Page 1 of 94
UWORLD-STYLE NCLEX-RN EXAM 2026
QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS
10-Point Summary of UWorld-Style NCLEX-RN Exam Coverage
1. Safe and Effective Care Environment: Management of care, delegation to LPNs
and UAPs, client rights, informed consent, incident reports, and disaster triage.
2. Health Promotion and Maintenance: Anticipatory guidance, disease prevention,
immunizations, growth and development milestones, prenatal care, and lifestyle
modifications.
3. Psychosocial Integrity: Therapeutic communication, coping mechanisms, grief and
loss, crisis intervention, psychiatric disorders, and substance abuse.
4. Pharmacological Therapies: Medication administration, side effects, adverse
reactions, contraindications, interactions, and client teaching for major drug classes.
5. Reduction of Risk Potential: Monitoring for complications, interpreting diagnostic
tests, preventing injury, and recognizing early signs of deterioration.
6. Physiological Adaptation: Managing acute and chronic conditions (cardiac,
respiratory, endocrine, renal, neurological), and responding to changes in client status.
7. Basic Care and Comfort: Mobility, nutrition, hydration, elimination, comfort
measures, and assistance with ADLs.
8. Maternal and Newborn Health: Antepartum, intrapartum, and postpartum care,
newborn assessment, and common complications.
9. Pediatric Nursing: Common childhood illnesses, developmental milestones, safety,
and management of pediatric emergencies.
10. Next Generation NCLEX (NGN) Clinical Judgment: NGN-style questions (e.g.,
"Select All That Apply," bow-tie, drag-and-drop) that test clinical judgment and
decision-making in complex scenarios.
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UWORLD-STYLE NCLEX-RN PRACTICE EXAM (50 Questions with Detailed
Rationales)
1. The nurse is caring for a client at 39 weeks gestation who is receiving an IV oxytocin
infusion for induction of labor. The client's contractions are occurring every 2 minutes
and lasting 90 seconds. The fetal heart rate tracing shows late decelerations. Which
action should the nurse take first?
• A. Administer an IV fluid bolus.
• B. Decrease the oxytocin infusion rate.
• C. Prepare the client for an emergency cesarean section.
• D. Place the client in a left lateral position.
• Answer: B. Rationale: Late decelerations indicate uteroplacental insufficiency. The
priority intervention is to stop or decrease the oxytocin infusion to reduce uterine
hyperstimulation. While positioning (D) and a fluid bolus (A) are also appropriate, the
oxytocin must be addressed first to stop the cause of the decelerations. Preparing for a
cesarean (C) may be necessary if the decelerations do not resolve, but it is not the first
action.
2. A nurse is caring for a client with a pulmonary embolism. Which of the following
clinical manifestations would the nurse anticipate? (Select All That Apply)
• A. Bradycardia
• B. Chest pain
• C. Dyspnea
• D. Hypoxemia
• E. Tachypnea
• F. Tracheal deviation
• Answer: B, C, D, E. Rationale: A pulmonary embolism (PE) obstructs pulmonary
blood flow, leading to ventilation-perfusion mismatch. Classic manifestations
include chest pain (often pleuritic), dyspnea (sudden onset), hypoxemia (low SpO2),
and tachypnea (rapid breathing). Bradycardia (A) is not typical; tachycardia is more
common. Tracheal deviation (F) is a sign of a tension pneumothorax, not a PE.
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3. The nurse is preparing to administer a dose of digoxin to a client with heart failure.
Which of the following findings would indicate the client is at risk for digoxin toxicity
and the nurse should hold the medication?
• A. Apical pulse of 58 beats per minute.
• B. Serum potassium level of 4.2 mEq/L.
• C. Blood pressure of 110/70 mm Hg.
• D. Respiratory rate of 18 breaths per minute.
• Answer: A. Rationale: Digoxin has a narrow therapeutic index. The medication
should be held if the apical pulse is below 60 beats per minute (in adults) because
bradycardia can be a sign of toxicity. A potassium level of 4.2 (B) is within normal
limits; hypokalemia (low potassium) increases the risk of digoxin toxicity, but this
level is safe. The blood pressure (C) and respiratory rate (D) are stable.
4. A client with chronic kidney disease (CKD) has a serum potassium level of 6.5
mEq/L. Which of the following interventions should the nurse anticipate?
• A. Administering oral potassium supplements.
• B. Preparing the client for hemodialysis.
• C. Encouraging the client to eat bananas and oranges.
• D. Administering a loop diuretic to increase potassium excretion.
• Answer: B. Rationale: A potassium level of 6.5 mEq/L is critically high
(hyperkalemia) and life-threatening due to the risk of cardiac arrhythmias. In clients
with CKD, the kidneys cannot effectively excrete potassium. The priority intervention
is to prepare for hemodialysis to rapidly remove excess potassium. Oral potassium
(A) and potassium-rich foods like bananas (C) would worsen the condition. Loop
diuretics (D) may be used, but they are less effective in advanced CKD and are not
the priority for a critical level.
