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20 free NCLEX-RN practice questions

Try a short set of original nursing questions, then use each rationale to guide what you review next.

These are original Passy questions based on the public NCLEX-RN Client Needs categories. The set includes all eight Client Needs subcategories, but it is not weighted like the real exam. They are not official NCLEX questions and do not predict your exam result.

Quick PracticeQuestion 1 of 20

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Safety and Infection Prevention and ControlStep 1 · Choose one answer

A nurse is preparing to enter the room of a client with suspected pulmonary tuberculosis. Which respiratory protection should the nurse use before entering?

Question review

All 20 NCLEX questions with explanations

Try the set above first, then use this list to review. Each answer and explanation stays closed until you open it.

Question 1 · Safety and Infection Prevention and Control
A nurse is preparing to enter the room of a client with suspected pulmonary tuberculosis. Which respiratory protection should the nurse use before entering?
1. A standard surgical mask
2. A fit-tested N95 respirator
3. A face shield without a mask
4. No mask unless the client is coughing
Show answer and explanation for question 1
Correct answer: B · A fit-tested N95 respirator
Suspected pulmonary tuberculosis requires airborne precautions. A fit-tested N95 respirator or a higher-level approved respirator is used before entering the room.
Look for this next time: Match protective equipment to the transmission route before entering the care space.
Question 2 · Management of Care
Which task is appropriate for the nurse to delegate to unlicensed assistive personnel?
1. Teach a client how to use an incentive spirometer
2. Assess a client who reports new chest pressure
3. Obtain routine vital signs for a stable client
4. Evaluate whether pain medicine was effective
Show answer and explanation for question 2
Correct answer: C · Obtain routine vital signs for a stable client
Routine data collection for a stable client can be delegated. Teaching, assessment, and evaluation require nursing judgment and remain the nurse's responsibility.
Look for this next time: Delegate stable, predictable tasks while keeping assessment, teaching, and evaluation with the nurse.
Question 3 · Health Promotion and Maintenance
Which parent statement shows correct understanding of safe sleep for a 6-month-old infant?
1. I will place my baby on the back on a firm, flat sleep surface.
2. I will use a sleep-positioning pillow to prevent rolling.
3. I will add a loose blanket when the room feels cool.
4. I will place my baby on the stomach after the last feeding.
Show answer and explanation for question 3
Correct answer: A · I will place my baby on the back on a firm, flat sleep surface.
Infants should be placed supine on a firm, flat sleep surface. Loose bedding and positioning products create avoidable suffocation hazards.
Look for this next time: Safe infant sleep means back positioning, a firm flat surface, and an uncluttered sleep space.
Question 4 · Psychosocial Integrity
A client who has just received a serious diagnosis says, "I cannot think about anything else." Which response is most therapeutic?
1. Try not to worry until all the tests are finished.
2. Everything will probably work out.
3. Tell me what feels most difficult to think about right now.
4. You should focus on the treatment options instead.
Show answer and explanation for question 4
Correct answer: C · Tell me what feels most difficult to think about right now.
An open-ended invitation acknowledges the client's distress and allows the client to identify the immediate concern. False reassurance and redirecting can close communication.
Look for this next time: Therapeutic communication names the concern and invites the client to lead without false reassurance.
Question 5 · Pharmacological and Parenteral Therapies
The order says to hold digoxin if the adult client’s apical pulse is below 60/min and to notify the prescriber. The nurse counts an apical pulse of 54/min. What should the nurse do?
1. Give the dose with food
2. Give half of the prescribed dose
3. Hold the dose and notify the prescriber
4. Ask the client to walk, then recheck the pulse
Show answer and explanation for question 5
Correct answer: C · Hold the dose and notify the prescriber
The order itself sets the hold point: below 60/min, notify the prescriber. An apical pulse of 54/min means the dose is held and the prescriber is notified. Giving the dose, cutting it in half, or walking the client first does not follow that order.
Look for this next time: Check the assessment tied to a medication's main risk before deciding whether to give the dose.
Question 6 · Physiological Adaptation
A conscious client with diabetes is shaky, can swallow safely, and has a blood glucose of 58 mg/dL (reference range 70–110 mg/dL). Which action should the nurse take first?
1. Give 15 g of a rapid-acting carbohydrate
2. Administer the scheduled long-acting insulin
3. Offer a high-fat meal
4. Restrict oral intake and recheck in one hour
Show answer and explanation for question 6
Correct answer: A · Give 15 g of a rapid-acting carbohydrate
A conscious client with hypoglycemia should receive a rapid-acting carbohydrate promptly. Glucose is then rechecked after about 15 minutes and treatment is repeated if it remains low.
Look for this next time: For a conscious client with hypoglycemia, correct the immediate glucose deficit before longer-term planning.
Question 7 · Reduction of Risk Potential
Fifteen minutes after a blood transfusion begins, a client reports chills and low-back pain. What is the nurse's first action?
1. Slow the transfusion rate
2. Stop the transfusion
3. Give a prescribed pain medicine
4. Reassure the client that this is expected
Show answer and explanation for question 7
Correct answer: B · Stop the transfusion
Chills and low-back pain can signal an acute transfusion reaction. The first action is to stop the transfusion, then maintain IV access with normal saline using new tubing and follow the reaction protocol.
