NCLEX-RN – PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A
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CORE DOMAINS
Management of Care
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
INTRODUCTION
The purpose of this comprehensive assessment is to evaluate the clinical judgment and entry-level competency of nursing
candidates. This exam focuses on the integration of medical-surgical knowledge, critical thinking, and the application of the
nursing process to ensure safe patient outcomes. The assessment utilizes a variety of multiple-choice and complex clinical
scenario-based questions designed to mirror the challenges found in diverse healthcare settings. Candidates are expected to
demonstrate proficiency in prioritizing care, interpreting diagnostic data, and adhering to legal and ethical standards of practice.
Emphasis is placed on real-world decision-making and the ability to provide evidence-based, holistic nursing care.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client with a chest tube. The nurse notices the suction control chamber has continuous bubbling.
Which action should the nurse take?
A. Document the finding as normal
B. Notify the healthcare provider immediately
C. Check for a leak in the drainage system
D. Clamp the chest tube close to the insertion site
🟢 A. Document the finding as normal
🔴 RATIONALE: Continuous bubbling in the suction control chamber is an expected finding, indicating that the suction is active
and set to the correct pressure. Bubbling in the water seal chamber, however, would indicate a leak.
, 2. A client is admitted with an acute exacerbation of heart failure. Which assessment finding is the highest priority for the
nurse to report?
A. Pitting edema 2+ in the lower extremities
B. Oxygen saturation of 88% on room air
C. S3 heart sound on auscultation
D. Weight gain of 2 lbs in 24 hours
🟢 B. Oxygen saturation of 88% on room air
🔴 RATIONALE: Using the ABC (Airway, Breathing, Circulation) priority framework, an oxygen saturation of 88% indicates
significant hypoxia and respiratory distress, requiring immediate intervention.
3. Which medication should the nurse anticipate administering to a client with a potassium level of 6.2 mEq/L?
A. Spironolactone
B. Sodium polystyrene sulfonate
C. Furosemide
D. Potassium chloride
🟢 B. Sodium polystyrene sulfonate
🔴 RATIONALE: Sodium polystyrene sulfonate is a cation-exchange resin used to treat hyperkalemia by promoting the
excretion of potassium through the gastrointestinal tract.
4. A nurse is preparing to administer digoxin to a client. Which vital sign must be assessed prior to administration?
A. Respiratory rate
B. Blood pressure
C. Apical pulse
D. Temperature
🟢 C. Apical pulse
🔴 RATIONALE: Digoxin is a cardiac glycoside that can cause bradycardia. The apical pulse must be counted for one full
minute, and the medication held if the rate is below 60 bpm in an adult.
5. A client with type 1 diabetes mellitus is found unconscious and diaphoretic. What is the nurse's first action?
,A. Check the client's blood glucose level
B. Administer 15g of simple carbohydrates
C. Call the healthcare provider
D. Administer intramuscular glucagon
🟢 D. Administer intramuscular glucagon
🔴 RATIONALE: In an unconscious client with suspected hypoglycemia, the nurse cannot safely provide oral glucose.
Glucagon is the emergency treatment of choice to mobilize glucose stores.
6. Which personal protective equipment (PPE) is required when caring for a client with active pulmonary tuberculosis?
A. Surgical mask
B. N95 respirator
C. Gown and gloves
D. Face shield
🟢 B. N95 respirator
🔴 RATIONALE: Tuberculosis is transmitted via the airborne route. Airborne precautions require the use of a fit-tested N95
respirator and a negative-pressure room.
7. A nurse is teaching a client about a low-purine diet. Which food choice indicates the client understands the teaching?
A. Liver and onions
B. Sardines
C. Grilled chicken breast
D. Red wine
🟢 C. Grilled chicken breast
🔴 RATIONALE: Purines are found in high concentrations in organ meats, seafood like sardines, and alcohol. Chicken is
relatively lower in purines and appropriate for a client with gout or uric acid stones.
8. A client is diagnosed with a deep vein thrombosis (DVT) in the left leg. Which intervention is appropriate?
A. Massage the affected area to reduce pain
B. Apply cold compresses to the calf
, C. Elevate the affected extremity
D. Maintain the client on strict bed rest
🟢 C. Elevate the affected extremity
🔴 RATIONALE: Elevation of the limb promotes venous return and reduces edema. Modern evidence-based practice
encourages early ambulation once anticoagulation is therapeutic, rather than strict bed rest.
9. The nurse identifies which rhythm as a medical emergency requiring immediate defibrillation?
A. Atrial fibrillation
B. Ventricular fibrillation
C. Second-degree heart block
D. Premature ventricular contractions
🟢 B. Ventricular fibrillation
🔴 RATIONALE: Ventricular fibrillation is a lethal arrhythmia characterized by a lack of cardiac output. Immediate defibrillation
and CPR are the treatments of choice.
10. A nurse is caring for a client who is 2 hours postoperative following a thyroidectomy. Which equipment should be kept at
the bedside?
A. Intubation tray
B. Tracheostomy set
C. Chest tube kit
D. Central line kit
🟢 B. Tracheostomy set
🔴 RATIONALE: Post-thyroidectomy complications include laryngeal edema or hematoma formation, which can cause sudden
airway obstruction. A tracheostomy set must be available for emergency airway access.
11. A client is prescribed warfarin. Which laboratory value should the nurse monitor to evaluate the effectiveness of the
therapy?
A. Partial thromboplastin time (PTT)
B. International Normalized Ratio (INR)
| INSTANT DOWNLOAD PDF.
