2024 Edition

NCLEX-RN Certification Test

A Free NCLEX-RN Practice Exam...

To become a certified or licensed registered nurse, you will have to take the NCLEX-RN.

The actual NCLEX exam includes these categories: Basic Nursing Care, Management and Practice Directives, Preventing Risks and Complications, Caring for Acute and Chronic Conditions, Safety, Mental Health, Pharmacology and Growth and Development.

To prepare for your RN licensure exam, see the complete Practice Exam for the NCLEX-RN with 750 questions, written by nursing experts and medical writers.

Take this free practice exam to get a sample of the types of questions that are on the NCLEX-RN exam.

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Basic Nursing Care

1.	A client has fallen asleep in his bed in the hospital. His heart rate is 65 bpm, his muscles are relaxed, and he is difficult to arouse. Which stage of the sleep cycle is this client experiencing?
		a. Stage 1
		b. Stage 2
		c. Stage 3
		d. Stage 4
A client in stage 3 of the sleep cycle has moved into deeper stages of sleep and is more difficult to arouse. The client may have relaxed muscles, a decrease in vital signs, and may lie very still. Stage 3 of sleep is a type of non-REM sleep in which the client progresses toward REM sleep and vivid dreams. Incorrect answer. Please choose another answer.

2.	A nurse is preparing to irrigate a client's indwelling catheter through a closed, intermittent system. Which of the following steps must the nurse take as part of this process?
		a. Use sterile solution from the refrigerator
		b. Position the client in the prone position
		c. Clamp the catheter at the level above the injection port
		d. Inject sterile solution through the injection port into the catheter
When performing a closed intermittent system of catheter irrigation, the nurse should draw up sterile solution that has been at room temperature using sterile technique. The client should be positioned for easy access to the catheter site and to assess the abdomen during the procedure. After clamping the tubing below the level of the injection port and cleansing the site, the nurse injects fluid into the port, which travels up the catheter to irrigate the tubing and the bladder. Incorrect answer. Please choose another answer.

3.	Which of the following statements best describes footdrop?
		a. The foot is permanently fixed in the dorsiflexion position
		b. The foot is permanently fixed in the plantar flexion position
		c. The toes of the foot are permanently fanned
		d. The heel of the foot is permanently rotated outward
Footdrop results in the foot becoming permanently fixed in a plantar flexion position. This position points the toes downward. The client may be unable to put weight on the foot, making ambulation difficult. Footdrop can be caused by immobility or chronic illnesses that cause muscle changes, such as multiple sclerosis or Parkinson's disease. Incorrect answer. Please choose another answer.

Management and Practice Directives

4.	Which of the following may be a cultural barrier that impacts a nurse's ability to provide care or education to the client?
		a. A nurse offers educational materials to a client that are written at an 8th grade reading level
		b. A Vietnamese woman wants to use steaming in addition to her prescription antibiotics
		c. A nurse uses pantomime to explain a procedure to a deaf client
		d. A Native American client requests a healing ritual before he will consider surgery
Cultural barriers can impede communication, preventing the nurse from providing education or instruction about a client's care. Cultural barriers may be subtle or obvious; however, the nurse may not always know the various practices and beliefs performed by other cultures. Pantomiming instructions to a deaf person implies that the nurse does not recognize the importance of a sign language interpreter. This barrier is likely to cause miscommunication if the client does not understand the nurse's gestures and actions. Incorrect answer. Please choose another answer.

5.	Mr. K is admitted to the orthopedic unit one morning in preparation for a total knee replacement to start in two hours. Which of the following is a priority topic to instruct this client on admission?
		a. The approximate length of the surgery
		b. The type of anticoagulants that will be prescribed
		c. The time of the next meal of solid food
		d. The length of time until the client can return to work
While follow-up care and discharge instructions are important to review throughout hospitalization, pre-surgical teaching should focus on what to expect for the upcoming procedure. The client may be more focused on the surgery and may want to know facts about the procedure to better prepare him or to relieve anxiety. Information about what to expect after the procedure can be presented well before the procedure and then reviewed again afterward. Incorrect answer. Please choose another answer.

