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NCLEX-RN Exam Questions
- Topic 1: Safe and Effective Care Environment: This section of the exam measures skills of Registered Nurses and covers how to manage client care while maintaining a safe and effective healthcare environment. It includes Management of Care, which assesses coordination with interdisciplinary teams, delegation, legal responsibilities, and resource utilization. It also includes Safety and Infection Control, focusing on minimizing risk to clients and staff through infection prevention, safe equipment use, emergency procedures, and addressing environmental hazards.
- Topic 2: Health Promotion and Maintenance: This section of the exam measures skills of Clinical Nurse Educators and covers strategies to support wellness and prevent disease. It includes client education across age groups, prenatal and postnatal care, and community health promotion. Nurses are tested on performing screenings, recognizing risk factors, and adapting education based on learning needs and readiness.
- Topic 3: Psychosocial Integrity: This section of the exam measures skills of Mental Health Nurses and covers emotional, mental, and social well-being. It includes assessing psychological needs, substance use, abuse, grief, and coping challenges. The nurse must use therapeutic communication, recognize psychosocial stressors, and support clients with behavioral disorders while maintaining cultural sensitivity.
- Topic 4: Physiological Integrity: This section of the exam measures skills of Acute Care Nurses and focuses on maintaining physical health through four subdomains. Basic Care and Comfort assesses support with daily living tasks and comfort measures. Pharmacological and Parenteral Therapies covers safe medication administration and client monitoring. Reduction of Risk Potential evaluates the ability to detect and prevent complications. Physiological Adaptation tests management of clients with acute, chronic, or life-threatening health conditions using clinical interventions.
Free NCLEX NCLEX-RN Exam Actual Questions
Note: Premium Questions for NCLEX-RN were last updated On May. 19, 2025 (see below)
A client on the infectious disease unit is discussing transmission of human immunodeficiency virus (HIV).
The nurse would need to provide more client education based on which client statement?
(A) HIV is transmitted through unprotected sexual contact. (B) Condoms are an effective barrier to prevent HIV transmission. (C) HIV is not easily transmitted by casual contact. (D) HIV can be transmitted intrauterinely at the time of delivery, and by breast-feeding.
A female client decides on hemodialysis. She has an internal vascular access device placed. To ensure patency of the device, the nurse must:
(A) This is an internal device. Assessment of the site should include assessing for swelling, pain, warmth, and discoloration. This measure does not assess patency. (B) The presence of a bruit indicates good blood flow through the device. (C) The nurse should inspect the site for bruising or hematoma; however, this measure does not assure patency of the device. (D) The nurse should inspect the vascular access site frequently for signs of infection. However, this does not assure patency.
The nurse who is caring for a client with pneumonia assesses that the client has become increasingly irritable and restless. The nurse realizes that this is a result of:
(A) Maintaining bed rest helps to decrease the O2 needs of the tissues, which decreases dyspnea and workload on the respiratory system. (B) The semi-Fowler or high-Fowler position is necessary to aid in lessening pressure on the diaphragm from the abdominal organs, which facilitates comfort and easier breathing patterns. (C) Cerebral hypoxia causes the client with pneumonia to be increasingly irritable and restless and results from the client not obtaining enough O2 to meet metabolic needs. (D) Proper hydration facilitates liquefaction of mucus trapped in the bronchioles and alveoli and enhances expectoration. Unless contraindicated, a reasonable amount of IV fluids to be administered is at least 2.5--3 liters in a 24-hour period.
When evaluating a client with symptoms of shock, it is important for the nurse to differentiate between neurogenic and hypovolemic shock. The symptoms of neurogenic shock differ from hypovolemic shock in that:
(A) Neurogenic shock is caused by injury to the cervical region, which leads to loss of sympathetic control. This loss leads to vasodilation of the vascular beds, bradycardia resulting from the lack of sympathetic balance to parasympathetic stimuli from the vagus nerve, and the loss of the ability to sweat below the level of injury. In neurogenic shock, the client is hypotensive but bradycardiac with warm, dry skin. (B) In hypovolemic shock, the client ishypotensive and tachycardiac with cool skin. (C) In hypovolemic shock, the capillary refill would be>5 seconds. (D) In neurogenic shock, there is no capillary delay, the vascular beds are dilated, and peripheral flow is good.
A postoperative prostatectomy client is preparing for discharge from the hospital the next morning. The nurse realizes that additional instructions are necessary when he states:
(A) This is correct health teaching. Drinking 10--12 glasses of clear liquid will help increase urine volumes and prevent clot formation. (B) This is correct health teaching. These types of exercises are prescribed by physicians to assist postprostatectomy clients to strengthen their perineal muscles. (C) This action is not recommended post-TURP because of the close proximity of the prostate and rectum. (D) This is correct healthcare teaching. The client should limit walking long distances, lifting heavy objects, or driving a car until these activities are cleared by the physician at the first office visit.
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3 hours ago