NCLEX-style practice questions (RN) with answers and rationales
Practice questions on the content of the NCLEX-RN, the licensing exam for registered nurses in the United States and most of Canada, in a single-best-answer style with an explanation for every option. The course brings together fundamentals of care, safety and infection control, prioritization and delegation, pharmacology, lab values, adult medical-surgical nursing, maternity, pediatric and mental health nursing, and the calculations nurses are tested on: dosages, IV rates, fluids, assessment scores, blood gases and ECG strips.
Cram pack (PDF)Formula sheets, method steps and practice problems with full solutions, ready to print.
This is independent practice material. ExamProblems is not affiliated with or endorsed by the organisation that runs this exam, and the exam name is used only to describe the content.
About the exam and how to practise
The exam is built around what patients need rather than around school subjects. Broadly it asks whether you can keep the care environment safe (coordinating care, delegating, legal and ethical duties, preventing infection and injury), promote health and development from pregnancy to old age, support mental and emotional health, and care for the body: comfort and daily care, medications and IV therapy, preventing complications through vital signs, lab values and tests, and responding to sudden or life-threatening change. Physical care is the largest part, and clinical judgement runs through all of it: noticing the important cues, deciding what matters most and choosing the safest action.
The NCLEX is computer adaptive: each answer changes the difficulty of the next question, and the test ends as soon as it can decide whether you pass, so its length varies. Besides standard multiple-choice questions it uses formats such as select all that apply, ordering, calculations and case studies built around one patient. This course practises single-best-answer questions and calculations; it does not copy the exam interface, its question formats or its scoring.
Start each topic at the easy level until most answers are right, then move to the hard level, where cases combine assessment data with a priority decision. Read the explanation after every question, including the ones you got right, because the reasons why the other options are wrong carry over to new questions. Use “Practise this course” for mixed sets, and timed mock exams without hints in the last weeks before your test. Check the candidate information of the exam organisation for the current test plan and rules.
Read the last line of the question first: does it ask for the first action, the priority patient, or the finding that needs follow-up?
Assess before you act, unless the patient is in immediate danger; then act first and assess after.
Rank threats to airway, breathing and circulation above pain, anxiety and teaching, and unexpected findings above expected ones.
Learn the typical ranges of potassium, sodium, glucose, clotting tests and blood gases together with the drugs and actions linked to them.
In calculations, write the units in every step and round only the final answer, as far as the question asks.
Worked examples
Nursing fundamentalsEasy
What does "polyuria" mean?
APassing urine painfully or with a burning feeling
BPassing large amounts of urine
CPassing urine at night
DPassing no urine at all
Show hints
"Poly" means many or much.
Two wrong answers are now crossed out. One of the remaining two is right.
Show the answer and explanation
Why this is the answer
Polyuria is an abnormally large urine volume, seen for example in uncontrolled diabetes. Dysuria is painful urination, nocturia is passing urine at night and anuria is no urine.
Answer
B · Passing large amounts of urine
Infection control & patient safetyMedium
Before a blood transfusion is started, which check is required?
AThe patient signs the blood bag label to confirm their name before it is hung
BOne nurse checks the blood product against the order at the nurses’ station
CThe nurse checks only that the bag number matches the order
DThe patient’s identity is checked against the blood product and its paperwork at the bedside
Show hints
Most serious reactions come from giving blood to the wrong person.
Two wrong answers are now crossed out. One of the remaining two is right.
Show the answer and explanation
Why this is the answer
Wrong-patient transfusion can cause a fatal ABO reaction, so the final check is always done at the bedside, with positive patient identification against the product label, compatibility tag and order. Many US hospitals require two qualified people for this check, while UK guidance allows one trained person if positive identification is used. Local policy decides who checks.
Answer
D · The patient’s identity is checked against the blood product and its paperwork at the bedside
How practising works
“Practise this course” mixes problems from all its topics, like a real exam.
Every problem has new values, so you learn the method instead of an answer.
Stuck? Open a small hint first, and the full explanation only when you need it.
Mock exams are timed and have no hints, and you get your score and a full review at the end.