2025 NCLEX-RN Past Exam with 130 Questions
& Answers – Practice for Guaranteed Success
1. A nurse is caring for a patient with heart failure. Which symptom would indicate
worsening condition?
A) Weight loss of 3 pounds in a week
B) Increased urine output at night
C) Shortness of breath while resting
D) Decreased appetite
Correct Answer: C) Shortness of breath while resting
Rationale: Orthopnea or dyspnea at rest is a sign of worsening heart failure due to fluid
overload and poor cardiac function.
2. A client with Type 1 Diabetes Mellitus is sweating, shaky, and confused. What is the
nurse’s priority action?
A) Administer insulin immediately
B) Check the client's blood glucose level
C) Call the physician
D) Provide a high-protein snack
Correct Answer: B) Check the client's blood glucose level
Rationale: The symptoms suggest hypoglycemia. Always confirm blood sugar before taking
corrective action.
3. A nurse is administering digoxin to a client. What finding would require the nurse to
hold the medication?
A) Heart rate of 52 bpm
B) Blood pressure of 140/90 mmHg
C) Respiratory rate of 20 breaths per minute
D) Temperature of 99°F (37.2°C)
Correct Answer: A) Heart rate of 52 bpm
Rationale: Digoxin slows heart rate. A pulse below 60 bpm is a contraindication, as it may
lead to bradycardia.
4. A patient with COPD is placed on oxygen therapy. Which oxygen delivery system is most
appropriate?
A) Non-rebreather mask at 10 L/min
B) Nasal cannula at 2 L/min
C) Venturi mask at 60% FiO₂
D) Simple face mask at 8 L/min
Correct Answer: B) Nasal cannula at 2 L/min
Rationale: Patients with COPD have a hypoxic drive to breathe. High-flow oxygen may
suppress their respiratory effort.
,5. A postpartum client complains of severe headache and blurred vision. What
complication should the nurse suspect?
A) Postpartum hemorrhage
B) Preeclampsia
C) Endometritis
D) Gestational diabetes
Correct Answer: B) Preeclampsia
Rationale: Severe headache and visual disturbances are key signs of preeclampsia, a
hypertensive disorder requiring urgent intervention.
6. A nurse is preparing to administer IV potassium to a hypokalemic patient. What is the
safest way to administer it?
A) IV push over 2 minutes
B) Diluted in 50 mL NS over 5 minutes
C) Diluted in 1000 mL NS and infused at 10 mEq/hr
D) Undiluted as a bolus
Correct Answer: C) Diluted in 1000 mL NS and infused at 10 mEq/hr
Rationale: IV potassium should never be given IV push or as a bolus, as it can cause fatal
cardiac arrhythmias.
7. A nurse is teaching a patient about warfarin (Coumadin). Which statement indicates the
patient understands the teaching?
A) "I will eat more green leafy vegetables to help my blood clot."
B) "I need to get my INR checked regularly."
C) "I can take aspirin for headaches while on warfarin."
D) "I should increase my intake of vitamin K supplements."
Correct Answer: B) "I need to get my INR checked regularly."
Rationale: Warfarin requires frequent INR monitoring to ensure therapeutic
anticoagulation and prevent bleeding risks.
8. A client with a latex allergy is scheduled for surgery. What precaution should the nurse
take?
A) Schedule the patient as the last case of the day
B) Avoid using IV tubing with latex ports
C) Use powdered latex gloves
D) Place a non-allergy wristband on the patient
Correct Answer: B) Avoid using IV tubing with latex ports
Rationale: Latex allergy can cause anaphylaxis. Latex-free equipment should be used,
including IV tubing and gloves.
9. A nurse is educating a patient with chronic kidney disease (CKD) about diet. Which food
should be avoided?
A) Apples
B) Grilled chicken
C) Bananas
,D) White rice
Correct Answer: C) Bananas
Rationale: Bananas are high in potassium, which should be restricted in CKD patients to
prevent hyperkalemia.
10. A patient with pneumonia is experiencing respiratory distress. What position should
the nurse place them in?
A) High Fowler’s
B) Supine
C) Trendelenburg
D) Side-lying
Correct Answer: A) High Fowler’s
Rationale: High Fowler’s position (sitting upright) promotes lung expansion and improves
oxygenation in patients with respiratory distress.
11. A nurse is monitoring a patient receiving morphine sulfate for pain. Which finding
requires immediate intervention?
A) Respiratory rate of 8 breaths per minute
B) Heart rate of 78 bpm
C) Pain level of 3/10
D) Blood pressure of 118/72 mmHg
Correct Answer: A) Respiratory rate of 8 breaths per minute
Rationale: Morphine can cause respiratory depression. A respiratory rate below 12 bpm
requires immediate intervention, such as administering naloxone (Narcan).
12. A client with tuberculosis (TB) is placed on airborne precautions. What PPE is required
for the nurse?
