Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX-RN exam! This updated guide for 2023 includes 1,000+ practice questions, a primer on the NCLEX-RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies.
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NCLEX-RN Practice Questions Test Bank
We have included more than 1,000+ NCLEX practice questions covering different nursing topics for this nursing test bank! We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning.
We recommend you do all practice questions before you take the actual exam. Doing so will help reduce your test anxiety and help identify nursing topics you need to review. To make the most of the practice exams, try to minimize mistakes to less than 15 questions and take your time answering the questions, especially when reading the rationales.
Included NCLEX-RN question sets for this nursing test bank are as follows:
- Comprehensive NCLEX-RN Practice Questions | Quiz #1: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #2: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #3: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #4: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #5: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #6: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #7: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #8: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #9: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #10: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #11: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #12: 75 Questions
- More practice questions available at our Nursing Test Bank.
- See also: FULL-TEXT Comprehensive NCLEX-RN Practice Quiz Test Bank (900 Questions)
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NCLEX-RN Practice Questions | Quiz #1: 75 Questions
This is the first set of 75 questions for your NCLEX-RN practice quiz!
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Where are the rationales? Please click the View Questions button below to review your answers and read through the rationales for each question.
Question 1 of 75
1. QuestionCategory: Health Promotion and Maintenance
While assessing a one-month-old infant, which of the findings warrants further investigation by the nurse? Select all that apply.CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Pharmacological and Parenteral Therapies
A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropisol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a preoperative client. List the order in which the nurse must carry out the following actions prior to the administration of preoperative medications.
Place the call bell within reach
Instruct the client to remain in bed
Raise the side rails on the bed
Have the client empty bladder
Question 3 of 75
3. QuestionCategory: Health Promotion and Maintenance
A 32-year-old pregnant woman comes to the clinic for her prenatal visit. The nurse gathers data about her obstetric history, which includes 3-year-old twins at home and a miscarriage 10 years ago at 12 weeks gestation. How would the nurse accurately document this information? Fill in the blanks.
Answer: Gravida para
Question 4 of 75
4. QuestionCategory: Reduction of Risk Potential
Which individual is at the greatest risk for developing hypertension?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Pharmacological and Parenteral Therapies
A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first?CorrectIncorrect
Question 6 of 75
6. QuestionCategory: Management of Care
Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after the procedure?CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Basic Care and Comfort
A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is:CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Health Promotion and Maintenance
What would the nurse expect to see while assessing the growth of children during their school-age years?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Health Promotion and Maintenance
At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client states “My blood pressure is usually much lower.” The nurse should tell the client to:CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Safety and Infection Control
The hospital has sounded the call for a disaster drill on the evening shift. Which of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission?CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Pharmacological and Parenteral Therapies
A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication:CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Physiological Adaptation
A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first?CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Physiological Adaptation
In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Physiological Adaptation
A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection?CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Management of Care
A registered nurse who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Health Promotion and Maintenance
When teaching a client with coronary artery disease about nutrition, the nurse should emphasize:CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Pharmacological and Parenteral Therapies
Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working?CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Health Promotion and Maintenance
The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse’s response?CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Physiological Adaptation
The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention?CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Physiological Adaptation
A child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Physiological Adaptation
The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs two (2) hours ago. The nurse shouldCorrectIncorrect
Question 22 of 75
22. QuestionCategory: Reduction of Risk Potential
Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Health Promotion and Maintenance
The nurse is giving discharge teaching to a client seven (7) days post-myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question?CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Management of Care
A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first?CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Health Promotion and Maintenance
While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child’s developmental needs?CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Basic Care and Comfort
The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is:CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Pharmacological and Parenteral Therapies
The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq potassium chloride in 1000 ml of 5% dextrose in water IV. Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued?CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Physiological Adaptation
A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Health Promotion and Maintenance
The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to:CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Physiological Adaptation
During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to:CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Reduction of Risk Potential
The nurse prepares the client for the insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about:CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Physiological Adaptation
A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is:CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Pharmacological and Parenteral Therapies
