A registered nurse on a medical-surgical unit is planning care with an assistive personnel (AP). Which task is appropriate for the nurse to delegate to the AP?

Measuring and recording vital signs for a client whose condition has been stable for two days after knee surgery

Teaching a client with newly diagnosed diabetes how to draw up and inject insulin so the client can practice before going home tomorrow

Performing the admission skin assessment of a client who arrived on the unit one hour ago

Deciding whether a client's pain medication given an hour ago relieved the pain enough

A client is about to sign the consent form for surgery and tells the nurse, "I'm not really sure what the surgeon is going to do or what could go wrong." What is the nurse's best action?

Hold the signing and notify the surgeon that the client needs more information before giving consent

Explain the surgery's risks, benefits and alternatives to the client in simple words, then witness the client's signature on the form

Reassure the client that the surgery is routine and have the client sign the form

Ask a family member to sign the form on the client's behalf

A caller tells the nurse she is the sister of a client admitted yesterday and asks how the client is doing. The hospital uses a client-chosen code word for telephone updates. What should the nurse do?

Ask the caller for the client's code word and share information only if she provides it

Give a brief general update without details about tests, because the caller is a close relative and family support helps the client

Transfer the call to the client's room phone without asking any questions

Confirm the client's diagnosis but say nothing about the treatment plan

A nurse is caring for a client with Clostridioides difficile (C. diff) infection. How should the nurse clean their hands after leaving the room?

Use alcohol-based hand sanitizer only

Rely on the gloves worn in the room instead of hand hygiene

Wipe the hands with a disinfectant made for surfaces

Before giving a medication, which method correctly identifies the client?

Ask the client's full name and date of birth and compare them with the wristband and medication record

Check the room and bed number on the assignment sheet and confirm that they match the room and bed listed on the medication record

Call the client by name and give the medication once the client answers to that name

Ask the client's roommate to confirm the client's name before giving the medication

Which action best reduces the risk of a fall for an older client who is drowsy after receiving an opioid?

Keep the bed in its lowest position with the call light within reach

Raise the bed to the nurse's working height and leave

Close the door and turn off the lights so the client can rest without interruption until the medication wears off

Tell the client to walk to the bathroom alone to stay active

Two hours after a vaginal birth, a client reports heavier bleeding. The nurse finds the fundus firm, above the umbilicus and deviated to the right. What should the nurse do first?

Help the client empty her bladder, then reassess the fundus

Massage the fundus firmly until it moves back to midline

Place the client flat and elevate her legs

Apply an ice pack to the perineum and recheck in 1 hour

A client who has just been told she has breast cancer is sitting quietly and crying. Which statement by the nurse is most therapeutic?

"This news seems very hard to hear. I'll stay with you. What is going through your mind right now?"

"Don't worry. Everything is going to be fine."

"Why are you so upset? The doctor said it was caught early."

"If I were you, I would get a second opinion right away."

A client with major depression started an antidepressant 2 weeks ago. Today he is suddenly cheerful and energetic and has given his guitar to his roommate. What is the nurse's priority action?

Ask the client directly whether he is thinking about suicide and whether he has a plan

Document that the medication is working and his mood has improved

Encourage him to join more group activities now that he has more energy

Tell the roommate to return the guitar to prevent conflict

A client with weakness in the left leg is learning to walk with a single-tip cane. Which instruction is correct?

Hold the cane in your right hand and move it forward together with your left leg

Hold the cane in your left hand and move it with your left leg

Hold the cane in your right hand and move it with your right leg

Hold the cane in either hand and move it after both legs

A client is bedbound after a stroke and cannot change position without help. What is the minimum repositioning schedule the nurse should plan?

At least every 2 hours, with a skin assessment at each position change

Every 4 hours, with a skin check once a day

Only when the client reports discomfort

A nurse is about to give the scheduled oral digoxin dose to an adult client with heart failure. The apical pulse, counted for 1 full minute, is 54 beats/min. What should the nurse do?

Withhold the dose and notify the health care provider

Give the dose and recheck the pulse in 1 hour

Give half of the dose and document the pulse

Give the dose with a potassium-rich snack

A client is prescribed regular insulin and NPH insulin to be given in one syringe. After injecting the right amount of air into each vial, which insulin should the nurse withdraw first?

The regular (clear) insulin, then the NPH (cloudy) insulin

The NPH (cloudy) insulin, then the regular (clear) insulin

Either one first, as long as the total number of units is correct

Neither; the two insulins must always be given as separate injections

A client with a serum potassium of 3.1 mEq/L has a prescription for intravenous potassium chloride. Which statement about giving this medication is correct?