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6.	Which of the following is an example of a living will?
		a. A client's son has been appointed to make his healthcare decisions if he becomes incapacitated
		b. A client has designated which of his children will receive his home and property before he dies
		c. A client has instructions that he does not want to be resuscitated through chest compressions if his heart stops beating
		d. A client designates what type of burial or cremation services he would want after his death
A living will is a type of advanced directive that a client develops to stipulate his preferences for healthcare in the event that he is unable to do so. A living will involves instructions about various situations that may occur and the client's preferences for treatment in each case, which may involve using or discontinuing life-saving measures. Incorrect answer. Please choose another answer.

Preventing Risks and Complications

7.	A nurse is preparing to draw a blood specimen from an adult client's central line. All of the following actions for this procedure are correct EXCEPT:
		a. Disconnect the current infusion
		b. Clean the cap with alcohol and attach a 5 cc syringe
		c. Draw 5 cc of a blood sample to discard
		d. Flush with saline after the sample
When drawing a blood specimen from a central line, the nurse should disconnect any infusions that are currently running and that could contaminate the specimen. The nurse should always use a minimum size of a 10 cc syringe when using a central line to avoid placing too much pressure on the catheter. Incorrect answer. Please choose another answer.

8.	Which of the following interventions is necessary before insertion of an arterial line into the radial artery?
		a. Ensure that the client does not need surgery
		b. Assess the client's grip strength
		c. Perform an Allen test
		d. Check a serum potassium level
Before a physician inserts an arterial line using the radial artery, the nurse should perform an Allen test to assess the client's circulation. To perform the Allen test, the nurse compresses both the radial and ulnar arteries that provide circulation to the hand. She then maintains occlusion on the radial artery while releasing the ulnar artery and checks the blood flow to the hand. This test ensures that if the radial artery is cannulated with an arterial line, the ulnar artery can still provide adequate blood flow. Incorrect answer. Please choose another answer.

9.	A nurse is caring for an 83-year old man who has had swallowing difficulties. All of the following interventions are appropriate for this client EXCEPT:
		a. Keep the client in an upright position at all times
		b. Auscultate lung sounds every shift and after feedings
		c. Maintain suction equipment at the client's bedside
		d. Instruct the client about how to perform swallowing exercises
A client who has difficulty swallowing is at risk of aspiration of food into the lungs. Nursing interventions in this situation include auscultating lung sounds each shift and after meals to assess for changes in breathing patterns, helping the client with swallowing exercises through occupational therapy, and maintaining suctioning equipment at the bedside in case of difficulties. Incorrect answer. Please choose another answer.

Caring for Acute or Chronic Conditions

10.	A nurse is caring for a 2-day old infant who has a bilirubin level of 19 mg/dl. The physician has ordered phototherapy. Which of the following actions indicates correct preparation of the infant for this procedure?
		a. Undress the baby down to a diaper and hat
		b. Place the baby in his mother's arms before turning on the light
		c. Position the phototherapy light approximately 3 inches above the baby's skin
		d. Secure eye protection for the infant without occluding the nose
Phototherapy is used to treat high levels of bilirubin among infants, typically evidenced as jaundice. The nurse must position the infant carefully during this procedure in order to maximize the benefits of the light therapy while protecting the baby at the same time. The nurse should place protective eyewear over the baby's eyes without occluding the nose, in order to protect the eyes from the ultraviolet light. Incorrect answer. Please choose another answer.

11.	Which of the following clients is most appropriate for receiving telemetry?
		a. A client with syncope potentially related to cardiac dysrhythmia
		b. A client with unstable angina
		c. A client with sinus rhythm and PVCs
		d. A client who had a myocardial infarction 6 hours ago
Telemetry is used to monitor the cardiac rhythms of clients with potentially unstable conditions or those rhythms that affect activities. Telemetry is not indicated for acutely unstable clients, such as those who have recently had heart attacks, or those with chest pain related to cardiac activity. Incorrect answer. Please choose another answer.

12.	Which of the following descriptions best describes the function of the thyroid gland?
		a. The thyroid gland converts glucose into glycogen
		b. The thyroid hormone secretes cortisol during times of stress
		c. The thyroid gland regulates body metabolism
		d. The thyroid gland affects skin pigmentation
The thyroid gland is responsible for secreting thyroxine (T4) and triiodothyronine (T3), which work to regulate metabolism of the body's cells. The thyroid also regulates carbohydrate, protein and fat metabolism as well as regulates both physical and mental development. Incorrect answer. Please choose another answer.

Safety

13.	A physician has ordered that a client must be placed in a high Fowler's position. How does the nurse position this client?
		a. The client is placed face-down
		b. The client lies on his back with his head lower than his feet
		c. The client lies on his back with the knees drawn up toward the chest
		d. The client is sitting with the backrest at a 90-degree angle
A high Fowler's position is a modification of the semi-Fowler's position, in which the client is seated with arms resting at the sides or in the lap. The high Fowler's position requires that the client's head and upper chest are elevated; the backrest is at a 90-degree angle, which supports breathing and appropriate chest wall movement. Incorrect answer. Please choose another answer.

14.	A nurse has just started a transfusion of packed red blood cells that a physician ordered for a client. Which of the following signs may indicate a transfusion reaction?
		a. The client suddenly complains of back pain and has chills
		b. The client develops dependent edema in the extremities
		c. The client has a seizure
		d. The client's heart rate drops to 60 bpm
Signs of a transfusion reaction include back pain, chills, dizziness, increased temperature, and blood in the urine. The nurse should be aware of symptoms of a transfusion reaction any time blood products are administered and watch closely for changes in the client's health status. Incorrect answer. Please choose another answer.

15.	Which of the following constitutes the five "rights" of medication administration?
		a. Right client, right nurse, right time, right dose, right route
		b. Right client, right time, right dose, right route, right order
		c. Right client, right drug, right dose, right time, right route
		d. Right physician, right nurse, right client, right drug, right dose
The nurse must confirm the five rights of medication administration when giving any drug to a client. The medication must be for the right client as prescribed, it must be the correct drug at the prescribed dose, and it must be given at the prescribed route at the designated time. Incorrect answer. Please choose another answer.

Mental Health

16.	Which of the following is an example of an opioid?
		a. Mescaline
		b. Diazepam
		c. Phenobarbital
		d. Methadone
Opioids are a type of drug classified as narcotics. Opioids may be one category of drug that nurses see when working with clients with substance abuse. Examples of opioids that may cause addiction among some clients include methadone, codeine, morphine, or hydromorphone. Incorrect answer. Please choose another answer.

17.	An increase in the neurotransmitter dopamine is associated with which of the following illnesses?
		a. Schizophrenia
		b. Depression
		c. Alzheimer's disease
		d. Anxiety
Schizophrenia is a type of mental illness that may be associated with increased levels of the neurotransmitter dopamine in the brain. Increased dopamine could be related to some of the symptoms of schizophrenia, such as hallucinations or delusions. Incorrect answer. Please choose another answer.

18.	Which of the following is an example of passive aggression?
		a. Clenched fists
		b. Yelling
		c. Jealousy
		d. Intimidation
Passive aggression involves directing anger to others in a way that is not overt. A person who exhibits passive aggression may not be openly hostile and this type of anger may be difficult to recognize or treat. Examples of passive aggression include jealousy, resentment, stubbornness, and pouting. Incorrect answer. Please choose another answer.