5. The nurse is caring for a client who is 2 days post-operative from a total hip
replacement. Which of the following assessment findings is the highest priority and
requires immediate intervention?
• A. The client reports pain at the surgical site rated 6/10.
• B. The client has a low-grade fever of 100.2°F (37.9°C).
• C. The client's foot is warm, and the dorsalis pedis pulse is palpable.
• D. The client is short of breath and has sudden chest pain.
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• Answer: D. Rationale: Sudden shortness of breath and chest pain are classic
symptoms of a pulmonary embolism (PE) , a life-threatening complication of lower
extremity surgeries like a hip replacement. This is the highest priority. Pain (A) and
low-grade fever (B) are expected post-operative findings. A warm foot with a
palpable pulse (C) indicates adequate circulation.
6. A client with a history of asthma is using a peak flow meter. The client's reading is in
the "red zone" (less than 50% of personal best). What should the nurse instruct the
client to do?
• A. Continue monitoring and reassess in 30 minutes.
• B. Use the rescue inhaler and seek immediate medical attention.
• C. Increase the dose of the maintenance inhaler.
• D. Perform a nebulizer treatment and then rest.
• Answer: B. Rationale: The "red zone" on a peak flow meter indicates severe airway
narrowing and a medical emergency. The client should use their rescue inhaler (e.g.,
albuterol) immediately and seek emergency medical care. The other options are
inappropriate and could delay life-saving treatment.
7. The nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates a need for further
teaching?
• A. "I will need to have my blood drawn regularly to check my INR."
• B. "I should avoid eating large amounts of green leafy vegetables."
• C. "I can take ibuprofen for my headaches if I need to."
• D. "I should report any unusual bleeding or bruising to my doctor."
• Answer: C. Rationale: Warfarin is an anticoagulant. Ibuprofen (an NSAID) increases
the risk of bleeding and should be avoided. Clients should use acetaminophen for pain
instead. Regular INR monitoring (A) is required. Vitamin K-rich foods like green
leafy vegetables (B) can interfere with warfarin's effectiveness; they should be
consumed consistently, not avoided entirely. Reporting unusual bleeding (D) is
correct.
UWORLD-STYLE NCLEX-RN EXAM 2026
QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS
10-Point Summary of UWorld-Style NCLEX-RN Exam Coverage
1. Safe and Effective Care Environment: Management of care, delegation to LPNs
and UAPs, client rights, informed consent, incident reports, and disaster triage.
2. Health Promotion and Maintenance: Anticipatory guidance, disease prevention,
immunizations, growth and development milestones, prenatal care, and lifestyle
modifications.
3. Psychosocial Integrity: Therapeutic communication, coping mechanisms, grief and
loss, crisis intervention, psychiatric disorders, and substance abuse.
4. Pharmacological Therapies: Medication administration, side effects, adverse
reactions, contraindications, interactions, and client teaching for major drug classes.
5. Reduction of Risk Potential: Monitoring for complications, interpreting diagnostic
tests, preventing injury, and recognizing early signs of deterioration.
6. Physiological Adaptation: Managing acute and chronic conditions (cardiac,
respiratory, endocrine, renal, neurological), and responding to changes in client status.
7. Basic Care and Comfort: Mobility, nutrition, hydration, elimination, comfort
measures, and assistance with ADLs.
8. Maternal and Newborn Health: Antepartum, intrapartum, and postpartum care,
newborn assessment, and common complications.
9. Pediatric Nursing: Common childhood illnesses, developmental milestones, safety,
and management of pediatric emergencies.
10. Next Generation NCLEX (NGN) Clinical Judgment: NGN-style questions (e.g.,
"Select All That Apply," bow-tie, drag-and-drop) that test clinical judgment and
decision-making in complex scenarios.
, Page 2 of 94
UWORLD-STYLE NCLEX-RN PRACTICE EXAM (50 Questions with Detailed
Rationales)
1. The nurse is caring for a client at 39 weeks gestation who is receiving an IV oxytocin
infusion for induction of labor. The client's contractions are occurring every 2 minutes
and lasting 90 seconds. The fetal heart rate tracing shows late decelerations. Which
action should the nurse take first?
• A. Administer an IV fluid bolus.
• B. Decrease the oxytocin infusion rate.
• C. Prepare the client for an emergency cesarean section.
• D. Place the client in a left lateral position.
• Answer: B. Rationale: Late decelerations indicate uteroplacental insufficiency. The
priority intervention is to stop or decrease the oxytocin infusion to reduce uterine
hyperstimulation. While positioning (D) and a fluid bolus (A) are also appropriate, the
oxytocin must be addressed first to stop the cause of the decelerations. Preparing for a
cesarean (C) may be necessary if the decelerations do not resolve, but it is not the first
action.
