NCLEX-RN Practice Questions (100 Q&A)
Q1 (Medical-Surgical): A client with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor most closely?
A. Hemoglobin
B. Potassium
C. Calcium
D. Platelets
Answer: B
Rationale: Furosemide increases potassium excretion, which may lead to hypokalemia.
Q2 (Leadership & Prioritization): Which client should the nurse assess first?
A. A post-op patient requesting pain medication
B. A diabetic patient with blood glucose of 45 mg/dL
C. A patient with a fever of 101°F
D. A patient scheduled for discharge
Answer: B
Rationale: The diabetic patient is at risk for hypoglycemia, which is life-threatening and needs
immediate attention.
Q3 (Medical-Surgical): A nurse is caring for a client receiving a blood transfusion. Which finding
requires immediate intervention?
A. Temperature increase of 1.5°F
B. Mild backache
C. Chills and hypotension
D. Nausea after eating lunch
Answer: C
Rationale: Chills and hypotension are signs of a transfusion reaction.
Q4 (Pharmacology): A client newly diagnosed with type 1 diabetes asks why they can't take oral
,medications. What's the best response?
A. 'Your pancreas still makes some insulin.'
B. 'Oral medications are not strong enough.'
C. 'You are allergic to oral diabetic meds.'
D. 'Insulin is needed because your body doesn't produce it.'
Answer: D
Rationale: Type 1 diabetics have no insulin production and require insulin therapy.
Q5 (Mental Health): What is the priority nursing intervention for a client experiencing a panic attack?
A. Encourage deep breathing
B. Provide anti-anxiety medication
C. Teach coping skills
D. Offer food and water
Answer: A
Rationale: Deep breathing helps manage acute anxiety and hyperventilation.
Q6 (Pharmacology): A nurse is preparing to administer digoxin. Which finding requires holding the
medication?
A. Blood pressure 110/70
B. Apical pulse 56 bpm
C. Potassium 4.0 mEq/L
D. Digoxin level 1.0 ng/mL
Answer: B
Rationale: Hold digoxin if the apical pulse is below 60 bpm.
Q7 (Medical-Surgical): Which dietary choice is best for a client with celiac disease?
A. Whole wheat pasta
B. Rye toast
C. Brown rice
D. Barley soup
, Answer: C
Rationale: Brown rice is gluten-free and safe for celiac patients.
Q8 (Maternity & Newborn): A pregnant client in the third trimester reports headaches and visual
changes. What complication is suspected?
A. Gestational diabetes
B. Hyperemesis gravidarum
C. Preeclampsia
D. Placenta previa
Answer: C
Rationale: These are classic signs of preeclampsia.
Q9 (Pharmacology): A nurse is reinforcing teaching with a client on warfarin. Which statement
shows understanding?
A. 'I will eat more leafy greens.'
B. 'I will use a soft toothbrush.'
C. 'I can take aspirin for pain.'
D. 'I'll double my dose if I miss one.'
Answer: B
Rationale: Using a soft toothbrush reduces the risk of bleeding gums with warfarin.
Q10 (Medical-Surgical): A client with COPD is receiving oxygen via nasal cannula at 6 L/min. What
should the nurse do?
A. Continue oxygen as ordered
B. Decrease oxygen to 2 L/min
C. Switch to non-rebreather mask
D. Call the provider for new orders
Answer: B
Rationale: High O2 flow in COPD can suppress respiratory drive; maintain low-flow oxygen.
Q11 (Pharmacology): Which instruction should the nurse give a client taking alendronate for
Q1 (Medical-Surgical): A client with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor most closely?
A. Hemoglobin
B. Potassium
C. Calcium
D. Platelets
Answer: B
Rationale: Furosemide increases potassium excretion, which may lead to hypokalemia.
Q2 (Leadership & Prioritization): Which client should the nurse assess first?
A. A post-op patient requesting pain medication
B. A diabetic patient with blood glucose of 45 mg/dL
C. A patient with a fever of 101°F
D. A patient scheduled for discharge
Answer: B
Rationale: The diabetic patient is at risk for hypoglycemia, which is life-threatening and needs
immediate attention.
Q3 (Medical-Surgical): A nurse is caring for a client receiving a blood transfusion. Which finding
requires immediate intervention?
A. Temperature increase of 1.5°F
B. Mild backache
C. Chills and hypotension
D. Nausea after eating lunch
Answer: C
Rationale: Chills and hypotension are signs of a transfusion reaction.
Q4 (Pharmacology): A client newly diagnosed with type 1 diabetes asks why they can't take oral
,medications. What's the best response?
A. 'Your pancreas still makes some insulin.'
B. 'Oral medications are not strong enough.'
C. 'You are allergic to oral diabetic meds.'
D. 'Insulin is needed because your body doesn't produce it.'
Answer: D
Rationale: Type 1 diabetics have no insulin production and require insulin therapy.
Q5 (Mental Health): What is the priority nursing intervention for a client experiencing a panic attack?
A. Encourage deep breathing
B. Provide anti-anxiety medication
C. Teach coping skills
D. Offer food and water
Answer: A
Rationale: Deep breathing helps manage acute anxiety and hyperventilation.
Q6 (Pharmacology): A nurse is preparing to administer digoxin. Which finding requires holding the
medication?
A. Blood pressure 110/70
B. Apical pulse 56 bpm
C. Potassium 4.0 mEq/L
D. Digoxin level 1.0 ng/mL
Answer: B
Rationale: Hold digoxin if the apical pulse is below 60 bpm.
Q7 (Medical-Surgical): Which dietary choice is best for a client with celiac disease?
A. Whole wheat pasta
B. Rye toast
C. Brown rice
D. Barley soup
, Answer: C
Rationale: Brown rice is gluten-free and safe for celiac patients.
Q8 (Maternity & Newborn): A pregnant client in the third trimester reports headaches and visual
changes. What complication is suspected?
A. Gestational diabetes
B. Hyperemesis gravidarum
C. Preeclampsia
D. Placenta previa
Answer: C
Rationale: These are classic signs of preeclampsia.
Q9 (Pharmacology): A nurse is reinforcing teaching with a client on warfarin. Which statement
shows understanding?
A. 'I will eat more leafy greens.'
B. 'I will use a soft toothbrush.'
C. 'I can take aspirin for pain.'
D. 'I'll double my dose if I miss one.'
Answer: B
Rationale: Using a soft toothbrush reduces the risk of bleeding gums with warfarin.
Q10 (Medical-Surgical): A client with COPD is receiving oxygen via nasal cannula at 6 L/min. What
should the nurse do?
A. Continue oxygen as ordered
B. Decrease oxygen to 2 L/min
C. Switch to non-rebreather mask
D. Call the provider for new orders
Answer: B
Rationale: High O2 flow in COPD can suppress respiratory drive; maintain low-flow oxygen.
Q11 (Pharmacology): Which instruction should the nurse give a client taking alendronate for
