NCLEX-PN Actual Exams Questions and Answers,
2026/2027 Version
100% Verified GRADE A+ NCLEX Exam
1. A patient develops sudden onset of shortness of breath, tachycardia, and pleuritic
chest pain after knee surgery. What is the priority nursing action?
Answer: Administer oxygen and notify the provider immediately.
Rationale: Symptoms indicate a possible pulmonary embolism, which is life-threatening.
Oxygen therapy improves tissue oxygenation and prevents hypoxia.
Prompt provider notification allows rapid diagnosis and initiation of anticoagulation therapy.
2. A patient reports sudden vision changes, headache, and a blood pressure of 210/120
mmHg. What is the priority intervention?
Answer: Place the patient on bed rest and notify the provider immediately.
Rationale: Severe hypertension with neurological symptoms suggests hypertensive
emergency.
Early intervention prevents stroke and other organ damage.
Continuous monitoring ensures that treatment is effective and complications are minimized.
3. A patient receiving morphine reports a respiratory rate of 6 breaths per minute and
somnolence. What is the first action?
Answer: Administer naloxone and support airway and ventilation.
Rationale: Respiratory depression is a life-threatening opioid side effect.
Naloxone reverses the effects of morphine rapidly.
Supporting the airway ensures oxygenation and prevents hypoxic injury.
4. A patient reports crushing chest pain radiating to the jaw and diaphoresis. What is
the priority nursing intervention?
Answer: Administer oxygen and prepare for emergency cardiac intervention.
Rationale: Symptoms suggest acute myocardial infarction requiring urgent treatment.
Oxygen improves myocardial oxygenation and reduces ischemia.
Early intervention prevents further cardiac tissue damage and arrhythmias.
5. A patient postoperatively has sudden swelling, redness, and pain in one leg. What is
the first nursing action?
Answer: Keep the leg immobile and notify the provider immediately.
Rationale: These are signs of deep vein thrombosis, which can lead to pulmonary embolism.
Movement or massage may dislodge the clot, causing a life-threatening event.
Early provider notification allows initiation of anticoagulation therapy.
,6. A patient with COPD on oxygen reports increasing confusion and drowsiness. What
is the likely cause?
Answer: Carbon dioxide retention due to suppressed hypoxic drive.
Rationale: COPD patients rely on low oxygen levels to stimulate breathing.
Excess oxygen can reduce respiratory drive and cause CO2 retention.
Hypercapnia can lead to lethargy, confusion, and respiratory failure if untreated.
7. A patient reports sudden, severe epigastric pain radiating to the back with nausea.
What is the priority action?
Answer: Sit the patient upright and notify the provider.
Rationale: Symptoms suggest acute pancreatitis, which requires careful management.
Upright positioning relieves abdominal pressure and improves comfort.
Early provider notification ensures timely interventions such as IV fluids and pain control.
8. A patient with diabetes reports dizziness, sweating, and shaking. Glucose is 42
mg/dL. What should the nurse do first?
Answer: Provide 15 grams of fast-acting carbohydrate orally if safe to swallow.
Rationale: Hypoglycemia can cause neurological complications if untreated.
Immediate carbohydrate intake restores glucose levels rapidly.
Reassessing glucose after 15 minutes ensures treatment effectiveness.
9. A patient develops sudden wheezing, facial swelling, and shortness of breath after a
new medication. What is the priority intervention?
Answer: Administer epinephrine and assess airway patency.
Rationale: These are signs of anaphylaxis, which is life-threatening.
Airway management ensures oxygenation and prevents hypoxia.
Rapid epinephrine administration stabilizes vital signs and prevents deterioration.
10. A patient presents with fever, neck stiffness, and severe headache. What
precautions should the nurse implement?
Answer: Place the patient on droplet isolation and notify the provider.
Rationale: Symptoms indicate possible meningitis, which is highly contagious.
Droplet precautions prevent transmission to others.
Early treatment reduces the risk of complications and improves outcomes.
11. A patient reports sudden unilateral weakness and facial drooping. What is the
priority nursing action?
Answer: Assess for stroke and notify the provider immediately.
Rationale: These are classic signs of cerebrovascular accident requiring rapid intervention.
Early recognition prevents permanent neurological deficits.
Timely provider notification allows diagnostic imaging and treatment.
12. A postoperative patient reports nausea, vomiting, and a distended abdomen. What
is the first nursing intervention?
Answer: Notify the provider and monitor vital signs closely.
, Rationale: Symptoms may indicate postoperative ileus or bowel obstruction.
