NCLEX RN ACTUAL EXAM TEST BANK WITH REAL AND EXACT EXAM QUESTIONS AND ANSWERS ALREADY
GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains:
Safe and Effective Care Environment
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity: Basic Care and Comfort
Physiological Integrity: Pharmacological and Parenteral Therapies
Physiological Integrity: Reduction of Risk Potential
Physiological Integrity: Physiological Adaptation
Management of Care and Prioritization
Infection Control and Safety
Ethical and Legal Nursing Practice
Introduction:
This comprehensive NCLEX-RN practice examination is designed to prepare candidates for the actual NCLEX-RN
licensing exam. It assesses foundational and applied nursing knowledge across all core content areas, including
safe and effective care environment, health promotion, psychosocial integrity, and physiological integrity. The
exam employs multiple-choice and scenario-based questions that challenge candidates to apply critical thinking,
prioritize patient care, interpret clinical data, and make sound nursing judgments. Emphasis is placed on real-
,world clinical application, patient safety, regulatory compliance, and the integration of core nursing principles
necessary for successful NCLEX-RN performance and safe, competent entry-level nursing practice.
Section One: Questions 1–100
1. A nurse is preparing to administer a blood transfusion to a patient. The patient's vital signs are: blood
pressure 110/70 mmHg, heart rate 92 bpm, respiratory rate 18/min, temperature 37.2°C. Which action should
the nurse take first?
A. Administer the blood transfusion at 125 mL/hr.
B. Verify the blood product with another licensed nurse.
C. Ask the patient about any previous transfusion reactions.
D. Obtain baseline vital signs and document them.
🟢 B. Verify the blood product with another licensed nurse.
🔴 RATIONALE: Before initiating a blood transfusion, the nurse must verify the blood product with another
licensed nurse using a two-person verification process to ensure patient safety and prevent transfusion errors.
This is a critical safety step required by protocol.
2. A nurse is caring for a patient who is 1 day postoperative following a total knee arthroplasty. The patient
reports severe pain in the calf of the operative leg. The nurse notes that the calf is swollen, red, and warm to
the touch. What is the nurse's priority action?
,A. Apply a warm compress to the calf.
B. Elevate the leg on pillows.
C. Notify the healthcare provider immediately.
D. Administer the prescribed PRN analgesic.
🟢 C. Notify the healthcare provider immediately.
🔴 RATIONALE: The signs of calf pain, swelling, redness, and warmth in a postoperative patient are classic signs
of a deep vein thrombosis (DVT). This is a medical emergency due to the risk of pulmonary embolism. The nurse
should notify the provider immediately and avoid massaging or applying heat to the area.
3. A patient with a history of heart failure is receiving digoxin. The nurse notes the patient's heart rate is 48
bpm and the patient reports nausea, vomiting, and visual disturbances. Which action should the nurse take
first?
A. Administer the digoxin as scheduled.
B. Hold the digoxin and notify the healthcare provider.
C. Administer a PRN antiemetic.
D. Check the patient's blood pressure.
🟢 B. Hold the digoxin and notify the healthcare provider.
🔴 RATIONALE: The patient is exhibiting signs of digoxin toxicity: bradycardia, nausea, vomiting, and visual
disturbances (yellow or green halos). The nurse should hold the digoxin and notify the provider immediately.
Administering the medication could worsen the toxicity.
, 4. A nurse is caring for a patient with a new tracheostomy. The nurse notes that the patient's oxygen
saturation has dropped to 88%. What is the priority nursing action?
A. Suction the tracheostomy tube.
B. Increase the oxygen flow rate.
C. Assess the tracheostomy tube for patency and ensure the obturator is at the bedside.
D. Notify the healthcare provider.
🟢 C. Assess the tracheostomy tube for patency and ensure the obturator is at the bedside.
🔴 RATIONALE: A sudden drop in oxygen saturation in a patient with a new tracheostomy may indicate airway
obstruction. The priority is to assess the tube for patency and ensure emergency equipment (including an
obturator and replacement tube) is at the bedside. Suctioning may be needed if the tube is patent, but
assessment comes first.
5. A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which dietary instruction should the
nurse include in the teaching plan?