A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications, which of the following should the nurse report immediately to the health care provider?CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Health Promotion and Maintenance
The nurse practicing in a maternity setting recognizes that the postmature fetus is at risk due to:CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Reduction of Risk Potential
The nurse is caring for a client who had a total hip replacement seven (7) days ago. Which statement by the client requires the nurse’s immediate attention?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Pharmacological and Parenteral Therapies
A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following assessment cues below may indicate the client is experiencing a negative side effect from the medication?CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Basic Care and Comfort
The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing intervention would be most effective in promoting healing?CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Health Promotion and Maintenance
Which of these statements best describes the characteristics of an effective reward-feedback system?CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Health Promotion and Maintenance
The nurse is providing information to a client with multiple sclerosis on performing exercises and physical activities. The nurse determines the client needs additional teaching if the client makes which statements? Select all that apply.CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Safety and Infection Control
During the evaluation of the quality of home care for a client with Alzheimer’s disease, the priority for the nurse is to reinforce which statement by a family member?CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Pharmacological and Parenteral Therapies
A nurse is reviewing a patient’s medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply.CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Pharmacological and Parenteral Therapies
A nurse is reviewing a patient’s past medical history (PMH). The history indicates the patient has photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select all that apply.CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Pharmacological and Parenteral Therapies
A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient’s medication does not cause urine discoloration?CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Pharmacological and Parenteral Therapies
You are responsible for reviewing the nursing unit’s refrigerator. Which of the following drugs, if found inside the fridge, should be removed?CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Pharmacological and Parenteral Therapies
A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Safety and Infection Control
A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take?CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Physiological Adaptation
A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Physiological Adaptation
You are taking the history of a 14-year-old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Physiological Adaptation
A 24-year-old female is admitted to the ER due to confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Pharmacological and Parenteral Therapies
Rhogam is most often used to treat____ mothers that have a ____ infant.CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Health Promotion and Maintenance
A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU?CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Pharmacological and Parenteral Therapies
A patient has taken an overdose of aspirin. Which of the following should a nurse must closely monitor for during acute management of this patient?CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Safety and Infection Control
A 50-year-old blind and deaf patient has been admitted to your floor. As the charge nurse, your primary responsibility for this patient is?CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Pharmacological and Parenteral Therapies
A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient?CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Physiological Adaptation
A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Physiological Adaptation
A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Pharmacological and Parenteral Therapies
A client with myocardial infarction is receiving tissue plasminogen activator, alteplase (Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following?CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Basic Care and Comfort
A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?”CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Physiological Adaptation
A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Physiological Adaptation
A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long do red blood cells live in my body? The correct response is:CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Health Promotion and Maintenance
A 65-year-old man has been admitted to the hospital for spinal stenosis surgery. When should the discharge training and planning begin for this patient?CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Psychosocial Integrity
A 5-year-old child and has been recently admitted to the hospital. According to Erik Erikson’s psychosocial development stages, the child is in which stage?CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Psychosocial Integrity
A toddler is 26 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in?CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Psychosocial Integrity
A young adult is 20 years old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the adult in?CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Reduction of Risk Potential
A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Pharmacological and Parenteral Therapies
When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Pharmacological and Parenteral Therapies
Which of the following conditions would a nurse not administer erythromycin?CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Physiological Adaptation
A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Physiological Adaptation
A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Physiological Adaptation
A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Physiological Adaptation
A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Physiological Adaptation
A nurse is reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition?CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Reduction of Risk Potential
A fragile 87-year-old female has recently been admitted to the hospital with increased confusion and falls over the last two (2) weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Reduction of Risk Potential
An 85-year-old male has been losing mobility and gaining weight over the last two (2) months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Reduction of Risk Potential
A 20-year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?CorrectIncorrect
What is NCLEX?
NCLEX stands for National Council Licensing Examination. It is a test to determine if the candidate possesses the minimum level of knowledge necessary to perform safe and effective entry-level nursing care. The NCLEX-RN (for registered nurses) and the NCLEX-PN (for practical/vocational nurses) are examinations prepared by the National Council of State Boards of Nursing (NCSBN), whose mandate is to protect the public from unsafe nursing care. The NCSBN members include nursing regulatory bodies in the 50 states of the US, the District of Columbia, and four US territories.
How to Register for the NCLEX?