A) Surgical mask, gloves, and gown
B) N95 respirator
C) Standard gloves only
D) Face shield and gown
Correct Answer: B) N95 respirator
Rationale: TB is airborne, requiring an N95 respirator to prevent inhalation of infected
droplets.
13. A patient with a deep vein thrombosis (DVT) suddenly develops shortness of breath and
chest pain. What is the nurse’s priority action?
A) Check the client’s blood pressure
B) Administer prescribed anticoagulant
C) Elevate the legs
D) Notify the healthcare provider immediately
Correct Answer: D) Notify the healthcare provider immediately
Rationale: The symptoms suggest a pulmonary embolism (PE), a life-threatening condition
requiring immediate intervention.
, 14. A client with a head injury has clear fluid leaking from the nose. What should the nurse
do first?
A) Test the fluid for glucose
B) Suction the fluid to maintain airway patency
C) Insert a nasal packing
D) Encourage the client to blow their nose
Correct Answer: A) Test the fluid for glucose
Rationale: Cerebrospinal fluid (CSF) leakage from the nose (rhinorrhea) can indicate a
basilar skull fracture. CSF is positive for glucose.
15. A nurse is caring for a client who has been prescribed furosemide (Lasix). What lab
value should the nurse monitor?
A) Sodium
B) Potassium
C) Calcium
D) Hemoglobin
Correct Answer: B) Potassium
Rationale: Furosemide (Lasix) is a loop diuretic that causes potassium loss, increasing the
risk of hypokalemia.
16. A nurse is teaching a client about a low-sodium diet for hypertension. Which food
should the client avoid?
A) Grilled salmon
B) Fresh strawberries
C) Canned soup
D) Steamed broccoli
Correct Answer: C) Canned soup
Rationale: Canned and processed foods are high in sodium, which can worsen
hypertension.
17. A nurse is assessing a patient receiving blood transfusion. Which finding is an early sign
of a transfusion reaction?
A) Hypothermia
B) Hypertension
C) Chills and back pain
D) Nausea and vomiting
Correct Answer: C) Chills and back pain
Rationale: Early signs of a transfusion reaction include fever, chills, back pain, and
flushing, indicating an immune response to the transfused blood.
The charge nurse has received a change-of-shift report on the following clients in labor.
The charge nurse should ask a staff member to first see the client in the
1. First stage of labor who has an oral temperature of 99.7F (37.6 C)
2. First stage of labor whose contractions are occurring every 30 seconds
3. Second stage of labor who has respirations of 26.
& Answers – Practice for Guaranteed Success
1. A nurse is caring for a patient with heart failure. Which symptom would indicate
worsening condition?
A) Weight loss of 3 pounds in a week
B) Increased urine output at night
C) Shortness of breath while resting
D) Decreased appetite
Correct Answer: C) Shortness of breath while resting
Rationale: Orthopnea or dyspnea at rest is a sign of worsening heart failure due to fluid
overload and poor cardiac function.
2. A client with Type 1 Diabetes Mellitus is sweating, shaky, and confused. What is the
nurse’s priority action?
A) Administer insulin immediately
B) Check the client's blood glucose level
C) Call the physician
D) Provide a high-protein snack
Correct Answer: B) Check the client's blood glucose level
Rationale: The symptoms suggest hypoglycemia. Always confirm blood sugar before taking
corrective action.
3. A nurse is administering digoxin to a client. What finding would require the nurse to
hold the medication?
A) Heart rate of 52 bpm
B) Blood pressure of 140/90 mmHg
C) Respiratory rate of 20 breaths per minute
D) Temperature of 99°F (37.2°C)
Correct Answer: A) Heart rate of 52 bpm
Rationale: Digoxin slows heart rate. A pulse below 60 bpm is a contraindication, as it may
lead to bradycardia.
4. A patient with COPD is placed on oxygen therapy. Which oxygen delivery system is most
appropriate?
A) Non-rebreather mask at 10 L/min
B) Nasal cannula at 2 L/min
C) Venturi mask at 60% FiO₂
D) Simple face mask at 8 L/min
Correct Answer: B) Nasal cannula at 2 L/min
Rationale: Patients with COPD have a hypoxic drive to breathe. High-flow oxygen may
suppress their respiratory effort.
,5. A postpartum client complains of severe headache and blurred vision. What
complication should the nurse suspect?
A) Postpartum hemorrhage
B) Preeclampsia
C) Endometritis
D) Gestational diabetes
Correct Answer: B) Preeclampsia
Rationale: Severe headache and visual disturbances are key signs of preeclampsia, a
hypertensive disorder requiring urgent intervention.
6. A nurse is preparing to administer IV potassium to a hypokalemic patient. What is the
safest way to administer it?
