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 #6: 75 Questions
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Question 1 of 75
1. QuestionCategory: Reduction of Risk Potential
After cardiac surgery, a client’s blood pressure measures 126/80 mm Hg. Nurse Katrina determines that mean arterial pressure (MAP) is which of the following?CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Physiological Adaptation
A female client arrives at the emergency department with chest and stomach pain and a report of black tarry stool for several months. Which of the following orders should the nurse Oliver anticipate?CorrectIncorrect
Question 3 of 75
Olivia had coronary artery bypass graft (CABG) surgery 3 days ago. Which of the following conditions is suspected by the nurse when a decrease in platelet count from 230,000 ul to 5,000 ul is noted?CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Pharmacological and Parenteral Therapies
Which of the following drugs would be ordered by the physician to improve the platelet count in a male client with idiopathic thrombocytopenic purpura (ITP)?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Reduction of Risk Potential
A female client is scheduled to receive a heart valve replacement with a porcine valve. Which of the following types of transplant is this?CorrectIncorrect
Question 6 of 75
6. QuestionCategory: Physiological Adaptation
Marco falls off his bicycle and injures his ankle. Which of the following actions shows the initial response to the injury in the extrinsic pathway?CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Physiological Adaptation
Instructions for a client with systemic lupus erythematosus (SLE) would include information about which of the following blood dyscrasias?CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Reduction of Risk Potential
The nurse is aware that the following symptom is most commonly an early indication of stage 1 Hodgkin’s disease?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Reduction of Risk Potential
Francis with leukemia has neutropenia. Which of the following functions must be frequently assessed?CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Physiological Adaptation
The nurse knows that neurologic complications of multiple myeloma (MM) usually involve which of the following body systems?CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Physiological Adaptation
Nurse Patricia is aware that the average length of time from human immunodeficiency virus (HIV) infection to the development of acquired immunodeficiency syndrome (AIDS)?CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Reduction of Risk Potential
An 18-year-old male client admitted with heat stroke begins to show signs of disseminated intravascular coagulation (DIC). Which of the following laboratory findings is most consistent with DIC?CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Physiological Adaptation
Mario comes to the clinic complaining of fever, drenching night sweats, and unexplained weight loss over the past 3 months. Physical examination reveals a single enlarged supraclavicular lymph node. Which of the following is the most probable diagnosis?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Physiological Adaptation
A male client with a gunshot wound requires an emergency blood transfusion. His blood type is AB negative. Which blood type would be the safest for him to receive?CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Health Promotion and Maintenance
Stacy was diagnosed with acute lymphoid leukemia (ALL). She was discharged from the hospital following her chemotherapy treatments. Which statement of Stacy’s mother indicated that she understands when she will contact the physician?CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Psychosocial Integrity
Molly Sue is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy. Her mother states to the nurse that it is hard to see Molly Sue with no hair. The best response for the nurse is:CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Basic Care and Comfort
Brittany who is undergoing chemotherapy for her throat cancer is experiencing stomatitis. To promote oral hygiene and comfort, the nurse-in-charge should:
- Provide frequent mouthwash with normal saline.