Look for this next time: When a serious infusion reaction is suspected, stop the source before moving to the remaining response steps.
Question 8 · Reduction of Risk Potential
A client receiving IV potassium reports burning at the site. The nurse notes swelling and coolness around the catheter. What should the nurse do first?
1. Increase the infusion rate
2. Apply pressure while the infusion continues
3. Stop the infusion
4. Flush the catheter forcefully
Show answer and explanation for question 8
Correct answer: C · Stop the infusion
Swelling, coolness, and burning suggest infiltration. Potassium is irritating to tissue, so the infusion should be stopped immediately and the site managed according to policy.
Look for this next time: New pain plus swelling or coolness at an IV site is a stop-and-assess cue, especially with an irritant.
Question 9 · Physiological Adaptation
A postoperative client develops new unilateral calf swelling, warmth, and pain. Which action is most appropriate?
1. Massage the calf to improve circulation
2. Encourage the client to walk in the hallway
3. Keep the client at rest and notify the healthcare provider
4. Apply a sequential compression device to that leg
Show answer and explanation for question 9
Correct answer: C · Keep the client at rest and notify the healthcare provider
The findings suggest a possible deep-vein thrombosis. Activity and massage can increase embolization risk, so the nurse limits movement and promptly reports the findings.
Look for this next time: When findings suggest a clot, avoid actions that could dislodge it and escalate the concern promptly.
Question 10 · Physiological Adaptation
A client with heart failure suddenly becomes short of breath. Oxygen saturation is 86%, and crackles are heard in both lungs. Which action should the nurse take first?
1. Place the client flat in bed
2. Raise the head of the bed and apply oxygen
3. Encourage the client to drink water
4. Delay intervention until a chest x-ray is completed
Show answer and explanation for question 10
Correct answer: B · Raise the head of the bed and apply oxygen
Acute hypoxemia and pulmonary congestion require immediate support of breathing. Upright positioning improves lung expansion, and oxygen addresses the low saturation while further help and treatment are arranged.
Look for this next time: When breathing is acutely compromised, support oxygenation and ventilation before nonurgent diagnostics.
Question 11 · Basic Care and Comfort
An older client has intact, nonblanchable redness over the sacrum after sitting for most of the morning. Which action is most appropriate?
1. Massage the red area with lotion to restore circulation
2. Reposition the client off the sacrum and keep pressure off that site
3. Apply a warm pack so the redness fades before the next meal
4. Leave the client sitting so the skin can be compared again in four hours
Show answer and explanation for question 11
Correct answer: B · Reposition the client off the sacrum and keep pressure off that site
Nonblanchable redness is an early pressure injury. The immediate nursing action is to remove pressure and protect the site. Massaging reddened tissue and adding heat can worsen damage, and waiting another four hours in the same position continues the injury.
Look for this next time: Take pressure off nonblanchable redness. Do not massage it or wait for the next routine turn.
Question 12 · Management of Care
A nurse has just received report on four adult clients. Which client should be assessed first?
1. A client waiting for a routine dressing change that is 30 minutes overdue
2. A client with asthma who is speaking in single words and has audible wheezing
3. A client who is asking for a refill of a scheduled oral pain tablet
4. A client whose family wants an update before visiting hours end
Show answer and explanation for question 12
Correct answer: B · A client with asthma who is speaking in single words and has audible wheezing
Single-word speech and wheezing signal an airway and breathing threat, so that client is first. A late dressing, a scheduled pain tablet, and a family update matter, but none of them is the immediate threat in this set.
Look for this next time: When several needs are real, see the client with the airway or breathing threat before routine care.
Question 13 · Safety and Infection Prevention and Control
A client has Clostridioides difficile diarrhea and is on contact precautions. Which hand-hygiene action is correct after leaving the room?
1. Use only an alcohol-based sanitizer because it is faster
2. Wash with soap and water
3. Skip hand hygiene if gloves were worn the whole time
4. Rinse with water only so the skin is not dried out
Show answer and explanation for question 13
Correct answer: B · Wash with soap and water
C. difficile spores are not reliably killed by alcohol sanitizer. Soap and water is the hand-hygiene step after caring for this client. Gloves reduce contamination, but they do not replace handwashing, and a water rinse alone does not clean the hands.
Look for this next time: For C. difficile, wash with soap and water. Do not treat sanitizer or gloves as a substitute.
Question 14 · Pharmacological and Parenteral Therapies
A new order says to give extended-release metoprolol through a feeding tube because the client cannot swallow tablets. What should the nurse do?
1. Crush the tablet and give it through the tube
2. Open the tablet and mix the contents with water
3. Hold the dose and contact the prescriber about a form that can be given safely
4. Give the whole tablet by mouth and document that the client refused the tube
Show answer and explanation for question 14
Correct answer: C · Hold the dose and contact the prescriber about a form that can be given safely
Crushing or opening an extended-release tablet can dump the full dose at once. The nurse does not change the route or invent a refusal. The safe step is to hold that form and ask for an order that matches the feeding tube.
Look for this next time: Do not crush an extended-release tablet to make it fit a tube. Ask for an appropriate form.
Question 15 · Psychosocial Integrity
