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Quizzes > Health & Medicine > Human Anatomy & Medicine

NCLEX RN Practice Quiz: Test Your Nursing Skills

Dive into this free NCLEX practice quiz and sharpen your NCLEX RN exam skills!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
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Hey future RNs! Ready to sharpen your skills with our Free NCLEX RN Practice Quiz: Test Your Nursing Skills? This free NCLEX practice quiz delivers realistic NCLEX RN practice questions and a dynamic practice mode quiz that mimics exam day. You'll tackle pharmacology, pediatrics, and patient care, track your progress, and pinpoint areas to improve. Whether you want to master the practice NCLEX RN exam or NCLEX practice questions free, our platform adapts to your pace. Explore our NCLEX practice exam and dive into targeted NCLEX RN practice questions to build confidence before test day. Leap into action - start now!

A nurse is assessing an adult client's blood pressure. Which of the following readings is within the normal range?
120/80 mm Hg
140/90 mm Hg
100/60 mm Hg
90/70 mm Hg
A normal adult blood pressure is considered to be around 120/80 mm Hg. Readings above 130/80 mm Hg are classified as hypertension according to AHA guidelines. Lower readings such as 100/60 mm Hg may be acceptable but are on the lower end of normal.
Which statement by a nurse demonstrates the use of therapeutic communication when interacting with a client?
``Tell me more about how you are feeling.''
``Why do you think you feel that way?''
``That must be very difficult for you.''
``You should try to focus on the positive aspects.''
Using open-ended prompts like Tell me more about how you are feeling encourages clients to share information without directing or judging their responses. Questions starting with why may cause the client to become defensive. Offering opinions or advice can shift focus away from the clients own thoughts and feelings.
When caring for a client with Clostridium difficile, which type of precautions should the nurse implement?
Contact precautions
Airborne precautions
Droplet precautions
Protective isolation
Clostridioides difficile is transmitted via the fecal-oral route and spores can survive on surfaces, so contact precautions are required. Gloves and gown should be worn when entering the client's room. Airborne and droplet precautions are not necessary for C. difficile infections.
A nurse is reviewing the laboratory results of a healthy adult client. Which fasting blood glucose level is considered within normal limits?
90 mg/dL
130 mg/dL
60 mg/dL
150 mg/dL
A normal fasting blood glucose range for a healthy adult is approximately 70 to 100 mg/dL. Levels above 126 mg/dL on two occasions indicate diabetes. Values below 70 mg/dL are considered hypoglycemia.
At what angle should a nurse administer an intramuscular injection?
90 degrees
45 degrees
30 degrees
15 degrees
Intramuscular injections are administered at a 90-degree angle to ensure the medication is deposited into muscle tissue. Subcutaneous injections typically use 45 degrees, and intradermal injections use 15 to 10 degrees. Administering at incorrect angles can lead to inadequate absorption or tissue damage.
What is the first action a nurse should take when preparing to administer any medication?
Verify the medication order against the client's chart
Explain the medication purpose to the client
Select the appropriate administration site
Check the injection equipment
The first step in safe medication administration is to verify the providers order against the client's medical record and prescription. This confirms the correct drug, dosage, route, and timing. Other steps, such as explaining the drug or preparing equipment, occur only after verifying the order.
In which position should a client be placed for administration of a cleansing enema?
Left lateral (Sims') position
Supine position
Prone position
High Fowler's position
The Sims' position, or left lateral position, allows for optimal flow of the enema solution by utilizing gravity and minimizing discomfort. The client lies on their left side with the right knee drawn toward the chest. Other positions do not facilitate enema administration as effectively.
Which method should a nurse use to verify placement of a newly inserted nasogastric tube before administering feeding?
Check the pH of aspirated gastric contents
Inject 10 mL of air and auscultate the epigastrium
Rely on tube length marking
Obtain an abdominal x-ray
Checking the pH of aspirated gastric contents (usually pH ?5.5) is a reliable bedside method to confirm tube placement. Although radiographic confirmation is the gold standard, it is not always feasible every time. Air auscultation alone is not recommended due to inaccuracy.
For subcutaneous heparin injections, which site is preferred to reduce the risk of bleeding and bruising?
Abdominal wall
Deltoid muscle
Ventrogluteal site
Vastus lateralis muscle
The abdominal wall, at least two inches from the umbilicus, is the preferred site for subcutaneous heparin to ensure consistent absorption and to minimize bruising. Muscle sites carry a higher risk of bleeding and hematoma formation. Rotating within the abdominal area further reduces tissue trauma.
Interpret the following arterial blood gas: pH 7.30, PaCO2 50 mm Hg, HCO3? 24 mEq/L.
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
A pH below 7.35 indicates acidemia. The elevated PaCO2 (normal 3545 mm Hg) shows respiratory retention of carbon dioxide causing acidosis. Since HCO3? is within normal limits, the primary disturbance is respiratory.
A nurse has these four clients to assess. Which client should the nurse see first?
A client reporting acute chest pain
A client with a scheduled routine dressing change
A postoperative client on the first day after surgery
A client awaiting discharge teaching
Clients with acute chest pain may be experiencing a myocardial infarction or other life-threatening condition and require immediate assessment. Routine dressing changes and discharge teaching can be delayed. Postoperative clients are stable enough to wait after urgent cases.
Calculate the IV drip rate for 1,000 mL IV fluid to infuse over 8 hours using a tubing set that delivers 15 drops/mL.
31 gtt/min
21 gtt/min
42 gtt/min
25 gtt/min
First, determine mL per minute: 1000 mL 480 minutes = 2.083 mL/min. Multiply by drop factor: 2.083 15 = approximately 31 gtt/min. Accurate drip rates ensure proper fluid balance.
Which of the following foods is highest in potassium and recommended for a client at risk for hypokalemia?
Bananas
White rice
Whole wheat bread
Cheddar cheese