A. "Increase your intake of leafy green vegetables."
B. "Avoid foods high in vitamin K, such as spinach and kale."
C. "Take the medication with a high-fat meal."
D. "Avoid drinking grapefruit juice."
GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains:
Safe and Effective Care Environment
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity: Basic Care and Comfort
Physiological Integrity: Pharmacological and Parenteral Therapies
Physiological Integrity: Reduction of Risk Potential
Physiological Integrity: Physiological Adaptation
Management of Care and Prioritization
Infection Control and Safety
Ethical and Legal Nursing Practice
Introduction:
This comprehensive NCLEX-RN practice examination is designed to prepare candidates for the actual NCLEX-RN
licensing exam. It assesses foundational and applied nursing knowledge across all core content areas, including
safe and effective care environment, health promotion, psychosocial integrity, and physiological integrity. The
exam employs multiple-choice and scenario-based questions that challenge candidates to apply critical thinking,
prioritize patient care, interpret clinical data, and make sound nursing judgments. Emphasis is placed on real-
,world clinical application, patient safety, regulatory compliance, and the integration of core nursing principles
necessary for successful NCLEX-RN performance and safe, competent entry-level nursing practice.
Section One: Questions 1–100
1. A nurse is preparing to administer a blood transfusion to a patient. The patient's vital signs are: blood
pressure 110/70 mmHg, heart rate 92 bpm, respiratory rate 18/min, temperature 37.2°C. Which action should
the nurse take first?
A. Administer the blood transfusion at 125 mL/hr.
B. Verify the blood product with another licensed nurse.
C. Ask the patient about any previous transfusion reactions.
D. Obtain baseline vital signs and document them.
🟢 B. Verify the blood product with another licensed nurse.
🔴 RATIONALE: Before initiating a blood transfusion, the nurse must verify the blood product with another
licensed nurse using a two-person verification process to ensure patient safety and prevent transfusion errors.
This is a critical safety step required by protocol.
2. A nurse is caring for a patient who is 1 day postoperative following a total knee arthroplasty. The patient
reports severe pain in the calf of the operative leg. The nurse notes that the calf is swollen, red, and warm to
the touch. What is the nurse's priority action?
,A. Apply a warm compress to the calf.
B. Elevate the leg on pillows.
C. Notify the healthcare provider immediately.
D. Administer the prescribed PRN analgesic.
🟢 C. Notify the healthcare provider immediately.
🔴 RATIONALE: The signs of calf pain, swelling, redness, and warmth in a postoperative patient are classic signs
of a deep vein thrombosis (DVT). This is a medical emergency due to the risk of pulmonary embolism. The nurse
should notify the provider immediately and avoid massaging or applying heat to the area.
3. A patient with a history of heart failure is receiving digoxin. The nurse notes the patient's heart rate is 48
bpm and the patient reports nausea, vomiting, and visual disturbances. Which action should the nurse take
first?
A. Administer the digoxin as scheduled.
B. Hold the digoxin and notify the healthcare provider.
C. Administer a PRN antiemetic.
D. Check the patient's blood pressure.
🟢 B. Hold the digoxin and notify the healthcare provider.
🔴 RATIONALE: The patient is exhibiting signs of digoxin toxicity: bradycardia, nausea, vomiting, and visual
disturbances (yellow or green halos). The nurse should hold the digoxin and notify the provider immediately.
Administering the medication could worsen the toxicity.
, 4. A nurse is caring for a patient with a new tracheostomy. The nurse notes that the patient's oxygen
saturation has dropped to 88%. What is the priority nursing action?
A. Suction the tracheostomy tube.
B. Increase the oxygen flow rate.
C. Assess the tracheostomy tube for patency and ensure the obturator is at the bedside.
D. Notify the healthcare provider.
🟢 C. Assess the tracheostomy tube for patency and ensure the obturator is at the bedside.
🔴 RATIONALE: A sudden drop in oxygen saturation in a patient with a new tracheostomy may indicate airway
obstruction. The priority is to assess the tube for patency and ensure emergency equipment (including an
obturator and replacement tube) is at the bedside. Suctioning may be needed if the tube is patent, but
assessment comes first.
5. A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which dietary instruction should the
nurse include in the teaching plan?
A. "Increase your intake of leafy green vegetables."
B. "Avoid foods high in vitamin K, such as spinach and kale."
C. "Take the medication with a high-fat meal."
D. "Avoid drinking grapefruit juice."
