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2025 NCLEX-RN Practice Exam –
Actual Questions with Comprehensive
Clinical Scenarios | 100% Accurate
Student Name: _________________________
Date: _______________
Time Limit: 120 minutes
Total Questions: 85
Safe and Effective Care Environment (1–20)
1. A nurse is prioritizing care for four clients. Which client should the nurse assess
first?
A. A client with stable angina requesting a follow-up
B. A client with a new onset of chest pain and diaphoresis
C. A client with a scheduled wound dressing change
D. A client with diabetes needing insulin
Correct Answer: B. A client with a new onset of chest pain and diaphoresis
Rationale: Chest pain and diaphoresis suggest an acute cardiac event, a life-
threatening priority, per NCLEX-RN guidelines.
2. Case Study: A nurse is delegating tasks to an assistive personnel (AP). Which
task is appropriate to delegate?
A. Administering oral medications
B. Assisting with ambulation
C. Performing a sterile dressing change
D. Developing a care plan
Correct Answer: B. Assisting with ambulation
Rationale: Assisting with ambulation is within the AP’s scope; medication
administration, sterile procedures, and care planning are RN tasks, per NCLEX-
RN guidelines.
3. A client with MRSA is on contact precautions. What is the nurse’s priority
action?
A. Wear gloves and a gown when entering the room
B. Allow shared equipment use
C. Restrict hand hygiene
D. Encourage unrestricted visitors
Correct Answer: A. Wear gloves and a gown when entering the room
Rationale: Contact precautions require gloves and a gown to prevent MRSA
spread, per CDC and NCLEX-RN guidelines.
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4. SATA: Which actions ensure safe medication administration? (Select All That
Apply)
A. Verify client identity with two identifiers
B. Check the medication label three times
C. Administer without checking allergies
D. Document after administration
E. Ignore the five rights
Correct Answers: A, B, D
Rationale: Verifying identity, checking the label, and documenting ensure
safety. Ignoring allergies and the five rights is unsafe, per NCLEX-RN
guidelines.
5. A client with a fall history is admitted. What is the nurse’s priority intervention?
A. Keep the bed in the highest position
B. Implement a fall prevention plan
C. Restrict all ambulation
D. Remove all safety devices
Correct Answer: B. Implement a fall prevention plan
Rationale: A fall prevention plan reduces fall risk, per NCLEX-RN guidelines.
6. A nurse is preparing a client for surgery. What is the priority preoperative
action?
A. Verify the signed consent form
B. Encourage oral fluids
C. Skip allergy checks
D. Restrict all monitoring
Correct Answer: A. Verify the signed consent form
Rationale: Verifying consent ensures legal and ethical compliance, per NCLEX-
RN guidelines.
7. A client with a latex allergy is scheduled for a procedure. What is the nurse’s
priority action?
A. Use latex gloves
B. Ensure a latex-free environment
C. Ignore the allergy
D. Restrict all equipment
Correct Answer: B. Ensure a latex-free environment
Rationale: A latex-free environment prevents allergic reactions, per NCLEX-RN
guidelines.
8. Calculation: A client is prescribed 1000 mL of IV fluid over 8 hours. What is the
infusion rate in mL/hr?
A. 100 mL/hr
B. 125 mL/hr
C. 150 mL/hr
D. 200 mL/hr
Correct Answer: B. 125 mL/hr
Rationale: Rate = 1000 mL ÷ 8 hr = 125 mL/hr, per NCLEX-RN calculation
standards.
9. A nurse is caring for a client with a central venous catheter. What is the priority
intervention to prevent infection?
A. Use sterile technique for dressing changes
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B. Allow non-sterile handling
C. Restrict site cleaning
D. Encourage site manipulation
Correct Answer: A. Use sterile technique for dressing changes
Rationale: Sterile technique prevents catheter-related infections, per NCLEX-
RN guidelines.
10. A client with a new prescription needs clarification. What is the nurse’s priority
action?
A. Administer without clarification
B. Consult the provider
C. Delegate to an AP
D. Ignore the prescription
Correct Answer: B. Consult the provider
Rationale: Clarification ensures safe administration, per NCLEX-RN guidelines.
11. A client with a terminal illness requests hospice care. What is the nurse’s
priority action?
A. Coordinate with the interdisciplinary team
B. Restrict all family involvement
C. Ignore the request
D. Administer a sedative
Correct Answer: A. Coordinate with the interdisciplinary team
Rationale: Coordination ensures appropriate hospice referral, per NCLEX-RN
guidelines.
12. A nurse is teaching a client about advance directives. What is the priority
teaching point?
A. Advance directives are optional and unnecessary
B. They outline the client’s healthcare wishes
C. They restrict all medical interventions
D. They are only for young clients
Correct Answer: B. They outline the client’s healthcare wishes
Rationale: Advance directives communicate client preferences, per NCLEX-RN
guidelines.
13. A client with a wound infection needs dressing changes. What is the priority
intervention?
A. Use non-sterile gloves
B. Perform sterile dressing changes
C. Restrict all dressings
D. Delegate to an AP
Correct Answer: B. Perform sterile dressing changes
Rationale: Sterile technique prevents infection worsening, per NCLEX-RN
guidelines.
14. A nurse is managing a client with a chest tube. What is the priority safety
action?