Pharmacology

19.	Which of the following medications is an example of an adjuvant drug?
		a. Ibuprofen
		b. Fentanyl
		c. Hydromorphone
		d. Hydroxyzine
Hydroxyzine (Vistaril) is an example of an adjuvant drug. Adjuvants are those drugs that work with analgesics to improve pain relief. For example, a nurse may administer an adjuvant that works as a muscle relaxant in addition to a narcotic analgesic for a client who is complaining of pain and who has a lot of tension. Incorrect answer. Please choose another answer.

20.	Which is the most appropriate muscle site for an intramuscular injection for a 9-month old child?
		a. Deltoid
		b. Ventrogluteal
		c. Dorsogluteal
		d. Vastus lateralis
The vastus lateralis is the site of choice for administering intramuscular medications to babies and young children. This muscle is developed enough even in young children that an injection in this location is ideal. The vastus lateralis muscle is located on the anterior and lateral portion of the thigh. Incorrect answer. Please choose another answer.

21.	Which of the following is more likely to occur with aging as a complication of medication administration?
		a. Increased renal function
		b. Increased gastrointestinal absorption
		c. Increased visual acuity
		d. Increased ratio of fat compared to lean body mass
Aging adults develop an increased ratio of fat to lean body mass, which affects how their bodies process medications. Increased fat tissues may cause the body to retain fat-soluble medications, which in turn places the older adult at risk of drug toxicity. Incorrect answer. Please choose another answer.

Growth and Development

22.	Which of the following best describes the cognitive development of an 18-month old child?
		a. The child can follow one-part directions
		b. The child understands the concept of "forever"
		c. The child can name six body parts
		d. The child has an attention span of approximately 5 minutes
An 18-month old child's level of cognitive development allows him to follow one-part directions from others. Children who are this age observe and imitate the behavior of others and thoroughly explore their environments out of curiosity. Although an 18-month old child is starting to remember the place or location of objects, his attention span is very short. Incorrect answer. Please choose another answer.

23.	A nurse is examining a 36-hour old infant when she notices the child's skin has a yellowish tint. The yellow skin appears on the baby's face and chest but the skin on the feet and legs appears pink. What is the next action of the nurse?
		a. Check a stat bilirubin level
		b. Begin phototherapy with eye protection
		c. Monitor the condition and notify the physician during rounds
		d. Transfer the infant to the neonatal intensive care unit
Many infants develop a small amount of jaundice in the first days after birth. Jaundice appears as a yellowing of the skin and often starts in the face and moves in a cephalocaudal direction. Jaundice that occurs before 24 hours of age may be associated with illness and should be checked by a physician. Incorrect answer. Please choose another answer.

24.	Which of the following is a potential complication associated with precocious puberty?
		a. Low serum calcium levels
		b. Short stature
		c. Weakness and lethargy
		d. Anemia
Precocious puberty occurs as the onset of puberty and secondary sex characteristics at an earlier age. In girls, precocious puberty is considered to be puberty starting at 7-8 years; in boys, the term is used for puberty starting before 9-10 years. Precocious puberty may be associated with increased bone growth, which may eventually lead to bone fusion. Although this normally takes place over time during and after puberty, early bone fusion can ultimately lead to short stature. Incorrect answer. Please choose another answer.

Quality starts with who wrote the material.

Our practice exam writer

Eileen Johnson, RN, MSN

is a registered nurse and medical writer who has worked in nursing for over 20 years. Eileen was an item writer for the Board of Certification of Emergency Nursing.

Alene Burke, RN, MSN

is a registered nurse since 1976. She is a multidisciplinary nursing educator who has taught nurses for the last 25 years and developed college level curriculum.

Chelsea Homich, RN, MSN

is a nurse educator at the Pittsburgh Technical Institute where she teaches nursing students foundational nursing courses.

Meg Brannagan, RN, BSN

is a medical writer, specializing in courses and curriculum designed for practicing nurses. She has practiced clinical nursing and medical writing for over 12 years.

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