So you’ve finally decided to take the NCLEX, the next step is registration or application for the exam. The following are the steps on how to register for the NCLEX, including some tips:
- Application to the Nursing Regulatory Board (NRB).The initial step in the registration process is to submit your application to the state board of nursing in the state in which you intend to obtain licensure. Inquire with your board of nursing regarding the specific registration process as requirements may vary from state to state.
- Registration with Pearson VUE.Once you have received the confirmation from the board of nursing that you have met all of their state requirements, proceed, register, and pay the fee to take the NCLEX with Pearson VUE. Follow the registration instructions and complete the forms precisely and accurately.
- Authorization to Test.If you were made eligible by the licensure board, you will receive an Authorization to Test (ATT) form from Pearson VUE. You must test within the validity dates (an average of 90 days) on the ATT. There are no extensions or you’ll have to register and pay the fee again. Your ATT contains critical information like your test authorization number, validity date, and candidate identification number.
- Schedule your Exam Appointment.The next step is to schedule a testing date, time, and location at Pearson VUE. The NCLEX will take place at a testing center, you can make an exam appointment online or by telephone. You will receive a confirmation via email of your appointment with the date and time you choose including the directions to the testing center.
*Changing Your Exam Appointment. You can change your appointment to test via Pearson VUE or by calling the candidate services. Rules for scheduling, rescheduling, and unscheduling are explained further here. Failing to arrive for the examination or failure to cancel your appointment to test without providing notice will forfeit your examination fee and you’ll have to register and pay again.
- On Exam Day.Arrive at the testing center on your exam appointment date at least 30 minutes before the schedule. You must have your ATT and acceptable identification (driver’s license, passport, etc) that is valid, not expired, and contains your photo and signature.
- Processing Results.You will receive your official results from the board of nursing after six weeks.
Computer Adaptive Test (CAT)
Like most standardized tests today, the NCLEX is administered by a computer. The NCLEX uses a computer adaptive test (CAT), which reacts to your answers to determine your competence level. The selection of questions is based on the NCLEX-RN test plan and by the level of item difficulty.
Every time you answer a question, the computer reevaluates your ability based on all the previous answers and the difficulty of those test items. Your first question is relatively easy; if you selected a correct answer, the computer supplies you with a more difficult question from its question bank. If you have selected an incorrect answer, the computer gives you an easier question. This process continues throughout the examination until the test plan requirements are met, and the computer can determine your level of competence.
Additionally, there is no option to skip a question, you must answer it, or the test will not move on. You cannot go back and review previous questions and change answers.
NCLEX-RN Test Plan
The NCLEX test plan is a content guideline to determine the distribution of test questions. NCSBN uses the “Client Needs” categories to ensure that the NCLEX covers a full spectrum of nursing activities. It is a summary of the content and scope of the NCLEX to serve as a guide for candidates preparing for the exam and to direct item writers in the development of items.
The content of the NCLEX-RN is organized into four major Client Needs categories: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, Physiological Integrity. Some of these categories are divided further into subcategories.
Below is the NCLEX-RN test plan effective as of April 2019 to March 2022:
|I. Safe and Effective Care Environment|
|Management of Care||17-23%|
|Safety and Infection Control||9-15%|
|II. Health Promotion and Maintenance||6-12%|
|III. Psychosocial Integrity||6-12%|
|IV. Physiological Integrity|
|Basic Care and Comfort||6-12%|
|Pharmacological and Parenteral Therapies||12-18%|
|Reduction of Risk Potential||9-15%|
Safe and Effective Care Environment
There are two subcategories under Safe and Effective Care Environment.
- Management of Care (17-23%) category includes content that tests the nurse’s knowledge and ability to direct nursing care that enhances the care delivery setting in order to protect clients, significant others, and health care personnel.
- Safety and Infection Control (9-15%) category includes content that tests the nurse’s ability required to protect clients, families, and health care personnel from health and environmental hazards.
Health Promotion and Maintenance
Health Promotion and Maintenance (6-12%) category includes content that tests the nurse’s ability to provide and direct nursing care of the client that incorporates knowledge of expected growth and development, preventing and early detection of health problems, and strategies to achieve optimal health.
The Psychosocial Integrity category (6-12%) is content related to the promotion and support for the emotional, mental, and social well-being of the client experiencing stressful events and clients with acute or chronic mental illness.
