NCLEX-RN EXAM – PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
*1. Management of Care*
*2. Safety and Infection Control*
*3. Health Promotion and Maintenance*
*4. Psychosocial Integrity*
*5. Basic Care and Comfort*
*6. Pharmacological and Parenteral Therapies*
*7. Reduction of Risk Potential*
*8. Physiological Adaptation*
*Introduction*
*The purpose of this practice examination is to prepare nursing candidates for the rigorous stand
Section One: Questions 1–100
1. A nurse is caring for a client with a suspected pheochromocytoma. Which assessment finding
requires the most immediate intervention?
A. Blood pressure of 180/110 mmHg
B. Heart rate of 110 beats per minute
C. Report of a severe, throbbing headache
D. Blood glucose level of 160 mg/dL
, 🟢 A. Blood pressure of 180/110 mmHg
🔴 RATIONALE: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive
catecholamines; severe hypertension poses the highest risk for hypertensive crisis, stroke, or organ
damage, requiring immediate attention.
2. Which action by the nurse is the priority when caring for a client who is experiencing a tonic-clonic
seizure?
A. Attempting to restrain the client’s extremities
B. Inserting a padded tongue blade into the mouth
C. Clearing the area around the client of hard objects
D. Administering an intravenous bolus of diazepam
🟢 C. Clearing the area around the client of hard objects
🔴 RATIONALE: Safety is the priority during a seizure; clearing the area prevents injury from flailing
limbs or head trauma, while other options are contraindicated or not the first step.
3. A nurse is evaluating a client’s understanding of a new prescription for warfarin. Which statement by
the client indicates a need for further teaching?
A. I will keep my intake of green leafy vegetables consistent daily.
B. I will use a soft-bristled toothbrush for daily oral hygiene.
C. I will take an extra dose if I miss one to maintain therapeutic levels.
D. I will contact my provider if I notice any unusual bruising.
🟢 C. I will take an extra dose if I miss one to maintain therapeutic levels.
🔴 RATIONALE: Doubling or taking an extra dose of warfarin significantly increases the risk of
hemorrhage and is unsafe; missed doses should not be doubled.
4. A client with type 1 diabetes mellitus is found unconscious and unresponsive. Which action should
the nurse take first?
A. Administer subcutaneous insulin
, B. Assess the client’s capillary blood glucose
C. Provide an oral source of fast-acting glucose
D. Prepare to administer intravenous dextrose
🟢 B. Assess the client’s capillary blood glucose
🔴 RATIONALE: The nurse must confirm hypoglycemia before initiating treatment; assessing blood
glucose provides the necessary data to determine if the client is experiencing hypoglycemia or
another emergency.
5. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling in the water seal
chamber. What is the priority nursing action?
A. Document the finding in the medical record
B. Increase the suction pressure to the drainage system
C. Assess the chest tube system for an air leak
D. Reposition the client to the semi-Fowler position
🟢 C. Assess the chest tube system for an air leak
🔴 RATIONALE: Continuous bubbling in the water seal chamber indicates an air leak in the system,
which must be identified and corrected immediately to ensure proper lung re-expansion.
6. Which laboratory result should the nurse report to the provider immediately for a client receiving
heparin therapy?
A. Platelet count of 90,000/mm3
B. Activated partial thromboplastin time (aPTT) of 60 seconds
C. International Normalized Ratio (INR) of 1.2
D. Hemoglobin of 13.5 g/dL
🟢 A. Platelet count of 90,000/mm3
🔴 RATIONALE: A platelet count below 100,000/mm3, especially in a client receiving heparin, is
, highly suggestive of Heparin-Induced Thrombocytopenia (HIT), a life-threatening condition requiring
immediate cessation of heparin.
7. A nurse is performing a physical assessment on an older adult client. Which finding is considered a
normal age-related change?
A. Decreased thoracic expansion
B. Increased gastric motility
C. Elevated serum albumin levels
D. Rapid response to stress
🟢 A. Decreased thoracic expansion
🔴 RATIONALE: Age-related changes in the musculoskeletal and respiratory systems often lead to
increased chest wall rigidity and decreased lung compliance, resulting in reduced thoracic
expansion.
8. A client is prescribed digoxin for heart failure. Which finding should cause the nurse to withhold the
medication and notify the provider?
A. Potassium level of 4.5 mEq/L
B. Apical pulse of 52 beats per minute
C. Digoxin level of 1.2 ng/mL
D. Blood pressure of 118/76 mmHg
🟢 B. Apical pulse of 52 beats per minute
🔴 RATIONALE: Digoxin has a negative chronotropic effect; an apical pulse below 60 beats per
minute in an adult is a sign of bradycardia and requires holding the medication to prevent further
cardiac depression.
9. A nurse is planning care for a client with neutropenia. Which intervention is most appropriate to
include?
