Sample Questions

NCLEX-RN Sample Questions

6 practice questions with complete answer explanations.

Sample Questions

Question 1priority

A client with heart failure is admitted with crackles in both lung bases, 2+ pedal edema, and oxygen saturation of 89%. Which intervention should the nurse implement FIRST?

A.Administer prescribed furosemide (Lasix)

B.Elevate the head of the bed to 45°✓ Correct

C.Obtain a 12-lead ECG

D.Notify the healthcare provider

Explanation

Airway/breathing first. Elevating the head of bed is a non-pharmacological intervention that can be done immediately and improves oxygenation. Lasix comes next.

Question 2lab-values

A nurse is caring for a client with type 1 diabetes who presents with blood glucose of 420 mg/dL, Kussmaul respirations, and fruity breath. Which laboratory result is the nurse MOST concerned about?

A.Serum sodium 132 mEq/L

B.Serum potassium 6.8 mEq/L✓ Correct

C.Serum creatinine 1.0 mg/dL

D.Hemoglobin A1C 11%

Explanation

This is DKA. Hyperkalemia (6.8) is life-threatening and must be addressed immediately despite the low pH driving K out of cells.

Question 3priority

Which of the following clients should the nurse assess FIRST?

A.A postoperative client reporting 7/10 incisional pain

B.A client on continuous bladder irrigation with bright red drainage

C.A client with new-onset atrial fibrillation with heart rate 120 bpm✓ Correct

D.A client with pneumonia with O2 saturation of 92% on 2L NC

Explanation

New-onset A-fib with RVR is the most unstable — risk of clot formation and hemodynamic compromise. The pneumonia client is stable at 92%.

Question 4medication

A client receiving heparin infusion has an aPTT of 110 seconds (normal 25–35). Which action should the nurse take first?

A.Stop the heparin infusion immediately✓ Correct

B.Administer protamine sulfate

C.Notify the healthcare provider

D.Apply pressure to all IV sites

Explanation

aPTT 110 is 3–4× normal — stop the heparin FIRST, then notify HCP. Protamine is the antidote but requires an order.

Question 5complication

A client with acute pancreatitis has been NPO for 3 days. Which assessment finding indicates a potential complication?

A.Serum amylase 320 (slightly elevated)

B.Reports of hunger

C.Serum calcium 7.2 mg/dL✓ Correct

D.Bowel sounds returning

Explanation

Hypocalcemia (<8.5) is a classic pancreatitis complication — fat saponification binds calcium. Risk of tetany and seizures.

Question 6teaching

The nurse is teaching a client about warfarin therapy. Which statement indicates the client needs MORE teaching?

A.'I'll use an electric razor instead of a blade.'

B.'I'll eat more spinach and kale to stay healthy.'✓ Correct

C.'I'll tell my dentist I'm on this medicine.'

D.'I'll check my stools for any dark color.'

Explanation

Vitamin-K-rich leafy greens antagonize warfarin. The client should keep intake CONSISTENT, not increase it.

Test-Taking Tips

1.Prioritize content review in high-yield areas: cardiac, respiratory, endocrine, OB, pharm.
2.Practice with NCLEX-style questions — 3,000+ before the exam is a common benchmark.
3.Focus on prioritization and delegation — these are the hardest question types.
4.Master SATA questions — they're often the trickiest.
5.Review NGN item types specifically — case studies account for ~10% of questions.
6.Don't study the day before the exam. Rest, hydrate, eat well.

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