A. Keep the drainage system above chest level
B. Ensure the drainage system is below chest level
C. Restrict all monitoring
D. Disconnect the system frequently
Correct Answer: B. Ensure the drainage system is below chest level
2025 NCLEX-RN Practice Exam –
Actual Questions with Comprehensive
Clinical Scenarios | 100% Accurate
Student Name: _________________________
Date: _______________
Time Limit: 120 minutes
Total Questions: 85
Safe and Effective Care Environment (1–20)
1. A nurse is prioritizing care for four clients. Which client should the nurse assess
first?
A. A client with stable angina requesting a follow-up
B. A client with a new onset of chest pain and diaphoresis
C. A client with a scheduled wound dressing change
D. A client with diabetes needing insulin
Correct Answer: B. A client with a new onset of chest pain and diaphoresis
Rationale: Chest pain and diaphoresis suggest an acute cardiac event, a life-
threatening priority, per NCLEX-RN guidelines.
2. Case Study: A nurse is delegating tasks to an assistive personnel (AP). Which
task is appropriate to delegate?
A. Administering oral medications
B. Assisting with ambulation
C. Performing a sterile dressing change
D. Developing a care plan
Correct Answer: B. Assisting with ambulation
Rationale: Assisting with ambulation is within the AP’s scope; medication
administration, sterile procedures, and care planning are RN tasks, per NCLEX-
RN guidelines.
3. A client with MRSA is on contact precautions. What is the nurse’s priority
action?
A. Wear gloves and a gown when entering the room
B. Allow shared equipment use
C. Restrict hand hygiene
D. Encourage unrestricted visitors
Correct Answer: A. Wear gloves and a gown when entering the room
Rationale: Contact precautions require gloves and a gown to prevent MRSA
spread, per CDC and NCLEX-RN guidelines.
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4. SATA: Which actions ensure safe medication administration? (Select All That
Apply)
A. Verify client identity with two identifiers
B. Check the medication label three times
C. Administer without checking allergies
D. Document after administration
E. Ignore the five rights
Correct Answers: A, B, D
Rationale: Verifying identity, checking the label, and documenting ensure
safety. Ignoring allergies and the five rights is unsafe, per NCLEX-RN
guidelines.
5. A client with a fall history is admitted. What is the nurse’s priority intervention?
A. Keep the bed in the highest position
B. Implement a fall prevention plan
C. Restrict all ambulation
D. Remove all safety devices
Correct Answer: B. Implement a fall prevention plan
Rationale: A fall prevention plan reduces fall risk, per NCLEX-RN guidelines.
6. A nurse is preparing a client for surgery. What is the priority preoperative
action?
A. Verify the signed consent form
B. Encourage oral fluids
C. Skip allergy checks
D. Restrict all monitoring
Correct Answer: A. Verify the signed consent form
Rationale: Verifying consent ensures legal and ethical compliance, per NCLEX-
RN guidelines.
7. A client with a latex allergy is scheduled for a procedure. What is the nurse’s
priority action?
A. Use latex gloves
B. Ensure a latex-free environment
C. Ignore the allergy
D. Restrict all equipment
Correct Answer: B. Ensure a latex-free environment
Rationale: A latex-free environment prevents allergic reactions, per NCLEX-RN
guidelines.
8. Calculation: A client is prescribed 1000 mL of IV fluid over 8 hours. What is the
infusion rate in mL/hr?
A. 100 mL/hr
B. 125 mL/hr
C. 150 mL/hr
D. 200 mL/hr
Correct Answer: B. 125 mL/hr
Rationale: Rate = 1000 mL ÷ 8 hr = 125 mL/hr, per NCLEX-RN calculation
standards.
9. A nurse is caring for a client with a central venous catheter. What is the priority
intervention to prevent infection?
A. Use sterile technique for dressing changes
, 3
B. Allow non-sterile handling
C. Restrict site cleaning
D. Encourage site manipulation
Correct Answer: A. Use sterile technique for dressing changes
Rationale: Sterile technique prevents catheter-related infections, per NCLEX-
RN guidelines.
10. A client with a new prescription needs clarification. What is the nurse’s priority
action?
A. Administer without clarification
B. Consult the provider
C. Delegate to an AP
D. Ignore the prescription
Correct Answer: B. Consult the provider
Rationale: Clarification ensures safe administration, per NCLEX-RN guidelines.
11. A client with a terminal illness requests hospice care. What is the nurse’s
priority action?
A. Coordinate with the interdisciplinary team
B. Restrict all family involvement
C. Ignore the request
D. Administer a sedative
Correct Answer: A. Coordinate with the interdisciplinary team
Rationale: Coordination ensures appropriate hospice referral, per NCLEX-RN
guidelines.
12. A nurse is teaching a client about advance directives. What is the priority
teaching point?
A. Advance directives are optional and unnecessary
B. They outline the client’s healthcare wishes
C. They restrict all medical interventions
D. They are only for young clients
Correct Answer: B. They outline the client’s healthcare wishes
Rationale: Advance directives communicate client preferences, per NCLEX-RN
guidelines.
13. A client with a wound infection needs dressing changes. What is the priority
intervention?
A. Use non-sterile gloves
B. Perform sterile dressing changes
C. Restrict all dressings
D. Delegate to an AP
Correct Answer: B. Perform sterile dressing changes
Rationale: Sterile technique prevents infection worsening, per NCLEX-RN
guidelines.
14. A nurse is managing a client with a chest tube. What is the priority safety
action?
A. Keep the drainage system above chest level
B. Ensure the drainage system is below chest level
C. Restrict all monitoring
D. Disconnect the system frequently
Correct Answer: B. Ensure the drainage system is below chest level
