RN NCLEX Exam

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Sample questions from RN NCLEX Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with pneumonia whose temperature is 38.1 C (100.6 F) and who is due for acetaminophen
   • B.A client with chronic heart failure who has bilateral ankle edema and oxygen saturation of 95% on room air
   • C.A client 2 hours after thyroidectomy who reports tingling around the mouth
   • D.A client 1 day after abdominal surgery who has not had a bowel movement

   Rationale: Perioral tingling after thyroidectomy can signal hypocalcemia from parathyroid injury and may precede laryngospasm, so this client needs prompt assessment. The stable oxygenation and chronic edema, fever with a scheduled antipyretic, and expected postoperative constipation are less urgent. Prioritize a potentially life-threatening airway complication over stable or expected findings.

2. 2.On a medical-surgical unit, a charge nurse is assigning care for the shift. Which tasks are appropriate to delegate to an experienced unlicensed assistive personnel (UAP)? Select all that apply.

   • A.Ambulate a stable client who has already been assessed and cleared for activity
   • B.Obtain routine vital signs for a stable client awaiting discharge
   • C.Assess a newly admitted client for fall risk
   • D.Assist a stable client with bathing
   • E.Teach a client how to use an incentive spirometer
   • F.Measure and record the intake and output of a stable client

   Rationale: Routine vital signs, ambulation of a client already assessed as safe, intake and output measurement, and bathing are predictable tasks appropriate for a competent UAP. Teaching and initial fall-risk assessment require nursing judgment and cannot be delegated. The RN remains responsible for interpreting findings and following up on unexpected results.

3. 3.In an outpatient clinic, a client with limited English proficiency is scheduled to sign consent for a procedure. The client speaks little English, and a bilingual adult child offers to translate. Which action should the nurse take?

   • A.Arrange for a qualified medical interpreter and remain present during the discussion
   • B.Use a translation application to explain the risks and alternatives
   • C.Ask the adult child to interpret because the client trusts the child
   • D.Ask the client to sign and document that the adult child offered to interpret

   Rationale: A qualified medical interpreter supports accurate communication and informed consent while protecting confidentiality. A family member may omit or alter information, and an application is not an adequate substitute for a trained interpreter for consent. Signing without understanding does not establish informed consent.

4. 4.A home health RN is planning care for an older adult with heart failure who has had two recent hospitalizations. Which actions support effective coordination of care? Select all that apply.

   • A.Coordinate a follow-up appointment before ending the visit
   • B.Include the client's stated goals in the care plan
   • C.Reconcile the client's medication list with the bottles in the home
   • D.Send the complete clinical record to every community agency without obtaining permission
   • E.Ask the client to identify symptoms that should prompt a call to the provider
   • F.Tell the client to stop all prescribed diuretics if urination is inconvenient

   Answer and rationale are in the full material.

5. 5.A provider prescribes a medication dose that appears substantially higher than the usual dose for a 6-year-old client. The medication is due now, and the client is stable. What should the nurse do first?

   • A.Ask the parent whether the child has taken this dose before
   • B.Administer the dose because the prescription is signed
   • C.Give half the prescribed dose and document the change
   • D.Hold the dose and clarify the prescription with the provider

   Answer and rationale are in the full material.