Nurse in teal scrubs reviewing a tablet at a hospital nurses' station
Free practice set · Original questions

All exams/Healthcare/NCLEX-RN/Free questions

Free NCLEX-RN practice questions

Tap an answer to see if you are right, and why. 20 questions across 8 topics, mostly Pharmacology (4).

Start the set Take a timed mock examPrintable cheat sheet
Passing score: 85% (target)
Format: 85–150 items (CAT)
Bank: 300 Qs (20 free)
100% Sourced explanations

Questions last updated October 15, 2026 · Questions written from the NCLEX-RN Test Plan effective April 2026 (NCSBN); not official or recalled NCLEX items.

0 of 20 answeredTap an answer to check it

  1. Pharmacology1 of 20

    A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse is reviewing the medication administration record. Which laboratory value should the nurse monitor most closely?

    The answer

    Answer: A. Warfarin is an anticoagulant that requires INR monitoring to ensure therapeutic effectiveness and prevent bleeding complications. The target INR for atrial fibrillation is typically 2.0 to 3.0. Hemoglobin and platelet count are not specific to warfarin therapy, and WBC is unrelated to anticoagulation monitoring.

    Source: Physiological Integrity — Pharmacological Therapies

  2. Infection Control2 of 20

    A nurse is caring for a client with a central venous catheter. Which intervention is the MOST effective in preventing catheter-related bloodstream infections?

    The answer

    Answer: B. Hand hygiene before and after accessing any vascular access device is the single most effective measure to prevent catheter-related bloodstream infections. Changing dressings every 72 hours is not evidence-based, antibiotic ointment increases infection risk, and prophylactic antibiotics promote resistance.

    Source: Safe Care Environment — Infection Control

  3. Management3 of 20

    A charge nurse observes that a newly licensed nurse is administering medications without scanning the barcode on the client's wristband. What is the best initial action?

    The answer

    Answer: A. The charge nurse should provide immediate feedback to correct the behavior and prevent harm. Filing an incident report or notifying the manager before addressing the issue directly is premature. The priority is correcting the unsafe practice in real time.

    Source: Safe Care Environment — Management of Care

  4. Health Promotion4 of 20

    A community health nurse is planning a smoking cessation program. According to the Health Promotion model, which action should the nurse take FIRST?

    The answer

    Answer: D. A needs assessment is the foundation of any health promotion program. The nurse must first identify the specific barriers, readiness to change, and resources available in the community before implementing interventions.

    Source: Health Promotion — Health Promotion and Maintenance

  5. Basic Care5 of 20

    A postoperative client reports severe pain rated 9 out of 10. The client has a physician order for morphine 2 mg IV every 4 hours as needed. What should the nurse do FIRST?

    The answer

    Answer: A. With severe pain rated 9/10 and an existing order, the nurse should administer the medication promptly and document. Reassessment occurs after administration. Non-pharmacological methods are adjuncts, not replacements for severe acute pain.

    Source: Physiological Integrity — Basic Care and Comfort

  6. Psychosocial6 of 20

    A client who recently experienced a sexual assault tells the nurse, I feel like it was my fault. What is the nurse's best response?

    The answer

    Answer: B. The nurse should validate the client's feelings while clearly stating that sexual assault is never the victim's fault. Reporting and therapy recommendations are important but secondary to addressing the client's immediate emotional state and dispelling self-blame.

    Source: Psychosocial Integrity — Psychosocial Adaptation

  8. Prioritization7 of 20

    The nurse is caring for four clients. Which client should the nurse assess FIRST?

    The answer

    Answer: B. Tingling around the mouth after thyroidectomy may indicate hypocalcemia from parathyroid gland damage, which can rapidly progress to tetany and respiratory compromise. This is the most life-threatening situation requiring immediate assessment.

    Source: Safe Care Environment — Management of Care

  9. Pharmacology8 of 20

    A client with heart failure is prescribed digoxin. The nurse notes a heart rate of 58 beats per minute. What is the priority nursing action?

    The answer

    Answer: C. Digoxin should be held if the heart rate is below 60 bpm because the drug slows the heart rate further. Administering it could cause dangerous bradycardia. The nurse must hold the dose and notify the provider for further instructions.

    Source: Physiological Integrity — Pharmacological Therapies

  10. Infection Control9 of 20

    A nurse is caring for a client with Clostridioides difficile. Which precaution should the nurse implement?

    The answer

    Answer: D. C. difficile is transmitted via the fecal-oral route through contact with contaminated surfaces and equipment. Contact precautions, including gown and gloves, are required. Hand hygiene with soap and water is preferred over alcohol-based hand rub.

    Source: Safe Care Environment — Infection Control

  11. Management10 of 20

    A nurse manager receives a call from a family member complaining about the quality of care. The family member is upset and raising their voice. What is the best initial response?

    The answer

    Answer: D. Active listening and acknowledging the family's concerns de-escalates the situation and demonstrates empathy. Telling them to leave or quoting policy is dismissive. Escalating before gathering information is premature.

    Source: Safe Care Environment — Management of Care

  12. Pharmacology11 of 20

    A client is prescribed metformin for type 2 diabetes. The nurse should monitor which laboratory value most closely?

