Free NCLEX practice questions with rationales

Here are 18 free NCLEX-RN practice questions with the answer and a reason for every option. They cover all eight Client Needs areas of the 2026 test plan. Answer each one, then check it. You do not need an account.

Sources checked 18 October 2026.

About these questions

Medibara wrote these questions on 18 October 2026. They are original. None is taken or recalled from the exam. Each rationale names the reference it rests on. A nurse educator has not reviewed them yet, so if a rationale disagrees with your course material, follow your course and tell us.

The set has 13 multiple-choice questions, 4 select-all-that-apply questions and 1 calculation. It uses US units, such as mg/dL and mEq/L, as the NCLEX-RN does. A short set shows you the format and your gaps. It cannot predict your result.

18 free NCLEX-RN practice questions

1. Question 1Multiple choiceManagement of Care
   After the morning report, which client should the registered nurse (RN) assess first?

   A client with chronic obstructive pulmonary disease whose oxygen saturation is 90% on 2 L/min, the same as yesterday.A client on day 1 after abdominal surgery who is newly anxious, with a respiratory rate of 30/min, a heart rate of 118/min and sudden sharp chest pain.A client with type 2 diabetes whose capillary glucose before lunch is 210 mg/dL.A client being discharged today who needs teaching on a new inhaler.
   Check answer
2. Question 2Multiple choiceManagement of Care
   The RN is working with unlicensed assistive personnel (UAP). Which task can the RN delegate to the UAP?

   Measuring and recording intake and output for a client whose condition is stable.Completing the admission assessment of a client just arrived from the emergency department.Teaching a client how to give an enoxaparin injection at home.Evaluating whether a PRN pain medication worked.
   Check answer
3. Question 3Multiple choiceManagement of Care
   A client scheduled for surgery in one hour says, "I signed the form, but I don't really know what they are going to do." What should the nurse do?

   Explain the surgery to the client in detail.Tell the client the form is already signed, so surgery can go ahead.Notify the surgeon so that the client's questions are answered before surgery.Ask a family member to explain the surgery.
   Check answer
4. Question 4Multiple responseSafety and Infection Prevention and Control
   A client is admitted with suspected pulmonary tuberculosis. Which actions should the nurse take? Select all that apply.

   Place the client in an airborne infection isolation room.Wear a fit-tested N95 respirator or higher when entering the room.Keep the door of the room closed.Place a surgical mask on the client for transport out of the room.Put the client in a semi-private room with another client who has a cough.
   Check answer
5. Question 5Multiple choiceSafety and Infection Prevention and Control
   A client has diarrhea, and Clostridioides difficile infection is suspected. Which action by the nurse is correct?

   Wear gloves and a gown on entering the room, even for a short visit.Rely on alcohol-based hand rub after leaving the room.Use droplet precautions and a surgical mask.Wait for the stool test result before starting precautions.
   Check answer
6. Question 6Multiple choiceHealth Promotion and Maintenance
   Four hours after a vaginal birth, the nurse finds the fundus firm, 2 fingerbreadths above the umbilicus and deviated to the right. Lochia is heavier than expected. What should the nurse do first?

   Assist the client to the bathroom to empty her bladder.Insert an indwelling urinary catheter.Call the provider to report a postpartum hemorrhage.Document the findings as expected and reassess in four hours.
   Check answer
7. Question 7Multiple choiceHealth Promotion and Maintenance
   The parent of a 14-month-old asks when to turn the car seat to face forward. Which reply by the nurse is correct?

   "Turn it around now. Twelve months is the usual age.""Keep the seat rear-facing until your child reaches the highest weight or height that the seat allows.""Turn it once your child weighs 20 pounds.""Turn it when your child's legs touch the back seat."
   Check answer
8. Question 8Multiple choicePsychosocial Integrity
   A client with major depression has seemed brighter for two days. Today the client gives a watch to a roommate and says goodbye to the staff. What should the nurse do first?

   Praise the client for the improved mood.Ask the client directly whether they are thinking of killing themselves.Return the watch to the client.Document the behavior and continue to observe.
   Check answer
9. Question 9Multiple responsePsychosocial Integrity
   A client admitted two days ago drank alcohol heavily until admission. The client is now tremulous and sweating, with a heart rate of 124/min, and says insects are crawling on the wall. Which actions should the nurse take? Select all that apply.

   Give the prescribed benzodiazepine.Assess withdrawal severity with a tool such as the CIWA-Ar.Start seizure precautions.Apply four-point restraints at once.Encourage the client to attend group therapy this afternoon.
   Check answer
10. Question 10Multiple responseBasic Care and Comfort
    A client receives continuous feeding through a nasogastric tube. Which actions reduce the risk of aspiration? Select all that apply.

    Keep the head of the bed at 30 to 45 degrees unless contraindicated.Check tube placement every 4 hours and before giving medications, per policy.Confirm placement by injecting air and listening over the stomach.Stop the feeding and notify the provider if the client develops new coughing or breathing problems.Flush a clogged tube with cranberry juice.
    Check answer
11. Question 11Multiple choiceBasic Care and Comfort
    The nurse sees that a client's urinary drainage bag is lying on the floor next to the bed. What should the nurse do?

    Hang the bag on the bed frame below the level of the bladder.Hang the bag on the side rail at the level of the client's chest.Clamp the tubing until the bag is emptied.Leave the bag on the floor so it cannot pull on the catheter.
    Check answer
12. Question 12Multiple choicePharmacological and Parenteral Therapies
    Before giving digoxin, the nurse counts an apical pulse of 52/min in an adult client. What should the nurse do?

