Author: Tanya Killian

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You should practice NCLEX® questions and various item types regularly to be most prepared for exam day. 
 	
Daily practice will help you determine your pain points and create a study plan to increase your competency in those areas. 
 	
Practice NCLEX® questions featured in this blog will give you an idea of what to expect on exam day. 




Do you find yourself finished with nursing school and question what to do now? How do I prep for the NCLEX®? Do I even need to prepare?  

The answer is simple, YES. Your new life motto until you take (and pass) the NCLEX-RN® exam is, “Practice NCLEX®, Practice NCLEX®, PRACTICE NCLEX®!” 

Practicing test-specific questions and taking readiness exams, or exams that mirror the NCLEX®, before exam day is vital to your success. It familiarizes you with the test format, question types, and style while empowering you to identify areas for further study. This practice sharpens your critical thinking skills as you apply essential nursing concepts, ultimately boosting your confidence and preparedness on test day and elevating your chances of passing the exam. 


Using NCLEX® practice questions is vital because it: 

 	
Helps you understand the exam format: NCLEX® questions are structured differently than standard multiple-choice questions, so practicing helps you get accustomed to their wording and structure. 
 	
Identifies knowledge gaps: Taking practice tests allows you to pinpoint specific areas of nursing knowledge that require more review. 
 	
Develops critical thinking skills: NCLEX® questions often require you to analyze situations and apply your knowledge, which practice questions help you refine. 
 	
Manages test anxiety: Regular practice can make you feel more comfortable with the exam environment, reducing anxiety on test day. 
 	
Assesses your readiness: Taking practice tests provides a realistic assessment of how prepared you are for the actual exam. 
 	
Builds test-taking strategies: Regular practice with NCLEX® questions helps you develop effective approaches for tackling questions on the actual exam. 
 	
Boosts confidence: Tracking your progress through practice tests can enhance your confidence and decrease anxiety on test day. 

Aim to tackle 200-400 practice NCLEX® questions each day, and make sure you use traditional and NGN NCLEX® item types. For more insight into the different item types read our blog, “Include These Item Types in Your NCLEX® Practice Questions.” 

Embrace the journey by taking at least two readiness exams: the first at the start of your NCLEX® preparation to establish a strong foundation for your study plan, and the second after completing around 1,500 practice questions. This approach will allow you to accurately assess your preparedness. 

When completing practice exams, make sure to answer questions and use readiness tests that cover all exam categories, both client need and clinical judgment.  
There are eight client need categories:  

 	
Management of care   
 	
Safety and infection control   
 	
Health promotion and maintenance   
 	
Psychosocial integrity   
 	
Basic care and comfort   
 	
Pharmacological and parenteral therapies   
 	
Reduction of risk potential   
 	
Physiological adaptation   

Additionally, you should incorporate the six clinical judgment categories:  

 	
Recognize cues   
 	
Analyze cues   
 	
Prioritize hypotheses   
 	
Generate solutions   
 	
Take actions   
 	
Evaluate outcomes   


Practice Questions to Review
I have 14 practice questions (one for each category) to help you get started and to get an idea of what to look for! 

1. Management of Care: The nurse is reviewing the Health Insurance Portability and Accountability Act (HIPAA) with a group of student nurses. Which of the following statements by a student indicates a need for further teaching? 

 	
A. “A client’s phone number is an example of personal identifiable information that is protected by HIPAA.” 
 	
B. “HIPAA is not a state law; it is a federal law.” 
 	
C. “HIPAA states that personal healthcare information is protected in all forms including verbal, electronic, and written.” 
 	
D. “Health information about a client can be provided only to family members at any time.” 

2. Safety and Infection Control: The nurse is admitting a client with tuberculosis. Which of the following transmission-based precautions does the nurse initiate? 

 	
A. Contact 
 	
B. Airborne 
 	
C. Droplet 
 	
D. Protective 

3. Health Promotion and Maintenance: The nurse is providing education to a client who struggles with irregular bowel movements and constipation. Which of the of the following does the nurse include in their teaching? 