    The answer

    Answer: C. Metformin is contraindicated in clients with renal impairment because it can cause lactic acidosis. Serum creatinine should be monitored regularly to assess kidney function. HbA1c is monitored for diabetes control but not for metformin safety.

    Source: Physiological Integrity — Pharmacological Therapies

  13. Basic Care12 of 20

    A client with a nasogastric tube is receiving enteral feedings. The nurse notes that the client has a distended abdomen and reports cramping. What is the priority action?

    The answer

    Answer: B. Checking residual volume helps determine if the feedings are being absorbed properly. A high residual with distention suggests intolerance. Slowing the rate and checking for residual are appropriate interventions. Elevating the head of bed is always important but does not address the acute issue.

    Source: Physiological Integrity — Basic Care and Comfort

  14. Health Promotion13 of 20

    A pregnant client at 28 weeks gestation asks the nurse about warning signs she should report immediately. Which symptom should the nurse instruct the client to report FIRST?

    The answer

    Answer: B. Decreased fetal movement can indicate fetal distress and is an emergency requiring immediate evaluation. Mild ankle edema, sleep difficulty, and lower back pain are common in pregnancy and do not require urgent intervention.

    Source: Health Promotion — Antepartum Care

  15. Psychosocial14 of 20

    A client with major depressive disorder tells the nurse, I have nothing left to live for. What is the nurse's priority response?

    The answer

    Answer: B. When a client expresses hopelessness, the nurse must assess for suicidal ideation by asking directly. Research shows that asking about suicide does not increase risk. Reassurance without assessment is inappropriate and may dismiss the client's distress.

    Source: Psychosocial Integrity — Mental Health Concepts

  16. Prioritization15 of 20

    A nurse is preparing to receive shift report on four clients. Which client should the nurse see FIRST after receiving report?

    The answer

    Answer: C. A blood pressure of 88/54 mmHg after surgery indicates possible hypovolemic shock or hemorrhage. This client requires immediate assessment. The other clients are stable or have non-urgent needs.

    Source: Safe Care Environment — Management of Care

  17. Pharmacology16 of 20

    A client is prescribed lisinopril for hypertension. Which adverse effect should the nurse teach the client to report immediately?

    The answer

    Answer: D. Swelling of the lips or tongue indicates angioedema, a potentially life-threatening allergic reaction to ACE inhibitors that requires immediate medical attention. A dry cough is common but not dangerous. Dizziness may require dose adjustment but is not emergent.

    Source: Physiological Integrity — Pharmacological Therapies

  19. Basic Care17 of 20

    A client with a spinal cord injury at T6 is at risk for autonomic dysreflexia. The nurse observes a sudden increase in blood pressure and a pounding headache. What should the nurse do FIRST?

    The answer

    Answer: B. Autonomic dysreflexia is triggered by noxious stimuli below the level of injury, most commonly bladder or bowel distention. Sitting the client upright lowers blood pressure, and checking for distention identifies and removes the trigger.

    Source: Physiological Integrity — Reduction of Risk Potential

  20. Infection Control18 of 20

    A nurse is caring for a client with active tuberculosis. Which statement by the client indicates understanding of discharge teaching?

    The answer

    Answer: D. Clients with TB must complete the full course of treatment, typically 6 to 9 months, even if symptoms improve. Stopping early promotes drug resistance. Covering the mouth when coughing reduces transmission. Returning to work before treatment completion risks spreading infection.

    Source: Safe Care Environment — Infection Control

  21. Delegation19 of 20

    A registered nurse is delegating tasks to an unlicensed assistive personnel. Which task is appropriate to delegate?

    The answer

    Answer: B. Ambulating a stable client is within the scope of delegation to UAP. Assessment, medication administration, and client teaching are nursing responsibilities that cannot be delegated to unlicensed personnel.

    Source: Safe Care Environment — Delegation and Supervision

  22. Management20 of 20

    A nurse is preparing to float to a medical-surgical unit. The nurse has not worked on that unit before. What is the BEST action?

    The answer

    Answer: D. The nurse should request an orientation to the unit to ensure safe care. Refusing or passing the assignment without attempting accommodation is inappropriate. Accepting without orientation may compromise client safety.

    Source: Safe Care Environment — Management of Care

Official Test Specs & Sourced Summary

The official NCLEX-RN knowledge examination covers 85–150 items (CAT) with a passing threshold of 85%. Questions written from the NCLEX-RN Test Plan effective April 2026 (NCSBN); not official or recalled NCLEX items. Every question on this page is original, with an explanation and a note citing its source.

Passing Score85% target
Format85–150 items (CAT) · 5-hour limit
Question Bank300 questions (20 free)
Verified Source2026 NCSBN NCLEX-RN Test Plan & Clinical Judgment Measurement Model

That’s the free set. The full bank has 300.

More original practice questions across the listed topics, a 85-question timed exam simulator, and saved mistake review. Internal QuizCram practice target. NCLEX uses computer-adaptive testing and an official logit passing standard, not a raw percentage. One payment of $29.99, yours forever.

Practice the free set