NCLEX-RN Practice Exam.
1. A nurse is caring for a client with chest pain. Which action should the nurse perform
first?
A. Obtain a complete health history
B. Administer prescribed pain medication
C. Assess the client's airway, breathing, and circulation (ABCs)
D. Prepare the client for discharge
Correct Answer: C. Assess the client's airway, breathing, and circulation (ABCs).
Rationale: The priority in any emergency is to assess and stabilize the airway, breathing, and
circulation. Once these are stable, the nurse can administer medications and continue with further
assessment.
2. A nurse is caring for a client with diabetes mellitus. Which finding indicates
hypoglycemia?
A. Increased thirst
B. Fruity breath odor
C. Sweating and confusion
D. Deep, rapid respirations
Correct Answer: C. Sweating and confusion.
Rationale: Hypoglycemia commonly presents with sweating, shakiness, confusion, hunger, and
tachycardia. Fruity breath and Kussmaul respirations are associated with diabetic ketoacidosis.
3. Which client should the nurse assess first?
A. A client with a temperature of 100.4°F (38°C)
B. A client reporting severe chest pain rated 10/10
C. A client requesting pain medication for arthritis
D. A client awaiting discharge instructions
Correct Answer: B. A client reporting severe chest pain rated 10/10.
Rationale: Chest pain may indicate myocardial infarction and requires immediate assessment
and intervention.
,4. Which laboratory value should concern the nurse most?
A. Sodium 140 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.2 mg/dL
D. Hemoglobin 14 g/dL
Correct Answer: B. Potassium 2.9 mEq/L.
Rationale: Severe hypokalemia increases the risk of life-threatening cardiac dysrhythmias and
requires prompt intervention.
5. A nurse is teaching infection prevention. Which statement by the client indicates
understanding?
A. "I should wash my hands before eating."
B. "Gloves replace hand hygiene."
C. "Hand sanitizer replaces soap after visible soil."
D. "I only need to wash my hands after using the bathroom."
Correct Answer: A. "I should wash my hands before eating."
Rationale: Hand hygiene before meals and after potential contamination is one of the most
effective methods of preventing infection.
6. Which client is at greatest risk for developing pressure injuries?
A. A 25-year-old with a fractured wrist
B. A 70-year-old who is immobile after a stroke
C. A 40-year-old with seasonal allergies
D. A teenager recovering from appendectomy
Correct Answer: B. A 70-year-old who is immobile after a stroke.
Rationale: Advanced age, immobility, poor nutrition, and decreased sensation increase the risk
for pressure injuries.
7. A nurse is preparing to administer insulin. Which action is appropriate?
,A. Shake the insulin vial vigorously.
B. Verify the insulin type and dosage with another nurse if required by policy.
C. Administer insulin without checking blood glucose.
D. Mix insulin with antibiotics.
Correct Answer: B. Verify the insulin type and dosage with another nurse if required by policy.
Rationale: Insulin is a high-alert medication. Verification helps prevent medication errors.
8. Which assessment finding requires immediate intervention?
A. Blood pressure 118/72 mmHg
B. Respiratory rate 8 breaths/min
C. Pulse 82 beats/min
D. Temperature 98.8°F (37.1°C)
Correct Answer: B. Respiratory rate 8 breaths/min.
Rationale: Bradypnea may lead to respiratory failure and requires immediate assessment and
intervention.
9. Which action demonstrates proper patient identification?
A. Ask the roommate to identify the client.
B. Check the room number only.
C. Use two patient identifiers before providing care.
D. Identify the client by diagnosis.
Correct Answer: C. Use two patient identifiers before providing care.
Rationale: Using two identifiers (such as name and date of birth) reduces the risk of patient
identification errors.
10. Which electrolyte imbalance is commonly associated with muscle weakness and cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
, Correct Answer: B. Hypokalemia.
Rationale: Low potassium affects skeletal and cardiac muscle function, increasing the risk for
weakness and dysrhythmias.
11. A nurse is caring for a postoperative client. Which finding requires immediate
notification of the healthcare provider?
A. Pain rated 5/10
B. Urine output of 15 mL/hr
C. Mild nausea
D. Temperature of 99°F (37.2°C)
Correct Answer: B. Urine output of 15 mL/hr.
Rationale: Urine output less than 30 mL/hr may indicate poor renal perfusion or hypovolemia
and requires prompt evaluation.
12. Which client should be placed in airborne precautions?
A. Influenza
B. Tuberculosis
C. MRSA wound infection
D. Clostridioides difficile
Correct Answer: B. Tuberculosis.
Rationale: Tuberculosis is transmitted through airborne particles and requires an airborne
infection isolation room and an N95 respirator.
13. A client with heart failure reports shortness of breath while lying flat. This symptom is
known as:
A. Syncope
B. Orthopnea
C. Vertigo
D. Claudication
Correct Answer: B. Orthopnea.