Bananas are well known for their high potassium content (around 422 mg per medium fruit) and are often recommended to prevent or treat mild hypokalemia. Grains and dairy products contain less potassium compared to fruits like bananas.
When should the nurse draw the peak level for a client receiving an intravenous antibiotic infusion over 30 minutes?
30 minutes after the infusion is completed
Immediately after starting the infusion
At the midpoint of the infusion
Just before the next dose
Peak levels are typically drawn 30 minutes after an IV infusion is completed to allow the drug to distribute and reach maximal serum concentration. Drawing too early or too late can misrepresent the true peak. Trough levels are drawn before the next dose.
Which early sign should a nurse recognize as indicative of hypoxia in a patient?
Restlessness
Bradycardia
Hypoactive bowel sounds
Hyporeflexia
Restlessness and agitation are early central nervous system signs of hypoxia due to insufficient oxygen delivery to the brain. Bradycardia and others can occur later. Prompt recognition of restlessness can prevent deterioration.
Which task can the registered nurse safely delegate to a nursing assistant on the medical-surgical unit?
Measuring and recording daily urine output
Administering oral pain medication
Assessing the client's respiratory status
Planning the client's discharge education
Nursing assistants can measure and record intake/output as it is a routine, noninvasive task. Medication administration, clinical assessment, and client education planning require nursing judgement and cannot be delegated.
A client with long-standing COPD has the following ABG results: pH 7.36, PaCO2 55 mm Hg, HCO3? 30 mEq/L. What do these results indicate?
Compensated respiratory acidosis
Uncompensated metabolic alkalosis
Compensated metabolic acidosis
Uncompensated respiratory alkalosis
The pH is within normal limits (7.357.45), indicating compensation. An elevated PaCO2 (normal 3545 mm Hg) suggests respiratory acidosis, and an elevated HCO3? (normal 2226 mEq/L) indicates renal compensation. Thus, this represents compensated respiratory acidosis.
Which assessment finding most specifically indicates digoxin toxicity in an older adult client?
Yellow-green halos around lights
Bradycardia
Peripheral edema
Hypertension
Visual disturbances such as yellow-green halos are hallmark signs of digoxin toxicity. While bradycardia can occur, it is less specific. Edema and hypertension are not direct indicators of digoxin toxicity.
A client with hyperkalemia is at highest risk for which change on their ECG?
Peaked T waves
Prolonged PR interval
ST-segment elevation
U-wave formation
Hyperkalemia typically presents with peaked (tall, narrow) T waves on ECG. Widening of the QRS complex and loss of P waves can also occur in severe cases. U-waves are associated with hypokalemia.
A nurse is teaching a client with Addison's disease about emergency management. Which instruction is most appropriate?
Carry an emergency kit with injectable glucocorticoids
Reduce salt intake during stress
Discontinue medications if feeling well
Increase fluid restriction during febrile illness
Clients with Addison's disease must carry an emergency kit containing injectable glucocorticoids to manage adrenal crisis during severe stress or inability to take oral meds. Salt intake usually increases to prevent hyponatremia. Abruptly stopping medication can precipitate crisis.
A client on warfarin therapy has an INR of 5.0. Which action should the nurse take first?
Hold the warfarin dose and notify the provider
Administer vitamin K orally
Obtain a prothrombin time level
Encourage the client to eat more green leafy vegetables
An INR above the therapeutic range (usually 2.03.0) increases bleeding risk. The nurse should hold the dose and notify the provider for orders. Administering vitamin K may be indicated but requires provider prescription. PT is not necessary when INR is known.
A client has been vomiting repeatedly and the nurse reviews the ABG results: pH 7.50, PaCO2 45 mm Hg, HCO3? 34 mEq/L. How should the nurse interpret these findings?
Metabolic alkalosis without compensation
Metabolic acidosis with respiratory compensation
Respiratory alkalosis
Respiratory acidosis with metabolic compensation
An elevated pH (>7.45) and increased HCO3? indicate a primary metabolic alkalosis. Because PaCO2 is within normal limits, there is no respiratory compensation evident. Vomiting leads to loss of gastric acid, causing metabolic alkalosis.
Which clinical sign is most indicative of fluid volume excess in a patient with heart failure?
Distended neck veins
Dry mucous membranes
Weight loss
Orthostatic hypotension
Jugular venous distension reflects increased central venous pressure from fluid overload. Dry mucous membranes and weight loss suggest dehydration. Orthostatic hypotension occurs with fluid volume deficit or certain medications.
A client is beginning therapy with clozapine. Which laboratory value should the nurse monitor closely?
White blood cell count
Liver enzymes
Blood urea nitrogen
Fasting blood glucose
Clozapine carries a risk for agranulocytosis, so regular monitoring of the white blood cell count is essential. Liver enzymes and blood glucose are monitored for other antipsychotics but are not the primary concern with clozapine. BUN is not directly affected.
A client is admitted with diabetic ketoacidosis. What is the nurses priority initial intervention?
Begin rapid infusion of isotonic saline
Administer subcutaneous insulin
Start potassium replacement
Obtain blood glucose level
Fluid resuscitation with isotonic saline is the first priority to restore intravascular volume and perfusion. Once vascular volume is addressed, insulin therapy and electrolyte replacement follow. Checking glucose is important but securing circulation is the initial action.
Which ventilator setting is most appropriate for a client with acute respiratory distress syndrome (ARDS)?
Low tidal volume and high PEEP
High tidal volume and low PEEP
Low tidal volume and low PEEP
High tidal volume and high respiratory rate
In ARDS, low tidal volume (46 mL/kg) helps prevent ventilator-induced lung injury, and higher PEEP maintains alveolar recruitment. High tidal volumes can exacerbate lung injury. Adjusting respiratory rate alone is insufficient.
A medication has a half-life of 6 hours. Approximately how long will it take to reach steady-state plasma concentration with repeated dosing?
24 hours
6 hours
12 hours
36 hours
Steady state is typically achieved after about 4 to 5 half-lives. With a half-life of 6 hours, 4 half-lives equal 24 hours. After this period, the drugs levels will plateau with consistent dosing.
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Study Outcomes