A client awaiting biopsy results says, “I keep thinking this is going to be the worst news.” Which response is most therapeutic?
1. “Why would you assume the worst before you even know?”
2. “You are worried about what the result might mean.”
3. “Try not to think about it until the doctor calls.”
4. “Most of these biopsies turn out fine, so you should relax.”
Show answer and explanation for question 15
Correct answer: B · “You are worried about what the result might mean.”
Reflecting the worry invites the client to keep talking without judging the fear. “Why” can sound like criticism. Telling the client not to think about it, or promising a good result, shuts down the concern and overclaims what the nurse knows.
Look for this next time: Name the feeling you hear. Do not argue the client out of it or predict the result.
Question 16 · Health Promotion and Maintenance
An older adult who lives alone says, “I got dizzy getting out of bed yesterday.” Which teaching is the best next step?
1. Stand up quickly so the body gets used to the change
2. Sit on the side of the bed for a minute before standing, and report repeated dizziness
3. Stop drinking fluids after dinner so nighttime bathroom trips are unnecessary
4. Ignore one dizzy episode because aging always causes it
Show answer and explanation for question 16
Correct answer: B · Sit on the side of the bed for a minute before standing, and report repeated dizziness
Rising in stages gives blood pressure time to adjust and is a practical fall-prevention step. Standing quickly increases the drop. Restricting fluids can cause other problems, and a dizzy episode still deserves attention rather than being dismissed as normal aging.
Look for this next time: Teach a slow rise for dizziness on standing, and do not treat the symptom as something to ignore.
Question 17 · Reduction of Risk Potential
A morning lab result shows a serum potassium of 2.8 mEq/L (reference range 3.5–5.0 mEq/L) for a client who is also receiving a loop diuretic. What should the nurse do first?
1. Document the result and recheck it with the next routine labs
2. Give the scheduled loop diuretic so the schedule stays on time
3. Notify the prescriber of the potassium result before giving the diuretic
4. Ask the client to eat a banana and then give every scheduled medication
Show answer and explanation for question 17
Correct answer: C · Notify the prescriber of the potassium result before giving the diuretic
2.8 mEq/L is critically low, and a loop diuretic can lower potassium further. The nurse reports the result and clarifies the diuretic before giving it. Waiting for routine labs, giving the diuretic on schedule, or relying on one banana does not address the immediate risk.
Look for this next time: A critically low potassium is a call-now result, especially before another potassium-wasting diuretic.
Question 18 · Management of Care
A client signed the consent form yesterday for surgery scheduled this morning. While the nurse completes the preoperative checklist, the client says, “I’m still not sure what the surgeon is going to do or what the risks are.” What should the nurse do?
1. Explain the risks and alternatives of the surgery so the signed form stays valid
2. Reassure the client that the signed form means consent is already complete
3. Notify the surgeon that the client needs more information before the procedure begins
4. Finish the checklist and document the comment after the client returns from surgery
Show answer and explanation for question 18
Correct answer: C · Notify the surgeon that the client needs more information before the procedure begins
Informed consent depends on understanding, not only a signature. Explaining the procedure, its risks, and its alternatives is the responsibility of the surgeon who will perform it. The nurse verifies the client’s understanding and advocates when it is missing, so the surgeon is notified before the procedure begins. Explaining the surgery in the surgeon’s place, treating the signature as the end of the process, or waiting until after surgery leaves the client’s question unanswered.
Look for this next time: A signature is not understanding. When a client cannot describe the procedure, bring the surgeon back before it starts.
Question 19 · Pharmacological and Parenteral Therapies
A provider orders potassium chloride 10 mEq IV now for a client with hypokalemia. Which administration plan is safe?
1. Give the dose by IV push over one minute
2. Dilute and infuse it through a controlled IV line at the ordered rate
3. Add it to a hanging blood transfusion so the client gets one line
4. Inject it into the subcutaneous tissue if no IV site is free
Show answer and explanation for question 19
Correct answer: B · Dilute and infuse it through a controlled IV line at the ordered rate
IV potassium is infused in a diluted, controlled way. IV push can cause cardiac arrest. It is not mixed into blood and it is not a subcutaneous injection. The nurse follows the ordered infusion rate and monitors the site.
Look for this next time: Never give IV potassium as a push. Infuse the diluted dose on a controlled line.
Question 20 · Safety and Infection Prevention and Control
A client with delirium keeps trying to climb out of bed. No order for a restraint is in the chart. What should the nurse do first?
1. Apply wrist restraints and tell the next shift
2. Move the client closer to the nurses’ station, lower the bed, and address the cause of the restlessness
3. Raise all four side rails and leave the room so the client can settle
4. Ask a family member to sign a restraint consent and then apply the device
Show answer and explanation for question 20
Correct answer: B · Move the client closer to the nurses’ station, lower the bed, and address the cause of the restlessness
Least-restrictive safety measures come before a restraint. Observation, a low bed, and looking for pain, hypoxia, or elimination needs address the behavior. Applying a restraint without an order, or using side rails as a substitute, is not the first action. Family consent does not replace the order and the assessment.
Look for this next time: Use the least restrictive safety step first. A restraint needs an order and is not the opening move.