Early recognition prevents complications such as bowel necrosis.
Close monitoring allows timely intervention and stabilization.
13. A patient reports sudden severe headache, blurred vision, and confusion with BP
200/120 mmHg. What is the priority action?
Answer: Place the patient on bed rest and notify the provider immediately.
Rationale: These are signs of hypertensive crisis that can lead to stroke.
Early intervention reduces risk of organ damage and neurological complications.
Monitoring blood pressure ensures effectiveness of prescribed therapy.
14. A patient develops sudden redness, swelling, and tenderness at a surgical incision
site. What is the nursing priority?
Answer: Notify the provider and implement infection control measures.
Rationale: Signs suggest wound infection, which can progress to sepsis if untreated.
Early intervention allows initiation of antibiotics and wound care.
Strict hygiene prevents spread and promotes healing.
15. A patient reports chest tightness, anxiety, and shortness of breath after prolonged
immobility. What is the first action?
Answer: Administer supplemental oxygen and notify the provider immediately.
Rationale: These symptoms suggest pulmonary embolism, a life-threatening condition.
Oxygen therapy improves tissue oxygenation and prevents hypoxia.
Rapid provider notification allows for diagnostic testing and anticoagulation therapy.
16. A patient presents with sudden palpitations, tremors, and heat intolerance. What
condition is suspected?
Answer: Hyperthyroidism; notify the provider and monitor vital signs.
Rationale: These are classic signs of excessive thyroid hormone activity.
Early detection prevents thyroid storm and cardiovascular complications.
Monitoring ensures stability and guides appropriate treatment.
17. A patient with diabetes reports persistent vomiting and abdominal pain. Glucose is
450 mg/dL. What is the priority nursing intervention?
Answer: Notify the provider and initiate IV fluids and insulin therapy as prescribed.
Rationale: Hyperglycemia at this level indicates possible hyperosmolar hyperglycemic state.
Prompt intervention prevents dehydration, electrolyte imbalance, and neurological
complications.
IV fluids and insulin restore fluid balance and stabilize glucose.
18. A patient reports sudden swelling, redness, and tenderness in one leg after long
travel. What is the first nursing action?
Answer: Keep the leg immobile and notify the provider immediately.
Rationale: Symptoms suggest deep vein thrombosis, which can lead to pulmonary embolism.
2026/2027 Version
100% Verified GRADE A+ NCLEX Exam
1. A patient develops sudden onset of shortness of breath, tachycardia, and pleuritic
chest pain after knee surgery. What is the priority nursing action?
Answer: Administer oxygen and notify the provider immediately.
Rationale: Symptoms indicate a possible pulmonary embolism, which is life-threatening.
Oxygen therapy improves tissue oxygenation and prevents hypoxia.
Prompt provider notification allows rapid diagnosis and initiation of anticoagulation therapy.
2. A patient reports sudden vision changes, headache, and a blood pressure of 210/120
mmHg. What is the priority intervention?
Answer: Place the patient on bed rest and notify the provider immediately.
Rationale: Severe hypertension with neurological symptoms suggests hypertensive
emergency.
Early intervention prevents stroke and other organ damage.
Continuous monitoring ensures that treatment is effective and complications are minimized.
3. A patient receiving morphine reports a respiratory rate of 6 breaths per minute and
somnolence. What is the first action?
Answer: Administer naloxone and support airway and ventilation.
Rationale: Respiratory depression is a life-threatening opioid side effect.
Naloxone reverses the effects of morphine rapidly.
Supporting the airway ensures oxygenation and prevents hypoxic injury.
4. A patient reports crushing chest pain radiating to the jaw and diaphoresis. What is
the priority nursing intervention?
Answer: Administer oxygen and prepare for emergency cardiac intervention.
Rationale: Symptoms suggest acute myocardial infarction requiring urgent treatment.
Oxygen improves myocardial oxygenation and reduces ischemia.
Early intervention prevents further cardiac tissue damage and arrhythmias.
5. A patient postoperatively has sudden swelling, redness, and pain in one leg. What is
the first nursing action?
Answer: Keep the leg immobile and notify the provider immediately.
Rationale: These are signs of deep vein thrombosis, which can lead to pulmonary embolism.
Movement or massage may dislodge the clot, causing a life-threatening event.
Early provider notification allows initiation of anticoagulation therapy.
,6. A patient with COPD on oxygen reports increasing confusion and drowsiness. What
is the likely cause?
Answer: Carbon dioxide retention due to suppressed hypoxic drive.
Rationale: COPD patients rely on low oxygen levels to stimulate breathing.
