NCLEX Practice Test – 15 Free Questions with Answers

1. A nurse is caring for a patient receiving IV potassium chloride. Which action is the priority?



Correct Answer: Monitor cardiac rhythm

Potassium affects cardiac conduction and can cause dangerous arrhythmias. Continuous cardiac monitoring is essential when administering IV potassium. IV push potassium is never allowed because it can cause fatal cardiac arrest.

2. A patient with heart failure suddenly develops shortness of breath and crackles in both lungs. What is the nurse’s first action?



Correct Answer: Place patient in high-Fowler’s position

This position improves lung expansion and reduces venous return to the heart, which decreases pulmonary congestion and improves oxygenation during acute heart failure symptoms.

3. A nurse is assessing a patient with hypoglycemia. Which symptom is most expected?



Correct Answer: Cool clammy skin

Hypoglycemia activates the sympathetic nervous system causing sweating, tremors, tachycardia, and cool clammy skin. These are classic early warning signs of low blood glucose.

4. Which laboratory value requires immediate nursing intervention?



Correct Answer: Potassium 6.2 mEq/L

A potassium level above 5.5 mEq/L indicates hyperkalemia, which can cause life-threatening cardiac arrhythmias. Immediate medical evaluation and intervention are required.

5. A nurse is caring for a postoperative patient. Which finding suggests possible pulmonary embolism?



Correct Answer: Sudden chest pain and shortness of breath

Pulmonary embolism often presents with sudden dyspnea, chest pain, tachycardia, and hypoxia. This is a medical emergency requiring immediate intervention.

6. A nurse is teaching a patient about warfarin therapy. Which food should the patient limit?



Correct Answer: Spinach

Spinach contains high levels of vitamin K, which can reduce the effectiveness of warfarin by promoting clotting. Patients must maintain consistent vitamin K intake.

7. Which symptom indicates increased intracranial pressure?



Correct Answer: Severe headache and vomiting

Classic signs of increased intracranial pressure include headache, vomiting, altered consciousness, and papilledema due to pressure on brain structures.

8. A nurse caring for a burn patient should prioritize monitoring which electrolyte?



Correct Answer: Potassium

Burn injuries cause massive cellular damage which releases potassium into the bloodstream, leading to hyperkalemia and possible cardiac complications.

9. Which action is most appropriate for a patient experiencing an asthma attack?



Correct Answer: Administer bronchodilator inhaler

Bronchodilators relax airway smooth muscles and rapidly relieve bronchospasm during acute asthma attacks.

10. Which sign indicates hypocalcemia?



Correct Answer: Positive Chvostek’s sign

Chvostek’s sign (facial muscle twitching when tapping the facial nerve) indicates neuromuscular irritability caused by low calcium levels.

11. Which patient should the nurse assess first?



Correct Answer: Patient with sudden confusion

Sudden confusion may indicate hypoxia, stroke, infection, or neurological changes. According to priority frameworks, acute neurological changes require immediate assessment.

12. A patient receiving heparin therapy develops bleeding gums. What should the nurse do first?



Correct Answer: Stop infusion and notify provider

Bleeding is a serious complication of heparin therapy. The infusion should be stopped immediately and the provider notified to evaluate coagulation levels.

13. Which symptom is a classic sign of appendicitis?



Correct Answer: Pain in right lower abdomen

Appendicitis typically presents with right lower quadrant abdominal pain (McBurney’s point), nausea, fever, and rebound tenderness.

14. Which patient finding suggests dehydration?



Correct Answer: Dark concentrated urine

Dehydration reduces urine volume and increases concentration, producing darker urine with a strong odor.

15. Which action helps prevent pressure ulcers in bedridden patients?



Correct Answer: Reposition every 2 hours

Frequent repositioning reduces prolonged pressure on tissues and helps maintain blood circulation, preventing pressure injuries.