CORE DOMAINS
Management of Care
Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
INTRODUCTION
The purpose of this comprehensive assessment is to evaluate the clinical judgment and entry-level competency of nursing
candidates. This exam focuses on the integration of medical-surgical knowledge, critical thinking, and the application of the
nursing process to ensure safe patient outcomes. The assessment utilizes a variety of multiple-choice and complex clinical
scenario-based questions designed to mirror the challenges found in diverse healthcare settings. Candidates are expected to
demonstrate proficiency in prioritizing care, interpreting diagnostic data, and adhering to legal and ethical standards of practice.
Emphasis is placed on real-world decision-making and the ability to provide evidence-based, holistic nursing care.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client with a chest tube. The nurse notices the suction control chamber has continuous bubbling.
Which action should the nurse take?
A. Document the finding as normal
B. Notify the healthcare provider immediately
C. Check for a leak in the drainage system
D. Clamp the chest tube close to the insertion site
🟢 A. Document the finding as normal
🔴 RATIONALE: Continuous bubbling in the suction control chamber is an expected finding, indicating that the suction is active
and set to the correct pressure. Bubbling in the water seal chamber, however, would indicate a leak.
, 2. A client is admitted with an acute exacerbation of heart failure. Which assessment finding is the highest priority for the
nurse to report?
A. Pitting edema 2+ in the lower extremities
B. Oxygen saturation of 88% on room air
C. S3 heart sound on auscultation
D. Weight gain of 2 lbs in 24 hours
🟢 B. Oxygen saturation of 88% on room air
🔴 RATIONALE: Using the ABC (Airway, Breathing, Circulation) priority framework, an oxygen saturation of 88% indicates
significant hypoxia and respiratory distress, requiring immediate intervention.
3. Which medication should the nurse anticipate administering to a client with a potassium level of 6.2 mEq/L?
A. Spironolactone
B. Sodium polystyrene sulfonate
C. Furosemide
D. Potassium chloride
🟢 B. Sodium polystyrene sulfonate
🔴 RATIONALE: Sodium polystyrene sulfonate is a cation-exchange resin used to treat hyperkalemia by promoting the
excretion of potassium through the gastrointestinal tract.
4. A nurse is preparing to administer digoxin to a client. Which vital sign must be assessed prior to administration?
A. Respiratory rate
B. Blood pressure
C. Apical pulse
D. Temperature
🟢 C. Apical pulse
🔴 RATIONALE: Digoxin is a cardiac glycoside that can cause bradycardia. The apical pulse must be counted for one full
minute, and the medication held if the rate is below 60 bpm in an adult.
5. A client with type 1 diabetes mellitus is found unconscious and diaphoretic. What is the nurse's first action?
,A. Check the client's blood glucose level
B. Administer 15g of simple carbohydrates
C. Call the healthcare provider
D. Administer intramuscular glucagon
🟢 D. Administer intramuscular glucagon
🔴 RATIONALE: In an unconscious client with suspected hypoglycemia, the nurse cannot safely provide oral glucose.
Glucagon is the emergency treatment of choice to mobilize glucose stores.
6. Which personal protective equipment (PPE) is required when caring for a client with active pulmonary tuberculosis?
A. Surgical mask
B. N95 respirator
C. Gown and gloves
D. Face shield
🟢 B. N95 respirator
🔴 RATIONALE: Tuberculosis is transmitted via the airborne route. Airborne precautions require the use of a fit-tested N95
respirator and a negative-pressure room.
7. A nurse is teaching a client about a low-purine diet. Which food choice indicates the client understands the teaching?
A. Liver and onions
B. Sardines
C. Grilled chicken breast
D. Red wine
🟢 C. Grilled chicken breast
🔴 RATIONALE: Purines are found in high concentrations in organ meats, seafood like sardines, and alcohol. Chicken is
relatively lower in purines and appropriate for a client with gout or uric acid stones.
8. A client is diagnosed with a deep vein thrombosis (DVT) in the left leg. Which intervention is appropriate?
A. Massage the affected area to reduce pain
B. Apply cold compresses to the calf
, C. Elevate the affected extremity
D. Maintain the client on strict bed rest
🟢 C. Elevate the affected extremity
🔴 RATIONALE: Elevation of the limb promotes venous return and reduces edema. Modern evidence-based practice
encourages early ambulation once anticoagulation is therapeutic, rather than strict bed rest.
9. The nurse identifies which rhythm as a medical emergency requiring immediate defibrillation?
A. Atrial fibrillation
B. Ventricular fibrillation
C. Second-degree heart block
D. Premature ventricular contractions
🟢 B. Ventricular fibrillation
🔴 RATIONALE: Ventricular fibrillation is a lethal arrhythmia characterized by a lack of cardiac output. Immediate defibrillation
and CPR are the treatments of choice.
10. A nurse is caring for a client who is 2 hours postoperative following a thyroidectomy. Which equipment should be kept at
the bedside?
A. Intubation tray
B. Tracheostomy set
C. Chest tube kit
D. Central line kit
🟢 B. Tracheostomy set
🔴 RATIONALE: Post-thyroidectomy complications include laryngeal edema or hematoma formation, which can cause sudden
airway obstruction. A tracheostomy set must be available for emergency airway access.
11. A client is prescribed warfarin. Which laboratory value should the nurse monitor to evaluate the effectiveness of the
therapy?
A. Partial thromboplastin time (PTT)
B. International Normalized Ratio (INR)