In the Physiological Integrity category are items that test the nurse’s ability to promote physical health and wellness by providing care and comfort, reducing risk potential, and managing health alterations. There are four subcategories under Physiological Integrity.
- Basic Care and Comfort (6-12%) are content to test the nurse’s ability to provide comfort and assistance to the client in the performance of activities of daily living.
- Pharmacological and Parenteral Therapies (12-18%) category includes content to test the nurse’s ability to administer medications and parenteral therapies (IV therapy, blood administration, and blood products).
- Reduction of Risk Potential (9-15%) category includes content to tests the nurse’s ability to prevent complications or health problems related to the client’s condition or prescribed treatments or procedures.
- Physiological Adaptation (11-17%) category includes questions that test the nurse’s ability to provide care to clients with acute, chronic, or life-threatening conditions.
Item Writers for NCLEX
Who writes questions for the NCLEX? The NCSBN sets the criteria and selection process for item writers who are registered nurses. Many of them are nursing educators who hold an advanced degree in nursing, so if you’ve completed an accredited nursing program, you have already taken several tests written by nurses with backgrounds similar to those who write for the NCLEX.
The maximum testing time for the NCLEX-RN is six (6) hours, and there is no time limit for each NCLEX question. The exam time includes all the tutorials and all the breaks. The first break is offered after two (2) hours, and the second break is offered after 3.5 hours of testing. All breaks are optional, and most test-takers may not need the full-time allotment to complete the examination.
How to Pass the NCLEX?
The NCSBN indicates that these three rules govern pass-or-fail decisions: 95% Confidence Interval Rule, Maximum-Length Exam Rule, and Run-Out-Of-Time Rule.
95% Confidence Interval Rule
In this scenario, the computer stops administering test questions when it is 95% certain that your ability is clearly above the passing standard or clearly below the passing standard.
When your ability is close to the passing standard, the computer continues to give you items until the maximum number of items is reached. At this point, the computer disregards the 95% confidence rule and decides whether you pass or fail by your final ability estimate. If your final ability estimate is above the passing standard, you pass; if it is below, you fail.
Run-Out-Of-Time (R.O.O.T.) Rule
When you run out of time before reaching the maximum amount of items, the computer has not been able to decide whether you passed or failed with 95% certainty and has to use an alternate rule. You fail if you have not answered the minimum number of required questions. If you have at least answered the minimum amount of items, the computer reviews your last 60 questions. If your ability estimate was consistently above the passing standard on the last 60 questions, you pass. If your ability dropped below the passing standard, even once, during your last 60 questions, you fail.
How many question are on the NCLEX?
For the NCLEX-RN, the minimum number of questions you need to answer is 75, while the maximum number in the test is 265. Regardless of the number of questions you answer, you are given 15 experimental questions (pretest questions). Pretest questions are indistinguishable from other questions on the test, not indicated as such, are being tested for future examination, and not counted against your score.
Question Types in the NCLEX-RN
Although most NCLEX items are multiple-choice, there are other formats as well. You may be administered multiple-choice items and questions written in alternate formats. These formats may include: multiple-response or select all that apply, fill-in-the-blank calculation, ordered response, hotspot, figure, chart or exhibit, graphic, audio, and video.
Many questions on the NCLEX are in multiple-choice format. This traditional text-based question will provide you data about the client’s situation, and you can only select one correct answer from the given four options. Multiple-choice questions may vary and include: audio clips, graphics, exhibits, or charts.
Chart or Exhibit Questions
A chart or exhibit is presented along with a problem. You’ll be provided with three tabs or buttons that you need to click to obtain the information needed to answer the question. Select the correct choice among four multiple-choice answer options.
In this format, four multiple-choice answer options are pictures rather than text. Each option is preceded by a circle that you need to click to represent your answer.
In an audio question format, you’ll be required to listen to a sound to answer the question. You’ll need to use the headset provided and click on the sound icon for it to play. You’ll be able to listen to the sound as many times as necessary. Choose the correct choice from among four multiple-choice answer options.
For the video question format, you must view an animation or a video clip to answer the following question. Select the correct choice among four multiple-choice answer options.
Select All That Apply or Multiple-Response
Multiple-response or select all that apply (SATA) alternate format question requires you to choose all correct answer options that relate to the information asked by the question. There are usually more than four possible answer options. No partial credit is given in scoring these items (i.e., selecting only 3 out of the 5 correct choices), so you must select all correct answers for the item to be counted as correct.
