NCLEX Exam NCLEX-PN Actual Exams
Questions and Answers, 2026/2027 Version
100% Verified GRADE A+
1. Sudden onset of severe palpitations, shortness of breath, and dizziness occurs. Heart
rate is 210 bpm and blood pressure is 90/60 mmHg. What is the priority nursing
intervention?
Supraventricular tachycardia is likely and requires immediate assessment and continuous
cardiac monitoring.
Prompt administration of antiarrhythmic medications or preparation for synchronized
cardioversion may be needed.
Rapid intervention prevents decreased cardiac output, hypotension, and syncope.
2. Progressive swelling, redness, and warmth develop in the right calf after prolonged
immobilization. The patient reports mild pain while walking. What complication
should be suspected and why?
Deep vein thrombosis is suspected due to unilateral leg edema and tenderness.
Early recognition allows prompt anticoagulation therapy to prevent clot propagation.
Preventing pulmonary embolism is the primary nursing concern.
3. Shortness of breath, frothy pink sputum, and orthopnea develop in a patient with
heart failure. Crackles are auscultated in both lungs. What is the priority nursing
action?
Acute pulmonary edema is present and requires upright positioning and high-flow oxygen.
Diuretic administration and continuous monitoring of vital signs stabilize fluid balance.
Rapid intervention prevents hypoxemia and respiratory failure.
4. Persistent thirst, frequent urination, and unexplained weight loss occur. Fasting
blood glucose is 320 mg/dL. What chronic condition is indicated and what is the focus
of nursing management?
Type 2 diabetes mellitus is indicated due to hyperglycemia and classic symptoms.
Management includes blood glucose monitoring, lifestyle modification, and medication
adherence.
Long-term control prevents neuropathy, nephropathy, and cardiovascular complications.
,5. Sudden, severe right upper quadrant abdominal pain follows a high-fat meal. Fever
and leukocytosis are present. What condition is suspected and what is the nursing
priority?
Acute cholecystitis is likely due to gallbladder inflammation.
Keeping the patient NPO and initiating IV fluids and pain management prevent
complications.
Early treatment reduces the risk of perforation and sepsis.
6. Increasing confusion, restlessness, and shallow respirations occur after opioid
administration. Pupils are pinpoint and oxygen saturation falls to 85%. What should be
done immediately?
Opioid overdose is present, and naloxone should be administered per protocol.
Airway support and supplemental oxygen are critical to prevent hypoxia.
Rapid intervention prevents respiratory arrest and possible brain injury.
7. Severe headache, nausea, and visual changes develop suddenly in a patient with
uncontrolled hypertension. Blood pressure is 220/120 mmHg. What is the priority
nursing action?
Hypertensive crisis is suspected.
Controlled IV antihypertensive administration is necessary to prevent stroke or organ
damage.
Continuous monitoring ensures safe blood pressure reduction.
8. Sudden chest pain radiates to the left arm and jaw with diaphoresis and nausea.
ECG shows ST elevation in leads II, III, and aVF. What is the priority intervention?
Acute myocardial infarction is occurring.
Immediate activation of the cardiac catheterization team or administration of thrombolytics
as ordered is essential.
Rapid reperfusion reduces myocardial tissue damage and mortality risk.
9. Severe, sudden flank pain radiates to the groin with nausea and hematuria. What is
the nursing focus?
Renal calculi are suspected.
Pain management, hydration, and monitoring urine output are essential.
Early recognition prevents obstruction and preserves renal function.
10. Persistent diarrhea, abdominal cramping, and mild fever occur after recent
antibiotic therapy. What complication is suspected and what precautions should be
taken?
, Clostridioides difficile infection is likely.
Contact precautions and stool testing are essential to prevent spread.
Early treatment prevents severe dehydration and colitis complications.
11. Gradual onset of fatigue, pallor, and frequent infections occurs. Laboratory results
reveal pancytopenia. What disorder is indicated and what is the nursing priority?
Aplastic anemia is suspected due to bone marrow suppression.
Infection and bleeding prevention through protective precautions is essential.
Early monitoring reduces risk of life-threatening complications.
12. Sudden severe right lower quadrant pain with nausea and vomiting occurs.
Rebound tenderness is noted. What is the priority nursing action?
Acute appendicitis is suspected.
Immediate surgical consultation is required to prevent rupture.
Delay can lead to peritonitis and sepsis.
13. Increasing shortness of breath and wheezing occur despite multiple rescue inhaler
uses. Oxygen saturation is 87%. What intervention is necessary?
Status asthmaticus is developing.
Rapid-acting bronchodilator therapy and supplemental oxygen are required.
Early intervention prevents hypoxic respiratory failure.
14. Severe unilateral eye pain with halos around lights and nausea develops suddenly.
What ophthalmologic emergency is occurring?
Acute angle-closure glaucoma is indicated.
Immediate treatment to lower intraocular pressure is required.
Delay can result in permanent vision loss.
15. Increasing lethargy, fruity breath, and deep rapid respirations are noted. Blood
glucose is 520 mg/dL with ketones in urine. What metabolic imbalance is present?
Diabetic ketoacidosis is occurring.
IV insulin therapy, fluid replacement, and electrolyte monitoring are essential.
Rapid correction prevents cardiac arrhythmias and organ failure.
16. Sudden swelling of lips, tongue, and throat occurs after eating shellfish. Stridor is
present. What is the priority nursing action?
Anaphylaxis is occurring.
Immediate intramuscular epinephrine administration and airway management are required.
