Free practice – nothing gated

16 NCLEX-RN practice questions, with a written rationale for every option.

Not just the answer you got wrong. Every option here explains the specific reasoning error behind it, because knowing why the other three looked right is what changes your score.

No signup No email required All 16 open Written by one nurse educator 2026 NCLEX-RN test plan

Read the stem and commit to an answer before you click. Guessing and then reading is how you learn the pattern.
Click your choice. All of the rationales open at once, including the ones you did not pick.
Read the rationale for the option you almost chose. That is where the useful information is.

Questions 1 to 3

Prioritization, delegation, and escalation

Management of Care items turn on which need is most immediate, not on which client sounds sickest. Watch what each distractor is actually sorting by.

Question 1

Management of Care – Prioritization

A nurse on a medical surgical unit receives report on four clients at the start of the shift. Which client should the nurse assess first?

Pick an answer. All four rationales open, not only the one you chose.

Question 2

Management of Care – Delegation and supervision

A charge nurse is assigning care on a medical surgical unit. Which client care activity is appropriate to delegate to a licensed practical nurse?

Question 3

Management of Care – Escalation

A nurse is caring for a client admitted with an upper gastrointestinal bleed. Over the past four hours the hemoglobin has fallen from 9.2 to 7.1 g per dL. The blood pressure is 92 over 54 mm Hg, the heart rate is 116 beats per minute, and the client has just passed a large melena stool. Two units of packed red blood cells are ordered and the blood bank reports the units will be ready in forty minutes. Which action should the nurse take first?

Questions 4 to 6

Pharmacology and parenteral therapies

Each of these three has a distractor that treats a correct nursing action for a different condition. The question is which condition you are actually looking at.

Question 4

Pharmacological and Parenteral Therapies

A client with type 2 diabetes who takes metformin daily is scheduled tomorrow morning for a computed tomography scan with iodinated contrast. Which action by the nurse is most appropriate?

Question 5

Pharmacological and Parenteral Therapies

A client is receiving a continuous intravenous heparin infusion on day five of treatment for a pulmonary embolism. The platelet count has fallen from 245,000 to 88,000 cells per microliter, and the client now reports new pain and swelling in the left calf. Which action should the nurse take?

Question 6

Pharmacological and Parenteral Therapies

A client on an inpatient psychiatric unit has been receiving haloperidol for three days. The nurse finds the client with a temperature of 39.4 degrees Celsius, a heart rate of 124 beats per minute, a blood pressure of 168 over 96 mm Hg, generalized muscle rigidity, profuse diaphoresis, and new confusion. Which action should the nurse take first?

Eight questions left on this page. There are 1,800 more inside.

Same structure every time: a rationale for every option, organized into 180 modules across the eight client needs areas and thirteen medical surgical body systems, so you can study the one unit you are actually being tested on.

See what is inside and what it costs

Questions 7 and 8

Safety and Infection Prevention and Control

Precaution questions are usually decided by transmission route. Two of these distractors apply the right rule to the wrong organism.

Question 7

Safety and Infection Prevention and Control

A client with suspected pulmonary tuberculosis is in an airborne infection isolation room and must go to the radiology department for a chest radiograph. Which action by the nurse is correct?

Question 8

Safety and Infection Prevention and Control

A nurse is reviewing four newly admitted clients. Which client requires contact precautions?

Questions 9 and 10

Reading a trend

Trend items give you a table and ask what it means. The answer is almost never a single value that crossed a threshold. It is the relationship among several values moving together.

Question 9

Reduction of Risk Potential – Trend

A 74 year old client was admitted three days ago with a heart failure exacerbation and has been receiving intravenous furosemide. The nurse reviews the record below. Which finding is of greatest concern and should be reported to the provider?

Finding	Day 1	Day 2	Day 3
Weight, kilograms	82.4	80.9	79.6
Blood pressure, mm Hg	138 over 84	128 over 76	104 over 58
Heart rate, beats per minute	92	88	106
Urine output, mL in twenty four hours	2,850	2,400	900
Potassium, mEq per L	4.1	3.8	3.4
Creatinine, mg per dL	1.0	1.2	1.9

Question 10

Physiological Adaptation – Trend

A 19 year old client was admitted this morning with a closed head injury after a fall from a skateboard. The provider was notified at 1200 of the change in the right pupil, and neurologic checks were increased to every thirty minutes. The nurse is now reviewing the 1600 findings. Which finding is the strongest evidence that intracranial pressure is rising and that herniation may be imminent?

