FREE NCLEX Exam Practice Questions for 2024

To become an RN, you need to pass NCLEX. It’s a comprehensive, adaptive test that can last for anywhere from 75 to 265 questions. Due to the computerized nature of the exam, no two NCLEX tests are the same. Many nursing students, very understandably, find the test to be a little daunting. When you decide to take the test, know that we’re here for you.

We can’t tell you what specific questions are going to be on the NCLEX when you take it. The National Council of State Boards of Nursing keeps those questions secret. What we can do, though, is tell you the types of questions you’re going to encounter and give you a few examples from previous tests. We scoured sites like Kaplan and Khan Academy (both of which are great resources for anyone studying for the NCLEX) for previously used questions.

1. Prioritization

Several questions on the NCLEX will ask you to evaluate and make decisions about your care environment, patient safety, and priorities for care. For example, here’s a question about management of care:

After receiving a report from the night nurse, which of the following clients should the nurse see FIRST?

• A 31-year-old woman refusing sucralfate before breakfast
• A 40-year-old man with left-sided weakness asking for assistance to the commode
• A 52-year-old woman complaining of chills who is scheduled for a cholecystectomy
• A 65-year-old man with a nasogastric tube who had a bowel resection yesterday

Answer: C, the least stable patient.

2. Illness and disease

Nurses will encounter a great deal of illnesses throughout their career, and it’s important to know the right solutions for addressing each problem. This question about allergies tests your ability to respond to information provided by a patient.

A client tells the nurse that she is allergic to eggs, dogs, rabbits, and chicken feathers. Which order should the nurse question?

• TB skin test
• Rubella vaccine
• ELISA test
• Chest X-ray

Answer: B. Preventable adverse drug events are associated with one out of five injuries or deaths. Associating medications with known allergic reactions will help protect the patients in your care.

3. Diagnosis

Evaluating and diagnosing patients is a part of daily life for many nurses. Knowing what symptoms point to larger maladies is an essential skill. Expect more than a few NCLEX questions like this one:

Which of these assessment findings should the healthcare provider expect to identify as an early clinical characteristic of multiple sclerosis (MS)?

• Vision loss
• Dementia
• Muscle atrophy
• Clonus

Answer: A. Vision problems are often the first sign of MS in many patients. Understanding the progression of a degenerative illness can mean the difference between catching something in its earliest stages or only noting changes in stages as an illness progresses.

4. Treatment Plans and Patient Communication

Nurses are the ones who meet with patients after major treatments and instruct them on how to proceed in their daily lives. It’s very likely that the NCLEX will quiz advice you might give patients following major medical events, like the following:

Which interventions are most likely to promote maximum self-care for a patient recovering from a stroke? Select all that apply.

• Encourage participation in activities of daily living.
• Educate patient on risks of repeat stroke.
• Assess neurological function every shift.
• Assist patient to track motor function and mobility levels.
• Provide adaptive equipment as indicated.

Answers: A, D, and E. Reintegrating a patient into daily living following a stroke, tracking their progress, and providing equipment as needed are the best ways to maximize self-care after a stroke.

5. Safety and Care Environment

Safety within a hospital or treatment center is crucial. The last thing anyone wants is for a patient’s time with healthcare providers to make their condition worse. Protocols and best practices are necessary to ensure healthcare workers have accurate information to provide the best care in the safest way possible. Those safety measures can even include how you find out a young patient’s name, like with this question:

The physician orders tobramycin sulfate 3 mg/kg IV every 8 hours for a 3-year-old boy. The nurse enters the client’s room to administer the medication and discovers that the boy does not have an identification bracelet. Which of the following should the nurse do?

• Ask the parents at the child’s bedside to state their child’s name.
• Ask the child to say his first and last name.
• Have a coworker identify the child before giving the medication.
• Hold the medication until an identification bracelet can be obtained.

Answer: A. A 3-year-old or a coworker may or may not be able to give you accurate information.

6. People Skills

Nursing is a people-oriented job. Nurses not only help treat physical diseases, they also have to interact with patients and their families at what are often stressful times. The NCLEX will very likely quiz you on your people skills and how you deal with potentially fraught interpersonal situations.

A 50-year-old male client comes to the nurses’ station and asks the nurse if he can go to the cafeteria to get something to eat. When told that his privileges do not include visiting the cafeteria, the client becomes verbally abusive. Which of the following approaches by the nurse would be MOST effective?

• Tell the client to lower his voice, because he is disturbing the other clients.
• Ask the client what he wants from the cafeteria and have it delivered to his room.
• Calmly but firmly escort the client back to his room.
• Assign the nursing assistive personnel (NAP) to accompany the client to the cafeteria.

Answer: C. Nurses should never reinforce abusive behavior. Hospital stays can be stressful, and it’s likely that at some point you’ll be faced with patients or family members who are in the grip of anger, frustration, or hopelessness.

7. Procedures and Physiological Adaptation

No NCLEX would be complete without a few questions about basic procedures.

The nurse delivers external cardiac compressions to a client while performing cardiopulmonary resuscitation (CPR). Which of the following actions by the nurse is BEST?

• Maintain a position close to the client’s side with the nurse’s knees apart.
• Maintain vertical pressure on the client’s chest through the heel of the nurse’s hand.
• Re-check the nurse’s hand position after every 10 chest compressions.
• Check for a return of the client’s pulse after every 8 breaths by the nurse.

Answer: B. Improper pressure could cause injury; proper positioning could save a broken rib or two. When going through your mental checklist, add your own stance as something to adjust before applying force.

8. Interpreting Information

As a nurse, you’ll encounter all kinds of data every day, and you’ll need to be familiar with it. Before sitting for the NCLEX, be ready for plenty of questions like this one:

The results of an adult patient’s blood pressure screening on three occasions are 120/80 mmHg, 130/76 mmHg, and 118/86 mmHg. How will the healthcare provider interpret this information?

• Normal blood pressure
• Hypertension Stage 2
• Hypertension Stage 1
• Prehypertension

Answer: D. The patient’s blood pressure is high, but it’s not yet at the point of hypertension. Diagnosis is only half the battle, though. Predicting where a patient is heading can greatly increase their wellbeing, or even save their life.

9. Identifying Tools and Terminology

As a healthcare provider you’ll have a large array of tools at your disposal. The NCLEX will ask you about them, like with this question about psychotic disorders:

The healthcare provider is assessing a patient using the Global Assessment of Functioning (GAF) scale. Which of these patient characteristics will the GAF measure?

• Overall physical health status
• Performance of activities of daily living without pain
• Ability to have friends and keep a job
• Current nutritional and hydration status

Answer: C. The GAF scale assesses the ability of mental health patients to function in a variety of ways, mostly social and professional. It does not include physical health, pain, nutrition, or hydration.

10. Patient Advice

Lastly, one of the most important things that nurses do is advise patients on what to do to promote health and wellbeing. Nearly every NCLEX will likely have one question like the following:

A patient with a diagnosis of lung cancer is receiving chemotherapy and reports nausea and loss of appetite resulting in decreased food intake. What should the healthcare provider recommend to promote adequate nutrition? Advise the patient to:

• Eat small meals throughout the day.
• Eat only when feeling hungry.
• Eat only favorite foods to increase appetite.
• Eat large meals but less frequently throughout the day.

Answer: A. This option will be easiest for the patient, and healthier than eating favorite foods, which could be of varying nutritional content.

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