1. A nurse is caring for a client with chest pain. Which action should the nurse perform
first?
A. Obtain a complete health history
B. Administer prescribed pain medication
C. Assess the client's airway, breathing, and circulation (ABCs)
D. Prepare the client for discharge
Correct Answer: C. Assess the client's airway, breathing, and circulation (ABCs).
Rationale: The priority in any emergency is to assess and stabilize the airway, breathing, and
circulation. Once these are stable, the nurse can administer medications and continue with further
assessment.
2. A nurse is caring for a client with diabetes mellitus. Which finding indicates
hypoglycemia?
A. Increased thirst
B. Fruity breath odor
C. Sweating and confusion
D. Deep, rapid respirations
Correct Answer: C. Sweating and confusion.
Rationale: Hypoglycemia commonly presents with sweating, shakiness, confusion, hunger, and
tachycardia. Fruity breath and Kussmaul respirations are associated with diabetic ketoacidosis.
3. Which client should the nurse assess first?
A. A client with a temperature of 100.4°F (38°C)
B. A client reporting severe chest pain rated 10/10
C. A client requesting pain medication for arthritis
D. A client awaiting discharge instructions
Correct Answer: B. A client reporting severe chest pain rated 10/10.
Rationale: Chest pain may indicate myocardial infarction and requires immediate assessment
and intervention.
,4. Which laboratory value should concern the nurse most?
A. Sodium 140 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.2 mg/dL
D. Hemoglobin 14 g/dL
Correct Answer: B. Potassium 2.9 mEq/L.
Rationale: Severe hypokalemia increases the risk of life-threatening cardiac dysrhythmias and
requires prompt intervention.
5. A nurse is teaching infection prevention. Which statement by the client indicates
understanding?
A. "I should wash my hands before eating."
B. "Gloves replace hand hygiene."
C. "Hand sanitizer replaces soap after visible soil."
D. "I only need to wash my hands after using the bathroom."
Correct Answer: A. "I should wash my hands before eating."
Rationale: Hand hygiene before meals and after potential contamination is one of the most
effective methods of preventing infection.
6. Which client is at greatest risk for developing pressure injuries?
A. A 25-year-old with a fractured wrist
B. A 70-year-old who is immobile after a stroke
C. A 40-year-old with seasonal allergies
D. A teenager recovering from appendectomy
Correct Answer: B. A 70-year-old who is immobile after a stroke.
Rationale: Advanced age, immobility, poor nutrition, and decreased sensation increase the risk
for pressure injuries.
7. A nurse is preparing to administer insulin. Which action is appropriate?
,A. Shake the insulin vial vigorously.
B. Verify the insulin type and dosage with another nurse if required by policy.
C. Administer insulin without checking blood glucose.
D. Mix insulin with antibiotics.
Correct Answer: B. Verify the insulin type and dosage with another nurse if required by policy.
Rationale: Insulin is a high-alert medication. Verification helps prevent medication errors.
8. Which assessment finding requires immediate intervention?
A. Blood pressure 118/72 mmHg
B. Respiratory rate 8 breaths/min
C. Pulse 82 beats/min
D. Temperature 98.8°F (37.1°C)
Correct Answer: B. Respiratory rate 8 breaths/min.
Rationale: Bradypnea may lead to respiratory failure and requires immediate assessment and
intervention.
9. Which action demonstrates proper patient identification?
A. Ask the roommate to identify the client.
B. Check the room number only.
C. Use two patient identifiers before providing care.
D. Identify the client by diagnosis.
Correct Answer: C. Use two patient identifiers before providing care.
Rationale: Using two identifiers (such as name and date of birth) reduces the risk of patient
identification errors.
10. Which electrolyte imbalance is commonly associated with muscle weakness and cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
, Correct Answer: B. Hypokalemia.
Rationale: Low potassium affects skeletal and cardiac muscle function, increasing the risk for
weakness and dysrhythmias.
11. A nurse is caring for a postoperative client. Which finding requires immediate
notification of the healthcare provider?
A. Pain rated 5/10
B. Urine output of 15 mL/hr
C. Mild nausea
D. Temperature of 99°F (37.2°C)
Correct Answer: B. Urine output of 15 mL/hr.
Rationale: Urine output less than 30 mL/hr may indicate poor renal perfusion or hypovolemia
and requires prompt evaluation.
12. Which client should be placed in airborne precautions?
A. Influenza
B. Tuberculosis
C. MRSA wound infection
D. Clostridioides difficile
Correct Answer: B. Tuberculosis.
Rationale: Tuberculosis is transmitted through airborne particles and requires an airborne
infection isolation room and an N95 respirator.
13. A client with heart failure reports shortness of breath while lying flat. This symptom is
known as:
A. Syncope
B. Orthopnea
C. Vertigo
D. Claudication
Correct Answer: B. Orthopnea.
