Ten NCLEX-RN style questions you can answer right here. No sign-in and nothing to install. Check each answer to see the key and a rationale for every option.
Questions 1 to 9 each use a different format. Question 10 is a six-part case study about one client, the same shape as the case studies on the Next Generation NCLEX.
Prescription: methylergonovine 0.2 mg IM now for uterine atony. The client gave birth vaginally 3 hours ago. Her fundus is boggy and 2 cm above the umbilicus despite massage. Which finding should cause the nurse to withhold the medication and contact the primary health care provider?
A 37-year-old client at 11 weeks' gestation has a blood pressure of 118/76 mm Hg at her first prenatal visit at the obstetric clinic. While completing the family and personal history, the nurse assesses for risk factors for preeclampsia so that the client can be taught about her risk and about preventive measures. Which findings increase this client's risk of developing preeclampsia? Select all that apply.
Select all that apply.
A 34-year-old client who had a cesarean birth under spinal anesthesia 2 hours ago still has decreased sensation and movement below the umbilicus and reports aching in her lower back. She is on the postpartum unit. For each nursing action, indicate whether it is indicated or contraindicated to prevent skin injury while the anesthesia wears off.
| Indicated | Contraindicated | |
|---|---|---|
| Apply an instant hot pack to the aching area of the lower back | ||
| Turn the client from side to side at least every 2 hours | ||
| Secure the abdominal dressing by stretching the tape tightly across the incision | ||
| Inspect the skin at the electrosurgical dispersive (grounding) pad site on the thigh | ||
| Place a pillow under the calves so the heels are lifted off the mattress |
Infusion pump display: vancomycin 180 mg in 36 mL at 36 mL/hour; DOWNSTREAM OCCLUSION alarm, the third in 20 minutes. The client is a 2-year-old weighing 12 kg in the pediatric intensive care unit with right orbital cellulitis and proptosis, receiving IV vancomycin and ceftriaxone through a peripheral IV catheter in the back of the left hand, secured to an arm board. The nurse finds the left hand and wrist swollen, pale, cool, and taut; the child cries and pulls away when the site is touched. There is no redness along the vein, no rash, and no facial flushing. Capillary refill in the left fingers is 2 seconds. Vital signs are unchanged from the last hour. Complete the following sentence by choosing from the lists of options. The nurse should recognize these findings as , immediately , and then while notifying the primary health care provider.
Before discharge, the parent of a 16-year-old client at 32 weeks' gestation restates the teaching given in labor and delivery triage, where the client was treated for acute cystitis and her contractions have stopped. The family is staying at a family shelter and gets rides in a friend's car. Highlight the statements that indicate the parent needs further teaching to keep the client safe.
Click or tap each finding to highlight it; click again to remove.
She'll wear the lap belt low, under her belly and across her hip bones. She'll tuck the shoulder strap behind her so it doesn't press on the baby. She'll stop drinking fluids after supper so she won't have to get up at night. We'll leave a night-light on so she can see the way to the bathroom. She can keep the top bunk at the shelter because she's still steady on the ladder. If she gets one-sided back pain with chills or fever, we'll bring her back right away.
An 83-year-old with age-related hearing loss who wears bilateral hearing aids has a venous stasis ulcer on the left lower leg and has come to the outpatient wound clinic to learn how to change the dressing at home. At check-in, the client answered questions inappropriately and asked staff to repeat themselves several times. Place the nurse's actions for this teaching session in the correct order.
Use the arrows to put the items in order, first at the top.
Before discharge from the inpatient rehabilitation unit, the spouse of a 61-year-old client who spent 3 weeks in the intensive care unit on mechanical ventilation for acute respiratory distress syndrome (ARDS) tells the nurse about several concerns. The nurse plans to obtain referral orders from the primary health care provider. Drag the referral that best addresses each finding to that finding. Not every referral will be used.
Choose the best match for each box. Each choice can be used once.
