NCLEX-RN — Free Study Materials
Free NCLEX-RN practice questions, study guides, and flashcards covering pharmacology, patient safety, care management, and all test plan categories.
Practice makes permanent. Select the best answer for each question. No account needed — completely free.
A patient with a nasogastric tube reports nausea and the tube is patent. What is the nurse’s first action?
A patient is prescribed digoxin. Before administering, the nurse notes a heart rate of 52 bpm. What should the nurse do?
A postoperative patient has shallow breathing and is reluctant to cough. What intervention takes priority?
A client is admitted with diabetic ketoacidosis (DKA). Which assessment finding is expected?
A patient with a new colostomy refuses to look at the stoma. What is the most appropriate nursing response?
A patient prescribed warfarin is found to have an INR of 7.5. What is the nurse’s priority action?
A child with a fever of 103.2°F is brought to the clinic. The parent says the child has had ibuprofen at home. What is the nurse’s first action?
A patient is receiving a blood transfusion and reports chills and flank pain. What should the nurse do first?
A patient with cirrhosis develops asterixis (liver flap). This indicates which complication?
Which behavior indicates a child is in the preoperational stage of cognitive development (ages 2-7)?
A patient with a history of falls is admitted. What is the most effective nursing intervention?
A patient with COPD is being discharged. Which instruction is most important to prevent exacerbation?
Quick Summary
NCLEX uses Computerized Adaptive Testing (CAT). Questions test higher-order thinking. Key categories: Safe & Effective Care, Health Promotion, Psychosocial Integrity, Physiological Integrity. Master prioritization and delegation.
The NCLEX-RN uses Computerized Adaptive Testing (CAT) — the computer selects questions based on your ability. The exam ranges from 75 to 145 questions. You pass when the computer is 95% confident you've met the competency threshold.
Test Plan Categories
**Safe and Effective Care Environment** (~24%): Management of care, safety and infection control. Know how to prioritize, delegate, and communicate with the healthcare team.
**Health Promotion and Maintenance** (~9%): Growth and development, disease prevention, health screening. Know developmental milestones, expected growth patterns, immunizations.
**Psychosocial Integrity** (~9%): Mental health concepts, coping, grief/loss, therapeutic communication. Cultural competence is essential.
**Physiological Integrity** (~58%): Basic care and comfort, pharmacology, reduction of risk potential, physiological adaptation. This is where most questions live.
Critical Thinking Framework: SATA (Select All That Apply)
SATA questions often test which actions are appropriate. Common pattern: 3-4 correct answers out of 6 options. Strategies:
- Read each option independently — don't compare
- True means it IS indicated/appropriate
- Look for options that are clearly unsafe or contraindicated
- "All of the following EXCEPT" — choose the one that is NOT true
Key Clinical Priorities
**ABCs first**: Airway, Breathing, Circulation. A patient with an occluded airway is always the top priority.
**Maslow's Hierarchy**: Physiological needs come before safety, love/belonging, esteem, self-actualization.
**Acute vs. Chronic**: New/worsening symptoms take priority over stable chronic conditions.
**Unstable vs. Stable**: Unstable patients require immediate intervention — vital signs outside normal ranges, sudden changes in LOC.
Top Drug Classifications to Know
- **Anticoagulants**: Heparin, warfarin, enoxaparin — monitor for bleeding
- **Cardiac glycosides**: Digoxin — monitor HR, signs of toxicity
- **Insulin**: Know onset, peak, duration — hypoglycemia management
- **Opioids**: Respiratory depression is the primary concern — have naloxone available
- **Diuretics**: Monitor K+, assess for orthostatic hypotension
Delegation Framework
RN tasks (ASSESS, teaching, care planning, evaluation): Cannot be delegated.
LPN tasks (stable patients, medication administration per protocol, data collection): Can be delegated but RN is accountable.
UAP tasks (ADLs, vital signs if stable, feeding, hygiene): Can be delegated.
Common NCLEX Traps
1. "Document and monitor" — usually wrong when a patient is unstable
2. "Call the physician" — only correct after you've done your assessment and nursing interventions
3. "Administer medication" — always check the 6 rights + patient ID + assess first
4. Ignoring a patient complaint is never the answer
5. Never assume — always assess before acting
How to Study
Focus on rationale, not memorization. For every question you get wrong (or right), understand why. Use the SATA format for all question types — it's how NCLEX thinks.
Click the card to flip. Use arrows or buttons to navigate.