NCLEX RN Prioritization Practice Exam
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026
1.
The nurse receives report on four clients. Which client should the nurse assess
first?
A. A client with pneumonia who has a temperature of 38.1°C (100.6°F)
B. A client with heart failure who has 2+ bilateral ankle edema
C. A client with asthma who is wheezing and has difficulty speaking
D. A client with diabetes who has a blood glucose of 210 mg/dL
Answer: C. A client with asthma who is wheezing and has difficulty speaking
Rationale: Difficulty speaking with wheezing indicates significant respiratory
compromise. Airway and breathing take priority over fever, edema, or
moderate hyperglycemia.
2.
Which client should the nurse assess first?
A. A postoperative client reporting incisional pain of 7/10
B. A client with COPD whose oxygen saturation is 88% and is newly confused
C. A client with hypertension and a blood pressure of 158/92 mmHg
D. A client with arthritis reporting morning stiffness
Answer: B. A client with COPD whose oxygen saturation is 88% and is newly
confused
Rationale: New confusion with hypoxemia may indicate inadequate
oxygenation and requires immediate assessment and intervention.
,3.
A nurse is caring for four clients. Which finding requires immediate
intervention?
A. Potassium 5.9 mEq/L in a client with renal failure
B. Hemoglobin 10.2 g/dL in a client with anemia
C. Sodium 133 mEq/L in a client with heart failure
D. Glucose 180 mg/dL in a client receiving steroids
Answer: A. Potassium 5.9 mEq/L in a client with renal failure
Rationale: Significant hyperkalemia can cause life-threatening cardiac
dysrhythmias. Electrolyte abnormalities that threaten cardiac function take
priority.
4.
Which client should the nurse see first after receiving change-of-shift report?
A. A client with a new tracheostomy who has noisy respirations
B. A client with a urinary catheter who reports bladder discomfort
C. A client awaiting discharge instructions
D. A client with chronic back pain requesting medication
Answer: A. A client with a new tracheostomy who has noisy respirations
Rationale: Noisy respirations in a client with a new tracheostomy may
indicate airway obstruction. Airway problems require immediate attention.
5.
The nurse is caring for clients on a medical-surgical unit. Which client is the
priority?
A. A client with pancreatitis reporting nausea
B. A client with a bowel obstruction who has absent bowel sounds
C. A client with a GI bleed who is pale, diaphoretic, and has a blood pressure of
82/48 mmHg
D. A client with constipation who has abdominal discomfort
Answer: C. A client with a GI bleed who is pale, diaphoretic, and has a blood
pressure of 82/48 mmHg
,Rationale: Hypotension, pallor, and diaphoresis suggest hypovolemic shock
from significant blood loss. Circulation is immediately threatened.
6.
Which postoperative client should the nurse assess first?
A. A client 24 hours after surgery with pain of 6/10
B. A client 4 hours after surgery with urine output of 20 mL/hr
C. A client 2 days after surgery requesting a stool softener
D. A client 12 hours after surgery with a temperature of 37.8°C (100°F)
Answer: B. A client 4 hours after surgery with urine output of 20 mL/hr
Rationale: Urine output below approximately 30 mL/hr may indicate
inadequate renal perfusion or hypovolemia and requires prompt assessment.
7.
Which client should the nurse assess first?
A. A client with a fractured arm reporting pain
B. A client with a head injury who becomes increasingly difficult to arouse
C. A client with a leg cast reporting itching
D. A client with a healed laceration awaiting discharge
Answer: B. A client with a head injury who becomes increasingly difficult to
arouse
Rationale: A decreasing level of consciousness may indicate increased
intracranial pressure or worsening neurologic injury and is an emergency.
8.
The nurse receives four prescriptions. Which client should receive attention
first?
A. A client with asthma prescribed a routine inhaled corticosteroid
B. A client with diabetes prescribed a bedtime insulin dose
C. A client with anaphylaxis prescribed intramuscular epinephrine
D. A client with hypertension prescribed an oral antihypertensive
Answer: C. A client with anaphylaxis prescribed intramuscular epinephrine
, Rationale: Anaphylaxis can rapidly cause airway obstruction and
cardiovascular collapse. Epinephrine is the priority treatment.
9.
Which client should the nurse assess first?
A. A client with chronic kidney disease and mild ankle edema
B. A client with pneumonia who suddenly develops severe dyspnea
C. A client with diabetes who reports increased thirst
D. A client with osteoarthritis requesting assistance with bathing
Answer: B. A client with pneumonia who suddenly develops severe dyspnea
Rationale: Acute severe dyspnea represents a potential life-threatening
respiratory problem and takes priority.
10.
Which assessment finding requires the nurse's immediate attention?
A. Heart rate of 104/min after ambulation
B. Respiratory rate of 8/min in a client receiving opioids
C. Blood pressure of 142/88 mmHg
D. Temperature of 37.7°C (99.9°F)
Answer: B. Respiratory rate of 8/min in a client receiving opioids
Rationale: Opioids can cause respiratory depression. A respiratory rate of
8/min indicates potentially dangerous hypoventilation and requires
immediate intervention.
11.
A nurse must prioritize care for four clients. Which client should be seen first?
A. A client with a chest tube who has continuous bubbling in the water-seal
chamber
B. A client with a chest tube who reports mild insertion-site discomfort
C. A client with pneumonia who has a productive cough
D. A client with emphysema requesting assistance with meals
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026
1.
