NCLEX-RN Comprehensive Practice Exam
2025 Questions and Answers with
Rationales
1. A client with heart failure is receiving furosemide. Which laboratory value
should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Hemoglobin
D. Magnesium
Rationale:
B. Potassium – Furosemide is a loop diuretic that causes potassium loss in the
urine. Hypokalemia can lead to serious cardiac arrhythmias.
2. A nurse is caring for a client who has been newly diagnosed with Type 1
diabetes. Which statement by the client indicates a need for further teaching?
A. "I will carry a source of glucose with me at all times."
B. "I will check my blood sugar before meals and at bedtime."
,C. "I will stop taking insulin if I become sick."
D. "I will rotate my insulin injection sites."
Rationale:
C. Insulin should never be discontinued during illness; in fact, illness can raise
blood glucose. The client needs to adjust insulin and monitor more closely.
3. The nurse is teaching a group of parents about child safety. Which statement
about car seat safety is correct?
A. "A toddler can face forward in a car seat after 12 months."
B. "Infants should ride rear-facing until they are at least 2 years old."
C. "Children can ride in the front seat at 4 years old."
D. "Booster seats are needed only until age 4."
Rationale:
B. Current guidelines recommend rear-facing seats until age 2 or until they reach
the height/weight limit of the car seat.
4. A nurse is preparing to administer morphine sulfate to a postoperative client.
Which is the highest priority nursing action before administration?
A. Assess the client’s pain level
B. Assess respiratory rate
C. Check for bowel sounds
D. Assess surgical site
, Rationale:
B. Morphine is a respiratory depressant. Always assess respirations before
administration to avoid hypoventilation or apnea.
5. A client with pneumonia has a productive cough and reports chest pain.
Which nursing diagnosis is most appropriate?
A. Ineffective airway clearance related to inflammation
B. Acute pain related to coughing and inflammation
C. Impaired gas exchange related to infection
D. Activity intolerance related to fatigue
Rationale:
B. The priority symptom reported is chest pain with coughing, which aligns with
the diagnosis of acute pain.
6. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. The nurse
should first:
A. Increase oxygen to 10 L/min
B. Notify the healthcare provider
C. Switch to a non-rebreather mask
D. Encourage coughing and deep breathing
Rationale:
B. High-flow oxygen may suppress the respiratory drive in COPD clients. Notify the
provider to reevaluate the order.
2025 Questions and Answers with
Rationales
1. A client with heart failure is receiving furosemide. Which laboratory value
should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Hemoglobin
D. Magnesium
Rationale:
B. Potassium – Furosemide is a loop diuretic that causes potassium loss in the
urine. Hypokalemia can lead to serious cardiac arrhythmias.
2. A nurse is caring for a client who has been newly diagnosed with Type 1
diabetes. Which statement by the client indicates a need for further teaching?
A. "I will carry a source of glucose with me at all times."
B. "I will check my blood sugar before meals and at bedtime."
,C. "I will stop taking insulin if I become sick."
D. "I will rotate my insulin injection sites."
Rationale:
C. Insulin should never be discontinued during illness; in fact, illness can raise
blood glucose. The client needs to adjust insulin and monitor more closely.
3. The nurse is teaching a group of parents about child safety. Which statement
about car seat safety is correct?
A. "A toddler can face forward in a car seat after 12 months."
B. "Infants should ride rear-facing until they are at least 2 years old."
C. "Children can ride in the front seat at 4 years old."
D. "Booster seats are needed only until age 4."
Rationale:
B. Current guidelines recommend rear-facing seats until age 2 or until they reach
the height/weight limit of the car seat.
4. A nurse is preparing to administer morphine sulfate to a postoperative client.
Which is the highest priority nursing action before administration?
A. Assess the client’s pain level
B. Assess respiratory rate
C. Check for bowel sounds
D. Assess surgical site
, Rationale:
B. Morphine is a respiratory depressant. Always assess respirations before
administration to avoid hypoventilation or apnea.
5. A client with pneumonia has a productive cough and reports chest pain.
Which nursing diagnosis is most appropriate?
A. Ineffective airway clearance related to inflammation
B. Acute pain related to coughing and inflammation
C. Impaired gas exchange related to infection
D. Activity intolerance related to fatigue
Rationale:
B. The priority symptom reported is chest pain with coughing, which aligns with
the diagnosis of acute pain.
6. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. The nurse
should first:
A. Increase oxygen to 10 L/min
B. Notify the healthcare provider
C. Switch to a non-rebreather mask
D. Encourage coughing and deep breathing
Rationale:
B. High-flow oxygen may suppress the respiratory drive in COPD clients. Notify the
provider to reevaluate the order.