 	
A. “Take all of your dietary fiber in the morning to help stimulate your gastrointestinal tract.” 
 	
B. “You should drink two to four glasses (8 oz) of water each day.” 
 	
C. “Increase your water and fiber intake daily.” 
 	
D. “You should have at least one bowel movement daily.” 

4. Psychosocial integrity: A nurse is caring for a client in preterm labor at 30 weeks gestation. The client asks the nurse, “Will my baby be okay?” Which statement by the nurse is the most appropriate? 

 	
A. “You must be feeling helpless and frightened.” 
 	
B. “Babies are born earlier than this all the time and are fine.” 
 	
C. “Every new mom feels worried about their baby when they are in labor.” 
 	
D. “We have the best OB doctors here they can handle it.” 

5. Basic Care and Comfort: A nurse is preparing to walk an older adult who loses their balance when walking. Which of the following devices does the nurse use when assisting this client with ambulation? 

 	
A. Cane 
 	
B. Front-wheeled walker 
 	
C. Gait belt 
 	
D. Harness 

6. Pharmacological and Parenteral Therapies: A nurse is preparing to administer metoprolol to a client with hypertension. Which of the following assessments alerts the nurse to hold the medication and call the physician? 

 	
A. Heart rate of 50 
 	
B. BP 104/68 
 	
C. Respiratory rate of 19 
 	
D. SpO2 of 93% on 2L NC 

7. Reduction of Risk Potential: The nurse is preparing to insert an indwelling foley catheter. Which of the following instructions does the nurse give to the client as they are inserting the catheter? 

 	
A. Inhale quickly 
 	
B. Sip water and swallow as the catheter is being inserted 
 	
C. Bear down 
 	
D. Exhale slowly 

8. Physiological Adaptation: The nurse is admitting a client at 34 weeks gestation that is experiencing painless, bright red vaginal bleeding. The nurse identifies that the client is likely experiencing which of the following conditions? 

 	
A. Preterm labor 
 	
B. Abruptio placentae 
 	
C. Spontaneous abortion 
 	
D. Placenta previa 

The Correct Answers are: 

 	
D – Under HIPAA regulations, clients can choose to whom they provide their health information, and family members do not have access to the client’s health information without their permission. 
 	
B – Clients with tuberculosis should be placed on airborne precautions. These precautions include: a private negative-pressure airflow room, and healthcare workers should wear fitted N95 or PAPR masks when caring for this client. 
 	
C – Clients with chronic constipation should be educated to increase their daily water intake to 2-4 L daily and increase their intake throughout the day using high-fiber sources. 
 	
A- When responding to a client who is fearful, the nurse should respond in a therapeutic way that shows empathy and recognizes the client’s concerns. This statement is open-ended and encourages further communication from the client. 
 	
C- The nurse would use a gait belt to help support this client with ambulation. A gait belt is used to help clients maintain balance and in turn prevent falls. 
 	
A- The nurse would call the doctor and report a heart rate below 60 beats per minute before administering metoprolol, which is a beta blocker medication and can further lower heart rate and blood pressure. 
 	
C- The nurse should educate the client to bear down as they are inserting the catheter as this helps the external sphincter to relax and eases the insertion of the urinary catheter.  
 	
D- The client with placenta previa will have painless, bright red vaginal bleeding in the second or third trimester. 



Clinical judgment category questions follow a scenario that unfolds and then you answer questions from the information provided. With each question you will receive more information about the client and/or scenario. Here is a scenario similar to something you may start with on an NCLEX® exam and questions that would go with it. 
 The client is brought to the emergency room via ambulance. They are alert and orientated x 4. The client complains of abdominal pain that worsens after eating. The client states “This has been going on for the last couple of months but has been way worse this past month. Sometimes this wakes me up at night and I eat a piece of toast with milk, which seems to help the pain. The client states that the pain is 6/10 and burns. The client’s abdomen appears distended, and bowel sounds are present in all four quadrants. Their abdomen is tender to touch. Lung sounds are clear throughout, and the client is voiding without difficulty. Peripheral pulses are +2 in all extremities. The client states “The past couple of days I have been really bloated, nauseous, and my poop has had blood in it the last three days.” 

