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Take your Free NCLEX Readiness Check

You’re in. Answer the 32 questions below to see where you stand, what may be holding you back, and what to focus on before test day.

This is not about judging your score. It is about giving you a clearer next step so you can stop guessing and study with a plan.

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Question 1 of 32

1. The nurse is caring for a patient post-operative after hip replacement who is receiving patient-controlled analgesia (PCA) with morphine. The patient is exhibiting slow, shallow respirations (RR = 8 breaths/min). ABGs: pH 7.28, PCO2 55 mm Hg, HCO3− 24 mEq/L. Which intervention is the most critical for the nurse to implement first?

A

Administer Naloxone (Narcan) and vigorously coach the patient to take deeper breaths.

B

Place the patient on a non-rebreather mask at 15 L/min of O2.

C

Administer sodium bicarbonate IV push as a compensation measure.

D

Increase the patient's pain medication dosage to reduce anxiety and improve respiratory effort.

Question 2 of 32

2. A client presents with crushing chest pain radiating to the left arm and jaw. The nurse's priority action is to:

A

Administer sublingual nitroglycerin as ordered.

B

Obtain a 12-lead electrocardiogram (ECG).

C

Start an IV line and draw blood for cardiac markers.

D

Notify the healthcare provider immediately.

Question 3 of 32

3. A nurse is assessing a client with peripheral artery disease (PAD). Which findings would the nurse expect? (Select all that apply.)

(Select all that apply)
A

Pulses are weak or absent in the lower extremities.

B

The skin on the feet is warm and reddish-blue.

C

Leg swelling is present, especially at the end of the day.

D

The client reports pain with exercise that is relieved by rest.

E

The skin on the lower legs and feet is cool and shiny.

Question 4 of 32

4. A client with an ulcerative colitis exacerbation is receiving IV fluids at 125 mL/hr. The tubing delivers 15 gtt/mL. How quickly should the nurse infuse the fluids in drops per minute? (Whole number.)

A

30 gtt/min

B

31 gtt/min

C

32 gtt/min

D

33 gtt/min

Question 5 of 32

5. A client with anemia from ulcerative colitis bleeding is to receive two units of PRBCs while receiving TPN. To ensure comfort and safety, the nurse should:

A

Discontinue the TPN infusion.

B

Start an intravenous (IV) infusion of normal saline.

C

Administer PRBCs in the same IV line as the TPN.

D

Wait until the TPN infusion is completed, and use the same IV line to infuse the PRBCs.

Question 6 of 32

6. A client is admitted with community-acquired pneumonia. The nurse should anticipate which findings? (Select all that apply.)

(Select all that apply)
A

Bradypnea

B

Crackles on auscultation

C

Elevated white blood cell count

D

Dry, non-productive cough

E

Dyspnea

Question 7 of 32

7. A client had a liver biopsy 1 hour ago. What should the nurse do first?

A

Auscultate lung sounds.

B

Check for fever.

C

Obtain a complete blood count (CBC).

D

Apply packing to the biopsy site.

Question 8 of 32

8. The triage nurse must prioritize children waiting to be seen. Which child is in the greatest need of emergency medical treatment?

A

A 6-year-old with a fever of 104°F (40°C), a muffled voice, no spontaneous cough, and drooling.

B

A 3-year-old with a fever of 100°F (37.8°C), a barky cough, and mild intercostal retractions.

C

A 4-year-old with a fever of 101°F (38.3°C), a hoarse cough, inspiratory stridor, and restlessness.

D

A 13-year-old with a fever of 104°F (40°C), chills, and a cough with thick yellow secretions.

Question 9 of 32

9. The nurse enters a client's room for the first time during the shift and realizes that the IV fluids are infusing 100 mL/hr faster than the prescribed rate. Which of the following actions should the nurse take first? 

A

Adjust the infusion rate to the prescribed rate

B

Assess the client's lung sounds and vital signs

C

Complete an incident report documenting the error

D

Notify the primary health care provider about the error

Question 10 of 32

10. The nurse is planning care for a client who is at risk for increased intracranial pressure. Which of the following assessments should the nurse prioritize in the client's plan of care? 

A

Babinski reflex

B

Presence of headache

C

Pupil size and reactivity

D

Level of consciousness

Question 11 of 32

11. The nurse is caring for a client with suspected chronic venous insufficiency. Which of the following findings would support a diagnosis of chronic venous insufficiency? 