The nurse receives report on four clients. Which client should the nurse assess
first?
A. A client with pneumonia who has a temperature of 38.1°C (100.6°F)
B. A client with heart failure who has 2+ bilateral ankle edema
C. A client with asthma who is wheezing and has difficulty speaking
D. A client with diabetes who has a blood glucose of 210 mg/dL
Answer: C. A client with asthma who is wheezing and has difficulty speaking
Rationale: Difficulty speaking with wheezing indicates significant respiratory
compromise. Airway and breathing take priority over fever, edema, or
moderate hyperglycemia.
2.
Which client should the nurse assess first?
A. A postoperative client reporting incisional pain of 7/10
B. A client with COPD whose oxygen saturation is 88% and is newly confused
C. A client with hypertension and a blood pressure of 158/92 mmHg
D. A client with arthritis reporting morning stiffness
Answer: B. A client with COPD whose oxygen saturation is 88% and is newly
confused
Rationale: New confusion with hypoxemia may indicate inadequate
oxygenation and requires immediate assessment and intervention.
,3.
A nurse is caring for four clients. Which finding requires immediate
intervention?
A. Potassium 5.9 mEq/L in a client with renal failure
B. Hemoglobin 10.2 g/dL in a client with anemia
C. Sodium 133 mEq/L in a client with heart failure
D. Glucose 180 mg/dL in a client receiving steroids
Answer: A. Potassium 5.9 mEq/L in a client with renal failure
Rationale: Significant hyperkalemia can cause life-threatening cardiac
dysrhythmias. Electrolyte abnormalities that threaten cardiac function take
priority.
4.
Which client should the nurse see first after receiving change-of-shift report?
A. A client with a new tracheostomy who has noisy respirations
B. A client with a urinary catheter who reports bladder discomfort
C. A client awaiting discharge instructions
D. A client with chronic back pain requesting medication
Answer: A. A client with a new tracheostomy who has noisy respirations
Rationale: Noisy respirations in a client with a new tracheostomy may
indicate airway obstruction. Airway problems require immediate attention.
5.
The nurse is caring for clients on a medical-surgical unit. Which client is the
priority?
A. A client with pancreatitis reporting nausea
B. A client with a bowel obstruction who has absent bowel sounds
C. A client with a GI bleed who is pale, diaphoretic, and has a blood pressure of
82/48 mmHg
D. A client with constipation who has abdominal discomfort
Answer: C. A client with a GI bleed who is pale, diaphoretic, and has a blood
pressure of 82/48 mmHg
,Rationale: Hypotension, pallor, and diaphoresis suggest hypovolemic shock
from significant blood loss. Circulation is immediately threatened.
6.
Which postoperative client should the nurse assess first?
A. A client 24 hours after surgery with pain of 6/10
B. A client 4 hours after surgery with urine output of 20 mL/hr
C. A client 2 days after surgery requesting a stool softener
D. A client 12 hours after surgery with a temperature of 37.8°C (100°F)
Answer: B. A client 4 hours after surgery with urine output of 20 mL/hr
Rationale: Urine output below approximately 30 mL/hr may indicate
inadequate renal perfusion or hypovolemia and requires prompt assessment.
7.
Which client should the nurse assess first?
A. A client with a fractured arm reporting pain
B. A client with a head injury who becomes increasingly difficult to arouse
C. A client with a leg cast reporting itching
D. A client with a healed laceration awaiting discharge
Answer: B. A client with a head injury who becomes increasingly difficult to
arouse
Rationale: A decreasing level of consciousness may indicate increased
intracranial pressure or worsening neurologic injury and is an emergency.
8.
The nurse receives four prescriptions. Which client should receive attention
first?
A. A client with asthma prescribed a routine inhaled corticosteroid
B. A client with diabetes prescribed a bedtime insulin dose
C. A client with anaphylaxis prescribed intramuscular epinephrine
D. A client with hypertension prescribed an oral antihypertensive
Answer: C. A client with anaphylaxis prescribed intramuscular epinephrine
, Rationale: Anaphylaxis can rapidly cause airway obstruction and
cardiovascular collapse. Epinephrine is the priority treatment.
9.
Which client should the nurse assess first?
A. A client with chronic kidney disease and mild ankle edema
B. A client with pneumonia who suddenly develops severe dyspnea
C. A client with diabetes who reports increased thirst
D. A client with osteoarthritis requesting assistance with bathing
Answer: B. A client with pneumonia who suddenly develops severe dyspnea
Rationale: Acute severe dyspnea represents a potential life-threatening
respiratory problem and takes priority.
10.
Which assessment finding requires the nurse's immediate attention?
A. Heart rate of 104/min after ambulation
B. Respiratory rate of 8/min in a client receiving opioids
C. Blood pressure of 142/88 mmHg
D. Temperature of 37.7°C (99.9°F)
Answer: B. Respiratory rate of 8/min in a client receiving opioids
Rationale: Opioids can cause respiratory depression. A respiratory rate of
8/min indicates potentially dangerous hypoventilation and requires
immediate intervention.
11.
A nurse must prioritize care for four clients. Which client should be seen first?
A. A client with a chest tube who has continuous bubbling in the water-seal
chamber
B. A client with a chest tube who reports mild insertion-site discomfort
C. A client with pneumonia who has a productive cough
D. A client with emphysema requesting assistance with meals