 	
Recognize Cues: The nurse is assessing the following client. Click to highlight the assessment findings that require follow up. 
 	
Analyze Cues: For each assessment finding, select the finding that is consistent with a duodenal or gastric ulcer. 
 	
Prioritize Solutions: From the information provided, complete the following sentence from the list of options. The nurse should first address the client’s _________ followed by the client’s ___________. 
 	
Generate Solutions: When planning care for the client, which of the following does the nurse anticipate the provider prescribing? 
 	
Take Actions: After reviewing the client information, the nurse should complete the following actions. 
 	
Evaluate Outcomes: When evaluating the plan of care for this client, the nurse identifies that which of the following shows that the client’s condition has improved. 

Correct answers may look something like: 

 	
Highlight: Abdominal pain that worsens with eating, going on for the past month and has gotten worse, but improves with eating toast and milk. Bloody stools, and an abdomen that is distended and tender to touch. 
 	
Duodenal ulcers present with abdominal pain that occurs 90 minutes to three hours after eating, but the pain is improved after eating for a brief period of time, bloody stools, tachycardia, low hemoglobin, and hypotension. Gastric ulcers present with bloody stools, tachycardia, low hemoglobin, and pain that increases after eating.  
 	
The nurse would first address the client’s bloody stools followed by their hemoglobin levels. 
 	
Administer pantoprazole IV push to client and prepare them for an esophagogastroduodenoscopy (EGD). 
 	
Place the client on a nothing by mouth diet and obtain a prescription to insert a nasogastric tube. 
 	
The client states their pain is improved and the client has not had any bloody stools in the past 24 hours. 

Start your exam prep journey with Slone NCLEX.
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To create an effective NCLEX-RN® study guide, focus on key concepts from major nursing domains. 
 	
Consider creating a cram sheet as part of the guide to reinforce need-to-know concepts. 
 	
Incorporate a prep program like Slone NCLEX into your study plan for a well-rounded approach.




As you prepare for the NCLEX-RN® exam, it’s a great idea to create a study guide that covers key concepts from the major nursing domains. Here are some friendly suggestions to make your study process effective and enjoyable! 

 
Key Areas to Include in Your NCLEX-RN® Study Guide

 	
Safety and Infection Control: It's important to think about keeping everyone safe and healthy. This means understanding infection control, safety procedures, and being aware of potential hazards. Remember to always select the options that practice good hand hygiene, wear personal protective equipment (PPE) when needed, use sterile techniques, and keep an eye out for anything that could be a safety issue in healthcare settings. 
 	
Management of Care: Prioritize tasks and delegate responsibilities effectively. It's all about teamwork! Making sure everyone has their roles, advocating for our clients, and managing resources well helps us provide the best care. This area really tests how well you can oversee the overall care delivery process for your clients. 
 	
Health Promotion and Maintenance: This includes discussing health screenings, preventative care, lifestyle changes, and finding effective ways to educate patients. The goal is to support our clients in maintaining their health, preventing illnesses, and catching any early health concerns at different life stages. 
 	
Psychosocial Integrity: Supporting your clients’ mental and emotional well-being is crucial. The NCLEX will test you on your ability to do so. Ensure that your NCLEX-RN® study guide includes mental health disorders, interventions to help clients cope with grief and loss, exploring healthy coping mechanisms, and enhancing communication skills to better connect with them. 
 	
Basic Care and Comfort: Ensure that you can identify options that provide essential care and assistance with daily activities like hygiene, positioning, mobility, nutrition, and hydration to promote overall well-being. 
 	
Pharmacological and Parenteral Therapies: Get comfortable with medication administration, understanding drug interactions, and the principles behind IV therapy, all while ensuring that you are providing safe and effective care for your clients. 
 	
Reduction of Risk Potential: Identify and prevent any areas that might complicate a client's condition. This means recognizing abnormal vital signs, interpreting lab results, and taking precautions to minimize risks related to treatments or procedures. 
 	
Physiological Adaptation: Understanding fluid and electrolyte balance, managing medical emergencies, and comprehending disease pathophysiology to help recognize cues and intervene. It's all about being ready to respond to your clients' needs! 