    Give the dose and recheck the pulse in an hour.Hold the dose and notify the prescriber.Give half the dose.Have the client walk, then recount the pulse.
    Check answer
13. Question 13Fill-in-the-blank calculationPharmacological and Parenteral Therapies
    Vancomycin 1 g in 250 mL is prescribed to infuse over 2 hours. At what rate should the nurse set the infusion pump? Record your answer as a whole number.

    Your answer, in mL/hr
    Check answer
14. Question 14Multiple responsePharmacological and Parenteral Therapies
    A client receives morphine after surgery. Which adverse effects should the nurse monitor for? Select all that apply.

    Respiratory depressionSedationConstipationNausea and vomitingHypertension
    Check answer
15. Question 15Multiple choiceReduction of Risk Potential
    The day after a total thyroidectomy, a client reports tingling around the mouth and in the fingertips. What should the nurse do?

    Reassure the client that this is a normal effect of anesthesia.Assess for signs of hypocalcemia and report to the provider.Place the client flat in bed.Give the prescribed levothyroxine early.
    Check answer
16. Question 16Multiple choiceReduction of Risk Potential
    Ten minutes into a transfusion of packed red blood cells, the client reports chills and low back pain. What should the nurse do first?

    Slow the transfusion and recheck vital signs in 15 minutes.Stop the transfusion and keep the IV line open with normal saline.Give the prescribed acetaminophen and continue.Send the client's blood sample, then stop the transfusion.
    Check answer
17. Question 17Multiple choicePhysiological Adaptation
    A client with kidney failure has a serum potassium of 6.8 mEq/L and peaked T waves on the monitor. Which prescription should the nurse give first?

    IV calcium gluconateOral sodium polystyrene sulfonateFurosemide IVA low-potassium diet
    Check answer
18. Question 18Multiple choicePhysiological Adaptation
    A client in diabetic ketoacidosis has a glucose of 520 mg/dL, a potassium of 5.2 mEq/L and an arterial pH of 7.18. Which prescription should the nurse start first?

    0.9% sodium chloride IV bolusSodium bicarbonate IVPotassium chloride IVRegular insulin subcutaneously
    Check answer

What the NCLEX-RN test plan covers

NCSBN's 2026 NCLEX-RN test plan applies from 1 April 2026 to 31 March 2029. It groups content into four Client Needs categories and eight subcategories. Each one gets a share of the questions.

Management of Care and pharmacology are the two largest areas, so this set gives them three questions each. Clinical judgment is measured on top of these areas, through case studies and stand-alone items.

How the adaptive exam works

The NCLEX-RN is a computerized adaptive test (CAT). After each answer, the computer estimates your ability again and picks the next question to match it. You cannot go back to a question after you move on.

• Every candidate answers at least 85 questions and at most 150, within five hours. The five hours include all breaks.
• The minimum exam has 52 questions from the eight content areas, 18 questions in three clinical judgment case studies, and 15 unscored pretest questions that you cannot tell apart from the scored ones.
• The exam usually stops when the computer is 95% certain that your ability is clearly above or clearly below the passing standard. If it stays unsure, you answer all 150 questions and your final ability estimate decides.
• The length of your exam does not tell you whether you passed. You can pass or fail at any length.

More detail is in how many questions are on the NCLEX and how long the NCLEX is.

Question types and NGN case studies

A case study gives you one client whose situation unfolds over six questions. Each question tests one step of NCSBN's clinical judgment model: recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action and evaluate outcomes. Stand-alone clinical judgment items, such as bow-tie and trend items, test the same thinking in one question.

Next Generation NCLEX items include extended multiple response, drag and drop, drop-down (cloze), highlight, matrix, bow-tie and trend formats. Classic multiple-choice, multiple-response (select all that apply) and calculation items still appear. NCSBN says there is no set percentage of each format. To see every format before exam day, use the tutorial and sample items on NCLEX.com.

Select-all-that-apply questions earn partial credit. See how SATA questions are scored for the rules and a worked example.

What to study next

• Priority questions: which client to assess first and prioritization and delegation.
• Pharmacology: the NCLEX pharmacology cheat sheet and the dosage calculation calculator, with worked steps and practice problems.
• Electrolytes: hyperkalemia ECG changes and hypokalemia ECG changes.
• Memory aids: nursing mnemonics.
• A schedule: the study plan builder weights your weeks by the table above.

To keep going after these 18, use Medibara for a few questions every day. Each round is a short lesson, then questions in your exam's format, and Ask Cappy, the tutor, explains a rationale you are unsure of. Free accounts get 10 answers from Cappy a day. REx-PN rounds are open now. NCLEX-RN rounds are being written. Start learning on Medibara.

Questions about NCLEX practice questions

How many questions are on the NCLEX-RN?

Between 85 and 150. The minimum exam has 52 content questions, 18 questions in three clinical judgment case studies and 15 unscored pretest questions. The exam stops when the computer is 95% certain of a pass or a fail, or at 150 questions, or when the five hours run out.

Are free NCLEX practice questions as good as paid ones?

A free set shows you the format and your weak areas. It is too small to prepare you on its own. Look for questions that explain every option and name a source, and avoid anyone who sells recalled exam questions.

How many practice questions should I do before the NCLEX?

NCSBN publishes no number. A question bank is useful when you read every rationale, including the ones you got right, and track which test plan areas you miss. Finishing a set number of questions matters less.

Does the NCLEX-RN have select-all-that-apply questions?

Yes. NCSBN calls them multiple-response items. They score with partial credit: you gain a point for each correct option you select and lose a point for each incorrect one, and the score on a question cannot go below zero.

Is there math on the NCLEX-RN?

Yes. The test plan includes calculations for medication administration. Each calculation item tells you whether to give a whole number or one to two decimal places, and you round only at the end.