NCLEX-RN Actual Exam Test Bank
,NCLEX-RN Actual Exam Test Bank
NCLEX-RN Actual Exam Test Bank | Real Questions & Verified Answers
Pass Pack (Latest 2026)
1. A nurse is caring for a patient who is 2 days post-operative
following a total hip replacement. Which finding requires immediate
intervention?
A. Pain of 4 on a 0-10 scale
B. Swelling and redness in the calf of the operative leg
C. Temperature of 99.2°F (37.3°C)
D. Urine output of 40 mL/hr
Rationale: Swelling and redness in the calf are signs of a deep vein
thrombosis (DVT), a serious complication of hip surgery requiring immediate
intervention. Pain of 4/10 and low-grade fever are expected. Urine output of
40 mL/hr is adequate (normal is at least 30 mL/hr).
2. A patient with heart failure is receiving IV furosemide. Which
assessment finding indicates the medication is having the desired
effect?
A. Heart rate of 110 beats/min
B. Weight loss of 2 pounds in 24 hours
C. Blood pressure of 160/90 mmHg
D. Respiratory rate of 28 breaths/min
Rationale: Furosemide is a diuretic used to reduce fluid volume in heart
failure. Weight loss indicates fluid loss and is a sign of therapeutic effect.
Tachycardia, hypertension, and tachypnea are signs of worsening heart
failure or inadequate treatment.
,NCLEX-RN Actual Exam Test Bank
3. A nurse is preparing to administer a blood transfusion to a patient.
Which action is most important to prevent a transfusion reaction?
A. Verifying the patient's identity and blood type with another nurse
B. Premedicating with diphenhydramine
C. Infusing the blood over 2 hours
D. Checking the patient's temperature before the transfusion
Rationale: Verification of patient identity and blood type compatibility with
another nurse is the most important safety measure to prevent transfusion
reactions. Premedication and temperature checks are important but
secondary to correct identification.
4. A patient with a history of seizures is prescribed phenytoin. Which
serum level indicates toxicity?
A. 12 mcg/mL
B. 25 mcg/mL
C. 15 mcg/mL
D. 10 mcg/mL
Rationale: The therapeutic range for phenytoin is 10-20 mcg/mL. A level of
25 mcg/mL indicates toxicity, which can cause nystagmus, ataxia, confusion,
and drowsiness.
5. A nurse is assessing a patient with a suspected pulmonary
embolism. Which finding is most consistent with this diagnosis?
A. Sudden onset of dyspnea and pleuritic chest pain
B. Gradual onset of dyspnea and cough
C. Chest pain radiating to the left arm
D. Fever and productive cough
, NCLEX-RN Actual Exam Test Bank
Rationale: Pulmonary embolism typically presents with sudden dyspnea,
pleuritic chest pain, tachycardia, and hypoxia. Gradual symptoms suggest
pneumonia or COPD. Chest pain radiating to the left arm suggests
myocardial infarction.
6. A patient with diabetes has a blood glucose of 45 mg/dL and is
unconscious. Which action should the nurse take first?
A. Administer 50% dextrose IV push
B. Administer glucagon 1 mg IM or SQ
C. Give orange juice orally
D. Recheck blood glucose in 15 minutes
Rationale: Glucagon is administered to an unconscious patient with severe
hypoglycemia when IV access is not immediately available. IV dextrose is
given if IV access is available. Oral glucose cannot be given to an
unconscious patient due to aspiration risk.
7. A patient is prescribed 750 mg of ciprofloxacin PO. The tablets are
250 mg each. How many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Rationale: 750 mg ÷ 250 mg/tablet = 3 tablets. Dosage calculation questions
are a core component of NCLEX-RN exam.
,NCLEX-RN Actual Exam Test Bank
NCLEX-RN Actual Exam Test Bank | Real Questions & Verified Answers
Pass Pack (Latest 2026)
1. A nurse is caring for a patient who is 2 days post-operative
following a total hip replacement. Which finding requires immediate
intervention?
A. Pain of 4 on a 0-10 scale
B. Swelling and redness in the calf of the operative leg
C. Temperature of 99.2°F (37.3°C)
D. Urine output of 40 mL/hr
Rationale: Swelling and redness in the calf are signs of a deep vein
thrombosis (DVT), a serious complication of hip surgery requiring immediate
intervention. Pain of 4/10 and low-grade fever are expected. Urine output of
40 mL/hr is adequate (normal is at least 30 mL/hr).
2. A patient with heart failure is receiving IV furosemide. Which
assessment finding indicates the medication is having the desired
effect?
A. Heart rate of 110 beats/min
B. Weight loss of 2 pounds in 24 hours
C. Blood pressure of 160/90 mmHg
D. Respiratory rate of 28 breaths/min
Rationale: Furosemide is a diuretic used to reduce fluid volume in heart
failure. Weight loss indicates fluid loss and is a sign of therapeutic effect.
Tachycardia, hypertension, and tachypnea are signs of worsening heart
failure or inadequate treatment.
,NCLEX-RN Actual Exam Test Bank
3. A nurse is preparing to administer a blood transfusion to a patient.
Which action is most important to prevent a transfusion reaction?
A. Verifying the patient's identity and blood type with another nurse
B. Premedicating with diphenhydramine
C. Infusing the blood over 2 hours
D. Checking the patient's temperature before the transfusion
Rationale: Verification of patient identity and blood type compatibility with
another nurse is the most important safety measure to prevent transfusion
reactions. Premedication and temperature checks are important but
secondary to correct identification.
4. A patient with a history of seizures is prescribed phenytoin. Which
serum level indicates toxicity?
A. 12 mcg/mL
B. 25 mcg/mL
C. 15 mcg/mL
D. 10 mcg/mL
Rationale: The therapeutic range for phenytoin is 10-20 mcg/mL. A level of
25 mcg/mL indicates toxicity, which can cause nystagmus, ataxia, confusion,
and drowsiness.
5. A nurse is assessing a patient with a suspected pulmonary
embolism. Which finding is most consistent with this diagnosis?
A. Sudden onset of dyspnea and pleuritic chest pain
B. Gradual onset of dyspnea and cough
C. Chest pain radiating to the left arm
D. Fever and productive cough
, NCLEX-RN Actual Exam Test Bank
Rationale: Pulmonary embolism typically presents with sudden dyspnea,
pleuritic chest pain, tachycardia, and hypoxia. Gradual symptoms suggest
pneumonia or COPD. Chest pain radiating to the left arm suggests
myocardial infarction.
6. A patient with diabetes has a blood glucose of 45 mg/dL and is
unconscious. Which action should the nurse take first?
A. Administer 50% dextrose IV push
B. Administer glucagon 1 mg IM or SQ
C. Give orange juice orally
D. Recheck blood glucose in 15 minutes
Rationale: Glucagon is administered to an unconscious patient with severe
hypoglycemia when IV access is not immediately available. IV dextrose is
given if IV access is available. Oral glucose cannot be given to an
unconscious patient due to aspiration risk.
7. A patient is prescribed 750 mg of ciprofloxacin PO. The tablets are
250 mg each. How many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Rationale: 750 mg ÷ 250 mg/tablet = 3 tablets. Dosage calculation questions
are a core component of NCLEX-RN exam.
