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The Best NCLEX-Style Practice Questions

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The best way to become more familiar with NCLEX-style questions is by practicing them. You’ve been through nursing school, so you have the knowledge. Now you just need to apply it. Choose your exam below to answer a few exam style questions …

The questions on the NCLEX-RN are designed to test your critical thinking skills and ability to apply knowledge in real-world scenarios. Don’t waste time practicing low-level questions! Challenge yourself with our NCLEX-RN sample questions.

The nurse is caring for a client at 39 weeks gestation who is receiving an IV oxytocin infusion for induction of labor. The nurse notes recurrent late decelerations on the fetal monitor. Which of the following actions should the nurse take? Select all that apply .

Explanation:

A late deceleration is a gradual decrease in fetal heart rate (FHR) with a uterine contraction that reaches its lowest point (ie, nadir) after the contraction’s peak with a slow return to baseline. Late decelerations occur as a reflexive chemoreceptor response to temporary fetal hypoxemia or fetal metabolic acidemia (in severe cases). Uteroplacental insufficiency, uterine tachysystole , and maternal supine hypotension are common causes because they compromise perfusion and oxygen availability to the fetus.

Intrauterine resuscitation interventions to improve fetal perfusion and oxygenation include:

• Administering an IV fluid bolus to increase maternal blood volume (Option 1)
• Discontinuing the IV oxytocin infusion to reduce uterine stimulation and decrease contraction frequency because relaxation of the uterus increases uteroplacental blood flow and fetal oxygenation (Option 3)
• Repositioning the client laterally to relieve compression of the maternal inferior vena cava , which can be occluded by the weight of the gravid uterus when supine (Option 5)

The mnemonic VEAL CHOP helps recall of causes of FHR changes on monitor tracings.

(Option 2) Vibroacoustic stimulation is used during nonreactive nonstress tests (ie, no accelerations) to provoke fetal movement, which helps determine whether the absence of expected accelerations is physiologic (eg, fetal sleep cycle) or pathophysiologic (ie, fetal acidemia). It is never performed during FHR decelerations or fetal bradycardia.

(Option 4) An amnioinfusion is indicated to relieve persistent, recurrent variable decelerations caused by umbilical cord compression. It is not indicated for late FHR decelerations or uterine tachysystole.

Educational objective: Late decelerations of fetal heart rate indicate compromised fetal oxygenation and perfusion. Intrauterine resuscitation interventions include administering an IV fluid bolus, discontinuing the IV oxytocin infusion, and repositioning the client laterally.

The nurse is delegating client care tasks to a licensed practical nurse (LPN) and unlicensed assistive personnel. Which of the following assignments are most appropriate to assign to the LPN? Select all that apply .

Nurses preparing to delegate client care to a licensed practical nurse (LPN) and/or unlicensed assistive personnel (UAP) should consider the 5 rights of delegation . The LPN can monitor and care for stable clients who have been initially evaluated by a registered nurse (RN). Interventions LPNs may perform include:

• Administering oral and parenteral medications , but excluding administering IV medications, which vary by state legislation (Options 1 and 2)
• Reinforcing teaching and skills that have been initially taught by the RN (Option 4)
• Focused assessments (eg, bowel sounds) after the RN’s initial assessment

(Option 3) Performing admission or initial assessments is outside the scope of the LPN and UAP. The RN must perform initial assessments in order to analyze the findings and formulate the client’s plan of care before delegating tasks.

(Option 5) The LPN is capable of performing routine care (eg, calculating daily intake and output, toileting). However, the UAP may also perform these tasks, which frees the LPN to perform more complex duties. Therefore, the most appropriate staff member to assign the task of calculating intake and output to is the UAP.

Educational objective: Nurses preparing to delegate client care should consider the 5 rights of delegation. Appropriate tasks to delegate to a licensed practical nurse include administration of oral and parenteral medications, excluding IV route, and reinforcement of teaching previously provided by the registered nurse.

The nurse cares for a client with aortic stenosis who was admitted due to syncope on exertion and dyspnea. Identify the area where the nurse would best auscultate the client’s heart murmur.

Think of a location on the image which you deem right and click on ‘Show Correct Regions’ link to see if your selection is correct .

Aortic stenosis (AS) is a type of valvular heart disease characterized by narrowing of the aortic valve opening, which limits the left ventricle’s ability to eject blood into the aorta. AS may occur from hardening (ie, calcification) of the valves, congenital heart disorders, or inflammation. If left untreated, AS may result in heart failure and pulmonary hypertension as compensatory mechanisms fail.

When assessing a client with AS, the nurse should auscultate in the aortic area (ie, second intercostal space at the right sternal border) for a loud, systolic ejection murmur heard following the first heart sound. The aortic area, rather than directly over the heart valve, is the preferred location for auscultation as the heart sounds travel in the direction the blood flows. Additional clinical manifestations of aortic stenosis include chest pain, shortness of breath, and/or syncope that are worsened by exertion.

Educational objective : Aortic stenosis is a type of valvular heart disease causing narrowing of the valve between the left ventricle and aorta, impairing ejection of blood from the heart. Nurses attempting to auscultate heart murmurs associated with aortic stenosis should listen at the right sternal border, second intercostal space (ie, aortic area).

A health care provider prescribes cefuroxime 30 mg/kg/day PO divided in equal doses every 12 hours for a child with a urinary tract infection. The child weighs 34 lb. Based on the available concentration of cefuroxime, how many mL would the nurse administer per dose? Click the exhibit button for additional information. Record your answer using one decimal place .

