100 Free NCLEX Practice Questions and Answers (2026)

Updated on: October 27, 2026

This free NCLEX practice test has 100 questions and answers, each with a short rationale.

The questions cover the eight areas of the NCLEX-RN test plan: management of care, safety and infection prevention, health promotion, psychosocial integrity, basic care and comfort, pharmacology, reduction of risk potential and physiological adaptation.

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Pick an answer to get instant feedback and learn why the other options are wrong.

Important: These are original practice questions written to help you study. They are not real NCLEX questions, and they are single-best-answer multiple choice. The real exam also uses case studies and other item formats, so use this test for content review and add clinical judgment practice from official and licensed sources. Always follow your own nursing program and your state board of nursing.

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Select an answer to see instant feedback and a rationale. Your score updates as you go. Exam facts and study tips are below the quiz.

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Management of Care

1. The charge nurse is making assignments. Which client is the most appropriate to assign to an LPN/LVN?

Answer: D. LPN/LVNs usually care for stable clients with predictable outcomes. New, unstable or teaching-heavy needs, and initial assessments, stay with the RN. Scope of practice varies by state.
2. Which task can the RN safely delegate to unlicensed assistive personnel (UAP)?

Answer: C. UAP can perform routine tasks on stable clients. Assessment, teaching, evaluation and care planning cannot be delegated.
3. The nurse is caring for four postoperative clients. Which client should the nurse assess first?

Answer: B. Low blood pressure, fast heart rate and restlessness suggest shock or bleeding, which threatens circulation. Unstable clients come before stable ones.
4. Who is responsible for obtaining informed consent for a surgical procedure?

Answer: B. The provider explains risks, benefits and alternatives. The nurse may witness the signature and clarify that the client understands.
5. A competent adult client refuses a prescribed blood transfusion. What should the nurse do first?

Answer: A. Competent clients have the right to refuse treatment. The nurse supports an informed decision, informs the provider and documents.
6. A client with a valid do-not-resuscitate (DNR) order has a cardiac arrest. What should the nurse do?

Answer: D. A valid DNR order is followed. Comfort care and notifying the provider continue.
7. Which action by the nurse is a violation of client confidentiality?

Answer: C. Information is shared only with staff who need it for care, and only in private settings.
8. Which statement about incident (occurrence) reports is correct?

Answer: C. Incident reports are for quality improvement and risk management. The chart should contain only factual care documentation.
9. A nurse tells the provider, “I recommend the client be seen now and a chest x-ray be ordered.” Which part of SBAR is this?

Answer: B. The R in SBAR is Recommendation (or request): what the nurse wants done.
10. Which finding in a client who had a thyroidectomy requires immediate intervention?

Answer: A. Stridor signals airway obstruction from swelling or bleeding. Airway comes first (airway, breathing, circulation).

Safety and Infection Prevention and Control

11. A client is admitted with suspected active tuberculosis. Which precautions should the nurse use?

Answer: D. Tuberculosis is spread through the air and requires airborne precautions.
12. Which hand hygiene method is required after caring for a client with Clostridioides difficile (C. diff)?

Answer: D. Alcohol does not kill C. diff spores. Soap and water mechanically removes them. Contact precautions also apply.
13. Which client requires droplet precautions?

Answer: C. Influenza spreads by large respiratory droplets. Tuberculosis and measles need airborne precautions. MRSA needs contact precautions.
14. Which intervention is best for a confused client who is at high risk for falls?

Answer: B. Low bed, a clear environment, call light in reach and frequent rounding reduce falls. Full side rails and vests are restraints with their own risks.
15. Before applying restraints to an agitated client, what should the nurse do first?

Answer: A. Restraints are a last resort. The least restrictive measure comes first, and a provider’s order is required.
16. Which two identifiers should the nurse use before giving a medication?

Answer: A. Room numbers and locations can change. Use two client-specific identifiers.
17. A client with a latex allergy may also react to which food?

Answer: D. Bananas, avocado, kiwi and chestnuts can cross-react with latex.
18. A nurse has a needlestick injury from a used needle. What should the nurse do first?

Answer: C. Immediate washing is the first step. Then report the injury and follow the facility’s exposure protocol.
19. Which action reduces a nurse’s exposure to radiation from an implant?

Answer: B. The three principles are limiting time, increasing distance and using shielding.
20. A fire starts in a client’s room. What is the nurse’s first action?

Answer: B. RACE: Rescue, Alarm, Contain, Extinguish or Evacuate.

Health Promotion and Maintenance

21. Which vaccine is contraindicated during pregnancy?

Answer: A. MMR is a live vaccine and is avoided in pregnancy. Inactivated influenza and Tdap are recommended.
22. At what age does an infant typically begin to sit without support?

Answer: D. Gross motor development: head control first, then rolling, then sitting, crawling and walking.
23. Which nutrient taken before and early in pregnancy reduces the risk of neural tube defects?

Answer: C. Folic acid supports early spinal cord and brain development.
24. A client’s last menstrual period began on January 10. Using Naegele’s rule, what is the estimated date of delivery?

Answer: C. Add 7 days to the first day of the last period (January 17), subtract 3 months (October 17).
25. Which is an example of secondary prevention?

Answer: B. Secondary prevention is early detection through screening. Primary prevents disease, and tertiary limits disability.
26. Which respiratory rate is expected for a healthy newborn?

Answer: A. Newborns breathe faster than adults. Sustained rates above 60 need evaluation.
27. Which approach best supports a toddler’s need for autonomy when giving medication?

Answer: D. Toddlers want control. Give limited choices, not a choice about whether to take the medicine.
28. Which change is expected in an older adult?

Answer: D. Kidney function falls with age, which affects how drugs are cleared. Doses may need adjusting.

Psychosocial Integrity

29. A client says, “I’m afraid the surgery will go wrong.” Which response is most therapeutic?

Answer: C. Reflecting and inviting the client to say more encourages expression. Reassurance and “why” questions block communication.
30. A client states a specific plan to commit suicide. What is the nurse’s priority action?

Answer: B. Safety comes first. Remove hazards, observe continuously and notify the provider.
31. Which medication class is typically used to treat alcohol withdrawal?

Answer: A. Benzodiazepines such as lorazepam reduce withdrawal symptoms and seizure risk.
32. Which serum lithium level is within the usual therapeutic range?

Answer: A. The maintenance range is about 0.6 to 1.2 mEq/L. Levels above 1.5 can be toxic.
33. The nurse suspects a client is a victim of intimate partner violence. What is the best approach?

Answer: D. Privacy protects the client’s safety. Follow reporting rules and provide resources.
34. A client who has been told they have cancer says, “The lab must have made a mistake.” Which defense mechanism is this?

Answer: C. Denial is refusing to accept reality. It can be protective early on.
35. A client with schizophrenia says, “The voices are telling me to leave.” Which response is most therapeutic?

Answer: B. Acknowledge the client’s experience without agreeing with the hallucination or arguing.
36. A client’s spouse died an hour ago, and the client is crying. What is the best nursing action?

Answer: B. Presence and listening support grief. Avoid clichés and unrequested teaching.

Basic Care and Comfort

37. Which method is the most reliable for confirming initial placement of a nasogastric feeding tube?

Answer: A. Radiography is the gold standard before the first feeding. Air auscultation is not reliable.
38. Which finding indicates a stage 1 pressure injury?

Answer: D. Stage 1 is intact skin with non-blanchable erythema. Early repositioning and relief of pressure prevent progression.
39. Which action is most important for a client with dysphagia during meals?

Answer: C. Upright positioning and small, slow bites reduce aspiration risk.
40. Which position is correct for a client receiving continuous tube feeding?

Answer: C. Elevating the head lowers the risk of aspiration. Many policies use 30 to 45 degrees.
41. Which intervention best prevents a catheter-associated urinary tract infection (CAUTI)?

Answer: B. Prompt removal is the most effective prevention.
42. A client is prescribed an opioid for pain. Which adverse effect should the nurse anticipate and prevent?

Answer: A. Opioids slow the gut. Fluids, fiber, activity and a stool softener or laxative help.
43. Which is the most reliable indicator of a client’s pain?

Answer: D. Pain is subjective. Use a numeric or other self-report scale when the client can answer.
44. Which instruction is correct for a client learning to walk with crutches?

Answer: D. Underarm pressure can damage nerves (crutch palsy). Slightly bent elbows and good posture help.

Pharmacological and Parenteral Therapies

45. What should the nurse do before giving digoxin?

Answer: C. Hold and notify the provider if the apical rate is below 60 beats per minute in an adult, per policy.
46. Which medication is the antidote for warfarin?

Answer: B. Warfarin blocks vitamin K-dependent clotting factors. Monitor the INR.
47. Which medication is the antidote for heparin?

Answer: A. Protamine sulfate binds heparin. Monitor aPTT.
48. Which insulin can be given intravenously?

Answer: A. Only regular (short-acting) insulin is given IV. Basal and intermediate insulins are for subcutaneous use.
49. When mixing regular insulin and NPH insulin in one syringe, which should be drawn up first?

Answer: D. Clear before cloudy. This prevents contaminating the regular insulin vial.
50. A client taking lisinopril reports swelling of the lips and tongue. What is the nurse’s priority?

Answer: C. Angioedema from ACE inhibitors can block the airway. A dry cough is more common but not an emergency.
51. A client on atorvastatin reports unexplained muscle pain and weakness. What should the nurse do?

Answer: B. Severe muscle breakdown is a rare but serious statin effect.
52. A client receiving gentamicin should be monitored for which adverse effects?

Answer: B. Aminoglycosides are nephrotoxic and ototoxic. Check creatinine, urine output and hearing, and monitor drug levels.
53. A client’s respiratory rate is 6 breaths per minute after receiving morphine. Which medication should the nurse anticipate?

Answer: A. Naloxone reverses opioid respiratory depression.
54. Which medication is the antidote for acetaminophen overdose?

Answer: D. Acetylcysteine limits liver injury if given early.
55. Which action is correct when giving intravenous potassium chloride?

Answer: C. IV push potassium can cause fatal arrhythmias. Follow the pharmacy’s concentration and rate limits.
56. A client develops chills, back pain and a fever shortly after a blood transfusion starts. What is the nurse’s first action?

Answer: C. Stop the transfusion, keep the vein open with saline through new tubing, check vital signs and notify the provider.

Dosage Calculations

57. The order is digoxin 0.25 mg by mouth. The tablets are 0.125 mg each. How many tablets should the nurse give?

Answer: B. 0.25 mg divided by 0.125 mg is 2 tablets.
58. The order is amoxicillin 500 mg. The supply is 250 mg per 5 mL. How many mL should the nurse give?

Answer: A. 500 mg divided by 250 mg is 2, times 5 mL equals 10 mL.
59. The order is heparin 5,000 units subcutaneously. The vial reads 10,000 units per mL. How many mL should the nurse give?

Answer: D. 5,000 divided by 10,000 equals 0.5 mL.
60. The order is 1,000 mL of IV fluid over 8 hours. At what rate in mL per hour should the pump be set?

Answer: D. 1,000 mL divided by 8 hours equals 125 mL per hour.
61. The order is 1,000 mL over 10 hours by gravity. The drop factor is 15 gtt/mL. How many drops per minute should the nurse set?

Answer: C. 1,000 mL times 15 gtt/mL equals 15,000 drops, divided by 600 minutes equals 25 drops per minute.
62. A client weighs 154 pounds. How much does the client weigh in kilograms?

Answer: B. Divide pounds by 2.2: 154 divided by 2.2 equals 70 kg.
63. The order is 15 mg/kg/day in 3 equally divided doses. The child weighs 20 kg. How many mg are in each dose?

Answer: A. 15 mg times 20 kg equals 300 mg per day, divided by 3 doses equals 100 mg per dose.
64. An antibiotic is ordered as 250 mL over 30 minutes by pump. What rate in mL per hour should the nurse set?

Answer: A. 250 mL in half an hour is 500 mL in one hour.

Reduction of Risk Potential

65. Which laboratory result requires immediate nursing action?

Answer: D. Normal potassium is about 3.5 to 5.0 mEq/L. A level of 6.2 can cause life-threatening arrhythmias.
66. Which finding suggests digoxin toxicity?

Answer: C. Digoxin toxicity can cause nausea, vision changes and arrhythmias. Check the level (usually 0.5 to 2 ng/mL) and notify the provider.
67. A client who takes warfarin for atrial fibrillation has an INR of 2.5. How should the nurse interpret this?

Answer: B. The usual INR goal on warfarin is 2 to 3 for many conditions. Follow the provider’s target.
68. The ABG results are pH 7.30, PaCO2 50 mm Hg and HCO3 24 mEq/L. Which acid-base imbalance is present?

Answer: B. Low pH with high PaCO2 and a normal bicarbonate points to a respiratory cause.
69. The ABG results are pH 7.30, PaCO2 38 mm Hg and HCO3 18 mEq/L. Which acid-base imbalance is present?

Answer: A. Low pH with low bicarbonate and a normal PaCO2 indicates metabolic acidosis.
70. Which instruction is correct for collecting a sputum specimen?

Answer: D. A deep cough in the morning gives the best sample. Rinsing with water limits contamination.
71. Before a procedure using contrast dye, which information is most important for the nurse to obtain?

Answer: C. Contrast can cause allergic reactions and can harm the kidneys.
72. After a cardiac catheterization through the femoral artery, what should the nurse monitor?

Answer: C. Keep the leg straight and watch for bleeding, hematoma and reduced circulation.
73. Which finding after a thyroidectomy suggests hypocalcemia?

Answer: B. Parathyroid injury can lower calcium. Keep calcium gluconate available and watch for tetany.
74. Which finding indicates orthostatic hypotension?

Answer: A. A systolic drop of at least 20 or a diastolic drop of at least 10 mm Hg within 3 minutes of standing is positive.
75. What is the lowest possible Glasgow Coma Scale score?

Answer: D. The scale scores eye opening, verbal response and motor response, each starting at 1. The total ranges from 3 to 15.
76. Which ECG finding is associated with hypokalemia?

Answer: D. Low potassium flattens T waves. High potassium produces tall, peaked T waves.

Physiological Adaptation: Cardiovascular and Respiratory

77. Which medication is given early to a client with suspected myocardial infarction to reduce platelet aggregation?

Answer: C. Aspirin is given early unless contraindicated. Follow the provider’s orders and the facility’s chest pain protocol.
78. Which finding indicates right-sided heart failure?

Answer: B. Right-sided failure backs blood into the systemic veins. Left-sided failure produces pulmonary signs.
79. A client with heart failure should be taught to report a weight gain of:

Answer: A. Rapid gain signals fluid retention. Weigh daily at the same time.
80. Which oxygen saturation goal is typically appropriate for a client with COPD?

Answer: A. Too much oxygen can reduce the drive to breathe in some COPD clients. Follow the provider’s order.
81. Which finding is ominous in a client having an asthma exacerbation?

Answer: D. A silent chest means very little air is moving.
82. A client with a chest tube has continuous bubbling in the water-seal chamber. What does this indicate?

Answer: C. Fluctuation with breathing (tidaling) is expected. Continuous bubbling in the water seal suggests a leak.
83. What is the maximum time for each tracheal suctioning pass?

Answer: B. Suctioning removes oxygen. Hyperoxygenate before and limit each pass.
84. Which finding most suggests a pulmonary embolism?

Answer: B. A clot in the lung causes sudden dyspnea, chest pain and often tachycardia.

Physiological Adaptation: Endocrine and Renal

85. Which finding is expected in diabetic ketoacidosis (DKA)?

Answer: A. DKA features high glucose, ketones, dehydration and acidosis.
86. A conscious client has a blood glucose of 52 mg/dL. What should the nurse do first?

Answer: D. Follow the rule of 15: give 15 g of carbohydrate, recheck in 15 minutes and repeat if needed.
87. Which finding is expected in hyperthyroidism?

Answer: C. Excess thyroid hormone speeds metabolism.
88. Which finding is associated with Cushing’s syndrome?

Answer: C. Excess cortisol causes central obesity, hypertension and hyperglycemia.
89. A client with chronic kidney disease and high potassium should limit which food?

Answer: B. Potatoes, bananas, oranges and tomatoes are high in potassium.
90. Which assessment is correct for a client with an arteriovenous (AV) fistula for dialysis?

Answer: A. A thrill and bruit mean the fistula is working. Avoid pressure and punctures in that arm.
91. Which urine output should the nurse report to the provider as a possible sign of acute kidney injury?

Answer: D. A low urine output, about below 0.5 mL/kg/hr, suggests decreased kidney perfusion. Follow the facility’s threshold.
92. Which finding is expected in diabetes insipidus?

Answer: D. Lack of antidiuretic hormone causes the kidneys to pass large amounts of dilute urine.

Physiological Adaptation: Neurologic, Gastrointestinal and Maternal-Newborn

93. Which information is most important to obtain for a client with symptoms of an ischemic stroke?

Answer: C. Thrombolytic treatment depends on how long ago symptoms began.
94. Which findings are known as Cushing’s triad, a late sign of increased intracranial pressure?

Answer: B. The triad signals brain stem compression and is an emergency.
95. What should the nurse do during a generalized tonic-clonic seizure?

Answer: A. Keep the client safe, turn to the side afterward and observe the seizure.
96. A client with a T4 spinal cord injury has a severe headache, flushing and a blood pressure of 210/110. What is the first action?

Answer: A. This is autonomic dysreflexia. Raise the head to lower the pressure and remove the trigger, often a full bladder or bowel.
97. Which finding suggests that a client’s appendix has perforated?

Answer: D. Rupture can briefly relieve pressure and then cause peritonitis.
98. Which stool description is typical of an upper gastrointestinal bleed?

Answer: C. Digested blood produces black, sticky, foul-smelling stools (melena).
99. A client receiving magnesium sulfate for severe preeclampsia has no patellar reflexes. What does this indicate?

Answer: B. Stop the infusion and notify the provider. Keep calcium gluconate available.
100. The nurse finds a boggy uterus and heavy bleeding in a client 30 minutes after delivery. What is the first action?

Answer: B. Fundal massage helps the uterus contract. Then check bleeding, vital signs and notify the provider.

Your Score

Section Score

About the NCLEX-RN Exam

The National Council of State Boards of Nursing (NCSBN) describes the NCLEX-RN as a computerized adaptive test, which means the difficulty of the items adjusts to the candidate's ability estimate. According to the NCSBN test plan effective April 2026, the exam has a minimum of 85 items and a maximum of 150 items, with a five-hour time limit that includes breaks. Fifteen items on each exam are unscored pretest items that candidates cannot tell apart from scored ones. The minimum-length exam includes 52 items from the eight content areas and 18 items in three clinical judgment case studies. Items can include charts, tables and graphics, and they appear in multiple formats.

The test plan lists the share of items from each client needs category. Individual exams can vary by up to 3 percent in each category. The 100 questions on this page are grouped by topic and are not in these proportions.

NCLEX-RN client needs category Share of exam items
Management of Care 15% to 21%
Safety and Infection Prevention and Control 10% to 16%
Health Promotion and Maintenance 6% to 12%
Psychosocial Integrity 6% to 12%
Basic Care and Comfort 6% to 12%
Pharmacological and Parenteral Therapies 13% to 19%
Reduction of Risk Potential 9% to 15%
Physiological Adaptation 11% to 17%

How to Use This Practice Test

  1. Pick an answer for each question. You get instant feedback and a rationale, and the scoreboard keeps count.
  2. Read every rationale, including for questions you got right. Understanding why the wrong options are wrong is how you learn the pattern.
  3. Check your section scores at the end. A low score in one area tells you what to review first.
  4. Use the "Retry missed" button after a day or two.
  5. Prioritize like the exam. Look for airway, breathing and circulation first, then unstable before stable, then the safest and least restrictive action.
  6. Practice dosage calculations by hand. Write the units and check that the answer is reasonable.
  7. Add case studies and other formats from official or licensed NCLEX resources. This page covers content, not the full exam experience.

Score Yourself

The real NCLEX is pass or fail, set by an adaptive standard, not by a percentage. The ranges below are only a study guide for this page.

  • 90 to 100: excellent. Move on to timed mixed practice and case studies.
  • 80 to 89: good. Review your lowest sections.
  • 70 to 79: keep studying, especially pharmacology, prioritization and lab values.
  • Below 70: review each rationale and the matching content, then retake the test in a few days.

Answer Key

Use this key to score yourself quickly. The rationales above tell you why.

Q A Q A Q A Q A Q A
1 D 21 A 41 B 61 C 81 D
2 C 22 D 42 A 62 B 82 C
3 B 23 C 43 D 63 A 83 B
4 B 24 C 44 D 64 A 84 B
5 A 25 B 45 C 65 D 85 A
6 D 26 A 46 B 66 C 86 D
7 C 27 D 47 A 67 B 87 C
8 C 28 D 48 A 68 B 88 C
9 B 29 C 49 D 69 A 89 B
10 A 30 B 50 C 70 D 90 A
11 D 31 A 51 B 71 C 91 D
12 D 32 A 52 B 72 C 92 D
13 C 33 D 53 A 73 B 93 C
14 B 34 C 54 D 74 A 94 B
15 A 35 B 55 C 75 D 95 A
16 A 36 B 56 C 76 D 96 A
17 D 37 A 57 B 77 C 97 D
18 C 38 D 58 A 78 B 98 C
19 B 39 C 59 D 79 A 99 B
20 B 40 C 60 D 80 A 100 B

Frequently Asked Questions

Click a question to see the answer.

How many questions are on the NCLEX-RN?

The NCSBN test plan effective April 2026 gives a minimum of 85 and a maximum of 150 items. Fifteen of the items are unscored pretest items.

How long do I have to take the NCLEX-RN?

The time limit is five hours, including breaks, according to the NCSBN test plan effective April 2026.

Is the NCLEX adaptive?

Yes. The NCLEX-RN uses computerized adaptive testing, so item difficulty adjusts to the candidate's ability estimate.

Are these real NCLEX questions?

No. They are original practice questions that cover the same kinds of topics and are for study only. The real exam also uses case studies and other item formats.

What topics are on the NCLEX-RN?

The test plan groups items into client needs categories: management of care, safety and infection prevention and control, health promotion and maintenance, psychosocial integrity, basic care and comfort, pharmacological and parenteral therapies, reduction of risk potential and physiological adaptation.

What is a good score on this practice test?

There is no official percentage, because the NCLEX is adaptive and scored differently. As a study guide, aim for 80 percent or more in every section, and review any section below that.

What should I do after I pass the NCLEX?

Apply for your license through your state board, then update your resume. See our entry-level registered nurse resume sample and new grad summary examples.

Conclusion

Practice questions work best when you read the rationale for every option, track your weak areas and then revisit them. Work through all 100 questions, retry the ones you missed and add official case study practice before test day. Good luck.

Related Reading

Source: NCLEX-RN Test Plan Effective April 2026, National Council of State Boards of Nursing. Checked in October 2026.

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