Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX-RN exam! This updated guide for 2022 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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For more NCLEX practice questions, please visit our Nursing Test Bank here.
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)
- Comprehend each item. Read and understand each question before choosing the best answer. The exam has no time limit so that you can make sense of each item at your own pace.
- Review your answers. Once you’re done with all the questions, you’ll be redirected to the Quiz Summary table, where you’ll be able to review which questions you’ve answered or may have skipped. Review your answers once more before pressing the Finish Quiz button.
- Read the rationales. After you have reviewed your answers, click on the Finish Quiz button to record your answers and show your score. Click on the View Questions button to review the quiz and read through the rationales for each question.
- Let us know your feedback! Comment us your thoughts, scores, ratings, and questions about the quiz in the comments section below.
NCLEX-RN Practice Questions | Quiz #2: 75 Questions
Welcome to the second part of your 75-question practice quiz for the NCLEX-RN.
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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: Reduction of Risk Potential
A 28-year-old male has been found wandering around in a confusing pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Health Promotion and Maintenance
A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?CorrectIncorrect
Question 3 of 75
3. QuestionCategory: Safety and Infection Control
A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank for 20 minutes. Which of the following is the most important instruction the nurse can give the parent?CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Pharmacological and Parenteral Therapies
A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Safety and Infection Control
A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4-year-old boy who is non-verbal. This child does not have any identification on. What should the nurse do?CorrectIncorrect
Question 6 of 75
6. QuestionCategory: Reduction of Risk Potential
A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient’s lab results would expect which of the following changes in laboratory findings?CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Basic Care and Comfort
A patient with Addison’s disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is not recommended?CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Physiological Adaptation
A patient with a history of diabetes mellitus is on the second postoperative day following cholecystectomy. She has complained of nausea and isn’t able to eat solid foods. The nurse enters the room to find the patient confused and shaky. Which of the following is the most likely explanation for the patient’s symptoms?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Reduction of Risk Potential
A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain, fever, and chills. Which of the following conditions poses the most immediate concern?CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Reduction of Risk Potential
A patient is admitted to the same-day surgery unit for a liver biopsy. Which of the following laboratory tests assesses coagulation? Select all that apply.CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Safety and Infection Control
A nurse is assessing a clinic patient with a diagnosis of hepatitis A. Which of the following is the most likely route of transmission?CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Safety and Infection Control
A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Pharmacological and Parenteral Therapies
A physician has diagnosed acute gastritis in a clinic patient. Which of the following medications would be contraindicated for this patient?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Health Promotion and Maintenance
The nurse is conducting nutrition counseling for a patient with cholecystitis. Which of the following information is important to communicate?CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Physiological Adaptation
A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Reduction of Risk Potential
A nurse caring for several patients in the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most likely to have this procedure?CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Reduction of Risk Potential
A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient?CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Physiological Adaptation
A nurse calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the nurse most likely observed?CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Reduction of Risk Potential
A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect?CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Reduction of Risk Potential
A patient with leukemia is receiving chemotherapy that is known to depress bone marrow. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. Which of the following actions related specifically to the platelet count should be included in the nursing care plan?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Physiological Adaptation
A nurse in the emergency department is observing a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle, resulting in head trauma. Which of the following signs or symptoms would be cause for concern?CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Health Promotion and Maintenance
A nonimmunized child appears at the clinic with a visible rash. Which of the following observations indicates the child may have rubeola (measles)?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Physiological Adaptation
A child is seen in the emergency department for scarlet fever. Which of the following descriptions of scarlet fever is not correct?CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Pharmacological and Parenteral Therapies
A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose?CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Health Promotion and Maintenance
The mother of a 2-month-old infant brings the child to the clinic for a well-baby check. She is concerned because she feels only one testis in the scrotal sac. Which of the following statements about the undescended testis is the most accurate?CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Physiological Adaptation
A child is admitted to the hospital with a diagnosis of Wilms tumor, stage II. Which of the following statements most accurately describes this stage?CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Reduction of Risk Potential