Correct Answer : 4.6 mL

Using dimensional analysis, the following steps are performed to calculate the volume of cefuroxime per dose in milliliters:

Identify the prescribed, available, and required medication information

Prescribed: 30 mg cefuroxime / kg / day   Available: 250 mg cefuroxime / 5 mL   Required: mL / dose

Convert the prescription to the volume needed for administration using dimensional analysis

Prescription × available data = mL per dose

( mg cefuroxime / kg / day ) ( kg / lb ) ( lb /   )( day / dose ) ( mL / mg cefuroxime ) = mL cefuroxime / dose

( 30 mg cefuroxime / kg / day ) ( kg / 2.2 lb ) ( 34 lb /   )( day / 2 doses ) ( 5 mL / 250 mg cefuroxime ) = 4.63 63 mL cefuroxime / dose

Round to the first decimal place

4.63 63 mL / dose = 4.6 mL / dose

Educational objective: To calculate the volume of cefuroxime in milliliters per dose, the nurse should first identify the prescribed dose (eg, 30 mg/kg/day) and available medication (eg, 250 mg/5 mL) and then convert to volume in milliliters per dose (eg, 4.6 mL).

Alternative Method :

The formula method is an alternate way to calculate medication dosages. However, this method may increase the occurrence of miscalculation and medication errors. If you choose to use this method, do not round calculations until the final step .

Using the formula method, the following steps are performed to calculate the volume of cefuroxime per dose in milliliters:

Convert pounds to kilograms

( kg / 2.2 lb ) ( 34 lb /   ) = 15.45 45 kg

Calculate the prescribed dose in milligrams

( 30 mg cefuroxime / kg / day ) ( 15.45 45 kg /   ) ( day / 2 doses ) = 231.81 81 mg cefuroxime / dose

Convert the prescription to administration volume

Prescribed dose / available dose x available volume = dose in ML

231.81 81 mg cefuroxime / 250 mg cefuroxime x 5 mL = 4.63 63 mL cefuroxime / dose

The nurse receives new prescriptions for a client with right lower quadrant pain and suspected acute appendicitis. Which prescription should the nurse implement first?

Appendicitis is inflammation of the appendix and often results from obstruction by fecal matter. Appendiceal obstruction traps fluid and mucus typically secreted into the colon, causing increased intraluminal pressure and inflammation. As appendiceal intraluminal pressure and inflammation increase, blood circulation to the appendix is impaired, resulting in swelling and ischemia . These factors increase the risk for appendiceal perforation , a medical emergency , which may lead to peritonitis and sepsis .

When prioritizing care of the client with appendicitis, the nurse should utilize the ABCs (ie, a irway, b reathing, c irculation). Fluid resuscitation with IV crystalloids (eg, normal saline, lactated Ringer solution) is an important intervention aimed at preventing circulatory collapse resulting from fluid losses (eg, vomiting, diarrhea) and NPO status (Option 3).

(Option 1) Pain medications may be administered to promote comfort, but should be administered via IV route to maintain NPO status in case of emergency surgery. However, circulation takes priority over pain medication.

(Options 2 and 4) Blood and urine samples often are prescribed to assist with treatment and care decisions. However, the nurse should prioritize circulatory status over obtaining laboratory specimens.

Educational objective: Nurses caring for clients with appendicitis should prioritize client care according to the ABCs (ie, airway, breathing, circulation). Initiating IV crystalloids (eg, normal saline) is a priority action that prevents circulatory collapse resulting from fluid losses (eg, vomiting, diarrhea) and NPO status.

NCLEX-style practice questions can help you identify areas where you may need additional study or review. Every question in our NCLEX-PN QBank includes detailed rationales for the correct and incorrect answers, so you learn as you practice.

The nurse auscultates the heart sounds of a 77-year-old client with chronic heart failure. Which heart sound should the nurse document? Listen to the audio clip . (Headphones are required for best audio quality.)

S1 and S2 are the normal “lub-dub” heart sounds that result from closure of valves . Systole occurs between S1 and S2, with S1 indicating closure of the atrioventricular (tricuspid, mitral) valves and S2 indicating closure of the pulmonic and aortic valves.

S3 is an adventitious (extra) heart sound heard as “ DUB ” immediately following S2 (Option 3) . S3 occurs during early diastole as a result of rapid ventricular filling and is a normal finding in children and young adults. In older adults , S3 is an abnormal finding that often indicates heart failure because the sound results from decreased ventricular compliance.

S3 can be difficult to distinguish from S4 . S4 is a “LUB” sound that occurs immediately before S1, during late diastole, and indicates ventricular hypertrophy.

(Option 1) A pericardial friction rub is a creaky, grating sound heard throughout systole and diastole. Friction rub occurs with pericarditis and is due to friction between inflamed layers of pericardium.

(Option 2) S1 and S2 are the normal heart sounds heard during cardiac auscultation.

(Option 4) A murmur is a swooshing, blowing, or rumbling sound caused by turbulent blood flow (eg, from valve regurgitation or stenosis).

Educational objective: S3, the third heart sound, is a “DUB” sound that immediately follows S2. It is a normal finding in children and young adults. S3, an abnormal finding in older adults, often indicates heart failure.

A client with a hip fracture is placed in Buck traction. Which activities are appropriate for the nurse to include in the client’s plan of care? