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NCLEX-RN COMPREHENSIVE EXAM PREP | PRACTICE QUESTIONS, ANSWERS & RATIONALES | NEXT GEN NCLEX (NGN) REVIEW | 2026–2027

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Prepare confidently for the NCLEX-RN with this comprehensive exam preparation resource featuring a wide range of NCLEX-style practice questions, verified answers, and detailed rationales. Designed to strengthen clinical judgment and reinforce core nursing concepts, this study guide covers medical-surgical nursing, pharmacology, pediatrics, maternity, mental health, fundamentals, leadership, prioritization, delegation, and Next Generation NCLEX (NGN)-style questions. Whether you're preparing for your first attempt or reviewing before exam day, this resource provides a structured and effective way to build confidence and improve exam readiness.

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NCLEX RN ACTUAL EXAM TEST
BANK WITH REAL AND EXACT
EXAM QUESTIONS & ANSWERS
SECTION A

1. The nurse is caring for a client scheduled for removal of a pituitary tumor using the
transsphenoidal approach. the nurse should be particularly alert to:

A. Nasal congestion
B. Abdominal Tenderness
C. Muscle Tetany
D. Oliguria: A. Nasal congestion

why? removal of the pituitary gland is usually done by transsphernoidal approach
through the nose. Nasal congestion further interferes with the airway.
2. A client with cancer is a, admitted to the oncology unit. Stat lab values revel Hgb 12.6,
WBC 6500, K+1.9, uric acid 7.0, Na+136, and platelets 178,000. The nurse evaluates that
the client is experiencing which of the following?

A. Hypernatremia
B. Hypokalemia
C. Myelosuppression
D. Leukocytosis: B. Hypokalemia






,why?
Hypokalemia is evident from the lab values listed. The other laboratory findings are within
normal limits. making answers A,C and D incorrect
3. A 24 year-old female client is scheduled for surgery in the morning. Which of the
following is the primary responsibility of the nurse?

A. taking the vital signs
B. obtaining the permit
C. explaining the procedure
D. Checking the lab work: A. taking the vital signs

why? the primary responisblity of the nurse is to take the vital
signs before any surgery. answers B,C and D are the
responsibility of the doctor.
4. The nurse is working in the emergency room when a client arrives with severe burns
of the left arm, hands, face, and neck. which action should receive priority?

A. starting an IV?
B. Applying oxygen
C.Obtaining blood gas
D. Medicating the client foe pain: B. Applying oxygen

why? the client with burns to the neck needs airway assessments and supplemental
oxygen, so applying oxygen is priority. the next action should be to start an IV and
medicate for pain.
5. The nurse is visiting a home health client with osteoporosis. The client has a new
prescription for alendronate (Fosamax). Which instructions should be given to the client

A. rest in bed after taking the medication for at least 30 mins
B. Avoid rapid movements after taking the medication
C. Take medication with water only
D. Allow at least 1 hour between taking the medicine and taking other med-ications:



, C. Take medication with water only why?

Fosmax should be taken with water only. The client should also remain upright for at least
30 mins after taking the medication.
6. The nurse is making initial rounds on a client with a C5 fracture and crutchfield thongs.
Which equipment should be kept at the bedside?

A. A pair of forceps
B. A torque wrench
C. A pair or wire cutters
D. A screwdriver:

B. A torque wrench

why?A tourque wrench is kept at the bedside to tighten and loosen the screws of

crutchfield tongs. This wrench controls the amount of pressure that is placed on the

screws.

7. An infant weighs 7 pounds at birth. The excpectd weight by 1 year should be:

A. 10 pounds B.12
pounds
C. 18 pounds
D. 21 pounds

why?A birth weight of 7 pounds would indicate 21

pounds in 1 year or triple the his birth weight.

8. A client is admitted with a Ewing's sacroma. which symptoms would be expected due
to this tumor's location?



, A. Hemiplegia
B. Aphasia
C. Nausea
D. Bone Pain: D. Bone Pain why?

Sacroma is a type of bone cancer, therefor, bone pain would be expected
9. The nurse is caring for a client with epilepsy who is being treated with carbamazepine
(Tegretol). Which labatory value might be a indicate a serious side effect of this drug?
A. Uric acid of 5mg/dL
B. Hematoccrit of 33%
C. WBC 2,000 per cubic millimeter
D. Platelets 150,000 per cubic millimeter: C. WBC 2,000 per cubic millimeter why?

Tegratol can suppress the bone marrow and decrease the white blood cells count; thus,
a lab value of WBC 2,000 per cubic millimeter indicates side effects of the drug.
10. A 6-month-old client is admitted with possible intussuception. Which question during
the nursing history is least helpful in obtaining information regarding this diagnosis?

A. "tell me about the pain"
B. "what does his vomit look like?"
C. " Describe his usual diet."
D. " have you noticed changes in his adominal size?": C." Describe his usual diet." why?

The least-helpful questions are those describing his usual diet. A, B, and D are useful in
determining the extent of disease process and thus, are incorrect
11. The nurse is assisting a client with diverticulosis to select appropiate foods. Which
food should be avoided?

A. Bran
B. Fresh Peaches
C. Cucumber salad

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