 
Important Concepts For Your NCLEX-RN® Study Guide: 

 	
Assessment: Conduct thorough head-to-toe assessments, keep an eye on vital signs, and improve your data interpretation skills. 
 	
Clinical Reasoning: Apply your nursing knowledge to real client situations and enhance your decision-making abilities. 
 	
Therapeutic Communication: Practice active listening, show empathy, and learn to provide clear, helpful information. 
 	
Critical Thinking: Strengthen your ability to analyze situations, spot priorities, and solve problems effectively. 
 	
Practice Questions: Mix it up with different question formats — try multiple-choice, select all that apply, and drag and drop!  
 	
Pay attention to the rationales for both the correct and incorrect answers: This will really enhance your understanding. Don’t forget to review practice questions from various sources (including Slone NCLEX) for a well-rounded prep experience!

[sp_wpcarousel id="1062"]
Final NCLEX-RN® Study Guide Tips 

 	
Prioritize Based on the NCLEX Blueprint: Spend a little more time on the areas that are weighted more heavily on the exam. 
 	
Use Mnemonic Devices: Get creative and come up with memorable tricks to help you remember key concepts. Slone NCLEX has great mnemonics you can use. Our TikTok/Instagram goes over these to help you as well. 
 	
Active Recall: Challenge yourself with flashcards or question banks. It’s a great way to test your knowledge! 
 	
Regular Review Sessions: Make it a habit to revisit what you’ve studied to keep everything fresh in your mind. 

The Bottom Line
Remember, this NCLEX-RN® study guide should reflect your personal learning style. Take the time to identify your strengths and weaknesses so you can focus your efforts where you need them most. You’ve got this! Happy studying! 
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The Next Generation NCLEX (NGN NCLEX®) has brought changes to the exam experience that could require you to change your study approach. 
 	
The design now mirrors real-world nursing practice and includes helpful features like partial credit for certain question types. 
 	
Consider the sample scenario as explained by Slone NCLEX Professor Tanya Killian. 




The Next Generation NCLEX (NGN NCLEX®) has brought some exciting changes to the exam experience, showing much higher pass rates than the traditional NCLEX.  

In 2023, the year the NGN made its debut, the pass rates were 88.56% for the NCLEX-RN® and 92.10% so far for 2024. That’s a big improvement! Just to compare, before the NGN NCLEX® rolled out in 2022, the pass rate for NCLEX-RN® was 79.9%. 

This increase is largely attributed to the NGN design, which mirrors real-world nursing practice and includes helpful features like partial credit for certain question types. The NGN NCLEX® employs an improved format for its questions, focusing on a more scenario-based approach that frequently incorporates case studies.  

 This method is believed to better evaluate candidates' clinical judgment and decision-making skills. 

 To successfully pass the NGN NCLEX®, you must have a comprehensive understanding of the exam structure and its content.  
 
Here are a few key NGN NCLEX® areas you should focus on: 

 	
 Know the Exam Format: Understand NGN NCLEX® structure, including the types of questions, both the traditional types (such as multiple-choice questions) and the new item types (such as case studies and drop-down questions) and how they evaluate clinical judgment.
 	
Create a Study Plan: Develop a structured study schedule covering all essential nursing concepts, prioritizing areas needing more practice. Use memory aids like mnemonics to retain important information and nursing principles. Identify the areas where you struggle and focus your study efforts on those topics.
 	
Practice with NGN Questions: Use practice exams and question banks specifically created for the Next Generation NCLEX® to become familiar with the question style and format.
 	
Join Study Groups: Collaborate with peers to discuss complex topics and gain different perspectives on nursing concepts.
 	
Apply Clinical Knowledge: Remember to leverage your real-world nursing experience and clinical judgment when answering questions. Always, keeping in mind that the NCLEX® will test you on perfect-world nursing, having all resources available.
 	
 Understand the Clinical Judgment Measurement Model (NCJMM): Familiarize yourself with this model, as it is the foundation of the NGN, outlining the decision-making process. Remember the clinical judgment categories: Recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, and evaluate outcomes.
 	