A teen patient is admitted to the hospital by his physician who suspects a diagnosis of acute glomerulonephritis. Which of the following findings is consistent with this diagnosis? Select all that apply.CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Physiological Adaptation
Which of the following conditions most commonly causes acute glomerulonephritis?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Health Promotion and Maintenance
An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of age. The scrotum is smaller than it was at birth, but the fluid is still visible on illumination. Which of the following actions is the physician likely to recommend?CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Physiological Adaptation
A nurse is caring for a patient with peripheral vascular disease (PVD). The patient complains of burning and tingling of the hands and feet and cannot tolerate touch of any kind. Which of the following is the most likely explanation for these symptoms?CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Health Promotion and Maintenance
A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Physiological Adaptation
Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication is correct? Select all that apply:CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Health Promotion and Maintenance
A nurse is providing discharge information to a patient with peripheral vascular disease. Which of the following information should be included in the instructions?CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Health Promotion and Maintenance
A patient who has been diagnosed with the vasospastic disorder (Raynaud’s disease) complains of cold and stiffness in the fingers. Which of the following descriptions is most likely to fit the patient?CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Health Promotion and Maintenance
A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Physiological Adaptation
Thrombolytic therapy is frequently used in the treatment of suspected stroke. Which of the following is a significant complication associated with thrombolytic therapy?CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Health Promotion and Maintenance
An infant is brought to the clinic by his mother, who has noticed that he holds his head in an unusual position and always faces to one side. Which of the following is the most likely explanation?CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Health Promotion and Maintenance
An adolescent brings a physician’s note to school stating that he is not to participate in sports due to a diagnosis of Osgood-Schlatter disease. Which of the following statements about the disease is correct?CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Health Promotion and Maintenance
The clinic nurse asks a 13-year-old female to bend forward at the waist with arms hanging freely. Which of the following assessments is the nurse most likely conducting?CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Psychosocial Integrity
A clinic nurse interviews a parent who is suspected of abusing her child. Which of the following characteristics is the nurse least likely to find in an abusing parent?CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Physiological Adaptation
A nurse is assigned to the pediatric rheumatology clinic and is assessing a child who has just been diagnosed with juvenile idiopathic arthritis. Which of the following statements about the disease is most accurate?CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Safety and Infection Control
A child is admitted to the hospital several days after stepping on a sharp object that punctured her athletic shoe and entered the flesh of her foot. The physician is concerned about osteomyelitis and has ordered parenteral antibiotics. Which of the following actions is done immediately before the antibiotic is started?CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Physiological Adaptation
A two-year-old child has sustained an injury to the leg and refuses to walk. The nurse in the emergency department documents swelling of the lower affected leg. Which of the following does the nurse suspect is the cause of the child’s symptoms?CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Health Promotion and Maintenance
A toddler has recently been diagnosed with cerebral palsy. Which of the following information should the nurse provide to the parents? Select all that apply.CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Health Promotion and Maintenance
A child has recently been diagnosed with Duchenne muscular dystrophy (DMD). The parents are receiving genetic counseling prior to planning another pregnancy. Which of the following statements includes the most accurate information?CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Reduction of Risk Potential
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is theCorrectIncorrect
Question 47 of 75
47. QuestionCategory: Physiological Adaptation
A newborn has been diagnosed with hypothyroidism. In discussing the condition and treatment with the family, the nurse should emphasize:CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Psychosocial Integrity
A priority goal of involuntary hospitalization of the severely mentally ill client isCorrectIncorrect
Question 49 of 75
49. QuestionCategory: Psychosocial Integrity
A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of “suppression”?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Physiological Adaptation
The nurse is caring for a woman 2 hours after a vaginal delivery. Documentation indicates that the membranes were ruptured for 36 hours prior to delivery. What are the priority nursing diagnoses at this time?CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Pharmacological and Parenteral Therapies
A 3-year-old had a hip spica cast applied 2 hours ago. In order to facilitate drying, the nurse should:CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Pharmacological and Parenteral Therapies
A client is scheduled for an Intravenous Pyelogram (IVP). In order to prepare the client for this test, the nurse would:CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Physiological Adaptation
Following a diagnosis of acute glomerulonephritis (AGN) in their 6-year-old child, the parent’s remark: “We just don’t know how he caught the disease!” The nurse’s response is based on an understanding that:CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Physiological Adaptation
The nurse is caring for a 20 lbs (9 kg) 6 month-old with a 3-day history of diarrhea, occasional vomiting and fever. Peripheral intravenous therapy has been initiated, with 5% dextrose in 0.33% normal saline with 20 mEq of potassium per liter infusing at 35 ml/hr. Which finding should be reported to the healthcare provider immediately?CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Physiological Adaptation