It must be given diluted, as an infusion on a pump, and never by IV push

It can be given by IV push over 1 minute if the dose is small

It can be pushed through a saline lock as long as the line is flushed afterward

It is safe to give by IV push because the client's potassium is low

A client with heart failure is due for oral furosemide. The morning serum potassium is 3.0 mEq/L. What should the nurse do?

Hold the furosemide and notify the provider of the low potassium

Give the furosemide as scheduled

Give the furosemide with a glass of orange juice instead of water

Give double the dose to remove more fluid

A provider has just inserted a central venous catheter through the right subclavian vein so a client can begin total parenteral nutrition (TPN). The TPN bag has arrived on the unit. What must happen before the nurse starts the TPN through the new line?

Confirm that a chest x-ray has been read and shows correct catheter placement

Start the TPN at a slow rate and watch the client for problems

Wait until the client's next meal so the TPN is given with food

Start the TPN as soon as the line flushes without resistance

During a morning assessment on a medical-surgical unit, the nurse finds that a client's face droops on the left side, the client's speech is slurred, and the left arm is weaker than the right. These findings were not present at the last check. What should the nurse do first?

Activate the facility's emergency stroke response

Give the client a few sips of water to check swallowing

Give the client's scheduled oral morning medications

Lower the head of the bed flat and recheck in 30 minutes

Minutes after an IV antibiotic is started, a client develops hives, wheezing, swelling of the lips, and a drop in blood pressure. The nurse stops the infusion. Which medication should the nurse expect to give next?

Intramuscular epinephrine in the outer (anterolateral) thigh

Free NCLEX Practice Questions (NCLEX-RN) with Explanations

NCLEX-RN format

Variable length (computerized adaptive test): at least 85 and at most 150 items. A minimum-length exam has 52 content-area items, 18 case-study items (3 case studies of 6 items) and 15 unscored pretest items.

NCLEX-RN	Official rule
Number of items	85 minimum, 150 maximum; the computer decides the length from your answers, and the length alone does not tell you whether you passed source
Unscored items	15 unscored pretest items on every exam, in the same style and format as scored items, so you cannot tell them apart source
Minimum-length exam	52 items from the eight content areas + 18 clinical judgment case-study items (3 case studies of 6 items) + 15 pretest items = 85 source
Time limit	5 hours in total, including the introductory screen and all breaks; optional breaks are offered after about 2 hours and 3.5 hours of testing, and the clock keeps running during breaks source
Test plan in force	2026 NCLEX-RN Test Plan, effective April 1, 2026 through March 31, 2029; content-area percentages are unchanged from the 2023 plan, and Safety and Infection Control is now named Safety and Infection Prevention and Control source
Content areas	Management of Care 15-21%, Safety and Infection Prevention and Control 10-16%, Health Promotion and Maintenance 6-12%, Psychosocial Integrity 6-12%, Basic Care and Comfort 6-12%, Pharmacological and Parenteral Therapies 13-19%, Reduction of Risk Potential 9-15%, Physiological Adaptation 11-17% source
Clinical judgment	Measured by 3 case studies of 6 items each, one item per step of the NCSBN Clinical Judgment Measurement Model (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, evaluate outcomes), plus about 10% stand-alone items source
How it stops	95% confidence rule (most common): stops once the computer is 95% certain you are clearly above or below the passing standard; maximum-length rule: at 150 items, the final ability estimate decides; run-out-of-time rule: fewer than 85 items answered is a fail, otherwise the final ability estimate decides source
Passing standard	0.00 logits for the NCLEX-RN, upheld by the NCSBN Board of Directors through March 31, 2029; there is no fixed percentage of candidates who pass source
Item formats and scoring	Items come in multiple formats, including multiple response (select all that apply) and calculation items, and may include charts, tables and graphics; items with more than one key earn partial credit (plus/minus, zero/one or rationale scoring). You cannot skip an item or go back to a previous one source
Registration fee	$200 for candidates seeking U.S. licensure, paid to Pearson VUE (non-refundable); for registrations completed on or after Feb. 1, 2027 the fee becomes $350. Your board of nursing charges its own licensure fee source
Authorization to Test (ATT)	Sent by email once your board of nursing makes you eligible and you have registered with Pearson VUE; valid for a period set by the board (90 days on average) and cannot be extended source
Results	Official results come only from your board of nursing, within six weeks; in participating states, unofficial Quick Results are available two business days after the exam for $7.95 source
Retakes	At least 45 test-free days between attempts and up to eight attempts a year under NCSBN policy; some boards of nursing are stricter. Each retake is a new registration and fee source
Testing accommodations	Granted only by your board of nursing: request them in writing from the board before registering with Pearson VUE, and schedule only after your ATT lists them source

Checked on the official sources on October 3, 2026. Rules change: always confirm on the official site before test day.