NCLEX-RN® Practice Exam with Answer
Key & Rationales | Nursing School Test
Bank | Fundamentals, Pharm, Med-Surg,
Peds & Maternity
Fundamentals & Safety (Questions 1-15)
1. The nurse is preparing to administer a tube feeding. Which action is the priority?
A. Check the residual volume.
B. Aspirate for gastric contents.
C. Verify the tube placement.
D. Flush the tube with water.
2. When a nurse discovers a fire in a client's room, the first action should be to:
A. Activate the fire alarm.
B. Contain the fire by closing the door.
C. Remove the client from the room.
D. Use the nearest fire extinguisher.
3. An elderly client with a history of falls is found wandering in the hall. What is the nurse's best initial
action?
A. Apply a vest restraint.
B. Escort the client back to their room.
C. Administer a prn sedative.
D. Place the client in a wheelchair with a lap tray.
4. The nurse is teaching a client about advance directives. The nurse understands that a living will
primarily provides instructions regarding:
A. Financial asset distribution.
B. Appointment of a healthcare proxy.
C. Desired medical treatments in specific situations.
D. Custody of minor children.
5. To prevent ventilator-associated pneumonia (VAP), which intervention is most critical for the nurse to
implement?
A. Administering prophylactic antibiotics.
B. Maintaining the head of the bed at 30-45 degrees.
C. Suctioning the endotracheal tube every 2 hours.
D. Using sterile saline during suctioning.
,6. A client is on contact precautions for Clostridium difficile. The nurse knows that:
A. A gown and gloves are needed when entering the room.
B. An N95 respirator must be worn.
C. The client must be placed in a negative pressure room.
D. Only soap and water hand hygiene is effective.
7. The nurse is delegating tasks to a Unlicensed Assistive Personnel (UAP). Which task is appropriate to
delegate?
A. Assessing a new post-operative client's pain.
B. Teaching a client how to use an incentive spirometer.
C. Feeding a stable client who had a stroke.
D. Changing the dressing on a central line.
8. When transferring a client with left-sided weakness from the bed to a chair, the nurse should stand:
A. On the client's right side.
B. On the client's left side.
C. In front of the client.
D. Behind the client.
9. The primary purpose of conducting a "time-out" before a surgical procedure is to:
A. Confirm the surgical site and client identity.
B. Allow the family to say goodbye.
C. Ensure all necessary equipment is present.
D. Let the surgical team take a break.
10. A client has a nasogastric tube connected to intermittent suction. The nurse should monitor for which
potential electrolyte imbalance?
A. Hyperkalemia
B. Hypocalcemia
C. Metabolic alkalosis
D. Metabolic acidosis
11. The nurse is caring for a client who only speaks a foreign language. The best action for the nurse to
take when obtaining consent for a procedure is to:
A. Use a family member as an interpreter.
B. Use a professional medical interpreter.
C. Speak slowly and use hand gestures.
D. Ask the client to write down their questions.
12. A client with a history of heart failure should be taught to weigh themselves daily and to report a
weight gain of:
A. 1 pound in 24 hours.
B. 2 pounds in 24 hours.
, C. 3 pounds in a week.
D. 5 pounds in a week.
13. The nurse is preparing to administer a blood transfusion. After obtaining the blood product from the
blood bank, the maximum time allowed to begin the infusion is:
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 4 hours
14. A client is receiving a continuous IV infusion. The nurse assesses the site and notes it is cool, pale,
and swollen. The nurse should first:
A. Slow the infusion rate.
B. Apply a warm compress.
C. Discontinue the IV.
D. Check for a blood return.
15. The "R" in the nursing prioritization tool "RACE" stands for:
A. Report.
B. Restrict.
C. Rescue.
D. Run.
Pharmacology (Questions 16-30)
16. A client is prescribed furosemide (Lasix). The nurse should specifically monitor for:
A. Hyperkalemia.
B. Hypokalemia.
C. Bradycardia.
D. Constipation.
17. The nurse is administering insulin. Which preparation is categorized as rapid-acting?
A. Insulin Glargine (Lantus)
B. Insulin Lispro (Humalog)
C. NPH Insulin (Humulin N)
D. Insulin Detemir (Levemir)
18. A client taking warfarin (Coumadin) should be instructed to maintain a consistent intake of foods
rich in:
