administration immediately
C. Complete an incident report
D. Notify the supervisor after administration
Answer: B. Stop the medication administration immediately
Rationale: Preventing patient harm is the immediate priority.
7. Which developmental milestone is expected in a 6-month-old infant?
A. Walking independently
B. Rolling over both directions
, C. Speaking three-word sentences
D. Riding a tricycle
Answer: B. Rolling over both directions
Rationale: Rolling over is a normal developmental milestone at approximately 6
months.
8. Which vaccine is contraindicated during pregnancy?
A. Influenza (inactivated)
B. Tdap
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: MMR is a live vaccine and should not be administered during
pregnancy.
9. Which statement demonstrates therapeutic communication?
A. "Everything will be fine."
B. "You shouldn't feel that way."
C. "Tell me more about what concerns you."
D. "Don't worry."
Answer: C. Tell me more about what concerns you.
Rationale: Open-ended questions encourage expression of feelings.
10.A client expresses suicidal thoughts. Which intervention is the priority?
A. Encourage journaling
B. Remove potentially harmful objects
C. Offer television
D. Ask family members to visit
Answer: B. Remove potentially harmful objects
Rationale: Client safety is the highest priority.