Question 18 of 75
18. QuestionCategory: Management of Care
During the administration of chemotherapy agents, Nurse Oliver observed that the IV site is red and swollen when the IV is touched Stacy shouts in pain. The first nursing action to take is:CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Physiological Adaptation
The term “blue bloater” refers to a male client which of the following conditions?CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Physiological Adaptation
The term “pink puffer” refers to the female client with which of the following conditions?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Reduction of Risk Potential
Jose is in danger of respiratory arrest following the administration of a narcotic analgesic. An arterial blood gas value is obtained. Nurse Oliver would expect the paco2 to be which of the following values?CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Reduction of Risk Potential
Timothy’s arterial blood gas (ABG) results are as follows; pH 7.16; Paco2 80 mm Hg; Pao2 46 mm Hg; HCO3- 24 mEq/L; Sao2 81%. This ABG result represents which of the following conditions?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Physiological Adaptation
Norma has started a new drug for hypertension. Thirty minutes after she takes the drug, she develops chest tightness and becomes short of breath and tachypnea. She has a decreased level of consciousness. These signs indicate which of the following conditions?CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Reduction of Risk Potential
Mr. Gonzales was admitted to the hospital with ascites and jaundice. To rule out cirrhosis of the liver which laboratory test indicates liver cirrhosis?CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Reduction of Risk Potential
The biopsy of Mr. Gonzales confirms the diagnosis of cirrhosis. Mr. Gonzales is at increased risk for excessive bleeding primarily because of:CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Physiological Adaptation
Mr. Jay develops hepatic encephalopathy. Which clinical manifestation is most common with this condition?CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Pharmacological and Parenteral Therapies
Patrick who is diagnosed with liver cirrhosis is experiencing symptoms of hepatic encephalopathy. The physician ordered 50 ml of Lactulose p.o. every 2 hours. Patrick suddenly develops diarrhea. The nurse best action would be:CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Physiological Adaptation
Which of the following groups of symptoms indicates a ruptured abdominal aortic aneurysm?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Reduction of Risk Potential
After undergoing a cardiac catheterization, Tracy has a large puddle of blood under his buttocks. Which of the following steps should the nurse take first?CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Physiological Adaptation
Which of the following treatments is a suitable surgical intervention for a client with unstable angina?CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Physiological Adaptation
The nurse is aware that the following terms used to describe reduced cardiac output and perfusion impairment due to ineffective pumping of the heart is:CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Physiological Adaptation
A client with hypertension asks the nurse which factors can cause blood pressure to drop to normal levels?CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Pharmacological and Parenteral Therapies
Nurse Rose is aware that the statement that best explains why furosemide (Lasix) is administered to treat hypertension is:CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Reduction of Risk Potential
Nurse Nikki knows that laboratory results supports the diagnosis of systemic lupus erythematosus (SLE) is:CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Health Promotion and Maintenance
Arnold, a 19-year-old client with a mild concussion is discharged from the emergency department. Before discharge, he complains of a headache. When offered acetaminophen, his mother tells the nurse the headache is severe and she would like her son to have something stronger. Which of the following responses by the nurse is appropriate?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Reduction of Risk Potential
When evaluating an arterial blood gas from a male client with a subdural hematoma, the nurse notes the Paco2 is 30 mm Hg. Which of the following responses best describes the result?CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Management of Care
When prioritizing care, which of the following clients should the nurse Olivia assess first?CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Physiological Adaptation
JP has been diagnosed with gout and wants to know why colchicine is used in the treatment of gout. Which of the following actions of colchicines explains why it’s effective for gout?CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Physiological Adaptation
Norma asks for information about osteoarthritis. Which of the following statements about osteoarthritis is correct?CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Pharmacological and Parenteral Therapies
Ruby is receiving thyroid replacement therapy, develops the flu, and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication will put the client at risk for developing which of the following life-threatening complications?CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Physiological Adaptation
Nurse Sugar is assessing a client with Cushing’s syndrome. Which observation should the nurse report to the physician immediately?CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Physiological Adaptation
Cyrill with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty-six hours later, the client’s urine output suddenly rises above 200 ml/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse’s suspicion of diabetes insipidus?CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Health Promotion and Maintenance
Jomari is diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which of the following statements indicates that the client understands her condition and how to control it?CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Physiological Adaptation
A 66-year-old client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse would suspect which of the following disorders?CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Health Promotion and Maintenance
Nurse Lourdes is teaching a client recovering from Addisonian crisis about the need to take fludrocortisone acetate and hydrocortisone at home. Which statement by the client indicates an understanding of the instructions?CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Reduction of Risk Potential
