NCLEX-RN COMPREHENSIVE
PRACTICE EXAM QUESTIONS &
ANSWERS (VERIFIED ANSWERS) WITH
EXPERT EXPLANATIONS | 2026 – 2027
UPDATE (PDF)
1. A client with a history of heart failure is admitted with reports of shortness of breath and a
persistent cough. The nurse notes crackles in the lung bases and a brain natriuretic peptide
(BNP) level of 800 pg/mL. Which prescription should the nurse implement first?
A. Administer furosemide 40 mg IV push
B. Obtain a 12-lead electrocardiogram
C. Apply oxygen at 2 L/min via nasal cannula
D. Draw a sample for serum electrolyte levels
Answer: C
Conceptual Explanation: According to the ABC (Airway-Breathing-Circulation) priority
framework, establishing oxygenation is the first priority for a client in respiratory distress,
even before administering diuretics.
2. A nurse is caring for a client who is 2 hours post-thyroidectomy. The client reports a feeling
of ‘tingling’ in the fingers and around the mouth. Which action should the nurse take first?
A. Check the client’s blood pressure
,B. Notify the surgeon immediately
C. Administer a PRN dose of calcium gluconate
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling in the extremities and circumoral area are signs of
hypocalcemia, a potential complication of thyroidectomy if the parathyroid glands are
damaged. Assessing for Chvostek’s sign confirms neuromuscular irritability before
notifying the provider or administering medication.
3. A client is diagnosed with a tension pneumothorax. Which clinical finding should the nurse
expect to observe?
A. Tracheal deviation toward the affected side
B. Flattened neck veins
C. Localized bradycardia
D. Hyperresonance on percussion of the affected side
Answer: D
Conceptual Explanation: A tension pneumothorax involves air trapped in the pleural
space, leading to hyperresonance on percussion. Tracheal deviation occurs toward the
unaffected (healthy) side, and neck veins are typically distended due to increased
intrathoracic pressure.
, 4. The nurse is preparing to administer nitroprusside by continuous IV infusion. Which safety
precaution is essential for this medication?
A. Protect the infusion bag from light
B. Monitor for hyperkalemia
C. Use a gravity flow set for administration
D. Assess for signs of hepatotoxicity
Answer: A
Conceptual Explanation: Nitroprusside is sensitive to light and can degrade into cyanide.
Therefore, the infusion bag and tubing must be covered with an opaque material to prevent
light exposure.
5. A 4-year-old child with Tetralogy of Fallot becomes acutely cyanotic and agitated during a
blood draw. Which action should the nurse take first?
A. Administer 100% oxygen by mask
B. Administer morphine sulfate intravenously
C. Place the child in a knee-chest position
D. Prepare for immediate intubation
Answer: C
PRACTICE EXAM QUESTIONS &
ANSWERS (VERIFIED ANSWERS) WITH
EXPERT EXPLANATIONS | 2026 – 2027
UPDATE (PDF)
1. A client with a history of heart failure is admitted with reports of shortness of breath and a
persistent cough. The nurse notes crackles in the lung bases and a brain natriuretic peptide
(BNP) level of 800 pg/mL. Which prescription should the nurse implement first?
A. Administer furosemide 40 mg IV push
B. Obtain a 12-lead electrocardiogram
C. Apply oxygen at 2 L/min via nasal cannula
D. Draw a sample for serum electrolyte levels
Answer: C
Conceptual Explanation: According to the ABC (Airway-Breathing-Circulation) priority
framework, establishing oxygenation is the first priority for a client in respiratory distress,
even before administering diuretics.
2. A nurse is caring for a client who is 2 hours post-thyroidectomy. The client reports a feeling
of ‘tingling’ in the fingers and around the mouth. Which action should the nurse take first?
A. Check the client’s blood pressure
,B. Notify the surgeon immediately
C. Administer a PRN dose of calcium gluconate
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling in the extremities and circumoral area are signs of
hypocalcemia, a potential complication of thyroidectomy if the parathyroid glands are
damaged. Assessing for Chvostek’s sign confirms neuromuscular irritability before
notifying the provider or administering medication.
3. A client is diagnosed with a tension pneumothorax. Which clinical finding should the nurse
expect to observe?
A. Tracheal deviation toward the affected side
B. Flattened neck veins
C. Localized bradycardia
D. Hyperresonance on percussion of the affected side
Answer: D
Conceptual Explanation: A tension pneumothorax involves air trapped in the pleural
space, leading to hyperresonance on percussion. Tracheal deviation occurs toward the
unaffected (healthy) side, and neck veins are typically distended due to increased
intrathoracic pressure.
, 4. The nurse is preparing to administer nitroprusside by continuous IV infusion. Which safety
precaution is essential for this medication?
A. Protect the infusion bag from light
B. Monitor for hyperkalemia
C. Use a gravity flow set for administration
D. Assess for signs of hepatotoxicity
Answer: A
Conceptual Explanation: Nitroprusside is sensitive to light and can degrade into cyanide.
Therefore, the infusion bag and tubing must be covered with an opaque material to prevent
light exposure.
5. A 4-year-old child with Tetralogy of Fallot becomes acutely cyanotic and agitated during a
blood draw. Which action should the nurse take first?
A. Administer 100% oxygen by mask
B. Administer morphine sulfate intravenously
C. Place the child in a knee-chest position
D. Prepare for immediate intubation
Answer: C
