NCLEX Practice Test 1

This free NCLEX Practice Test 1 has 40 questions written to the current NCLEX-RN test plan, spanning all Client Needs areas — from management of care and safety to pharmacology and physiological adaptation. Answer each question, then review the explanation to understand the reasoning behind the correct choice.

1. A client admitted with a heart failure exacerbation has gained 4 kg (about 9 lb) over 3 days, has 3+ pitting edema in both lower legs, and reports worsening shortness of breath. Which prescribed intervention should the nurse implement first?

Question 1 of 40

2. The nurse is caring for a client with suspected appendicitis who has been vomiting and reports sharp right lower quadrant pain. The client is kept NPO pending surgical evaluation. Which action is the priority for the nurse?

Question 2 of 40

3. A client with cancer has decided to discontinue further treatment. Although the nurse would prefer that the client continue, the nurse recognizes that the client is competent and supports the decision. Which ethical principle is the nurse upholding?

Question 3 of 40

4. The nurse is talking with a client who has age-related macular degeneration. Which client statement is consistent with this condition?

Question 4 of 40

5. A client with type 1 diabetes has a blood glucose of 320 mg/dL, deep rapid breathing, and fruity-smelling breath. Which complication is most likely?

Question 5 of 40

6. A client with a terminal illness has a valid do-not-resuscitate (DNR) order. The client's family asks the nurse to "ignore the DNR if the client's heart stops." What is the nurse's best response?

Question 6 of 40

7. A nurse is caring for a client with suspected tuberculosis. Which personal protective equipment is required when entering the client's room?

Question 7 of 40

8. A patient is brought to the emergency department by ambulance for a presumed heroin overdose. The nurse expects the patient to have received which medication in the field?

Question 8 of 40

9. A client is admitted with a potassium level of 2.8 mEq/L. Which finding does the nurse expect?

Question 9 of 40

10. Which client should the nurse assess first at the start of the shift?

Question 10 of 40

11. A client with diabetes has a fingerstick glucose of 48 mg/dL and is alert. What should the nurse do first?

Question 11 of 40

12. A nurse is caring for a client after a thyroidectomy. Which finding requires immediate attention?

Question 12 of 40

13. Which action best prevents ventilator-associated pneumonia?

Question 13 of 40

14. A postpartum client has a boggy uterus and heavy bleeding. What is the nurse's first action?

Question 14 of 40

15. A client with cirrhosis has an elevated ammonia level. Which medication does the nurse anticipate?

Question 15 of 40

16. Which food should a client on a low-potassium diet avoid?

Question 16 of 40

17. A client with a chest tube has continuous bubbling in the water-seal chamber. What does this indicate?

Question 17 of 40

18. Which assessment is the priority for a client receiving a first dose of IV antibiotic?

Question 18 of 40

19. A client with Addison's disease is at risk for which imbalance?

Question 19 of 40

20. A client with a nasogastric tube to suction is at risk for which imbalance?

Question 20 of 40

21. A client with pneumonia has a room-air SpO₂ of 86%. What should the nurse do first?

Question 21 of 40

22. A client reports calf pain and swelling in one leg. What is the priority nursing action?

Question 22 of 40

23. A client is 1 day post-op after abdominal surgery. Which intervention best prevents atelectasis?

Question 23 of 40

24. A client with heart failure has gained 3 kg (6.6 lb) over the past week and reports increasing shortness of breath. Which interpretation is most appropriate?

Question 24 of 40

25. A client with sepsis has a blood pressure of 82/48 mm Hg, heart rate of 124/min, and altered mental status. Which condition is the nurse most concerned about?

Question 25 of 40

26. A client with an acute myocardial infarction reports crushing substernal chest pain. Which finding requires immediate attention?

Question 26 of 40

27. A client with a suspected stroke suddenly develops facial drooping and right-sided weakness. What is the nurse's priority?

Question 27 of 40

28. A client with heart failure suddenly develops severe dyspnea and pink, frothy sputum. What should the nurse suspect?

Question 28 of 40

29. A client with a central venous catheter develops fever, chills, and redness at the insertion site. What should the nurse suspect?

Question 29 of 40

30. A first-time mother brings her 12-month-old daughter to the clinic for a routine well-child visit. Which assessment finding requires further investigation by the nurse?

Question 30 of 40

31. What is the primary purpose of applying a splint to an injured extremity?

Question 31 of 40

32. A client with acute pancreatitis reports numbness around the mouth and muscle twitching. Which action should the nurse take first?

Question 32 of 40

33. A client with a new colostomy has a stoma that appears dusky and dark red. What is the nurse's priority action?

Question 33 of 40

34. A client with heart failure is prescribed both furosemide and digoxin. Which lab value most increases the risk of digoxin toxicity?

Question 34 of 40

35. A nurse assesses a client with a pressure injury on the heel that is covered by intact, hard, dry, black tissue. Which intervention is most appropriate?

Question 35 of 40

36. A client 6 hours post-op reports the surgical dressing is saturated with bright red blood. After reinforcing the dressing, what should the nurse do next?

Question 36 of 40

37. A client receiving a blood transfusion becomes short of breath with crackles and distended neck veins after 30 minutes. Which complication is most likely?

Question 37 of 40

38. A client taking phenytoin for seizures has a level of 25 mcg/mL. Which finding supports this result?

Question 38 of 40

39. A client with chronic kidney disease has a phosphate binder prescribed. Which instruction should the nurse give?

Question 39 of 40

40. A client is receiving IV vancomycin. The nurse notes the trough level was drawn but questions the timing. When should a vancomycin trough be obtained?

Question 40 of 40