Manage Test Anxiety: Practice relaxation techniques and employ time management strategies to stay calm during the exam.

If you're wondering about the best way to approach the NGN NCLEX®, the answer is with peace of mind knowing that the NGN NCLEX® is for your benefit. 



 To further help you understand the NGN NCLEX®, let’s complete this case study together.  
Scenario: The client presents to the emergency room with new-onset, right-sided facial drooping and weakness. They are alert and oriented to person, place, and time but are unable to explain why they are in the hospital. The client follows commands appropriately but shows distinct weakness on the right side. When asked to smile, facial drooping is noted on the right side. Drooling from the right side of their mouth. The client is able to maintain eye contact and no visual loss is noted. Their National Institutes of Health Stroke Scale (NIHSS) score is 8. Lung sounds are clear throughout, and peripheral pulses are +1 in all extremities, with pitting edema noted in the bilateral lower extremities. S1 and S2 heart sounds noted. The abdomen is soft and nontender, and the client voided x 1 and urine was amber in color.
1. Recognize Cues: A nurse is assessing the client. Highlight the findings that require immediate follow-up.
The client presents to the emergency room with new-onset, right-sided facial drooping and weakness. They are alert and oriented to person, place, and time but are unable to explain why they are in the hospital. The client follows commands appropriately but shows distinct weakness on the right side. When asked to smile facial drooping is noted on the right side. Drooling from the right side of their mouth. The client is able to maintain eye contact and no visual loss is noted. Their NIHSS score is 8. Lung sounds are clear throughout, and peripheral pulses are +1 in all extremities, with pitting edema noted in the bilateral lower extremities. S1 and S2 heart sounds noted. The abdomen is soft and nontender, and the client voided x 1 and urine was amber in color. 

Added Information:  

Vitals: BP 128/88, HR 97, RR 19, T 37.0 C (98.6 F), SpO2 95% on RA, Pain is stated as being a 0/10.  

Nurse’s Notes:

Day 1: 0945- Client is having a difficult time swallowing; when attempting to administer morning medications the client coughs trying to swallow liquids and medications.  

Day 1 Labs: 
Urinalysis - 
Color- (Normal-Yellow) Amber
Clarity (Normal-Clear) Clear 
Glucose (Negative mg/dL) Negative 
Bilirubin (Negative mg/dL) Negative 
Ketones (Negative mg/dL) 
Specific Gravity (1.005-1.035) 1.016 
Blood (Negative-Trace mg/dL) Negative 
pH (5.5-8.5) 7.5 
Protein (Negative-10 mg/dL) Negative 
Urobilinogen (<2.0 mg/dL) <2.0 
Nitrate (Negative0 Negative 
Leukocyte Esterase (Negative leu/uL) Negative 
2. Analyze Cues: Based off of the information the nurse recognizes the client is at risk for which of the following conditions?
A. Urinary tract infection
B. Aspiration
C. Hypoxia
D. Hypertenstive crisis  

Added Information:  

Provider Orders:  

Admit to critical care unit 

Administer alteplase: 0.9 mg/kg. The total dose should not exceed 90 mg. 10% of the total dose gets administered as an intravenous (IV) bolus over 1 minute, infuse remaining over 60 minutes. 
3. Prioritize Hypotheses: The nurse is reviewing the client’s medical record. Which of the following areas does the nurse identify as the priority? (select 4)
A. Elimination
B. Maintaining a Patent Airway
C. Skin Breakdown
D. Risk for bleeding
E. Neurological status
F. Fall risk 

Added Information: 

Nurse’s Notes:  

Day 2: 1045- While assessing the client, they became frustrated when they were trying to express their thoughts. Speech is slurred and the client is unable to say familiar words. The client continues to cough when swallowing and has right-sided weakness with the right arm being flaccid. 
4. Generate Solutions: When planning care for this client, the nurse identifies which of the following nursing interventions as anticipated (A) or contraindicated (C)? 

 	
Initiate using straws and thin liquids for this client. (A or C) 
 	
Request a speech therapist evaluation (A or C) 
 	
Initiate swallowing precautions for this client (A or C) 
 	
Place the client on fall precautions (A or C) 
 	
Use picture boards to help the client communicate (A or C) 
 	
Encourage the family to finish the client’s sentences when they are having difficulty communicating. (A or C) 

Added Information: 

Day 3: Vital signs: BP 108/74, HR 101, T 39 C (102.2 F) RR 21, SpO2 90% on room air, client states pain is 0/10. 

Nurses Note: 

Day 3 1100- The client is alert and orientated x 4. Speech is clear and the client responds with appropriate words and is able to communicate without delay. Course crackles are noted in bilateral lung bases. The client continues to cough when swallowing liquids and their voice is hoarse. NIHSS score is 4. 

Provider orders: Based off of speech language pathologist report, client placed on full liquid diet with honey-thickened liquids. Repeat swallow evaluation ordered for next week.  
5. Take Actions: Based off of the information from the client’s electronic medical record, which of the following actions does the nurse take? (Select all that apply) 
A. Place food on the right side of the client’s mouth
B. Sit client at 45 degrees when eating
C. Encourage the client to use their incentive spirometer
D. Request a chest X-ray
E. Ensure all liquids are honey consistency
F. Request a supplemental oxygen order 

Added Information: 

Nurses Notes:  

Day 3: 1200- The client is being seen by the social worker to discuss discharge planning. 

Evaluate Outcomes: Based off of all the information above, which findings indicate that the client has improved (I) or declined (D) in condition since they were brought into the emergency room. 

 	
Oxygen saturation (I or D) 
 	
NIHSS score (I or D) 
 	
Temperature (I or D) 
 	
Communication (I or D) 


Correct Answers: 

 	
Recognize cues: new-onset right-sided facial drooping, unable to explain why they are in the hospital, distinct weakness on the right side, facial drooping is noted on the right side. Drooling from the right side of their mouth. 
 	
Analyze Cues: B- Aspiration 
 	
Prioritize Hypotheses: B (Patent Airway), D (Risk for Bleeding), E (Neuro status), F (fall risk) 
 	
Generate Solutions: C, A, A, A, A, C (Contraindicated, Anticipated, Anticipated, Anticipated, Anticipated, Contraindicated) 
 	
Take Actions: B, D, E, F 
 	
Evaluate Outcomes: D, I, D, I (Declined, Improved, Declined, Improved) 

                    [post_title] => How to Approach the NGN NCLEX®
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You should practice NCLEX® questions and various item types regularly to be most prepared for exam day. 
 	
Daily practice will help you determine your pain points and create a study plan to increase your competency in those areas. 
 	
Practice NCLEX® questions featured in this blog will give you an idea of what to expect on exam day. 




Do you find yourself finished with nursing school and question what to do now? How do I prep for the NCLEX®? Do I even need to prepare?  

The answer is simple, YES. Your new life motto until you take (and pass) the NCLEX-RN® exam is, “Practice NCLEX®, Practice NCLEX®, PRACTICE NCLEX®!” 

Practicing test-specific questions and taking readiness exams, or exams that mirror the NCLEX®, before exam day is vital to your success. It familiarizes you with the test format, question types, and style while empowering you to identify areas for further study. This practice sharpens your critical thinking skills as you apply essential nursing concepts, ultimately boosting your confidence and preparedness on test day and elevating your chances of passing the exam. 


Using NCLEX® practice questions is vital because it: 

 	
Helps you understand the exam format: NCLEX® questions are structured differently than standard multiple-choice questions, so practicing helps you get accustomed to their wording and structure. 
 	
Identifies knowledge gaps: Taking practice tests allows you to pinpoint specific areas of nursing knowledge that require more review. 
 	
Develops critical thinking skills: NCLEX® questions often require you to analyze situations and apply your knowledge, which practice questions help you refine. 
 	
Manages test anxiety: Regular practice can make you feel more comfortable with the exam environment, reducing anxiety on test day. 
 	
Assesses your readiness: Taking practice tests provides a realistic assessment of how prepared you are for the actual exam. 
 	