A

Absent pedal pulse

B

Intermittent leg cramping with exercise

C

Ulcers on the toes with well-defined edges

D

Brown discoloration to the lower extremities

Question 12 of 32

12. The nurse is caring for a client who received a kidney transplant 12 hours ago. Which of the following findings would require immediate follow-up? 

A

Low serum sodium level

B

Blood pressure 89/52 mmHg

C

Urine output of 400 mL/hr for 2 hours

D

Pink-tinged urine in the catheter drainage bag

Question 13 of 32

13. The nurse receives a prescription for IV push 2 mg diazepam and is unsure whether this is the appropriate dose for this medication. Which of the following is the best action for the nurse to take? 

A

Verify the medication dosage in the hospital's online medication reference

B

Ask the charge nurse whether or not this is a safe dose for this medication

C

Page the primary health care provider to clarify the intended correct dosage

D

Contact the hospital pharmacist to confirm that the correct dosage was prescribed

Question 14 of 32

14. An elderly client is brought to the emergency department with lethargy, chills, and pain with deep breathing. Pulse oximeter shows 93% on room air. What is the nurse's initial action?

 

A

Administer intravenous (IV) morphine

B

Auscultate the client's lung sounds

C

Initiate an IV infusion of normal saline

D

Initiate nasal oxygen at 3 L/min

Question 15 of 32

15. The nurse on a cardiac floor prepares a nursing care plan for a client with heart failure and excess fluid volume. Which nursing diagnosis is appropriate for this client?

 

A

Fluid volume excess related to decreased cardiac output as evidenced by a cough

B

Heart failure related to decreased cardiac output as evidenced by venous stasis ulcers

C

Excess fluid volume related to decreased cardiac output as evidenced by weight gain and shortness of breath

D

Heart failure related to excess fluid volume as evidenced by shortness of breath at rest

Question 16 of 32

16. The nurse is caring for a client who reports feeling faint and is experiencing a symptomatic bradycardic rhythm shown on the ECG strip. Which of the following actions would be appropriate for the nurse to take? (Select all that apply.)

 

(Select all that apply)
A

Administer the client's prescribed beta blocker

B

Prepare for transcutaneous pacing

C

Instruct the client to perform the Valsalva maneuver

D

Begin chest compressions

E

Assess the client for angina

Question 17 of 32

17. A nurse on a surgical unit assumes care for four clients. Which client should the nurse assess first?

 

A

A client with sickle cell disease reporting lower back pain rated 7/10

B

A client with a plaster cast on the lower leg reporting severe calf pain unrelieved by opioids that worsens when the toes are passively stretched

C

A client with type 2 diabetes and a blood glucose of 588 mg/dL

D

A client who is 8 hours post abdominal surgery with a heart rate of 124/min, blood pressure of 86/52 mm Hg, and growing abdominal distention

Question 18 of 32

18. The nurse is planning a staff education program about tuberculosis (TB). Which of the following information should the nurse include? 

A

Two clients with TB can share the same room

B

Clients should be placed in a positive pressure room

C

A surgical mask must be worn within 6 feet of the client

D

Clients need to wear a surgical mask when being transported

Question 19 of 32

19. The nurse has attended a staff education program about informed consent. Which of the following statements by the nurse would indicate a correct understanding of the teaching? 

A

"The client can provide consent after a recent dose of diazepam if the client is awake and alert."

B

"As the nurse, I can witness that the client is providing consent for the procedure or treatment."

C

"The next time a client refuses to sign an informed consent for a procedure, we can use emergency consent instead."

D

"If the surgical team is in a hurry, I can get the consent signed, and the client can get more information in the surgical unit."

Question 20 of 32

20. The nurse has been made aware of the following client situations. The nurse should first assess the client who is:

 

A

75-years-old with atrial fibrillation and has metoprolol due

B

6-years-old with bacterial endocarditis and a heart rate of 105

C

57-years-old with hypokalemia with frequent artifact on the telemetry monitor

D

17-years-old with anorexia nervosa with a heart rate of 50 and has not eaten today

Question 21 of 32

21. A nurse on a medical-surgical unit is assigned four clients. Which client should the nurse assess first?

 

A

A client 1 day post thyroidectomy with a high-pitched squeaking sound on inspiration and difficulty speaking in full sentences

B

A client with pneumonia and an oxygen saturation of 92% receiving supplemental oxygen.

C

A client with a bowel obstruction reporting crampy abdominal pain and nausea

D

A client with COPD presenting with unilateral calf swelling, warmth, and D-dimer 750 ng/mL

Question 22 of 32

22. The nurse understands that which of the following benefits can be attributed to delayed cord clamping of the umbilical cord in a newborn? (Select all that apply.) 

