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 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 | Set 1 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 2 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 3 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 4 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 5 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 6 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 7 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 8 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 9 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 10 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 11 (75 Questions)
- Comprehensive NCLEX-RN Practice Questions | Set 12 (75 Questions) NEW!
- More practice questions available at our Nursing Test Bank.
- 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.
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- After the quiz, please make sure to read the questions and rationales again by click on the "View Questions" button.
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NCLEX-RN Practice Questions Set 3 (75 Questions)
This is the third set of NCLEX-RN practice questions! Be sure to read the rationales!
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Looking for the rationales? Please click on the “View Questions” button below to review your answers and read through the rationales for each question.
Question 1 of 75
A patient with Parkinson’s disease has a nursing diagnosis of Impaired Physical Mobility related to neuromuscular impairment. You observe a nursing assistant performing all of these actions. For which action must you intervene?CorrectIncorrect
Question 2 of 75
The nurse is preparing to discharge a patient with chronic low back pain. Which statement by the patient indicates that additional teaching is necessary?CorrectIncorrect
Question 3 of 75
A patient with a spinal cord injury (SCI) complains about a severe throbbing headache that suddenly started a short time ago. Assessment of the patient reveals increased blood pressure (168/94) and decreased heart rate (48/minute), diaphoresis, and flushing of the face and neck. What action should you take first?CorrectIncorrect
Question 4 of 75
Which patient should you, as charge nurse, assign to a new graduate RN who is orienting to the neurologic unit?CorrectIncorrect
Question 5 of 75
A patient with a spinal cord injury at level C3-4 is being cared for in the ED. What is the priority assessment?CorrectIncorrect
Question 6 of 75
You are pulled from the ED to the neurologic floor. Which action should you delegate to the nursing assistant when providing nursing care for a patient with SCI?CorrectIncorrect
Question 7 of 75
You are helping the patient with an SCI to establish a bladder-retraining program. What strategies may stimulate the patient to void? Select all that apply.CorrectIncorrect
Question 8 of 75
The patient with a cervical SCI has been placed in fixed skeletal traction with a halo fixation device. When caring for this patient the nurse may delegate which action (s) to the LPN/LVN? Select all that apply.CorrectIncorrect
Question 9 of 75
You are preparing a nursing care plan for the patient with SCI including the nursing diagnosis Impaired Physical Mobility and Self-Care Deficit. The patient tells you, “I don’t know why we’re doing all this. My life’s over.” What additional nursing diagnosis takes priority based on this statement?CorrectIncorrect
Question 10 of 75
Which patient should be assigned to the traveling nurse, new to neurologic nursing care, who has been in the neurologic unit for 1 week?CorrectIncorrect
Question 11 of 75
The patient with multiple sclerosis tells the nursing assistant that after physical therapy she is too tired to take a bath. What is your priority nursing diagnosis at this time?CorrectIncorrect
Question 12 of 75
The LPN/LVN, under your supervision, is providing nursing care for a patient with GBS. What observation would you instruct the LPN/LVN to report immediately?CorrectIncorrect
Question 13 of 75
The nursing assistant reports to you, the RN, that the patient with myasthenia gravis (MG) has an elevated temperature (102.20 F), heart rate of 120/minute, rise in blood pressure (158/94), and was incontinent of urine and stool. What is your best first action at this time?CorrectIncorrect
Question 14 of 75
You are providing care for a patient with an acute hemorrhage stroke. The patient’s husband has been reading a lot about strokes and asks why his wife did not receive alteplase. What is your best response?CorrectIncorrect
Question 15 of 75
You are supervising a senior nursing student who is caring for a patient with a right hemisphere stroke. Which action by the student nurse requires that you intervene?CorrectIncorrect
Question 16 of 75
Which of the following arteries primarily feeds the anterior wall of the heart?CorrectIncorrect
Question 17 of 75
When do coronary arteries primarily receive blood flow?CorrectIncorrect
Question 18 of 75
Which of the following illnesses is the leading cause of death in the US?CorrectIncorrect
Question 19 of 75
Which of the following conditions most commonly results in CAD?CorrectIncorrect
Question 20 of 75
Atherosclerosis impedes coronary blood flow by which of the following mechanisms?CorrectIncorrect
Question 21 of 75
Which of the following risk factors for coronary artery disease cannot be corrected?CorrectIncorrect
Question 22 of 75
Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease?CorrectIncorrect
Question 23 of 75
Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease?CorrectIncorrect
Question 24 of 75
Medical treatment of coronary artery disease includes which of the following procedures?CorrectIncorrect
Question 25 of 75