Builds test-taking strategies: Regular practice with NCLEX® questions helps you develop effective approaches for tackling questions on the actual exam. 
 	
Boosts confidence: Tracking your progress through practice tests can enhance your confidence and decrease anxiety on test day. 

Aim to tackle 200-400 practice NCLEX® questions each day, and make sure you use traditional and NGN NCLEX® item types. For more insight into the different item types read our blog, “Include These Item Types in Your NCLEX® Practice Questions.” 

Embrace the journey by taking at least two readiness exams: the first at the start of your NCLEX® preparation to establish a strong foundation for your study plan, and the second after completing around 1,500 practice questions. This approach will allow you to accurately assess your preparedness. 

When completing practice exams, make sure to answer questions and use readiness tests that cover all exam categories, both client need and clinical judgment.  
There are eight client need categories:  

 	
Management of care   
 	
Safety and infection control   
 	
Health promotion and maintenance   
 	
Psychosocial integrity   
 	
Basic care and comfort   
 	
Pharmacological and parenteral therapies   
 	
Reduction of risk potential   
 	
Physiological adaptation   

Additionally, you should incorporate the six clinical judgment categories:  

 	
Recognize cues   
 	
Analyze cues   
 	
Prioritize hypotheses   
 	
Generate solutions   
 	
Take actions   
 	
Evaluate outcomes   


Practice Questions to Review
I have 14 practice questions (one for each category) to help you get started and to get an idea of what to look for! 

1. Management of Care: The nurse is reviewing the Health Insurance Portability and Accountability Act (HIPAA) with a group of student nurses. Which of the following statements by a student indicates a need for further teaching? 

 	
A. “A client’s phone number is an example of personal identifiable information that is protected by HIPAA.” 
 	
B. “HIPAA is not a state law; it is a federal law.” 
 	
C. “HIPAA states that personal healthcare information is protected in all forms including verbal, electronic, and written.” 
 	
D. “Health information about a client can be provided only to family members at any time.” 

2. Safety and Infection Control: The nurse is admitting a client with tuberculosis. Which of the following transmission-based precautions does the nurse initiate? 

 	
A. Contact 
 	
B. Airborne 
 	
C. Droplet 
 	
D. Protective 

3. Health Promotion and Maintenance: The nurse is providing education to a client who struggles with irregular bowel movements and constipation. Which of the of the following does the nurse include in their teaching? 

 	
A. “Take all of your dietary fiber in the morning to help stimulate your gastrointestinal tract.” 
 	
B. “You should drink two to four glasses (8 oz) of water each day.” 
 	
C. “Increase your water and fiber intake daily.” 
 	
D. “You should have at least one bowel movement daily.” 

4. Psychosocial integrity: A nurse is caring for a client in preterm labor at 30 weeks gestation. The client asks the nurse, “Will my baby be okay?” Which statement by the nurse is the most appropriate? 

 	
A. “You must be feeling helpless and frightened.” 
 	
B. “Babies are born earlier than this all the time and are fine.” 
 	
C. “Every new mom feels worried about their baby when they are in labor.” 
 	
D. “We have the best OB doctors here they can handle it.” 

5. Basic Care and Comfort: A nurse is preparing to walk an older adult who loses their balance when walking. Which of the following devices does the nurse use when assisting this client with ambulation? 

 	
A. Cane 
 	
B. Front-wheeled walker 
 	
C. Gait belt 
 	
D. Harness 

6. Pharmacological and Parenteral Therapies: A nurse is preparing to administer metoprolol to a client with hypertension. Which of the following assessments alerts the nurse to hold the medication and call the physician? 

 	
A. Heart rate of 50 
 	
B. BP 104/68 
 	
C. Respiratory rate of 19 
 	
D. SpO2 of 93% on 2L NC 

7. Reduction of Risk Potential: The nurse is preparing to insert an indwelling foley catheter. Which of the following instructions does the nurse give to the client as they are inserting the catheter? 

 	
A. Inhale quickly 
 	
B. Sip water and swallow as the catheter is being inserted 
 	
C. Bear down 
 	
D. Exhale slowly 

8. Physiological Adaptation: The nurse is admitting a client at 34 weeks gestation that is experiencing painless, bright red vaginal bleeding. The nurse identifies that the client is likely experiencing which of the following conditions? 