(Select all that apply)
A

A. Increased blood volume

B

B. Decreased brain hemorrhages

C

C. Decreased risk of polycythemia

D

D. Decreased jaundice

E

E. Increased iron stores

Question 23 of 32

23. The nurse at an outpatient care facility is reviewing telephone messages from clients previously seen at the facility. The nurse should first telephone the client who began: 

A

using capsaicin cream 2 days ago and reports burning in the eyes

B

taking phenytoin 1 week ago and reports blisters on the face and trunk

C

taking carbidopa-levodopa 1 day ago and reports dizziness when rising

D

taking hydroxyzine 3 days ago and reports urinary difficulty and hesitancy

Question 24 of 32

24. The nurse is caring for a client born 6 hours ago and observes peeling/desquamation of the skin on the feet. Which of the following actions should the nurse take? 

A

Notify the primary health care provider of the finding

B

Administer oxygen therapy prescribed p.r.n.

C

Continue to perform routine newborn care

D

Prepare the client for phototherapy

Question 25 of 32

25. The nurse is contributing to a staff education program about confidentiality. Which of the following information should the nurse suggest including? 

A

"Clients must wait until after discharge to view their medical records."

B

"Clients must disclose all personal information in order to receive care."

C

"Nurses in a hospital unit may review the medical records for all clients in that unit."

D

"Certain information in the client's medical record may not be considered confidential."

Question 26 of 32

26. The nurse receives a prescription for IV push 2 mg diazepam and is unsure whether this is the appropriate dose for this medication. Which of the following is the best action for the nurse to take? 

A

Verify the medication dosage in the hospital's online medication reference

B

Ask the charge nurse whether or not this is a safe dose for this medication

C

Page the primary health care provider to clarify the intended correct dosage

D

Contact the hospital pharmacist to confirm that the correct dosage was prescribed

Question 27 of 32

27. The nurse is caring for a client who reported having thoughts of self-injury yesterday. Which of the following statements by the client should the nurse recognize as risk factors for suicide? (Select all that apply.) 

(Select all that apply)
A

"I am currently unemployed and looking for a job."

B

"I have been married for five years with three children."

C

"I have multiple firearms at home stored in a safe."

D

"It has been about a year since I last overdosed."

E

"My family and I attend weekly religious activities."

F

"Sometimes I experience feelings of hopelessness."

Question 28 of 32

28. The nurse enters a client's room for the first time during the shift and realizes that the IV fluids are infusing 100 mL/hr faster than the prescribed rate. Which of the following actions should the nurse take first? 

A

Adjust the infusion rate to the prescribed rate

B

Assess the client's lung sounds and vital signs

C

Complete an incident report documenting the error

D

Notify the primary health care provider about the error

Question 29 of 32

29. The nurse is planning care for a client with type 2 diabetes who is taking metformin. Which of the following would be a priority for the nurse to include in the plan of care? 

A

Monitoring the client's serum creatinine level daily

B

Checking the client's blood glucose four times daily

C

Encouraging the client to eat whenever appetite is poor

D

Holding metformin before the client has a CT scan with contrast

Question 30 of 32

30. A nurse is caring for four patients. Which patient should the nurse assess FIRST? 

A

A patient with pancreatitis who reports sudden, severe abdominal pain and has a blood pressure of 88/52 mmHg

B

A patient with COPD whose oxygen saturation is 90% on 2 L/min via nasal cannula

C

A patient 6 hours after a thyroidectomy who is restless, has a hoarse voice, and is having difficulty swallowing

D

A patient with atrial fibrillation whose heart rate is 118/min and reports mild palpitations

Question 31 of 32

31. The nurse on the mental health unit is caring for assigned clients. The nurse should first check the client who is: 

A

being continuously monitored by a staff member after reporting a detailed suicide plan

B

with major depressive disorder who has declined to participate in group therapy

C

with schizophrenia who is speaking to someone who is not in the room

D

receiving haloperidol and has involuntary smacking of the lips

Question 32 of 32

32. The nurse is caring for an adolescent client who is experiencing an acute exacerbation of asthma. The client's parent is visibly upset and confronts the client about the smell of cigarette smoke on the clothes. Which of the following actions should the nurse take next? 

A

Ask the parent to leave the room until the parent is able to remain calm

B

Redirect the parent to focus on the client's breathing technique

C

Allow the client and parent to finish the conversation privately

D

Provide teaching about the importance of smoking cessation

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