Free NCLEX practice questions
Ten free NCLEX-RN practice questions are below, playable on this page with no account. Each one is written by a registered nurse, mapped to an NCSBN test-plan category, and followed by a rationale that explains why the other options fail. The set covers safe and effective care, pharmacology, physiological adaptation, and psychosocial integrity — the four heaviest categories on the exam.
Written and reviewed by Dana Whitfield, RN, MSN · Updated August 2026
Section 1
10 real questions, answerable right here
This is the whole product, ungated. Answer, check, read the rationale, move on.
Free set · mixed categories
1 of 10A nurse on a medical unit receives report on four clients. Which client should the nurse assess first?
Rationale
Prioritization items are airway, breathing, circulation, in that order — the ranking survives every rewording. Audible gurgling around a fresh tracheostomy is a partially obstructed airway and it is the only option that can kill the client in the next few minutes. Fever, post-op pain, and a glucose of 232 are all real problems that need the nurse, just not first.
Answer: C
A client with heart failure is started on furosemide 40 mg PO daily. Which findings should the nurse report to the provider before administering the next dose? Select all that apply.
Rationale
Furosemide is a loop diuretic, so the two things you are watching are potassium and kidney function. A potassium of 2.9 mEq/L is below the 3.5–5.0 reference range and puts the client at risk for dysrhythmia — hold and report. Muscle cramps with palpitations are the clinical face of that same hypokalemia, so they are reported together, not separately. A creatinine that doubles signals the diuresis has outrun renal perfusion. A blood pressure of 132/78 and a 1 kg loss are the expected response to the drug working, not reasons to hold it.
Answer: A, D, E
A client with chronic obstructive pulmonary disease has an oxygen saturation of 88% on 2 L/min via nasal cannula and is alert with no distress. What should the nurse do first?
Rationale
In COPD a saturation of 88–92% is the therapeutic target, not an emergency, and this client is alert with no distress. The first action is the independent nursing intervention that is least invasive and most likely to help: sit them up and reassess. Turning the oxygen up to 6 L/min risks blunting the hypoxic drive, and calling rapid response or drawing an ABG escalates ahead of an assessment you have not finished.
Answer: B
A client admitted with major depressive disorder tells the nurse, "Everyone would be better off without me." Which response is most appropriate?
Rationale
Ask directly. Asking about suicide does not plant the idea, and a veiled statement like this one has to be converted into an assessable answer before anything else happens — including exploring feelings. Reassurance dismisses the statement, deferring to group delays a safety assessment, and 'what made you feel this way' is a therapeutic question in the wrong order: safety first, then exploration.
Answer: B
Four hours after a cardiac catheterization via the right femoral artery, the nurse notes the client's right dorsalis pedis pulse is now faint and the foot is cool and pale. What is the nurse's priority action?
Rationale
A pulse that was present and is now faint, with a cool, pale extremity distal to the puncture site, is arterial occlusion until proven otherwise — a limb-threatening complication that needs the provider now. Documenting and rechecking wastes the window, warming treats the symptom and masks the change, and asking the client to move the ankle neither restores flow nor gives you new information.
Answer: C
A nurse is preparing to feed a client who had a stroke and has mild dysphagia. Which action best reduces the risk of aspiration?
Rationale
Upright at 90 degrees with a chin tuck narrows the airway entrance and directs the bolus toward the esophagus — it is the single highest-yield positioning intervention for dysphagia. Thin liquids and straws move fastest and aspirate most easily, side-lying removes the gravity you want, and large bites overwhelm a swallow that is already impaired.
Answer: B
A client is admitted with diabetic ketoacidosis. Which findings does the nurse expect? Select all that apply.
Rationale
DKA is hyperglycemia plus ketosis plus metabolic acidosis, and four of these are that picture: Kussmaul respirations blowing off CO₂, ketones on the breath, a glucose well above 250 mg/dL, and dehydration showing as warm, flushed, dry skin. A bicarbonate of 30 mEq/L is above the reference range — in DKA bicarbonate is consumed and falls below 18. On a select-all, check each option against the pathophysiology on its own; there is no partial credit on the real exam.
Answer: A, B, D, E
A client at 30 weeks' gestation reports a headache that will not resolve, blurred vision, and swelling of the hands. Blood pressure is 158/104 mm Hg. Which action should the nurse take first?
Rationale
Headache that will not resolve, visual changes, and a blood pressure of 158/104 after 20 weeks are severe features of preeclampsia — the client is at risk of seizing. Notify and prepare for magnesium sulfate, which is given for seizure prophylaxis rather than for the blood pressure itself. Resting and rechecking in an hour delays treatment, and a urine culture answers a different question entirely.
Answer: B
The provider prescribes heparin 25,000 units in 250 mL of 0.9% sodium chloride to infuse at 1,000 units/hour. At what rate in mL/hour should the nurse set the pump?
Rationale
Find the concentration first: 25,000 units ÷ 250 mL = 100 units/mL. Then divide the ordered dose by that concentration: 1,000 units/hour ÷ 100 units/mL = 10 mL/hour. Dosage items almost always reduce to two steps like this, and the distractors are the answers you get from a single misplaced decimal — which is exactly what the item is testing.
Answer: B
Which tasks may the registered nurse delegate to unlicensed assistive personnel (UAP)? Select all that apply.
Rationale
Delegate tasks, never the nursing process. Vital signs on a stable client, ambulation of a stable client, and recording intake and output are standardized, predictable, and have a known outcome — all delegable. Teaching and assessment belong to the RN, and the word that gives it away is 'newly': a new inhaler and a new admission both require judgement the UAP is not licensed to make.
Answer: A, C, E
Section 2
Practice questions by topic
Nine test-plan sets, each weighted the way the NCSBN plan weights that category, and twelve clinical subjects that re-cut the same bank by body system.
Pharmacology
Dosage math, adverse effects, and the drugs that show up every time.
Med-surg
Complications, decompensation, and what to do first when a client turns.
Safe and effective care
Delegation, prioritization, infection control, and client rights.
Psychosocial integrity
Therapeutic communication, crisis, and the response that is never reassurance.
Basic care and comfort
Mobility, nutrition, elimination, rest, and non-pharmacological comfort.
Reduction of risk potential
Lab values, diagnostics, and catching the complication before it lands.
Health promotion
Pregnancy, newborn, growth and development, screening, and prevention.
SATA questions
The format that has no partial credit, drilled on its own.
By clinical subject
- Cardiovascular10
- Respiratory10
- Endocrine10
- Neurological10
- Gastrointestinal10
- Renal and genitourinary10
- Maternity and newborn10
- Pediatrics10
- Mental health10
- Fundamentals10
- Prioritization and delegation10
- Dosage calculation and lab values10
Practise any topic on one page
Pick a topic, answer the set in place, and get a scored review with a line on every option. No account.
Section 3
The question types, explained
Since April 2023 the exam mixes Next Generation formats in with standard single-answer items. The reasoning is the same; the interface is not.
- Select all that apply
- Five or six options, any number correct, and no partial credit on the classic format. Judge each option on its own against the pathophysiology — never against the other options.
- Matrix
- A grid of findings to classify as expected, unexpected, or unrelated. Partial credit applies, with a penalty for wrong selections, so answer only the cells you can defend.
- Bowtie
- One condition in the centre, two actions on the left, two parameters to monitor on the right. It is a whole case compressed into a single scored item.
- Drag and drop
- Ordered response items — usually a procedure sequence or a prioritization. Build the list from the safety step backwards and it resolves faster.
Section 4
How to use practice questions properly
The gap between candidates who pass on the first attempt and candidates who repeat is mostly a gap in method, not hours. Practice questions only work if the rationale is the point and the score is a by-product.
- Read every rationale, including the ones you got right. A lucky correct answer is a wrong answer you have not met yet.
- Around 75 questions a day, for four to six weeks. Two hundred that you do not review teaches you almost nothing.
- Mix categories after week two. Blocked practice inflates your score; the real exam never tells you which category you are in.
- Track why you missed it, not that you missed it. Misread the stem, did not know the fact, or knew it and ranked it wrong — three different problems with three different fixes.
Our 4-week study plan lays this out day by day, and how to answer SATA covers the format that costs most candidates the most marks.
FAQ
NCLEX practice question FAQ
How many questions are on the NCLEX?
The NCLEX-RN is adaptive and ranges from 85 to 150 questions, including 15 unscored pretest items. It ends when the engine is 95% confident you are above or below the passing standard, or when you reach the maximum length or the five-hour limit.
Is the NCLEX hard?
About 88% of first-time US-educated candidates pass. It is difficult in a specific way: most items give you four defensible answers and ask which comes first, so it tests ranking rather than recall.
How many practice questions should I do a day?
Around 75 a day for four to six weeks, with every rationale read — including the ones you got right. Reviewing carefully beats volume; 200 questions you do not review teaches you almost nothing.
What is a good score on practice questions?
Consistently scoring 65% or above across mixed-category sets is the usual signal that you are tracking toward a pass. A single set is noise; look at the trend across at least ten sets.
Are these Next Generation NCLEX questions?
Yes. Our bank includes unfolding case studies, matrix, bowtie, and select-all-that-apply items alongside standard single-answer questions, matching the item types on the exam since April 2023.
Are these questions really free?
The 10 questions on this page are free with no account. A free account adds 50 more questions, full rationales, and your weak topics, and it never asks for a card.
50 free questions. No card.
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