 	
A. Preterm labor 
 	
B. Abruptio placentae 
 	
C. Spontaneous abortion 
 	
D. Placenta previa 

The Correct Answers are: 

 	
D – Under HIPAA regulations, clients can choose to whom they provide their health information, and family members do not have access to the client’s health information without their permission. 
 	
B – Clients with tuberculosis should be placed on airborne precautions. These precautions include: a private negative-pressure airflow room, and healthcare workers should wear fitted N95 or PAPR masks when caring for this client. 
 	
C – Clients with chronic constipation should be educated to increase their daily water intake to 2-4 L daily and increase their intake throughout the day using high-fiber sources. 
 	
A- When responding to a client who is fearful, the nurse should respond in a therapeutic way that shows empathy and recognizes the client’s concerns. This statement is open-ended and encourages further communication from the client. 
 	
C- The nurse would use a gait belt to help support this client with ambulation. A gait belt is used to help clients maintain balance and in turn prevent falls. 
 	
A- The nurse would call the doctor and report a heart rate below 60 beats per minute before administering metoprolol, which is a beta blocker medication and can further lower heart rate and blood pressure. 
 	
C- The nurse should educate the client to bear down as they are inserting the catheter as this helps the external sphincter to relax and eases the insertion of the urinary catheter.  
 	
D- The client with placenta previa will have painless, bright red vaginal bleeding in the second or third trimester. 



Clinical judgment category questions follow a scenario that unfolds and then you answer questions from the information provided. With each question you will receive more information about the client and/or scenario. Here is a scenario similar to something you may start with on an NCLEX® exam and questions that would go with it. 
 The client is brought to the emergency room via ambulance. They are alert and orientated x 4. The client complains of abdominal pain that worsens after eating. The client states “This has been going on for the last couple of months but has been way worse this past month. Sometimes this wakes me up at night and I eat a piece of toast with milk, which seems to help the pain. The client states that the pain is 6/10 and burns. The client’s abdomen appears distended, and bowel sounds are present in all four quadrants. Their abdomen is tender to touch. Lung sounds are clear throughout, and the client is voiding without difficulty. Peripheral pulses are +2 in all extremities. The client states “The past couple of days I have been really bloated, nauseous, and my poop has had blood in it the last three days.” 

 	
Recognize Cues: The nurse is assessing the following client. Click to highlight the assessment findings that require follow up. 
 	
Analyze Cues: For each assessment finding, select the finding that is consistent with a duodenal or gastric ulcer. 
 	
Prioritize Solutions: From the information provided, complete the following sentence from the list of options. The nurse should first address the client’s _________ followed by the client’s ___________. 
 	
Generate Solutions: When planning care for the client, which of the following does the nurse anticipate the provider prescribing? 
 	
Take Actions: After reviewing the client information, the nurse should complete the following actions. 
 	
Evaluate Outcomes: When evaluating the plan of care for this client, the nurse identifies that which of the following shows that the client’s condition has improved. 

Correct answers may look something like: 

 	
Highlight: Abdominal pain that worsens with eating, going on for the past month and has gotten worse, but improves with eating toast and milk. Bloody stools, and an abdomen that is distended and tender to touch. 
 	
Duodenal ulcers present with abdominal pain that occurs 90 minutes to three hours after eating, but the pain is improved after eating for a brief period of time, bloody stools, tachycardia, low hemoglobin, and hypotension. Gastric ulcers present with bloody stools, tachycardia, low hemoglobin, and pain that increases after eating.  
 	
The nurse would first address the client’s bloody stools followed by their hemoglobin levels. 
 	
Administer pantoprazole IV push to client and prepare them for an esophagogastroduodenoscopy (EGD). 
 	
Place the client on a nothing by mouth diet and obtain a prescription to insert a nasogastric tube. 
 	
The client states their pain is improved and the client has not had any bloody stools in the past 24 hours. 

Start your exam prep journey with Slone NCLEX.
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