NCLEX-RN COMPREHENSIVE
PRACTICE EXAMINATION 100
CERTIFICATION-LEVEL PRACTICE
QUESTIONS WITH DETAILED
RATIONALES
DOCUMENT DESCRIPTION
The NCLEX-RN Comprehensive Practice Examination is designed to prepare nursing
candidates for success on the National Council Licensure Examination for Registered Nurses
(NCLEX-RN). This examination contains 100 certification-level multiple-choice questions
that reflect current nursing standards, evidence-based practice, clinical judgment, and patient-
centered care principles expected of entry-level registered nurses.
Content areas covered throughout this examination include:
• Safe and Effective Care Environment
• Management of Care
• Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
,• Reduction of Risk Potential
• Physiological Adaptation
• Medical-Surgical Nursing
• Maternal-Newborn Nursing
• Pediatric Nursing
• Mental Health Nursing
• Leadership and Delegation
• Ethical and Legal Nursing Practice
• Evidence-Based Practice
• Clinical Judgment and Prioritization
• Interdisciplinary Collaboration
• Professional Responsibilities
This examination is designed to simulate the rigor and structure of professional nursing
certification testing while strengthening critical thinking, patient safety awareness,
prioritization skills, and nursing knowledge required for successful NCLEX-RN
performance.
, PRACTICE QUESTIONS
Question One
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first?
A. A client with chronic obstructive pulmonary disease who reports increased fatigue
B. A client who received insulin 30 minutes ago and is diaphoretic and confused
C. A client scheduled for discharge who requires medication teaching
D. A client with hypertension whose blood pressure is 148/88 mm Hg
Correct Answer: B. A client who received insulin 30 minutes ago and is
diaphoretic and confused
Rationale: The nurse should prioritize clients experiencing immediate threats to
physiological stability. Diaphoresis and confusion shortly after insulin administration
strongly suggest hypoglycemia, which can rapidly progress to seizures, loss of
consciousness, and death if not promptly recognized and treated. Using the ABCs and
prioritization principles, this client requires immediate assessment and intervention. The
remaining clients are stable and can safely wait while the nurse addresses the urgent
situation.
Question Two
A nurse receives report on four clients. Which client should be seen first?
A. A postoperative client reporting sudden shortness of breath and chest pain
B. A client requesting assistance to the bathroom
C. A client awaiting discharge instructions
D. A client requesting pain medication for chronic back pain
Correct Answer: A. A postoperative client reporting sudden shortness of
breath and chest pain
, Rationale: Sudden shortness of breath and chest pain in a postoperative client may
indicate a pulmonary embolism, a life-threatening complication requiring immediate
assessment and intervention. The nurse should prioritize according to airway, breathing,
circulation, and actual versus potential problems. While the other clients have legitimate
needs, none present an immediate threat to life comparable to a suspected pulmonary
embolism.
Question Three
A nurse is reinforcing infection-control measures with newly hired staff members. Which
statement demonstrates correct understanding?
A. Gloves replace the need for hand hygiene.
B. Hand hygiene should be performed before and after patient contact.
C. Hand hygiene is necessary only after exposure to body fluids.
D. Alcohol-based hand rubs are ineffective against microorganisms.
Correct Answer: B. Hand hygiene should be performed before and after
patient contact
Rationale: Hand hygiene remains the most effective method for preventing healthcare-
associated infections. Nurses should perform hand hygiene before touching a patient,
before aseptic procedures, after exposure risks, after touching a patient, and after contact
with patient surroundings. Gloves do not eliminate the need for hand hygiene because
contamination can occur during removal. Consistent hand hygiene significantly reduces
transmission of infectious organisms within healthcare settings.
Question Four
A nurse is caring for a client receiving intravenous potassium chloride. Which action requires
immediate correction?