Finding	0800	1200	1600
Level of consciousness	Oriented to person, place, and time	Drowsy, oriented to person and place	Opens eyes to voice, confused
Glasgow Coma Scale score	15	13	11
Blood pressure, mm Hg	118 over 70	132 over 68	154 over 62
Heart rate, beats per minute	78	68	54
Respirations, breaths per minute	16, regular	14, regular	10, irregular
Right pupil	3 mm, brisk	4 mm, sluggish	5 mm, nonreactive

Questions 11 to 13

Health promotion, psychosocial, and basic care

Three areas that get less study time than pharmacology and show up on the examination anyway.

Question 11

Health Promotion and Maintenance

A client at 32 weeks of gestation comes to the clinic reporting a headache that has not been relieved by acetaminophen and states she has twice today seen spots in her vision. The blood pressure is 158 over 98 mm Hg, up from 118 over 72 mm Hg at 20 weeks, and the nurse notes 2 plus pitting edema of the hands and face. Which action should the nurse take?

Question 12

Psychosocial Integrity

During an admission interview a client says, “I have been thinking that my family would be better off without me. I have my husband’s old pain pills at home.” Which response by the nurse is most appropriate?

Question 13

Basic Care and Comfort

A client on day four after an ischemic stroke has left sided weakness and mild dysphagia confirmed by a speech language pathologist. The client is on a dysphagia diet with thickened liquids. Which approach by the nurse best reduces the risk of aspiration during the meal?

Questions 14 and 15

Select all that apply

On the examination these are scored plus and minus: a correct selection earns a point and an incorrect one subtracts a point, with the item floored at zero. Selecting everything is therefore a losing strategy. The skill is evaluating each option independently rather than looking for a pattern across them.

Question 14

Select all that apply

Reduction of Risk Potential – Vascular access

A client has a new arteriovenous fistula in the left arm that was created three days ago. Which nursing actions are appropriate? Select all that apply.

There is more than one correct option. Pick every option you believe is correct, then check your answers. Nothing is scored or stored.

Question 15

Select all that apply

Pharmacological and Parenteral Therapies – Client teaching

A client is being discharged on warfarin after treatment for a deep vein thrombosis. Which client statements indicate correct understanding of the teaching? Select all that apply.

There is more than one correct option. Pick every option you believe is correct, then check your answers. Nothing is scored or stored.

The last one

Bowtie item, Next Generation format

The bowtie asks you to name the condition, act on it, and then say how you would know whether the action worked. Answer each part before moving to the next.

Question 16

Bowtie item

Physiological Adaptation – Next Generation format

A 68 year old client is on day one after surgical repair of a hip fracture. The client has been receiving intravenous fluids at 150 mL per hour and has just completed the second of two units of packed red blood cells. The client now reports difficulty breathing and is sitting upright. Respirations are 32 breaths per minute, oxygen saturation is 88 percent on room air, and the nurse hears crackles to the mid lung fields bilaterally with pink frothy sputum and notes jugular venous distention. The blood pressure is 178 over 96 mm Hg and the heart rate is 118 beats per minute. The client has a history of heart failure with an ejection fraction of 35 percent.

A bowtie has three parts. Identify the condition, choose the two immediate actions, then choose the two parameters that tell you whether the actions worked. Each part opens only after you answer it.

Part one – the client is most likely experiencing

Part two – two immediate actions

Both correct actions remove the load and reduce the work of breathing. Stopping the transfusion and the maintenance fluids halts the volume being added, and keeping the line with a saline lock preserves access for the diuretic and for any blood bank workup. Sitting the client fully upright with the legs dependent moves volume out of the pulmonary circulation and lets the diaphragm descend.

Part three – the provider orders intravenous furosemide. Two parameters that best evaluate whether the interventions are working

Both correct parameters measure the problem itself. Oxygen saturation with work of breathing shows whether pulmonary edema is clearing, and urine output after the furosemide shows whether the excess volume is actually being removed. The distractors all monitor for a different transfusion reaction than the one this client is having.

Want to know which subject is actually holding you back?

The free readiness diagnostic is fifty more questions across eight core nursing subjects, and every subject is scored on its own. The useful number is not your total. It is the gap between your strongest subject and your weakest one, because that gap is where the studying should go. Thirty six pages, formatted to print, with a rationale for every option.

The questions on this page stay open whether or not you enter an email. You will also get new questions and cheat sheets as they are written. Unsubscribe in one click, any time.

16 Free NCLEX-RN Practice Questions With Full Rationales

Prioritization, delegation, and escalation

Pharmacology and parenteral therapies

Eight questions left on this page. There are 1,800 more inside.

Safety and Infection Prevention and Control

Reading a trend

Health promotion, psychosocial, and basic care

Select all that apply

Bowtie item, Next Generation format

Part one – the client is most likely experiencing

Part two – two immediate actions

Part three – the provider orders intravenous furosemide. Two parameters that best evaluate whether the interventions are working

Want to know which subject is actually holding you back?