2025-2026 NCLEX-STYLE PRACTICE EXAM QUESTIONS
WITH 100% VERIFIED ANSWERS PLUS RATIONALES.
1. A nurse is assessing a patient with heart failure. Which finding indicates fluid
overload?
A. Dry mucous membranes
B. Weight loss of 2 kg in 24 hours
C. Crackles in lung bases
D. Decreased jugular venous pressure
Correct Answer: C
Rationale: Crackles indicate fluid accumulation in the lungs, a sign of fluid overload.
Dry mucous membranes and weight loss suggest dehydration, while decreased JVP is
not consistent with overload.
2. A client with diabetes mellitus is experiencing hypoglycemia. Which symptom should
the nurse expect?
A. Fruity breath odor
B. Kussmaul respirations
C. Diaphoresis and tremors
D. Polyuria
Correct Answer: C
Rationale: Hypoglycemia causes adrenergic symptoms such as sweating and tremors.
Fruity breath and Kussmaul respirations occur in hyperglycemia (DKA).
3. Which intervention is the nurse’s priority for a patient experiencing anaphylaxis?
A. Administer antihistamines
B. Provide IV fluids
C. Administer epinephrine
D. Monitor vital signs
Correct Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it reverses
airway constriction and hypotension. Other interventions are supportive.
4. A nurse is caring for a postoperative patient. Which finding requires immediate
action?
A. Pain rated 6/10
B. Urine output of 30 mL/hr
C. Oxygen saturation of 88%
D. Temperature of 37.5°C
Correct Answer: C
, Rationale: Oxygen saturation of 88% indicates hypoxia and requires immediate
intervention. The other findings are expected or less urgent.
5. Which electrolyte imbalance is associated with peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Hyperkalemia causes peaked T waves, which can lead to life-threatening
arrhythmias. Hypokalemia causes flattened T waves.
6. A nurse is teaching a patient about warfarin therapy. Which statement indicates
understanding?
A. “I will increase my intake of green leafy vegetables.”
B. “I will take aspirin for headaches.”
C. “I will have my INR checked regularly.”
D. “I will stop the medication if I feel better.”
Correct Answer: C
Rationale: Regular INR monitoring is essential for warfarin therapy. Vitamin K foods
and aspirin can interfere with the drug.
7. A patient with COPD is receiving oxygen therapy. What is the priority nursing
consideration?
A. Maintain oxygen at high flow rates
B. Monitor for respiratory depression
C. Encourage deep breathing exercises
D. Increase fluid intake
Correct Answer: B
Rationale: COPD patients rely on hypoxic drive; excessive oxygen can suppress
respiration. Monitoring is critical.
8. A nurse is caring for a client with increased intracranial pressure (ICP). Which
position is appropriate?
A. Supine with head flat
B. Trendelenburg position
C. Head elevated 30 degrees
D. Side-lying with knees flexed
Correct Answer: C
Rationale: Elevating the head promotes venous drainage and reduces ICP. Other
positions may increase ICP.
,9. Which lab value is most concerning for a patient receiving chemotherapy?
A. Hemoglobin 12 g/dL
B. Platelets 150,000/mm³
C. WBC 1,000/mm³
D. Sodium 140 mEq/L
Correct Answer: C
Rationale: A WBC count of 1,000 indicates severe immunosuppression, increasing
infection risk.
10. A nurse is assessing a newborn. Which finding requires immediate attention?
A. Heart rate 140 bpm
B. Respiratory rate 50/min
C. Central cyanosis
D. Acrocyanosis
Correct Answer: C
Rationale: Central cyanosis indicates hypoxia and is abnormal. Acrocyanosis is
common in newborns.
11. Which patient should the nurse assess first?
A. Patient with stable angina
B. Patient with BP 150/90
C. Patient with chest pain and diaphoresis
D. Patient requesting pain medication
Correct Answer: C
Rationale: Chest pain with diaphoresis suggests myocardial infarction and requires
immediate assessment.
12. A nurse is administering insulin. Which action is correct?
A. Shake the vial before use
B. Inject into muscle
C. Rotate injection sites
D. Aspirate before injection
Correct Answer: C
Rationale: Rotating sites prevents lipodystrophy. Insulin should not be shaken or
injected intramuscularly.
13. Which sign indicates infection in a surgical wound?
A. Serous drainage
B. Redness and warmth
C. Mild swelling
, D. Slight tenderness
Correct Answer: B
Rationale: Redness and warmth are classic signs of infection. Mild swelling and
tenderness can be normal postoperatively.
14. A nurse is caring for a patient with hypokalemia. Which food should be
recommended?
A. Apples
B. Bananas
C. Rice
D. Bread
Correct Answer: B
Rationale: Bananas are high in potassium and help correct hypokalemia.
15. Which action is appropriate when administering blood transfusion?
A. Use dextrose solution
B. Verify patient with another nurse
C. Infuse over 6 hours
D. Warm blood in microwave
Correct Answer: B
Rationale: Double-checking patient identity prevents transfusion errors. Blood should
not be mixed with dextrose or microwaved.
16. A patient has a potassium level of 6.5 mEq/L. What is the priority action?
A. Administer potassium supplements
B. Monitor ECG
C. Encourage fluids
D. Restrict sodium
Correct Answer: B
Rationale: Severe hyperkalemia can cause arrhythmias; ECG monitoring is critical.
17. Which finding indicates effective pain management?
A. Patient sleeping
B. Patient reports pain 2/10
C. Patient avoids movement
D. Patient requests medication
Correct Answer: B
Rationale: Patient self-report is the most reliable indicator of pain control.