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The rationale matters more than the score.

A short set can show you what deserves another look. It is intentionally small, so it cannot measure full NCLEX readiness.

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Choose the best answer, check it, and read the rationale before moving on.

Read every rationale

Confirm why the best option fits, even when you were right.

Follow the pattern

Use recurring misses—not one score—to choose your next focus.

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20 original questions

20 free NCLEX-RN practice questions

A nurse is preparing to enter the room of a client with suspected pulmonary tuberculosis. Which respiratory protection should the nurse use before entering?

All 20 NCLEX questions with explanations

A nurse is preparing to enter the room of a client with suspected pulmonary tuberculosis. Which respiratory protection should the nurse use before entering?

Which task is appropriate for the nurse to delegate to unlicensed assistive personnel?

Which parent statement shows correct understanding of safe sleep for a 6-month-old infant?

A client who has just received a serious diagnosis says, "I cannot think about anything else." Which response is most therapeutic?

The order says to hold digoxin if the adult client’s apical pulse is below 60/min and to notify the prescriber. The nurse counts an apical pulse of 54/min. What should the nurse do?

A conscious client with diabetes is shaky, can swallow safely, and has a blood glucose of 58 mg/dL (reference range 70–110 mg/dL). Which action should the nurse take first?

Fifteen minutes after a blood transfusion begins, a client reports chills and low-back pain. What is the nurse's first action?

A client receiving IV potassium reports burning at the site. The nurse notes swelling and coolness around the catheter. What should the nurse do first?

A postoperative client develops new unilateral calf swelling, warmth, and pain. Which action is most appropriate?

A client with heart failure suddenly becomes short of breath. Oxygen saturation is 86%, and crackles are heard in both lungs. Which action should the nurse take first?

An older client has intact, nonblanchable redness over the sacrum after sitting for most of the morning. Which action is most appropriate?

A nurse has just received report on four adult clients. Which client should be assessed first?

A client has Clostridioides difficile diarrhea and is on contact precautions. Which hand-hygiene action is correct after leaving the room?

A new order says to give extended-release metoprolol through a feeding tube because the client cannot swallow tablets. What should the nurse do?

A client awaiting biopsy results says, “I keep thinking this is going to be the worst news.” Which response is most therapeutic?

An older adult who lives alone says, “I got dizzy getting out of bed yesterday.” Which teaching is the best next step?

A morning lab result shows a serum potassium of 2.8 mEq/L (reference range 3.5–5.0 mEq/L) for a client who is also receiving a loop diuretic. What should the nurse do first?

A client signed the consent form yesterday for surgery scheduled this morning. While the nurse completes the preoperative checklist, the client says, “I’m still not sure what the surgeon is going to do or what the risks are.” What should the nurse do?

A provider orders potassium chloride 10 mEq IV now for a client with hypokalemia. Which administration plan is safe?

A client with delirium keeps trying to climb out of bed. No order for a restraint is in the chart. What should the nurse do first?

The rationale matters more than the score.

Answer before reviewing

Read every rationale

Follow the pattern

Choose your next step.

Try free practice

Build a study plan

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