A. Iron.
B. Calcium.
Key & Rationales | Nursing School Test
Bank | Fundamentals, Pharm, Med-Surg,
Peds & Maternity
Fundamentals & Safety (Questions 1-15)
1. The nurse is preparing to administer a tube feeding. Which action is the priority?
A. Check the residual volume.
B. Aspirate for gastric contents.
C. Verify the tube placement.
D. Flush the tube with water.
2. When a nurse discovers a fire in a client's room, the first action should be to:
A. Activate the fire alarm.
B. Contain the fire by closing the door.
C. Remove the client from the room.
D. Use the nearest fire extinguisher.
3. An elderly client with a history of falls is found wandering in the hall. What is the nurse's best initial
action?
A. Apply a vest restraint.
B. Escort the client back to their room.
C. Administer a prn sedative.
D. Place the client in a wheelchair with a lap tray.
4. The nurse is teaching a client about advance directives. The nurse understands that a living will
primarily provides instructions regarding:
A. Financial asset distribution.
B. Appointment of a healthcare proxy.
C. Desired medical treatments in specific situations.
D. Custody of minor children.
5. To prevent ventilator-associated pneumonia (VAP), which intervention is most critical for the nurse to
implement?
A. Administering prophylactic antibiotics.
B. Maintaining the head of the bed at 30-45 degrees.
C. Suctioning the endotracheal tube every 2 hours.
D. Using sterile saline during suctioning.
,6. A client is on contact precautions for Clostridium difficile. The nurse knows that:
A. A gown and gloves are needed when entering the room.
B. An N95 respirator must be worn.
C. The client must be placed in a negative pressure room.
D. Only soap and water hand hygiene is effective.
7. The nurse is delegating tasks to a Unlicensed Assistive Personnel (UAP). Which task is appropriate to
delegate?
A. Assessing a new post-operative client's pain.
B. Teaching a client how to use an incentive spirometer.
C. Feeding a stable client who had a stroke.
D. Changing the dressing on a central line.
8. When transferring a client with left-sided weakness from the bed to a chair, the nurse should stand:
A. On the client's right side.
B. On the client's left side.
C. In front of the client.
D. Behind the client.
9. The primary purpose of conducting a "time-out" before a surgical procedure is to:
A. Confirm the surgical site and client identity.
B. Allow the family to say goodbye.
C. Ensure all necessary equipment is present.
D. Let the surgical team take a break.
10. A client has a nasogastric tube connected to intermittent suction. The nurse should monitor for which
potential electrolyte imbalance?
A. Hyperkalemia
B. Hypocalcemia
C. Metabolic alkalosis
D. Metabolic acidosis
11. The nurse is caring for a client who only speaks a foreign language. The best action for the nurse to
take when obtaining consent for a procedure is to:
A. Use a family member as an interpreter.
B. Use a professional medical interpreter.
C. Speak slowly and use hand gestures.
D. Ask the client to write down their questions.
12. A client with a history of heart failure should be taught to weigh themselves daily and to report a
weight gain of:
A. 1 pound in 24 hours.
B. 2 pounds in 24 hours.
, C. 3 pounds in a week.
D. 5 pounds in a week.
13. The nurse is preparing to administer a blood transfusion. After obtaining the blood product from the
blood bank, the maximum time allowed to begin the infusion is:
A. 15 minutes
B. 30 minutes
C. 1 hour
D. 4 hours
14. A client is receiving a continuous IV infusion. The nurse assesses the site and notes it is cool, pale,
and swollen. The nurse should first:
A. Slow the infusion rate.
B. Apply a warm compress.
C. Discontinue the IV.
D. Check for a blood return.
15. The "R" in the nursing prioritization tool "RACE" stands for:
A. Report.
B. Restrict.
C. Rescue.
D. Run.
Pharmacology (Questions 16-30)
16. A client is prescribed furosemide (Lasix). The nurse should specifically monitor for:
A. Hyperkalemia.
B. Hypokalemia.
C. Bradycardia.
D. Constipation.
17. The nurse is administering insulin. Which preparation is categorized as rapid-acting?
A. Insulin Glargine (Lantus)
B. Insulin Lispro (Humalog)
C. NPH Insulin (Humulin N)
D. Insulin Detemir (Levemir)
18. A client taking warfarin (Coumadin) should be instructed to maintain a consistent intake of foods
rich in:
A. Iron.
B. Calcium.