WITH 100% VERIFIED ANSWERS PLUS RATIONALES.
1. A nurse is assessing a patient with heart failure. Which finding indicates fluid
overload?
A. Dry mucous membranes
B. Weight loss of 2 kg in 24 hours
C. Crackles in lung bases
D. Decreased jugular venous pressure
Correct Answer: C
Rationale: Crackles indicate fluid accumulation in the lungs, a sign of fluid overload.
Dry mucous membranes and weight loss suggest dehydration, while decreased JVP is
not consistent with overload.
2. A client with diabetes mellitus is experiencing hypoglycemia. Which symptom should
the nurse expect?
A. Fruity breath odor
B. Kussmaul respirations
C. Diaphoresis and tremors
D. Polyuria
Correct Answer: C
Rationale: Hypoglycemia causes adrenergic symptoms such as sweating and tremors.
Fruity breath and Kussmaul respirations occur in hyperglycemia (DKA).
3. Which intervention is the nurse’s priority for a patient experiencing anaphylaxis?
A. Administer antihistamines
B. Provide IV fluids
C. Administer epinephrine
D. Monitor vital signs
Correct Answer: C
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it reverses
airway constriction and hypotension. Other interventions are supportive.
4. A nurse is caring for a postoperative patient. Which finding requires immediate
action?
A. Pain rated 6/10
B. Urine output of 30 mL/hr
C. Oxygen saturation of 88%
D. Temperature of 37.5°C
Correct Answer: C
, Rationale: Oxygen saturation of 88% indicates hypoxia and requires immediate
intervention. The other findings are expected or less urgent.
5. Which electrolyte imbalance is associated with peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Hyperkalemia causes peaked T waves, which can lead to life-threatening
arrhythmias. Hypokalemia causes flattened T waves.
6. A nurse is teaching a patient about warfarin therapy. Which statement indicates
understanding?
A. “I will increase my intake of green leafy vegetables.”
B. “I will take aspirin for headaches.”
C. “I will have my INR checked regularly.”
D. “I will stop the medication if I feel better.”
Correct Answer: C
Rationale: Regular INR monitoring is essential for warfarin therapy. Vitamin K foods
and aspirin can interfere with the drug.
7. A patient with COPD is receiving oxygen therapy. What is the priority nursing
consideration?
A. Maintain oxygen at high flow rates
B. Monitor for respiratory depression
C. Encourage deep breathing exercises
D. Increase fluid intake
Correct Answer: B
Rationale: COPD patients rely on hypoxic drive; excessive oxygen can suppress
respiration. Monitoring is critical.
8. A nurse is caring for a client with increased intracranial pressure (ICP). Which
position is appropriate?
A. Supine with head flat
B. Trendelenburg position
C. Head elevated 30 degrees
D. Side-lying with knees flexed
Correct Answer: C
Rationale: Elevating the head promotes venous drainage and reduces ICP. Other
positions may increase ICP.
,9. Which lab value is most concerning for a patient receiving chemotherapy?
A. Hemoglobin 12 g/dL
B. Platelets 150,000/mm³
C. WBC 1,000/mm³
D. Sodium 140 mEq/L
Correct Answer: C
Rationale: A WBC count of 1,000 indicates severe immunosuppression, increasing
infection risk.
10. A nurse is assessing a newborn. Which finding requires immediate attention?
A. Heart rate 140 bpm
B. Respiratory rate 50/min
C. Central cyanosis
D. Acrocyanosis
Correct Answer: C
Rationale: Central cyanosis indicates hypoxia and is abnormal. Acrocyanosis is
common in newborns.
11. Which patient should the nurse assess first?
A. Patient with stable angina
B. Patient with BP 150/90
C. Patient with chest pain and diaphoresis
D. Patient requesting pain medication
Correct Answer: C
Rationale: Chest pain with diaphoresis suggests myocardial infarction and requires
immediate assessment.
12. A nurse is administering insulin. Which action is correct?
A. Shake the vial before use
B. Inject into muscle
C. Rotate injection sites
D. Aspirate before injection
Correct Answer: C
Rationale: Rotating sites prevents lipodystrophy. Insulin should not be shaken or
injected intramuscularly.
13. Which sign indicates infection in a surgical wound?
A. Serous drainage
B. Redness and warmth
C. Mild swelling
, D. Slight tenderness
Correct Answer: B
Rationale: Redness and warmth are classic signs of infection. Mild swelling and
tenderness can be normal postoperatively.
14. A nurse is caring for a patient with hypokalemia. Which food should be
recommended?
A. Apples
B. Bananas
C. Rice
D. Bread
Correct Answer: B
Rationale: Bananas are high in potassium and help correct hypokalemia.
15. Which action is appropriate when administering blood transfusion?
A. Use dextrose solution
B. Verify patient with another nurse
C. Infuse over 6 hours
D. Warm blood in microwave
Correct Answer: B
Rationale: Double-checking patient identity prevents transfusion errors. Blood should
not be mixed with dextrose or microwaved.
16. A patient has a potassium level of 6.5 mEq/L. What is the priority action?
A. Administer potassium supplements
B. Monitor ECG
C. Encourage fluids
D. Restrict sodium
Correct Answer: B
Rationale: Severe hyperkalemia can cause arrhythmias; ECG monitoring is critical.
17. Which finding indicates effective pain management?
A. Patient sleeping
B. Patient reports pain 2/10
C. Patient avoids movement
D. Patient requests medication
Correct Answer: B
Rationale: Patient self-report is the most reliable indicator of pain control.
