NCLEX Practice Questions Test Bank (2021 Update)

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Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX-RN exam! Included in this updated guide for 2021 are 1,000+ practice questions, a primer on what is the NCLEX-RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies.

Looking for the complete collection of practice questions?
Please visit our Nursing Test Bank.

NCLEX-RN Practice Questions Test Bank

For this nursing test bank, we have included more than 1,000+ NCLEX practice questions covering different nursing topics! We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each questions 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 make sure to take your time in answering the questions especially when reading the rationales.

Included NCLEX-RN question sets for this nursing test bank are as follows:

Guidelines

  • Read and understand each question before choosing the best answer. 
  • Since this is a review, answers and rationales are shown after you click on the "Check" button. 
  • There is no time limit, answer the questions at your own pace. 
  • Once all questions are answered, you'll be prompted to click the "Quiz Summary" button where you'll be shown the questions you've answered or placed under "Review". Click on the "Finish Quiz" button to show your rating. 
  • After the quiz, please make sure to read the questions and rationales again by click on the "View Questions" button. 
  • Comment us your thoughts, scores, ratings, and questions about the quiz in the comments section below!
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NCLEX-RN Practice Questions Set 11 (75 Questions)

Welcome to another set of NCLEX-RN practice questions. This is the 11th set. If you’ve made it this far, you have answered 825 NCLEX practice questions so far.

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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. 

NCLEX Changes for 2020: The NCSBN introduced a few modifications for the NCLEX examinations. For the summary of these modifications, please visit this link.

How to Register for the NCLEX?

So you’ve finally made the decision 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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. 
  5. 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.
  6. 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 computer adaptive test (CAT) which reacts to the answers you give to determine your level of competence. 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 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 is able to 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 a full spectrum of nursing activities is covered by the NCLEX. 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 which include: 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: 

Safe and Effective Care Environment 
Management of Care17-23%
Safety and Infection Control9-15%
Health Promotion and Maintenance6-12%
Psychosocial Integrity6-12%
Physiological Integrity 
Basic Care and Comfort6-12%
Pharmacological and Parenteral Therapies12-18%
Reduction of Risk Potential9-15%
Physiological Adaptation11-17%

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. 

Psychosocial Integrity 

The Psychosocial Integrity category (6-12%) are content related to the promotion and support for emotional, mental, and social well-being of the client experiencing stressful events, as well as clients with acute or chronic mental illness. 

Physiological Integrity

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.

Testing Time

The maximum testing time for the NCLEX-RN is six (6) hours and there is no time limit for each individual NCLEX question. The exam time includes all the tutorials and all the breaks. The first break is offered after two (2) hours, 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 to complete the examination. 

How to Pass the NCLEX?

The NCSBN indicates that a pass-or-fail decision is governed by these three rules: 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. 

Maximum-Length Exam

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. If you have not answered the minimum number of required questions, you fail. 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 total number of questions you answer, you are given 15 questions that are experimental (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.

Multiple-Choice Questions

Multiple-choice question format for the NCLEX
Multiple-choice question format for the NCLEX

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

Chart or Exhibit Alternate Format for the NCLEX
Chart or exhibit question format

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. 

Graphic Option

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.

Audio

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. 

Video

For the video question format, you are required to 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

Select All That Apply Question format for the NCLEX
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 the scoring of 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.

Fill-in-the-Blank

Fill-in-the-Blank question format for the NCLEX
Fill-in-the-blank

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. In this question format, you’ll be asked to perform a calculation 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. 

Ordered-Response

Ordered-response question format for the NCLEX
Ordered-response question format for the NCLEX

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.

Hotspot

Hotspot Alternate Question Format for the NCLEX
Sample hotspot alternate question format

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 to test-drive 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.

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

51 COMMENTS

  1. Thank you so much for this free site. I found it just as helpful as Kaplan and Sanders which I paid for. I recommended this nurseslabs to some of my nurse friends preparing for the NCLEX. I used it to study and passed my NCLEX October 28. I will continue to use this as a reference. Once again Thank-You.
    A.Haynes RN

  2. Hey Matt,
    I am impressed by your generosity. I couldn’t believe these were all free. In all fairness, there should be a tab for donations for the constant upkeep of the web. A very minimal way to show our gratitude.

    Thanks.

    Hill

    • Although I just started nursing school the i formation is mind blowing and very useful for me already. Thank you for your generosity. I will be using all the practice quizzes and test to prepare myself. Thank you again.

  3. you guys all thank you so much for this massively hard work and huge success for all the nurses around the world .

  4. Your efforts are immeasurable, you are not only helping nurses to pass their NCLEX exams but also increasing the number of qualified/competent nurses providing healthcare around the globe. We are grateful. I used this site to prepare for internal exams whilst I was in school and it really helped me. I’ll be writing NCLEX soon..

  5. Thank you so much Nurse matt vera for this qbank,most beneficial, God bless you., if I may
    ask for some videos or pictures associated with the questions, will also help e.g lung sounds,abdominal sound etc thank you

  6. I loved your blog and thanks for publishing this about NCLEX practice questions!! I am really happy to come across this exceptionally well written content. Thanks for sharing and look for more in future!! Keep doing this inspirational work and share with us.

  7. My name is Daniel m Johnson from Tanzania
    I’m holding diploma in nursing and midwifery
    I’m looking for different nurse from different country so as we can share ideas and experience since I’m student I need to no much thing about nursing ….any one who is touched to please help me I wish to be came a good nurse and help different people from different society

  8. THANK YOU so so much Matt, this is great beyond measure.. I have been hook to this website. God will bless you and yours abundantly

  9. i just want to confirm for #39 it state pt need additional teaching so E should also be included to the answer cause it was contraindicated to MS right? . thank you :)

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