While caring for the client during the first hour after delivery, the nurse determines that the uterus is boggy and there is vaginal bleeding. What should be the nurse’s first action?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Physiological Adaptation
The nurse is assessing an infant with developmental dysplasia of the hip. Which finding would the nurse anticipate?CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Pharmacological and Parenteral Therapies
To prevent a Valsalva maneuver in a client recovering from an acute myocardial infarction, the nurse would:CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Management of Care
On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse’s initial response should be to:CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Physiological Adaptation
During the admission assessment on a client with chronic bilateral glaucoma, which statement by the client would the nurse anticipate since it is associated with this problem?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Physiological Adaptation
A client with asthma has low pitched wheezes present in the final half of exhalation. One hour later the client has high pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client:CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Psychosocial Integrity
Which behavioral characteristic describes the domestic abuser?CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Health Promotion and Maintenance
The nurse is caring for a client with a long leg cast. During discharge teaching about appropriate exercises for the affected extremity, the nurse should recommend:CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Reduction of Risk Potential
A client is in her third month of her first pregnancy. During the interview, she tells the nurse that she has several sex partners and is unsure of the identity of the baby’s father. Which of the following nursing interventions is a priority?A. Counsel the woman to consent to HIV screening.CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Psychosocial Integrity
A 16-month-old child has just been admitted to the hospital. As the nurse assigned to this child enters the hospital room for the first time, the toddler runs to the mother, clings to her, and begins to cry. What would be the initial action by the nurse?CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Psychosocial Integrity
While planning care for a 2-year-old hospitalized child, which situation would the nurse expect to most likely affect the behavior?CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Psychosocial Integrity
While explaining an illness to a 10-year-old, what should the nurse keep in mind about the cognitive development at this age?CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Psychosocial Integrity
The nurse has just admitted a client with severe depression. From which focus should the nurse identify a priority nursing diagnosis?CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Safety and Infection Control
Which playroom activities should the nurse organize for a small group of 7-year-old hospitalized children?CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Health Promotion and Maintenance
A client is discharged following hospitalization for congestive heart failure. The nurse teaching the family suggests they encourage the client to rest frequently in which of the following positions?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Physiological Adaptation
The nurse is caring for a 10-year-old on admission to the burn unit. One assessment parameter that will indicate that the child has adequate fluid replacement is:CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Physiological Adaptation
What is the priority nursing diagnosis for a patient experiencing a migraine headache?CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Health Promotion and Maintenance
You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key items should be included in the teaching plan? Select all that apply.CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Management of Care
The patient with migraine headaches has a seizure. After the seizure, which action can you delegate to the nursing assistant?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Management of Care
You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to LPN/LVN?CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Health Promotion and Maintenance
A nursing student is teaching a patient and family about epilepsy prior to the patient’s discharge. For which statement should you intervene?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:
|Safe and Effective Care Environment|
|Management of Care||17-23%|
|Safety and Infection Control||9-15%|
|Health Promotion and Maintenance||6-12%|
|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 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.
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 (8th Edition)
The most comprehensive and complete NCLEX exam review book with over 5,200 NCLEX-style questions that are thoroughly updated to reflect the most recent test plan.
- Saunders Q & A Review for the NCLEX-RN® Examination (8th Edition)
This popular review offers more than 6,000 test questions, giving you all the Q&A practice you need to pass the NCLEX-RN examination! Each question enhances review by including a test-taking strategy and rationale for correct and incorrect answers.
- NCLEX-RN Prep Plus by Kaplan (24th Edition)
Kaplan’s NCLEX-RN Prep Plus uses expert critical thinking strategies and targeted sample questions to help you put your expertise into practice and face the exam with confidence.
- Illustrated Study Guide for the NCLEX-RN Exam
Using colorful illustrations and fun mnemonic cartoons, the Illustrated Study Guide for the NCLEX-RN® Exam, 10th Edition brings the concepts found on the NCLEX-RN to life!
- NCLEX RN Examination Prep Flashcards
Easy to use flash cards developed by test prep books for test takers trying to achieve a passing score on the NCLEX RN test, these flashcards cover.
- Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX-RN Examination
This book is the first and the most popular NCLEX-RN Exam review book focused exclusively on building management-of-care clinical judgment skills.
- Saunders Comprehensive Review for the NCLEX-PN Examination (8th Edition)
The book includes a review of all nursing content areas, more than 4,500 NCLEX exam-style questions, detailed rationales, test-taking tips and strategies, and new Next-Generation NCLEX (NGN)-style questions.
- More NCLEX review books here.