A. Place the client in a private room with positive-pressure airflow
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains*
*1. Management of Care*
*2. Safety and Infection Control*
*3. Health Promotion and Maintenance*
*4. Psychosocial Integrity*
*5. Basic Care and Comfort*
*6. Pharmacological and Parenteral Therapies*
*7. Reduction of Risk Potential*
*8. Physiological Adaptation*
*Introduction*
*The purpose of this practice examination is to prepare nursing candidates for the rigorous stand
Section One: Questions 1–100
1. A nurse is caring for a client with a suspected pheochromocytoma. Which assessment finding
requires the most immediate intervention?
A. Blood pressure of 180/110 mmHg
B. Heart rate of 110 beats per minute
C. Report of a severe, throbbing headache
D. Blood glucose level of 160 mg/dL
, 🟢 A. Blood pressure of 180/110 mmHg
🔴 RATIONALE: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive
catecholamines; severe hypertension poses the highest risk for hypertensive crisis, stroke, or organ
damage, requiring immediate attention.
2. Which action by the nurse is the priority when caring for a client who is experiencing a tonic-clonic
seizure?
A. Attempting to restrain the client’s extremities
B. Inserting a padded tongue blade into the mouth
C. Clearing the area around the client of hard objects
D. Administering an intravenous bolus of diazepam
🟢 C. Clearing the area around the client of hard objects
🔴 RATIONALE: Safety is the priority during a seizure; clearing the area prevents injury from flailing
limbs or head trauma, while other options are contraindicated or not the first step.
3. A nurse is evaluating a client’s understanding of a new prescription for warfarin. Which statement by
the client indicates a need for further teaching?
A. I will keep my intake of green leafy vegetables consistent daily.
B. I will use a soft-bristled toothbrush for daily oral hygiene.
C. I will take an extra dose if I miss one to maintain therapeutic levels.
D. I will contact my provider if I notice any unusual bruising.
🟢 C. I will take an extra dose if I miss one to maintain therapeutic levels.
🔴 RATIONALE: Doubling or taking an extra dose of warfarin significantly increases the risk of
hemorrhage and is unsafe; missed doses should not be doubled.
4. A client with type 1 diabetes mellitus is found unconscious and unresponsive. Which action should
the nurse take first?
A. Administer subcutaneous insulin
, B. Assess the client’s capillary blood glucose
C. Provide an oral source of fast-acting glucose
D. Prepare to administer intravenous dextrose
🟢 B. Assess the client’s capillary blood glucose
🔴 RATIONALE: The nurse must confirm hypoglycemia before initiating treatment; assessing blood
glucose provides the necessary data to determine if the client is experiencing hypoglycemia or
another emergency.
5. A nurse is caring for a client with a chest tube. The nurse notes continuous bubbling in the water seal
chamber. What is the priority nursing action?
A. Document the finding in the medical record
B. Increase the suction pressure to the drainage system
C. Assess the chest tube system for an air leak
D. Reposition the client to the semi-Fowler position
🟢 C. Assess the chest tube system for an air leak
🔴 RATIONALE: Continuous bubbling in the water seal chamber indicates an air leak in the system,
which must be identified and corrected immediately to ensure proper lung re-expansion.
6. Which laboratory result should the nurse report to the provider immediately for a client receiving
heparin therapy?
A. Platelet count of 90,000/mm3
B. Activated partial thromboplastin time (aPTT) of 60 seconds
C. International Normalized Ratio (INR) of 1.2
D. Hemoglobin of 13.5 g/dL
🟢 A. Platelet count of 90,000/mm3
🔴 RATIONALE: A platelet count below 100,000/mm3, especially in a client receiving heparin, is
, highly suggestive of Heparin-Induced Thrombocytopenia (HIT), a life-threatening condition requiring
immediate cessation of heparin.
7. A nurse is performing a physical assessment on an older adult client. Which finding is considered a
normal age-related change?
A. Decreased thoracic expansion
B. Increased gastric motility
C. Elevated serum albumin levels
D. Rapid response to stress
🟢 A. Decreased thoracic expansion
🔴 RATIONALE: Age-related changes in the musculoskeletal and respiratory systems often lead to
increased chest wall rigidity and decreased lung compliance, resulting in reduced thoracic
expansion.
8. A client is prescribed digoxin for heart failure. Which finding should cause the nurse to withhold the
medication and notify the provider?
A. Potassium level of 4.5 mEq/L
B. Apical pulse of 52 beats per minute
C. Digoxin level of 1.2 ng/mL
D. Blood pressure of 118/76 mmHg
🟢 B. Apical pulse of 52 beats per minute
🔴 RATIONALE: Digoxin has a negative chronotropic effect; an apical pulse below 60 beats per
minute in an adult is a sign of bradycardia and requires holding the medication to prevent further
cardiac depression.
9. A nurse is planning care for a client with neutropenia. Which intervention is most appropriate to
include?
A. Place the client in a private room with positive-pressure airflow