Excess oxygen can reduce respiratory drive and cause CO2 retention.
Hypercapnia can lead to lethargy, confusion, and respiratory failure if untreated.
7. A patient reports sudden, severe epigastric pain radiating to the back with nausea.
What is the priority action?
Answer: Sit the patient upright and notify the provider.
Rationale: Symptoms suggest acute pancreatitis, which requires careful management.
Upright positioning relieves abdominal pressure and improves comfort.
Early provider notification ensures timely interventions such as IV fluids and pain control.
8. A patient with diabetes reports dizziness, sweating, and shaking. Glucose is 42
mg/dL. What should the nurse do first?
Answer: Provide 15 grams of fast-acting carbohydrate orally if safe to swallow.
Rationale: Hypoglycemia can cause neurological complications if untreated.
Immediate carbohydrate intake restores glucose levels rapidly.
Reassessing glucose after 15 minutes ensures treatment effectiveness.
9. A patient develops sudden wheezing, facial swelling, and shortness of breath after a
new medication. What is the priority intervention?
Answer: Administer epinephrine and assess airway patency.
Rationale: These are signs of anaphylaxis, which is life-threatening.
Airway management ensures oxygenation and prevents hypoxia.
Rapid epinephrine administration stabilizes vital signs and prevents deterioration.
10. A patient presents with fever, neck stiffness, and severe headache. What
precautions should the nurse implement?
Answer: Place the patient on droplet isolation and notify the provider.
Rationale: Symptoms indicate possible meningitis, which is highly contagious.
Droplet precautions prevent transmission to others.
Early treatment reduces the risk of complications and improves outcomes.
11. A patient reports sudden unilateral weakness and facial drooping. What is the
priority nursing action?
Answer: Assess for stroke and notify the provider immediately.
Rationale: These are classic signs of cerebrovascular accident requiring rapid intervention.
Early recognition prevents permanent neurological deficits.
Timely provider notification allows diagnostic imaging and treatment.
12. A postoperative patient reports nausea, vomiting, and a distended abdomen. What
is the first nursing intervention?
Answer: Notify the provider and monitor vital signs closely.
, Rationale: Symptoms may indicate postoperative ileus or bowel obstruction.
Early recognition prevents complications such as bowel necrosis.
Close monitoring allows timely intervention and stabilization.
13. A patient reports sudden severe headache, blurred vision, and confusion with BP
200/120 mmHg. What is the priority action?
Answer: Place the patient on bed rest and notify the provider immediately.
Rationale: These are signs of hypertensive crisis that can lead to stroke.
Early intervention reduces risk of organ damage and neurological complications.
Monitoring blood pressure ensures effectiveness of prescribed therapy.
14. A patient develops sudden redness, swelling, and tenderness at a surgical incision
site. What is the nursing priority?
Answer: Notify the provider and implement infection control measures.
Rationale: Signs suggest wound infection, which can progress to sepsis if untreated.
Early intervention allows initiation of antibiotics and wound care.
Strict hygiene prevents spread and promotes healing.
15. A patient reports chest tightness, anxiety, and shortness of breath after prolonged
immobility. What is the first action?
Answer: Administer supplemental oxygen and notify the provider immediately.
Rationale: These symptoms suggest pulmonary embolism, a life-threatening condition.
Oxygen therapy improves tissue oxygenation and prevents hypoxia.
Rapid provider notification allows for diagnostic testing and anticoagulation therapy.
16. A patient presents with sudden palpitations, tremors, and heat intolerance. What
condition is suspected?
Answer: Hyperthyroidism; notify the provider and monitor vital signs.
Rationale: These are classic signs of excessive thyroid hormone activity.
Early detection prevents thyroid storm and cardiovascular complications.
Monitoring ensures stability and guides appropriate treatment.
17. A patient with diabetes reports persistent vomiting and abdominal pain. Glucose is
450 mg/dL. What is the priority nursing intervention?
Answer: Notify the provider and initiate IV fluids and insulin therapy as prescribed.
Rationale: Hyperglycemia at this level indicates possible hyperosmolar hyperglycemic state.
Prompt intervention prevents dehydration, electrolyte imbalance, and neurological
complications.
IV fluids and insulin restore fluid balance and stabilize glucose.
18. A patient reports sudden swelling, redness, and tenderness in one leg after long
travel. What is the first nursing action?
Answer: Keep the leg immobile and notify the provider immediately.
Rationale: Symptoms suggest deep vein thrombosis, which can lead to pulmonary embolism.