Prolonged occlusion of the right coronary artery produces an infarction in which of the following areas of the heart?CorrectIncorrect
Question 26 of 75
Which of the following is the most common symptom of myocardial infarction?CorrectIncorrect
Question 27 of 75
Which of the following landmarks is the correct one for obtaining an apical pulse?CorrectIncorrect
Question 28 of 75
Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration?CorrectIncorrect
Question 29 of 75
A murmur is heard at the second left intercostal space along the left sternal border. Which valve area is this?CorrectIncorrect
Question 30 of 75
Which of the following blood tests is most indicative of cardiac damage?CorrectIncorrect
Question 31 of 75
What is the primary reason for administering morphine to a client with myocardial infarction?CorrectIncorrect
Question 32 of 75
Which of the following conditions is most commonly responsible for myocardial infarction?CorrectIncorrect
Question 33 of 75
What supplemental medication is most frequently ordered in conjunction with furosemide (Lasix)?CorrectIncorrect
Question 34 of 75
After myocardial infarction, serum glucose levels and free fatty acids are both increased. What type of physiologic changes are these?CorrectIncorrect
Question 35 of 75
Which of the following complications is indicated by a third heart sound (S3)?CorrectIncorrect
Question 36 of 75
After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs?CorrectIncorrect
Question 37 of 75
Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?CorrectIncorrect
Question 38 of 75
What is the first intervention for a client experiencing myocardial infarction?CorrectIncorrect
Question 39 of 75
What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying?CorrectIncorrect
Question 40 of 75
Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation?CorrectIncorrect
Question 41 of 75
What is the most common complication of a myocardial infarction?CorrectIncorrect
Question 42 of 75
With which of the following disorders is jugular vein distention most prominent?CorrectIncorrect
Question 43 of 75
What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention?CorrectIncorrect
Question 44 of 75
Which of the following parameters should be checked before administering digoxin?CorrectIncorrect
Question 45 of 75
Toxicity from which of the following medications may cause a client to see a green halo around lights?CorrectIncorrect
Question 46 of 75
Which of the following symptoms is most commonly associated with left-sided heart failure?CorrectIncorrect
Question 47 of 75
In which of the following disorders would the nurse expect to assess sacral edema in bedridden client?CorrectIncorrect
Question 48 of 75
Which of the following symptoms might a client with right-sided heart failure exhibit?CorrectIncorrect
Question 49 of 75
Which of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility?CorrectIncorrect
Question 50 of 75
Stimulation of the sympathetic nervous system produces which of the following responses?CorrectIncorrect
Question 51 of 75
Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?CorrectIncorrect
Question 52 of 75
What is the most common cause of an abdominal aortic aneurysm?CorrectIncorrect
Question 53 of 75
In which of the following areas is an abdominal aortic aneurysm most commonly located?CorrectIncorrect
Question 54 of 75
A pulsating abdominal mass usually indicates which of the following conditions?CorrectIncorrect
Question 55 of 75
What is the most common symptom in a client with abdominal aortic aneurysm?CorrectIncorrect
Question 56 of 75
Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?CorrectIncorrect
Question 57 of 75
What is the definitive test used to diagnose an abdominal aortic aneurysm?CorrectIncorrect
Question 58 of 75
Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?CorrectIncorrect
Question 59 of 75
Which of the following blood vessel layers may be damaged in a client with an aneurysm?CorrectIncorrect
Question 60 of 75
When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated?CorrectIncorrect
Question 61 of 75
Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms?CorrectIncorrect
Question 62 of 75
Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client?CorrectIncorrect
Question 63 of 75
Which of the following groups of symptoms indicated a ruptured abdominal aneurysm?CorrectIncorrect
Question 64 of 75
Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area?CorrectIncorrect
Question 65 of 75
Which hereditary disease is most closely linked to an aneurysm?CorrectIncorrect
Question 66 of 75
Which of the following treatments is the definitive one for a ruptured aneurysm?CorrectIncorrect
Question 67 of 75
Which of the following heart muscle diseases is unrelated to other cardiovascular diseases?CorrectIncorrect
Question 68 of 75
Which of the following types of cardiomyopathy can be associated with childbirth?CorrectIncorrect
Question 69 of 75
Septal involvement occurs in which type of cardiomyopathy?CorrectIncorrect
Question 70 of 75
Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?CorrectIncorrect
Question 71 of 75
What is the term used to describe an enlargement of the heart muscle?CorrectIncorrect
Question 72 of 75
Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions?CorrectIncorrect
Question 73 of 75
Which of the following types of cardiomyopathy does not affect cardiac output?CorrectIncorrect
Question 74 of 75
Which of the following cardiac conditions does a fourth heart sound (S4) indicate?CorrectIncorrect
Question 75 of 75
Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?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 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: 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 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.
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 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.