,NCLEX-RN Actual Exam Test Bank | Real Questions & Verified Answers Pass Pack
(Latest 2026-2027)
1. A nurse is caring for a patient receiving heparin therapy for a
pulmonary embolism. Which laboratory value should the nurse
monitor closely?
A. International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Platelet count
D. Hemoglobin A1c
Rationale: Heparin is monitored using aPTT to ensure therapeutic
anticoagulation and prevent bleeding or clotting complications. INR is used
to monitor warfarin therapy. Platelet count is monitored for heparin-induced
thrombocytopenia (HIT) but aPTT is the primary therapeutic monitoring
parameter.
2. A patient with congestive heart failure reports shortness of breath
when lying flat. Which intervention is best to relieve symptoms
immediately?
A. Administer oral furosemide now
B. Raise the head of bed and offer oxygen
C. Encourage slow, deep breathing while supine
D. Teach pursed-lip breathing and ambulate
Rationale: Elevating the head of bed improves ventilation and diaphragmatic
excursion. Orthopnea (difficulty breathing when lying flat) is a classic
symptom of heart failure. Oxygen treats hypoxemia. While diuretics may be
needed, immediate noninvasive measures should be implemented first.
,3. A patient is to receive 1000 mL of normal saline over 8 hours. What
is the IV flow rate in mL/hr?
A. 100 mL/hr
B. 125 mL/hr
C. 150 mL/hr
D. 175 mL/hr
Rationale: 1000 mL ÷ 8 hours = 125 mL/hr. This calculation is essential for
safe medication administration and is a common NCLEX dosage calculation
question.
4. A patient is prescribed 600 mg of ibuprofen PO. The tablets are 200
mg each. How many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Rationale: 600 mg ÷ 200 mg/tablet = 3 tablets. Dosage calculation questions
are frequently tested on the NCLEX-RN exam.
5. A nurse is preparing to administer a blood transfusion. Which action
is most important before starting the transfusion?
A. Checking the patient's temperature
B. Verifying the blood type with another nurse
C. Administering an antihistamine
D. Flushing the IV line with D5W
, Rationale: Verifying the blood type with another nurse prevents transfusion
reactions due to mismatched blood. This is a critical safety measure required
before any blood product administration.
6. A patient with a history of heart failure reports dyspnea when lying
flat. What is the nurse's best action?
A. Place the patient in a supine position
B. Elevate the head of the bed
C. Administer a bronchodilator
D. Restrict fluid intake
Rationale: Elevating the head of the bed relieves orthopnea, a common
symptom of heart failure. This intervention improves ventilation and reduces
venous return, decreasing cardiac workload.
7. A patient is to receive 0.5 mg of lorazepam IV. The vial contains 2
mg/mL. How many mL should the nurse administer?
A. 0.25 mL
B. 0.5 mL
C. 1 mL
D. 1.5 mL
Rationale: 0.5 mg ÷ 2 mg/mL = 0.25 mL. Accurate medication calculation is
essential for safe IV medication administration.
8. A nurse is caring for a patient with a suspected myocardial
infarction. Which diagnostic test is most specific?
A. Chest X-ray
(Latest 2026-2027)
1. A nurse is caring for a patient receiving heparin therapy for a
pulmonary embolism. Which laboratory value should the nurse
monitor closely?
A. International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Platelet count
D. Hemoglobin A1c
Rationale: Heparin is monitored using aPTT to ensure therapeutic
anticoagulation and prevent bleeding or clotting complications. INR is used
to monitor warfarin therapy. Platelet count is monitored for heparin-induced
thrombocytopenia (HIT) but aPTT is the primary therapeutic monitoring
parameter.
2. A patient with congestive heart failure reports shortness of breath
when lying flat. Which intervention is best to relieve symptoms
immediately?
A. Administer oral furosemide now
B. Raise the head of bed and offer oxygen
C. Encourage slow, deep breathing while supine
D. Teach pursed-lip breathing and ambulate
Rationale: Elevating the head of bed improves ventilation and diaphragmatic
excursion. Orthopnea (difficulty breathing when lying flat) is a classic
symptom of heart failure. Oxygen treats hypoxemia. While diuretics may be
needed, immediate noninvasive measures should be implemented first.
,3. A patient is to receive 1000 mL of normal saline over 8 hours. What
is the IV flow rate in mL/hr?
A. 100 mL/hr
B. 125 mL/hr
C. 150 mL/hr
D. 175 mL/hr
Rationale: 1000 mL ÷ 8 hours = 125 mL/hr. This calculation is essential for
safe medication administration and is a common NCLEX dosage calculation
question.
4. A patient is prescribed 600 mg of ibuprofen PO. The tablets are 200
mg each. How many tablets should the nurse administer?
A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets
Rationale: 600 mg ÷ 200 mg/tablet = 3 tablets. Dosage calculation questions
are frequently tested on the NCLEX-RN exam.
5. A nurse is preparing to administer a blood transfusion. Which action
is most important before starting the transfusion?
A. Checking the patient's temperature
B. Verifying the blood type with another nurse
C. Administering an antihistamine
D. Flushing the IV line with D5W
, Rationale: Verifying the blood type with another nurse prevents transfusion
reactions due to mismatched blood. This is a critical safety measure required
before any blood product administration.
6. A patient with a history of heart failure reports dyspnea when lying
flat. What is the nurse's best action?
A. Place the patient in a supine position
B. Elevate the head of the bed
C. Administer a bronchodilator
D. Restrict fluid intake
Rationale: Elevating the head of the bed relieves orthopnea, a common
symptom of heart failure. This intervention improves ventilation and reduces
venous return, decreasing cardiac workload.
7. A patient is to receive 0.5 mg of lorazepam IV. The vial contains 2
mg/mL. How many mL should the nurse administer?
A. 0.25 mL
B. 0.5 mL
C. 1 mL
D. 1.5 mL
Rationale: 0.5 mg ÷ 2 mg/mL = 0.25 mL. Accurate medication calculation is
essential for safe IV medication administration.
8. A nurse is caring for a patient with a suspected myocardial
infarction. Which diagnostic test is most specific?
A. Chest X-ray
