NCLEX 75-Question Mock: Test Your Nursing Knowledge

1. When caring for a client with a nasogastric tube, which action prevents aspiration?

Check residual volume before each feeding

Position client supine during feeding

Flush tube with water only

Clamp tube between feedings

2. When a client refuses a blood transfusion due to religious beliefs, the nurse should:

Override refusal and administer transfusion

Respect refusal, document, and explore alternatives

Consult only the provider

Delay care until family arrives

3. A client receiving total parenteral nutrition develops hyperglycemia. Which intervention should be tried first?

Reduce dextrose concentration and monitor glucose

Stop TPN immediately

Administer insulin subcutaneously

Increase TPN infusion rate

4. A client with pneumonia has a respiratory rate of 32 and PaO₂ of 65 mmHg. What is the priority?

Increase oxygen delivery and notify provider

Encourage coughing and deep breathing

Administer a sedative

Position client supine

5. Which precaution is essential when a client receives gentamicin IV?

Monitor renal function and hearing

Administer with food

Give rapidly over 1 minute

Restrict potassium intake

6. A client with gestational diabetes requires insulin. Which statement by the client indicates understanding?

I will stop insulin after delivery

I should check my blood glucose before meals

I can skip insulin if I feel well

Insulin will harm my baby

7. When assessing a client for compartment syndrome, which finding is most significant?

Pain with passive stretch of muscles

Mild swelling of the limb

Skin blanching with pressure

Slightly elevated temperature

8. A client on warfarin has an INR of 8.5. Which action is most appropriate?

Continue warfarin at current dose

Hold warfarin and notify provider

Increase warfarin dose

Give vitamin K supplement

9. The nurse notes a client with sudden severe headache and neck stiffness. What is the priority action?

Administer acetaminophen

Notify provider and implement isolation precautions

Apply a cold compress

Encourage ambulation

10. A client with acute kidney injury has hyperkalemia. Which medication should be available?

Insulin with glucose

Sodium chloride

Magnesium sulfate

Calcium gluconate

11. A client receiving IV heparin develops thrombocytopenia. Which action should the nurse take first?

Continue heparin and monitor CBC daily

Stop heparin and notify the provider immediately

Switch to warfarin without provider order

Increase heparin dose to improve platelet count

12. A client is prescribed lithium for bipolar disorder. Which lab value requires dose adjustment?

Serum lithium level 0.6 mEq/L

Serum lithium level 1.8 mEq/L

Serum lithium level 0.8 mEq/L

Serum lithium level 1.0 mEq/L

13. Which finding in a newborn requires immediate notification to the provider?

Milia on the nose

Cyanosis of the lips that does not improve with oxygen

Vernix caseosa on the skin

Caput succedaneum

14. A client with acute MI reports chest pain unrelieved by nitroglycerin. Which intervention is priority?

Administer aspirin and notify provider

Give another dose of nitroglycerin

Apply a heating pad

Have client rest quietly for 30 minutes

15. The nurse observes a client receiving chemotherapy with extravasation. What is the first action?

Continue the infusion and monitor closely

Stop the infusion and notify the provider

Apply heat to the site

Massage the area vigorously

16. A client with COPD is on oxygen therapy. Which oxygen saturation target is appropriate?

88–92%

95–100%

85–90%

90–95%

17. When teaching a client about ACE inhibitor side effects, which symptom warrants stopping the medication?

Dry cough

Angioedema of the face or lips

Mild dizziness on first dose

Slight fatigue

18. A postoperative client has decreased urine output and elevated creatinine. What is the priority nursing action?

Increase IV fluids and notify the provider

Encourage oral fluids only

Restrict all fluids

Administer a diuretic

19. A nurse administers metformin to a diabetic client. Which adverse effect requires immediate intervention?

Mild nausea lasting 1–2 hours

Lactic acidosis with abdominal pain

Temporary headache

Slight increase in appetite

20. When assessing a patient with sepsis, which vital sign pattern is most concerning?

BP 140/90, HR 68, RR 16, Temp 37°C

BP 90/60, HR 110, RR 28, Temp 39.5°C

BP 120/80, HR 72, RR 20, Temp 37.2°C

BP 130/85, HR 80, RR 18, Temp 38°C

75-Question NCLEX Quiz: Could You Pass Today?