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NCLEX-RN SAMPLE QUESTIONS WITH RATIONALES 2026-27
LATEST VERSION FULL BLUEPRINT
### 1. **Maternity: Fetal Heart Monitoring**
**Question:** A nurse is monitoring a patient in labor and notes a fetal heart
rate (FHR) of 180 beats per minute. Which action should the nurse take first?
- **A.** Reassess the FHR in 10 minutes.
- **B.** Administer oxygen at 8-10 L/min via face mask.
- **C.** Place the patient in a lateral position.
- **D.** Notify the healthcare provider.
**Correct Answer:** **C.** Place the patient in a lateral position.
**Rationale:** A fetal heart rate above 160 beats per minute is considered
tachycardia, which can indicate fetal distress. Placing the patient in a lateral
position helps improve uteroplacental blood flow, which may decrease fetal
distress. Administering oxygen and notifying the healthcare provider are
appropriate, but positioning the patient is the priority.
---
### 2. **Pharmacology: Digoxin Administration**
**Question:** A nurse is preparing to administer digoxin to a patient with heart
failure. The patient's apical pulse is 54 beats per minute. What should the nurse
do next?
- **A.** Administer the medication as prescribed.
- **B.** Hold the medication and recheck the pulse in one hour.
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- **C.** Hold the medication and notify the healthcare provider.
- **D.** Administer half the prescribed dose.
**Correct Answer:** **C.** Hold the medication and notify the healthcare provider.
**Rationale:** Digoxin is a cardiac glycoside that increases the force of
myocardial contraction. It is crucial to check the apical pulse before
administration, and if the pulse is below 60 beats per minute,
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the nurse should hold the medication and notify the healthcare provider, as
administering digoxin could exacerbate bradycardia.
---
### 3. **Medical-Surgical: Postoperative Care**
**Question:** A nurse is caring for a patient who is postoperative from abdominal
surgery and reports severe pain. Which intervention should the nurse implement
first?
- **A.** Administer prescribed analgesics.
- **B.** Assess the patient's surgical site.
- **C.** Reposition the patient to enhance comfort.
- **D.** Encourage the patient to use incentive spirometry.
**Correct Answer:** **B.** Assess the patient's surgical site.
**Rationale:** Severe pain in a postoperative patient could indicate
complications such as bleeding, infection, or dehiscence. The priority is to
assess the surgical site to determine the cause of the pain. Administering
analgesics or repositioning the patient is appropriate after the assessment.
---
### 4. **Pediatrics: Developmental Milestones**
**Question:** A nurse is assessing a 9-month-old infant. Which developmental
milestone should the nurse expect to observe?
- **A.** Saying single words like "mama" or "dada."
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- **B.** Pulling up to stand.
- **C.** Playing pat-a-cake.
- **D.** Walking independently.
**Correct Answer:** **B.** Pulling up to stand.
NCLEX-RN SAMPLE QUESTIONS WITH RATIONALES 2026-27
LATEST VERSION FULL BLUEPRINT
### 1. **Maternity: Fetal Heart Monitoring**
**Question:** A nurse is monitoring a patient in labor and notes a fetal heart
rate (FHR) of 180 beats per minute. Which action should the nurse take first?
- **A.** Reassess the FHR in 10 minutes.
- **B.** Administer oxygen at 8-10 L/min via face mask.
- **C.** Place the patient in a lateral position.
- **D.** Notify the healthcare provider.
**Correct Answer:** **C.** Place the patient in a lateral position.
**Rationale:** A fetal heart rate above 160 beats per minute is considered
tachycardia, which can indicate fetal distress. Placing the patient in a lateral
position helps improve uteroplacental blood flow, which may decrease fetal
distress. Administering oxygen and notifying the healthcare provider are
appropriate, but positioning the patient is the priority.
---
### 2. **Pharmacology: Digoxin Administration**
**Question:** A nurse is preparing to administer digoxin to a patient with heart
failure. The patient's apical pulse is 54 beats per minute. What should the nurse
do next?
- **A.** Administer the medication as prescribed.
- **B.** Hold the medication and recheck the pulse in one hour.
,2
- **C.** Hold the medication and notify the healthcare provider.
- **D.** Administer half the prescribed dose.
**Correct Answer:** **C.** Hold the medication and notify the healthcare provider.
**Rationale:** Digoxin is a cardiac glycoside that increases the force of
myocardial contraction. It is crucial to check the apical pulse before
administration, and if the pulse is below 60 beats per minute,
,3
the nurse should hold the medication and notify the healthcare provider, as
administering digoxin could exacerbate bradycardia.
---
### 3. **Medical-Surgical: Postoperative Care**
**Question:** A nurse is caring for a patient who is postoperative from abdominal
surgery and reports severe pain. Which intervention should the nurse implement
first?
- **A.** Administer prescribed analgesics.
- **B.** Assess the patient's surgical site.
- **C.** Reposition the patient to enhance comfort.
- **D.** Encourage the patient to use incentive spirometry.
**Correct Answer:** **B.** Assess the patient's surgical site.
**Rationale:** Severe pain in a postoperative patient could indicate
complications such as bleeding, infection, or dehiscence. The priority is to
assess the surgical site to determine the cause of the pain. Administering
analgesics or repositioning the patient is appropriate after the assessment.
---
### 4. **Pediatrics: Developmental Milestones**
**Question:** A nurse is assessing a 9-month-old infant. Which developmental
milestone should the nurse expect to observe?
- **A.** Saying single words like "mama" or "dada."
, 4
- **B.** Pulling up to stand.
- **C.** Playing pat-a-cake.
- **D.** Walking independently.
**Correct Answer:** **B.** Pulling up to stand.