  1. Understand NCLEX RN question formats -

    Familiarize yourself with realistic NCLEX RN practice questions and learn how to approach multiple-choice, select-all-that-apply, and alternate-format items effectively.

  2. Apply clinical knowledge to exam scenarios -

    Use your nursing fundamentals and critical-thinking skills to answer practice NCLEX RN exam questions under simulated conditions.

  3. Evaluate performance and identify knowledge gaps -

    Track your score in NCLEX practice mode quiz to pinpoint strengths and areas that need targeted review.

  4. Interpret instant feedback for improvement -

    Review detailed rationales for each answer to understand correct concepts and avoid common test-taking errors.

  5. Boost exam confidence through repeated practice -

    Build consistency and reduce test anxiety by engaging with a free NCLEX practice quiz designed for progressive skill development.

Cheat Sheet

  1. Pharmacology Dosage Calculations -

    Master dimensional analysis and use the formula D/H × V = Dose to accurately convert and calculate medication doses. For example, if a physician orders 250 mg and the vial reads 500 mg/5 mL, apply (250/500)×5 = 2.5 mL. Consistent practice with NCLEX RN practice questions solidifies this skill following NCSBN guidelines.

  2. Prioritization Using ABCs and Maslow -

    Apply the ABC (Airway, Breathing, Circulation) mnemonic and Maslow's Hierarchy to determine nursing priorities in critical scenarios. Remember "Airway always first" followed by breathing and circulation to prevent life-threatening complications. This framework is endorsed by the American Nurses Association for safe clinical decision-making.

  3. Interpretation of Acid-Base Imbalances -

    Use the ROME mnemonic (Respiratory Opposite, Metabolic Equal) to identify primary disturbances in pH, PaCO₂, and HCO₃❻ from arterial blood gases. For instance, a pH of 7.25 with PaCO₂ of 50 mm Hg indicates respiratory acidosis. Regular practice with NCLEX practice mode quiz questions ensures accurate assessment.

  4. Fluid and Electrolyte Management -

    Know normal lab values - sodium 135 - 145 mEq/L, potassium 3.5 - 5.0 mEq/L, calcium 8.5 - 10.5 mg/dL - and their clinical significance in homeostasis. Use sample case scenarios to predict signs of hypo- or hypernatremia, such as confusion versus muscle weakness. Referrals to textbooks like Lehne's Pharmacology reinforce these essentials.

  5. Infection Control and Safety Precautions -

    Follow CDC guidelines on hand hygiene (minimum 20 seconds), standard, contact, and droplet precautions to break the chain of infection. Memorize the sequence of donning and doffing PPE to reduce cross-contamination risks. Consistent practice with free NCLEX practice quiz items cements adherence to safe nursing care.

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