Noon handoff at a high school's on-site health center: "The child-care room for student-parents just called. The 19-day-old infant of a 16-year-old student is feeding poorly and feels warm; the attendant got an axillary temperature of 38.2°C (100.8°F). Our nurse practitioner is off-site today, and I'm leaving for lunch." Which actions should the receiving nurse take? Select all that apply.
Select all that apply.
Two hours after the evening meal, a 68-year-old resident of a long-term care facility who has heart failure reports intense thirst and a dry mouth. The resident has a prescribed fluid restriction of 1,500 mL per 24 hours (0700 to 0700). Intake since 0700: - Breakfast: 240 mL coffee, 120 mL juice - 1000 medication pass: 180 mL water - Lunch: 240 mL milk, 180 mL broth - Afternoon snack: 120 mL gelatin - Evening meal: 240 mL tea The 2100 medication pass will require 60 mL of water, and no other fluids are planned before 0700. In addition to oral care, the nurse plans to offer ice chips to ease the thirst. The facility counts ice chips as one-half of their measured volume toward fluid intake. What is the maximum volume of ice chips, in mL, that the nurse can offer for the rest of this 24-hour period without exceeding the restriction? (Enter a whole number.)
One client, six linked questions. New chart entries appear as the case unfolds. Check each part before you move on.
Case study · item 1 of 6
Casted Leg Pain at 29 Weeks' Gestation
26-year-old female · community care, community health center walk-in clinic with prenatal services · Walk-in visit at 29 weeks' gestation for worsening pain in a right leg casted 36 hours earlier for a tibial fracture
0930Intake note
Walk-in visit. Client is at 29 weeks' gestation (G2 P1). Two days ago she slipped on wet stairs and landed on her right leg; she denies striking her abdomen. The emergency department (ED) diagnosed a closed, nondisplaced right tibial shaft fracture and applied a long-leg fiberglass cast about 36 hours ago. Non-weight-bearing with crutches; arrived by wheelchair with her partner. Client states, 'My leg has been getting worse since last night.'
0945Focused assessment
Right lower leg pain rated 9/10, described as deep and burning, and not relieved by the 0700 oxycodone dose. Client reports pins-and-needles in the right toes that began this morning. Right toes are pale and cool, with capillary refill of 4 seconds (left toes 2 seconds). Passive movement of the right toes causes severe pain. Cast is intact with no drainage or odor. Denies shortness of breath or chest pain. Fetal heart rate 145/min with fetal movement felt by the client. Denies contractions, vaginal bleeding, or leaking of fluid. Left calf soft and nontender.
Part 1 of 6 · Recognize cuesHighlight
At 0945, the clinic nurse completes a focused assessment and documents the note below. Right lower leg pain rated 9/10, described as deep and burning, and not relieved by the 0700 oxycodone dose. Client reports pins-and-needles in the right toes that began this morning. Right toes are pale and cool, with capillary refill of 4 seconds (left toes 2 seconds). Passive movement of the right toes causes severe pain. Cast is intact with no drainage or odor. Denies shortness of breath or chest pain. Fetal heart rate 145/min with fetal movement felt by the client. Denies contractions, vaginal bleeding, or leaking of fluid. Left calf soft and nontender. Highlight the findings that require immediate follow-up.
Click or tap each finding to highlight it; click again to remove.
Denies shortness of breath or chest pain. not relieved by the 0700 oxycodone dose. Cast is intact with no drainage or odor. pins-and-needles in the right toes. capillary refill of 4 seconds. Fetal heart rate 145/min. Passive movement of the right toes causes severe pain. Left calf soft and nontender.
The nurse reviews the ED discharge instructions and rechecks the cast. For each finding, specify the condition that the finding (a sign or a risk factor) most supports: acute compartment syndrome, deep vein thrombosis (DVT), or neither.
| Acute compartment syndrome | Deep vein thrombosis | Neither | |
|---|---|---|---|
| Severe pain with passive movement of the right toes | |||
| Pregnancy at 29 weeks' gestation combined with a casted, non-weight-bearing leg | |||
| Fetal heart rate 145/min with fetal movement felt | |||
| Cast too tight to slide a finger under the proximal edge | |||
| Pins-and-needles sensation in the right toes |
At 1000, the client's findings have changed (see chart). Place the client problems in priority order, from the problem the nurse should address first to the problem the nurse should address last.