Rapid intervention prevents respiratory failure and death.
Questions and Answers, 2026/2027 Version
100% Verified GRADE A+
1. Sudden onset of severe palpitations, shortness of breath, and dizziness occurs. Heart
rate is 210 bpm and blood pressure is 90/60 mmHg. What is the priority nursing
intervention?
Supraventricular tachycardia is likely and requires immediate assessment and continuous
cardiac monitoring.
Prompt administration of antiarrhythmic medications or preparation for synchronized
cardioversion may be needed.
Rapid intervention prevents decreased cardiac output, hypotension, and syncope.
2. Progressive swelling, redness, and warmth develop in the right calf after prolonged
immobilization. The patient reports mild pain while walking. What complication
should be suspected and why?
Deep vein thrombosis is suspected due to unilateral leg edema and tenderness.
Early recognition allows prompt anticoagulation therapy to prevent clot propagation.
Preventing pulmonary embolism is the primary nursing concern.
3. Shortness of breath, frothy pink sputum, and orthopnea develop in a patient with
heart failure. Crackles are auscultated in both lungs. What is the priority nursing
action?
Acute pulmonary edema is present and requires upright positioning and high-flow oxygen.
Diuretic administration and continuous monitoring of vital signs stabilize fluid balance.
Rapid intervention prevents hypoxemia and respiratory failure.
4. Persistent thirst, frequent urination, and unexplained weight loss occur. Fasting
blood glucose is 320 mg/dL. What chronic condition is indicated and what is the focus
of nursing management?
Type 2 diabetes mellitus is indicated due to hyperglycemia and classic symptoms.
Management includes blood glucose monitoring, lifestyle modification, and medication
adherence.
Long-term control prevents neuropathy, nephropathy, and cardiovascular complications.
,5. Sudden, severe right upper quadrant abdominal pain follows a high-fat meal. Fever
and leukocytosis are present. What condition is suspected and what is the nursing
priority?
Acute cholecystitis is likely due to gallbladder inflammation.
Keeping the patient NPO and initiating IV fluids and pain management prevent
complications.
Early treatment reduces the risk of perforation and sepsis.
6. Increasing confusion, restlessness, and shallow respirations occur after opioid
administration. Pupils are pinpoint and oxygen saturation falls to 85%. What should be
done immediately?
Opioid overdose is present, and naloxone should be administered per protocol.
Airway support and supplemental oxygen are critical to prevent hypoxia.
Rapid intervention prevents respiratory arrest and possible brain injury.
7. Severe headache, nausea, and visual changes develop suddenly in a patient with
uncontrolled hypertension. Blood pressure is 220/120 mmHg. What is the priority
nursing action?
Hypertensive crisis is suspected.
Controlled IV antihypertensive administration is necessary to prevent stroke or organ
damage.
Continuous monitoring ensures safe blood pressure reduction.
8. Sudden chest pain radiates to the left arm and jaw with diaphoresis and nausea.
ECG shows ST elevation in leads II, III, and aVF. What is the priority intervention?
Acute myocardial infarction is occurring.
Immediate activation of the cardiac catheterization team or administration of thrombolytics
as ordered is essential.
Rapid reperfusion reduces myocardial tissue damage and mortality risk.
9. Severe, sudden flank pain radiates to the groin with nausea and hematuria. What is
the nursing focus?
Renal calculi are suspected.
Pain management, hydration, and monitoring urine output are essential.
Early recognition prevents obstruction and preserves renal function.
10. Persistent diarrhea, abdominal cramping, and mild fever occur after recent
antibiotic therapy. What complication is suspected and what precautions should be
taken?
, Clostridioides difficile infection is likely.
Contact precautions and stool testing are essential to prevent spread.
Early treatment prevents severe dehydration and colitis complications.
11. Gradual onset of fatigue, pallor, and frequent infections occurs. Laboratory results
reveal pancytopenia. What disorder is indicated and what is the nursing priority?
Aplastic anemia is suspected due to bone marrow suppression.
Infection and bleeding prevention through protective precautions is essential.
Early monitoring reduces risk of life-threatening complications.
12. Sudden severe right lower quadrant pain with nausea and vomiting occurs.
Rebound tenderness is noted. What is the priority nursing action?
Acute appendicitis is suspected.
Immediate surgical consultation is required to prevent rupture.
Delay can lead to peritonitis and sepsis.
13. Increasing shortness of breath and wheezing occur despite multiple rescue inhaler
uses. Oxygen saturation is 87%. What intervention is necessary?
Status asthmaticus is developing.
Rapid-acting bronchodilator therapy and supplemental oxygen are required.
Early intervention prevents hypoxic respiratory failure.
14. Severe unilateral eye pain with halos around lights and nausea develops suddenly.
What ophthalmologic emergency is occurring?
Acute angle-closure glaucoma is indicated.
Immediate treatment to lower intraocular pressure is required.
Delay can result in permanent vision loss.
15. Increasing lethargy, fruity breath, and deep rapid respirations are noted. Blood
glucose is 520 mg/dL with ketones in urine. What metabolic imbalance is present?
Diabetic ketoacidosis is occurring.
IV insulin therapy, fluid replacement, and electrolyte monitoring are essential.
Rapid correction prevents cardiac arrhythmias and organ failure.
16. Sudden swelling of lips, tongue, and throat occurs after eating shellfish. Stridor is
present. What is the priority nursing action?
Anaphylaxis is occurring.
Immediate intramuscular epinephrine administration and airway management are required.
Rapid intervention prevents respiratory failure and death.