Which of the following laboratory test results would suggest to the nurse Len that a client has a corticotropin-secreting pituitary adenoma?CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Reduction of Risk Potential
A male client is scheduled for a transsphenoidal hypophysectomy to remove a pituitary tumor. Preoperatively, the nurse should assess for potential complications by doing which of the following?CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Pharmacological and Parenteral Therapies
Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Mariner should expect the dose’s:CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Reduction of Risk Potential
The physician orders laboratory tests to confirm hyperthyroidism in a female client with classic signs and symptoms of this disorder. Which test result would confirm the diagnosis?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Health Promotion and Maintenance
Rico with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U-100 regular insulin and 35 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Reduction of Risk Potential
Nurse Sarah expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Basic Care and Comfort
For a client with Graves’ disease, which nursing intervention promotes comfort?CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Physiological Adaptation
Patrick is treated in the emergency department for a Colles’ fracture sustained during a fall. What is a Colles’ fracture?CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Physiological Adaptation
Cleo is diagnosed with osteoporosis. Which electrolytes are involved in the development of this disorder?CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Physiological Adaptation
Johnny, a firefighter, was involved in extinguishing a house fire and is being treated for smoke inhalation. He developed severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. He most likely has developed which of the following conditions?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Physiological Adaptation
A 67-year-old client develops acute shortness of breath and progressive hypoxia requiring right femur. The hypoxia was probably caused by which of the following conditions?CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Physiological Adaptation
A client with shortness of breath has decreased to absent breath sounds on the right side, from the apex to the base. Which of the following conditions would best explain this?CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Physiological Adaptation
A 62-year-old male client was in a motor vehicle accident as an unrestrained driver. He’s now in the emergency department complaining of difficulty of breathing and chest pain. On auscultation of his lung field, no breath sounds are present in the upper lobe. This client may have which of the following conditions?CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Physiological Adaptation
If a client requires a pneumonectomy, what fills the area of the thoracic cavity?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Physiological Adaptation
Hemoptysis may be present in the client with a pulmonary embolism because of which of the following reasons?CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Reduction of Risk Potential
Alvin with a massive pulmonary embolism will have an arterial blood gas analysis performed to determine the extent of hypoxia. The acid-base disorder that may be present is?CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Reduction of Risk Potential
After a motor vehicle accident, Armand, a 22-year-old client, is admitted with a pneumothorax. The surgeon inserts a chest tube and attaches it to a chest drainage system. Bubbling soon appears in the water seal chamber. Which of the following is the most likely cause of the bubbling?CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Pharmacological and Parenteral Therapies
Nurse Michelle calculates the IV flow rate for a postoperative client. The client receives 3,000 ml of Ringer’s lactate solution IV to run over 24 hours. The IV infusion set has a drop factor of 10 drops per milliliter. The nurse should regulate the client’s IV to deliver how many drops per minute?CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Pharmacological and Parenteral Therapies
Mickey, a 6-year-old child with a congenital heart disorder is admitted with congestive heart failure. Digoxin (lanoxin) 0.12 mg is ordered for the child. The bottle of Lanoxin contains .05 mg of Lanoxin in 1 ml of solution. What amount should the nurse administer to the child?CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Health Promotion and Maintenance
Nurse Alexandra teaches a client about elastic stockings. Which of the following statements, if made by the client, indicates to the nurse that the teaching was successful?CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Physiological Adaptation
The primary reason for rapid continuous rewarming of the area affected by frostbite is to:CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Reduction of Risk Potential
A client recently started on hemodialysis wants to know how the dialysis will take the place of his kidneys. The nurse’s response is based on the knowledge that hemodialysis works by:CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Health Promotion and Maintenance
During a home visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most appropriate?CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Safety and Infection Control
A client hospitalized with MRSA (methicillin-resistant staph aureus) is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Physiological Adaptation
A client who is admitted with an above-the-knee amputation tells the nurse that his foot hurts and itches. Which response by the nurse indicates an understanding of phantom limb pain?CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Reduction of Risk Potential
A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is aware that during the Whipple procedure, the doctor will remove the:CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Health Promotion and Maintenance
The physician has ordered a minimal-bacteria diet for a client with neutropenia. The client should be taught to avoid eating:CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Health Promotion and Maintenance
A client is discharged home with a prescription for Coumadin (sodium warfarin). The client should be instructed to:CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Reduction of Risk Potential
The nurse is assisting the physician with the removal of a central venous catheter. To facilitate removal, the nurse should instruct the client to:CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Pharmacological and Parenteral Therapies
A client has an order for streptokinase. Before administering the medication, the nurse should assess the client for: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.