Use the arrows to put the items in order, first at the top.
The clinic does not have a cast saw, and the nearest ED is 15 minutes away. Complete the nurse's plan by selecting from the options for each blank. The nurse should arrange . While waiting, the nurse should keep the right leg because this position .
The on-call orthopedic primary health care provider will meet the client in the ED and anticipates cast release and possible surgery. The ambulance will arrive in 10 minutes. Complete the diagram by selecting the condition the client is most likely experiencing, 2 actions the nurse should take before transfer, and 2 parameters the nurse should monitor to track the condition.
Actions to take (choose 2)
Condition most likely (choose 1)
Parameters to monitor (choose 2)
Three days later, the clinic nurse reviews the hospital records received for the client (see chart and the trend below). Which conclusion is best supported by the data?
Clinic, 1000 (before transfer)
Postoperative day 1
Postoperative day 3
The answer you picked tells you less than the ones you ruled out. If you got it right by guessing between two options, you don’t know it yet, even though your score says you do.
Twenty questions worked through properly teach more than two hundred skimmed. Add volume once you can explain why each answer is right.
Thirty misses spread evenly is a different problem from thirty misses in one area. The first says keep going. The second says stop and review that area.
Many questions ask what the nurse should do first, not what the nurse knows. Airway, breathing and circulation, Maslow and safety are the usual tie-breakers.
The real exam runs 85 to 150 questions in up to five hours, breaks included. Find out where your focus fades during practice, not on test day.
More on this: how to review NCLEX rationales.
Knowing the content doesn’t protect you from losing time to a screen you’ve never seen. Here is what each format in this set asks you to do.
| Format | What you do |
|---|---|
| Multiple choice | Pick the one best answer. |
| Select all that apply | Pick every correct option. Each choice counts on its own. |
| Matrix | Sort each row into a column, such as indicated or contraindicated. |
| Drop-down (cloze) | Finish the sentence by choosing from a list in each blank. |
| Highlight | Tap the words in a note or teaching statement that need follow-up. |
| Ordered response | Put the steps or priorities in order, first to last. |
| Drag and drop | Match each choice to the box it belongs in. Some choices go unused. |
| Fill in the blank | Do the math and type a number. |
| Bowtie and trend | Inside the case study: pick a condition, actions and things to monitor, then read data over time. |
| Case study | Six linked questions about one client, with the chart growing as you go. |
What NCSBN says about the real exam’s case studies and scoring: NGN case studies and item formats, explained.
They are enough to practice the reasoning and the formats. Paid banks usually add more questions, full-length exams and progress tracking. Either way, the gains come from reading the rationales and fixing the pattern in your misses. No question bank, free or paid, can tell you whether you will pass.
There is no magic number. Aim for accuracy that holds steady across mixed-topic sets, not just in the topic you studied yesterday. If you still can’t explain why an answer is right, more volume won’t fix it.
NCSBN launched the Next Generation NCLEX on April 1, 2023 to better measure clinical judgment. It tests clinical judgment in two ways: case studies, which are six linked questions about one client, and stand-alone items. Questions with more than one correct answer can earn partial credit. Practice the formats so the screen isn’t new to you on test day.
Yes. Under the 2026 test plans both exams run 85 to 150 questions in up to five hours, but they test different scopes of practice and are scored on separate scales. The PN plan has Coordinated Care (18–24% of questions) where the RN plan has Management of Care (15–21%). Study from the test plan for the exam you are taking.
No. The real NCLEX is a computerized adaptive test. It picks each question based on your answers so far and stops once it can make a pass or fail decision. A short, fixed set of practice questions works differently. Use practice scores to find weak topics, not to forecast a result.