2. A nurse is caring for a client with a pulmonary embolism. Which of the following
clinical manifestations would the nurse anticipate? (Select All That Apply)
• A. Bradycardia
• B. Chest pain
• C. Dyspnea
• D. Hypoxemia
• E. Tachypnea
• F. Tracheal deviation
• Answer: B, C, D, E. Rationale: A pulmonary embolism (PE) obstructs pulmonary
blood flow, leading to ventilation-perfusion mismatch. Classic manifestations
include chest pain (often pleuritic), dyspnea (sudden onset), hypoxemia (low SpO2),
and tachypnea (rapid breathing). Bradycardia (A) is not typical; tachycardia is more
common. Tracheal deviation (F) is a sign of a tension pneumothorax, not a PE.
, Page 3 of 94
3. The nurse is preparing to administer a dose of digoxin to a client with heart failure.
Which of the following findings would indicate the client is at risk for digoxin toxicity
and the nurse should hold the medication?
• A. Apical pulse of 58 beats per minute.
• B. Serum potassium level of 4.2 mEq/L.
• C. Blood pressure of 110/70 mm Hg.
• D. Respiratory rate of 18 breaths per minute.
• Answer: A. Rationale: Digoxin has a narrow therapeutic index. The medication
should be held if the apical pulse is below 60 beats per minute (in adults) because
bradycardia can be a sign of toxicity. A potassium level of 4.2 (B) is within normal
limits; hypokalemia (low potassium) increases the risk of digoxin toxicity, but this
level is safe. The blood pressure (C) and respiratory rate (D) are stable.
4. A client with chronic kidney disease (CKD) has a serum potassium level of 6.5
mEq/L. Which of the following interventions should the nurse anticipate?
• A. Administering oral potassium supplements.
• B. Preparing the client for hemodialysis.
• C. Encouraging the client to eat bananas and oranges.
• D. Administering a loop diuretic to increase potassium excretion.
• Answer: B. Rationale: A potassium level of 6.5 mEq/L is critically high
(hyperkalemia) and life-threatening due to the risk of cardiac arrhythmias. In clients
with CKD, the kidneys cannot effectively excrete potassium. The priority intervention
is to prepare for hemodialysis to rapidly remove excess potassium. Oral potassium
(A) and potassium-rich foods like bananas (C) would worsen the condition. Loop
diuretics (D) may be used, but they are less effective in advanced CKD and are not
the priority for a critical level.
5. The nurse is caring for a client who is 2 days post-operative from a total hip
replacement. Which of the following assessment findings is the highest priority and
requires immediate intervention?
• A. The client reports pain at the surgical site rated 6/10.
• B. The client has a low-grade fever of 100.2°F (37.9°C).
• C. The client's foot is warm, and the dorsalis pedis pulse is palpable.
• D. The client is short of breath and has sudden chest pain.
, Page 4 of 94
• Answer: D. Rationale: Sudden shortness of breath and chest pain are classic
symptoms of a pulmonary embolism (PE) , a life-threatening complication of lower
extremity surgeries like a hip replacement. This is the highest priority. Pain (A) and
low-grade fever (B) are expected post-operative findings. A warm foot with a
palpable pulse (C) indicates adequate circulation.
6. A client with a history of asthma is using a peak flow meter. The client's reading is in
the "red zone" (less than 50% of personal best). What should the nurse instruct the
client to do?
• A. Continue monitoring and reassess in 30 minutes.
• B. Use the rescue inhaler and seek immediate medical attention.
• C. Increase the dose of the maintenance inhaler.
• D. Perform a nebulizer treatment and then rest.
• Answer: B. Rationale: The "red zone" on a peak flow meter indicates severe airway
narrowing and a medical emergency. The client should use their rescue inhaler (e.g.,
albuterol) immediately and seek emergency medical care. The other options are
inappropriate and could delay life-saving treatment.
7. The nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates a need for further
teaching?
• A. "I will need to have my blood drawn regularly to check my INR."
• B. "I should avoid eating large amounts of green leafy vegetables."
• C. "I can take ibuprofen for my headaches if I need to."
• D. "I should report any unusual bleeding or bruising to my doctor."
• Answer: C. Rationale: Warfarin is an anticoagulant. Ibuprofen (an NSAID) increases
the risk of bleeding and should be avoided. Clients should use acetaminophen for pain
instead. Regular INR monitoring (A) is required. Vitamin K-rich foods like green
leafy vegetables (B) can interfere with warfarin's effectiveness; they should be
consumed consistently, not avoided entirely. Reporting unusual bleeding (D) is
correct.