A) IV push over 2 minutes
B) Diluted in 50 mL NS over 5 minutes
C) Diluted in 1000 mL NS and infused at 10 mEq/hr
D) Undiluted as a bolus
Correct Answer: C) Diluted in 1000 mL NS and infused at 10 mEq/hr
Rationale: IV potassium should never be given IV push or as a bolus, as it can cause fatal
cardiac arrhythmias.
7. A nurse is teaching a patient about warfarin (Coumadin). Which statement indicates the
patient understands the teaching?
A) "I will eat more green leafy vegetables to help my blood clot."
B) "I need to get my INR checked regularly."
C) "I can take aspirin for headaches while on warfarin."
D) "I should increase my intake of vitamin K supplements."
Correct Answer: B) "I need to get my INR checked regularly."
Rationale: Warfarin requires frequent INR monitoring to ensure therapeutic
anticoagulation and prevent bleeding risks.
8. A client with a latex allergy is scheduled for surgery. What precaution should the nurse
take?
A) Schedule the patient as the last case of the day
B) Avoid using IV tubing with latex ports
C) Use powdered latex gloves
D) Place a non-allergy wristband on the patient
Correct Answer: B) Avoid using IV tubing with latex ports
Rationale: Latex allergy can cause anaphylaxis. Latex-free equipment should be used,
including IV tubing and gloves.
9. A nurse is educating a patient with chronic kidney disease (CKD) about diet. Which food
should be avoided?
A) Apples
B) Grilled chicken
C) Bananas
,D) White rice
Correct Answer: C) Bananas
Rationale: Bananas are high in potassium, which should be restricted in CKD patients to
prevent hyperkalemia.
10. A patient with pneumonia is experiencing respiratory distress. What position should
the nurse place them in?
A) High Fowler’s
B) Supine
C) Trendelenburg
D) Side-lying
Correct Answer: A) High Fowler’s
Rationale: High Fowler’s position (sitting upright) promotes lung expansion and improves
oxygenation in patients with respiratory distress.
11. A nurse is monitoring a patient receiving morphine sulfate for pain. Which finding
requires immediate intervention?
A) Respiratory rate of 8 breaths per minute
B) Heart rate of 78 bpm
C) Pain level of 3/10
D) Blood pressure of 118/72 mmHg
Correct Answer: A) Respiratory rate of 8 breaths per minute
Rationale: Morphine can cause respiratory depression. A respiratory rate below 12 bpm
requires immediate intervention, such as administering naloxone (Narcan).
12. A client with tuberculosis (TB) is placed on airborne precautions. What PPE is required
for the nurse?
A) Surgical mask, gloves, and gown
B) N95 respirator
C) Standard gloves only
D) Face shield and gown
Correct Answer: B) N95 respirator
Rationale: TB is airborne, requiring an N95 respirator to prevent inhalation of infected
droplets.
13. A patient with a deep vein thrombosis (DVT) suddenly develops shortness of breath and
chest pain. What is the nurse’s priority action?
A) Check the client’s blood pressure
B) Administer prescribed anticoagulant
C) Elevate the legs
D) Notify the healthcare provider immediately
Correct Answer: D) Notify the healthcare provider immediately
Rationale: The symptoms suggest a pulmonary embolism (PE), a life-threatening condition
requiring immediate intervention.
, 14. A client with a head injury has clear fluid leaking from the nose. What should the nurse
do first?
A) Test the fluid for glucose
B) Suction the fluid to maintain airway patency
C) Insert a nasal packing
D) Encourage the client to blow their nose
Correct Answer: A) Test the fluid for glucose
Rationale: Cerebrospinal fluid (CSF) leakage from the nose (rhinorrhea) can indicate a
basilar skull fracture. CSF is positive for glucose.
15. A nurse is caring for a client who has been prescribed furosemide (Lasix). What lab
value should the nurse monitor?
A) Sodium
B) Potassium
C) Calcium
D) Hemoglobin
Correct Answer: B) Potassium
Rationale: Furosemide (Lasix) is a loop diuretic that causes potassium loss, increasing the
risk of hypokalemia.
16. A nurse is teaching a client about a low-sodium diet for hypertension. Which food
should the client avoid?
A) Grilled salmon
B) Fresh strawberries
C) Canned soup
D) Steamed broccoli
Correct Answer: C) Canned soup
Rationale: Canned and processed foods are high in sodium, which can worsen
hypertension.
17. A nurse is assessing a patient receiving blood transfusion. Which finding is an early sign
of a transfusion reaction?
A) Hypothermia
B) Hypertension
C) Chills and back pain
D) Nausea and vomiting
Correct Answer: C) Chills and back pain
Rationale: Early signs of a transfusion reaction include fever, chills, back pain, and
flushing, indicating an immune response to the transfused blood.
The charge nurse has received a change-of-shift report on the following clients in labor.
The charge nurse should ask a staff member to first see the client in the
1. First stage of labor who has an oral temperature of 99.7F (37.6 C)
2. First stage of labor whose contractions are occurring every 30 seconds
3. Second stage of labor who has respirations of 26.