Tips when answering Select All That Apply Questions
- You’ll know it’s a multiple-response or SATA question because you’ll explicitly be instructed to “Select all that apply.”
- Treat each answer choice as a True or False by rewording the question and proceed to answer each option by responding with a “yes” or “no”. Go down the list of answer options one by one and ask yourself if it’s a correct answer.
- Consider each choice as a possible answer separate to other choices. Never group or assume they are linked together.
The fill-in-the-blank question format is usually used for medication calculation, IV flow rate calculation, or determining the intake-output of a client. You’ll be asked to perform a calculation in this question format and type in your answer in the blank space provided.
Tips when answering Fill-in-the-Blank
- Always follow the specific directions as noted on the screen.
- There will be an on-screen calculator on the computer for you to use.
- Do not put any words, units of measurements, commas, or spaces with your answer, type only the number. Only the number goes into the box.
- Rounding an answer should be done at the end of the calculation or as what the question specified, and if necessary, type in the decimal point.
In an ordered-response question format, you’ll be asked to use the computer mouse to drag and drop your nursing actions in order or priority. Based on the information presented, determine what you’ll do first, second, third, and so forth. Directions are provided with the question.
Tips when answering Ordered-Response questions
- Questions are usually about nursing procedures. Imagine yourself performing the procedure to help you answer these questions.
- You’ll have to place the options in correct order by clicking an option and dragging it on the box on the right. You can rearrange them before you hit submit for your final answer.
A picture or graphic will be presented along with a question. This could contain a chart, a table, or an illustration where you’ll be asked to point or click on a specific area. Figures may also appear along with a multiple-choice question. Be as precise as possible when marking the location.
Tips when answering Hotspot questions
- Mostly used to evaluate your knowledge of anatomy, physiology, and pathophysiology.
- Locate anatomical landmarks to help you select the location needed by the item.
Want a trial run of the NCLEX? We highly recommend you complete the online tutorial by the NCSBN to help you familiarize yourself with the different question types for the NCLEX.
Want more practice questions?
Please visit our Nursing Test Bank page if you’re looking to answer more practice questions from different topics and different question formats.
Recommended books and resources for your NCLEX success:
Saunders Comprehensive Review for the NCLEX-RN
Saunders Comprehensive Review for the NCLEX-RN Examination is often referred to as the best nursing exam review book ever. More than 5,700 practice questions are available in the text. Detailed test-taking strategies are provided for each question, with hints for analyzing and uncovering the correct answer option.
Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items
Next Generation NCLEX®-style practice questions of all types are illustrated through stand-alone case studies and unfolding case studies. NCSBN Clinical Judgment Measurement Model (NCJMM) is included throughout with case scenarios that integrate the six clinical judgment cognitive skills.
Saunders Q & A Review for the NCLEX-RN® Examination
This edition contains over 6,000 practice questions with each question containing a test-taking strategy and justifications for correct and incorrect answers to enhance review. Questions are organized according to the most recent NCLEX-RN test blueprint Client Needs and Integrated Processes. Questions are written at higher cognitive levels (applying, analyzing, synthesizing, evaluating, and creating) than those on the test itself.
NCLEX-RN Prep Plus by Kaplan
The NCLEX-RN Prep Plus from Kaplan employs expert critical thinking techniques and targeted sample questions. This edition identifies seven types of NGN questions and explains in detail how to approach and answer each type. In addition, it provides 10 critical thinking pathways for analyzing exam questions.
Illustrated Study Guide for the NCLEX-RN® Exam
The 10th edition of the Illustrated Study Guide for the NCLEX-RN Exam, 10th Edition. This study guide gives you a robust, visual, less-intimidating way to remember key facts. 2,500 review questions are now included on the Evolve companion website. 25 additional illustrations and mnemonics make the book more appealing than ever.
NCLEX RN Examination Prep Flashcards (2023 Edition)
NCLEX RN Exam Review FlashCards Study Guide with Practice Test Questions [Full-Color Cards] from Test Prep Books. These flashcards are ready for use, allowing you to begin studying immediately. Each flash card is color-coded for easy subject identification.