nursing exam with questions and correct answers
Comprehensive Nursing Practice Exam 2023–2026
| 50 NCLEX-Style Questions with Correct Answers
& Detailed Rationales
Question 1
A nurse is caring for a client with heart failure. Which symptom should the nurse
recognize as an indication of fluid overload?
A. Weight loss
B. Crackles in the lungs
C. Dry mucous membranes
D. Decreased blood pressure
Correct Answer: B. Crackles in the lungs
Rationale:
Fluid overload in heart failure causes fluid accumulation in the lungs, resulting in
crackles (rales) during auscultation. Other common signs include edema, shortness
of breath, and weight gain.
Question 2
A nurse is administering insulin to a client with diabetes. Which complication is
most important for the nurse to monitor?
A. Hyperglycemia
B. Hypoglycemia
C. Hypertension
D. Hypercalcemia
Correct Answer: B. Hypoglycemia
Rationale:
Insulin lowers blood glucose levels. The most immediate and dangerous
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,complication is hypoglycemia, which can cause confusion, sweating, shakiness,
seizures, or unconsciousness.
Question 3
A nurse is caring for a client who is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. Hemoglobin
B. Platelet count
C. INR
D. Blood glucose
Correct Answer: C. INR
Rationale:
Warfarin therapy is monitored using the International Normalized Ratio (INR). A
typical therapeutic range for many conditions is 2.0–3.0.
Question 4
A nurse is caring for a client with pneumonia. Which intervention helps improve
oxygenation?
A. Encourage coughing and deep breathing
B. Limit fluid intake
C. Keep the client flat in bed
D. Restrict activity completely
Correct Answer: A. Encourage coughing and deep breathing
Rationale:
Coughing and deep breathing help mobilize secretions, expand the lungs, and
improve oxygen exchange in clients with pneumonia.
Question 5
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, A nurse is caring for a client receiving morphine for pain management. Which
assessment should be performed first?
A. Respiratory rate
B. Temperature
C. Blood glucose
D. Urine output
Correct Answer: A. Respiratory rate
Rationale:
Morphine is an opioid that can cause respiratory depression. The nurse must assess
respiratory rate before administering the medication.
Question 6
A nurse is caring for a client with dehydration. Which finding should the nurse
expect?
A. Decreased hematocrit
B. Increased urine output
C. Dry mucous membranes
D. Bradycardia
Correct Answer: C. Dry mucous membranes
Rationale:
Dehydration causes dry mucous membranes, decreased urine output, tachycardia,
and increased hematocrit due to fluid loss.
Question 7
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD).
Which oxygen flow rate is generally recommended?
A. 1–2 L/min via nasal cannula
B. 6–8 L/min via mask
Page 3 of 23
Comprehensive Nursing Practice Exam 2023–2026
| 50 NCLEX-Style Questions with Correct Answers
& Detailed Rationales
Question 1
A nurse is caring for a client with heart failure. Which symptom should the nurse
recognize as an indication of fluid overload?
A. Weight loss
B. Crackles in the lungs
C. Dry mucous membranes
D. Decreased blood pressure
Correct Answer: B. Crackles in the lungs
Rationale:
Fluid overload in heart failure causes fluid accumulation in the lungs, resulting in
crackles (rales) during auscultation. Other common signs include edema, shortness
of breath, and weight gain.
Question 2
A nurse is administering insulin to a client with diabetes. Which complication is
most important for the nurse to monitor?
A. Hyperglycemia
B. Hypoglycemia
C. Hypertension
D. Hypercalcemia
Correct Answer: B. Hypoglycemia
Rationale:
Insulin lowers blood glucose levels. The most immediate and dangerous
Page 1 of 23
,complication is hypoglycemia, which can cause confusion, sweating, shakiness,
seizures, or unconsciousness.
Question 3
A nurse is caring for a client who is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. Hemoglobin
B. Platelet count
C. INR
D. Blood glucose
Correct Answer: C. INR
Rationale:
Warfarin therapy is monitored using the International Normalized Ratio (INR). A
typical therapeutic range for many conditions is 2.0–3.0.
Question 4
A nurse is caring for a client with pneumonia. Which intervention helps improve
oxygenation?
A. Encourage coughing and deep breathing
B. Limit fluid intake
C. Keep the client flat in bed
D. Restrict activity completely
Correct Answer: A. Encourage coughing and deep breathing
Rationale:
Coughing and deep breathing help mobilize secretions, expand the lungs, and
improve oxygen exchange in clients with pneumonia.
Question 5
Page 2 of 23
, A nurse is caring for a client receiving morphine for pain management. Which
assessment should be performed first?
A. Respiratory rate
B. Temperature
C. Blood glucose
D. Urine output
Correct Answer: A. Respiratory rate
Rationale:
Morphine is an opioid that can cause respiratory depression. The nurse must assess
respiratory rate before administering the medication.
Question 6
A nurse is caring for a client with dehydration. Which finding should the nurse
expect?
A. Decreased hematocrit
B. Increased urine output
C. Dry mucous membranes
D. Bradycardia
Correct Answer: C. Dry mucous membranes
Rationale:
Dehydration causes dry mucous membranes, decreased urine output, tachycardia,
and increased hematocrit due to fluid loss.
Question 7
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD).
Which oxygen flow rate is generally recommended?
A. 1–2 L/min via nasal cannula
B. 6–8 L/min via mask
Page 3 of 23