A. Monitoring urine output
B. Infusing potassium using an electronic infusion pump
C. Administering potassium by gravity infusion
D. Assessing the client's cardiac rhythm
Correct Answer: C. Administering potassium by gravity infusion
PRACTICE EXAMINATION 100
CERTIFICATION-LEVEL PRACTICE
QUESTIONS WITH DETAILED
RATIONALES
DOCUMENT DESCRIPTION
The NCLEX-RN Comprehensive Practice Examination is designed to prepare nursing
candidates for success on the National Council Licensure Examination for Registered Nurses
(NCLEX-RN). This examination contains 100 certification-level multiple-choice questions
that reflect current nursing standards, evidence-based practice, clinical judgment, and patient-
centered care principles expected of entry-level registered nurses.
Content areas covered throughout this examination include:
• Safe and Effective Care Environment
• Management of Care
• Safety and Infection Control
• Health Promotion and Maintenance
• Psychosocial Integrity
• Physiological Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
,• Reduction of Risk Potential
• Physiological Adaptation
• Medical-Surgical Nursing
• Maternal-Newborn Nursing
• Pediatric Nursing
• Mental Health Nursing
• Leadership and Delegation
• Ethical and Legal Nursing Practice
• Evidence-Based Practice
• Clinical Judgment and Prioritization
• Interdisciplinary Collaboration
• Professional Responsibilities
This examination is designed to simulate the rigor and structure of professional nursing
certification testing while strengthening critical thinking, patient safety awareness,
prioritization skills, and nursing knowledge required for successful NCLEX-RN
performance.
, PRACTICE QUESTIONS
Question One
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse
assess first?
A. A client with chronic obstructive pulmonary disease who reports increased fatigue
B. A client who received insulin 30 minutes ago and is diaphoretic and confused
C. A client scheduled for discharge who requires medication teaching
D. A client with hypertension whose blood pressure is 148/88 mm Hg
Correct Answer: B. A client who received insulin 30 minutes ago and is
diaphoretic and confused
Rationale: The nurse should prioritize clients experiencing immediate threats to
physiological stability. Diaphoresis and confusion shortly after insulin administration
strongly suggest hypoglycemia, which can rapidly progress to seizures, loss of
consciousness, and death if not promptly recognized and treated. Using the ABCs and
prioritization principles, this client requires immediate assessment and intervention. The
remaining clients are stable and can safely wait while the nurse addresses the urgent
situation.
Question Two
A nurse receives report on four clients. Which client should be seen first?
A. A postoperative client reporting sudden shortness of breath and chest pain
B. A client requesting assistance to the bathroom
C. A client awaiting discharge instructions
D. A client requesting pain medication for chronic back pain
Correct Answer: A. A postoperative client reporting sudden shortness of
breath and chest pain
, Rationale: Sudden shortness of breath and chest pain in a postoperative client may
indicate a pulmonary embolism, a life-threatening complication requiring immediate
assessment and intervention. The nurse should prioritize according to airway, breathing,
circulation, and actual versus potential problems. While the other clients have legitimate
needs, none present an immediate threat to life comparable to a suspected pulmonary
embolism.
Question Three
A nurse is reinforcing infection-control measures with newly hired staff members. Which
statement demonstrates correct understanding?
A. Gloves replace the need for hand hygiene.
B. Hand hygiene should be performed before and after patient contact.
C. Hand hygiene is necessary only after exposure to body fluids.
D. Alcohol-based hand rubs are ineffective against microorganisms.
Correct Answer: B. Hand hygiene should be performed before and after
patient contact
Rationale: Hand hygiene remains the most effective method for preventing healthcare-
associated infections. Nurses should perform hand hygiene before touching a patient,
before aseptic procedures, after exposure risks, after touching a patient, and after contact
with patient surroundings. Gloves do not eliminate the need for hand hygiene because
contamination can occur during removal. Consistent hand hygiene significantly reduces
transmission of infectious organisms within healthcare settings.
Question Four
A nurse is caring for a client receiving intravenous potassium chloride. Which action requires
immediate correction?
A. Monitoring urine output
B. Infusing potassium using an electronic infusion pump
C. Administering potassium by gravity infusion
D. Assessing the client's cardiac rhythm
Correct Answer: C. Administering potassium by gravity infusion
