Practice NCLEX®: The Mantra Worth Repeating

• 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: 

1. 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. 
2. Identifies knowledge gaps: Taking practice tests allows you to pinpoint specific areas of nursing knowledge that require more review. 
3. Develops critical thinking skills: NCLEX® questions often require you to analyze situations and apply your knowledge, which practice questions help you refine. 
4. Manages test anxiety: Regular practice can make you feel more comfortable with the exam environment, reducing anxiety on test day. 
5. Assesses your readiness: Taking practice tests provides a realistic assessment of how prepared you are for the actual exam. 
6. Builds test-taking strategies: Regular practice with NCLEX® questions helps you develop effective approaches for tackling questions on the actual exam. 
7. 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:  

1. Management of care   
2. Safety and infection control   
3. Health promotion and maintenance   
4. Psychosocial integrity   
5. Basic care and comfort   
6. Pharmacological and parenteral therapies   
7. Reduction of risk potential   
8. Physiological adaptation   

Additionally, you should incorporate the six clinical judgment categories:  

1. Recognize cues   
2. Analyze cues   
3. Prioritize hypotheses   
4. Generate solutions   
5. Take actions   
6. 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: 

1. 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. 
2. 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. 
3. 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. 
4. 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. 
5. 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. 
6. 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. 
7. 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.  
8. 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.” 

1. Recognize Cues: The nurse is assessing the following client. Click to highlight the assessment findings that require follow up. 
2. Analyze Cues: For each assessment finding, select the finding that is consistent with a duodenal or gastric ulcer. 
3. 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 ___________. 
4. Generate Solutions: When planning care for the client, which of the following does the nurse anticipate the provider prescribing? 
5. Take Actions: After reviewing the client information, the nurse should complete the following actions. 
6. 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: 

1. 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. 
2. 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.  
3. The nurse would first address the client’s bloody stools followed by their hemoglobin levels. 
4. Administer pantoprazole IV push to client and prepare them for an esophagogastroduodenoscopy (EGD). 
5. Place the client on a nothing by mouth diet and obtain a prescription to insert a nasogastric tube. 
6. 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.