1
Page | 1
NCLEX-Style Comprehensive Practice Test
Bank Updated for 2025–2026 |
HESI/NCLEX RN Format | Critical
Thinking Focused
, 2
QUESTION 1
Page | 2 A nurse is caring for a postoperative client who underwent abdominal surgery 2 hours ago.
The client is alert and oriented but reports increasing pain at the surgical site. Vital signs are:
BP 136/84 mmHg, HR 110 bpm, RR 22/min, Temp 99.4°F. The nurse notes the abdominal
dressing is dry and intact. Which of the following actions should the nurse take first?
A) Notify the healthcare provider of the increased pain
B) Reassess the client's pain level in 30 minutes
✔✔✔ Correct Answer > C) Perform a full pain assessment including location, quality, and
intensity
D) Administer a PRN dose of acetaminophen for pain
Rationale: Before intervening or notifying the provider, the nurse must perform a complete
pain assessment to determine appropriate interventions and evaluate whether the pain is
expected or a sign of complication.
QUESTION 2
A nurse is reviewing lab results for a client receiving chemotherapy for leukemia. The
client’s WBC count is 2,000/mm³, platelets are 75,000/mm³, and hemoglobin is 8.5 g/dL. The
nurse should implement which of the following precautions based on this data?
A) Seizure precautions
B) Contact precautions
, 3
✔✔✔ Correct Answer > C) Neutropenic precautions
D) Droplet precautions
Page | 3 Rationale: A WBC count of 2,000/mm³ indicates severe neutropenia, placing the client at
high risk for infection. Neutropenic precautions, including reverse isolation and limiting
visitors, are required.
QUESTION 3
A nurse is assessing a client admitted with acute pancreatitis. The client reports severe
abdominal pain radiating to the back, nausea, and vomiting. The abdomen is tender and
distended. Which laboratory value is most indicative of this condition?
A) Elevated BUN
B) Decreased albumin
✔✔✔ Correct Answer > C) Elevated serum lipase
D) Increased bilirubin
Rationale: Serum lipase is the most specific and sensitive marker for pancreatitis. Elevated
levels confirm the diagnosis.
QUESTION 4
A nurse is caring for a 78-year-old client with Alzheimer’s disease who is frequently
wandering at night and attempting to leave the facility. Which of the following is the most
appropriate nursing intervention?
, 4
A) Restrain the client to prevent injury
B) Keep the client in bed with all four side rails up
C) Administer a sedative at bedtime
Page | 4
✔✔✔ Correct Answer > D) Implement a motion sensor and frequent rounds during the
night
Rationale: Using non-restrictive safety measures such as motion sensors and close
monitoring preserves dignity and reduces fall/injury risk. Restraints and sedation should be
avoided unless all alternatives fail.
QUESTION 5
A nurse is preparing to administer furosemide 40 mg IV to a client with congestive heart
failure. Which of the following assessments is most important to perform before
administration?
A) Respiratory rate
B) Pupillary reaction
C) Skin turgor
✔✔✔ Correct Answer > D) Serum potassium level
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Monitoring serum
potassium prior to administration is critical to avoid life-threatening arrhythmias.
Page | 1
NCLEX-Style Comprehensive Practice Test
Bank Updated for 2025–2026 |
HESI/NCLEX RN Format | Critical
Thinking Focused
, 2
QUESTION 1
Page | 2 A nurse is caring for a postoperative client who underwent abdominal surgery 2 hours ago.
The client is alert and oriented but reports increasing pain at the surgical site. Vital signs are:
BP 136/84 mmHg, HR 110 bpm, RR 22/min, Temp 99.4°F. The nurse notes the abdominal
dressing is dry and intact. Which of the following actions should the nurse take first?
A) Notify the healthcare provider of the increased pain
B) Reassess the client's pain level in 30 minutes
✔✔✔ Correct Answer > C) Perform a full pain assessment including location, quality, and
intensity
D) Administer a PRN dose of acetaminophen for pain
Rationale: Before intervening or notifying the provider, the nurse must perform a complete
pain assessment to determine appropriate interventions and evaluate whether the pain is
expected or a sign of complication.
QUESTION 2
A nurse is reviewing lab results for a client receiving chemotherapy for leukemia. The
client’s WBC count is 2,000/mm³, platelets are 75,000/mm³, and hemoglobin is 8.5 g/dL. The
nurse should implement which of the following precautions based on this data?
A) Seizure precautions
B) Contact precautions
, 3
✔✔✔ Correct Answer > C) Neutropenic precautions
D) Droplet precautions
Page | 3 Rationale: A WBC count of 2,000/mm³ indicates severe neutropenia, placing the client at
high risk for infection. Neutropenic precautions, including reverse isolation and limiting
visitors, are required.
QUESTION 3
A nurse is assessing a client admitted with acute pancreatitis. The client reports severe
abdominal pain radiating to the back, nausea, and vomiting. The abdomen is tender and
distended. Which laboratory value is most indicative of this condition?
A) Elevated BUN
B) Decreased albumin
✔✔✔ Correct Answer > C) Elevated serum lipase
D) Increased bilirubin
Rationale: Serum lipase is the most specific and sensitive marker for pancreatitis. Elevated
levels confirm the diagnosis.
QUESTION 4
A nurse is caring for a 78-year-old client with Alzheimer’s disease who is frequently
wandering at night and attempting to leave the facility. Which of the following is the most
appropriate nursing intervention?
, 4
A) Restrain the client to prevent injury
B) Keep the client in bed with all four side rails up
C) Administer a sedative at bedtime
Page | 4
✔✔✔ Correct Answer > D) Implement a motion sensor and frequent rounds during the
night
Rationale: Using non-restrictive safety measures such as motion sensors and close
monitoring preserves dignity and reduces fall/injury risk. Restraints and sedation should be
avoided unless all alternatives fail.
QUESTION 5
A nurse is preparing to administer furosemide 40 mg IV to a client with congestive heart
failure. Which of the following assessments is most important to perform before
administration?
A) Respiratory rate
B) Pupillary reaction
C) Skin turgor
✔✔✔ Correct Answer > D) Serum potassium level
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Monitoring serum
potassium prior to administration is critical to avoid life-threatening arrhythmias.
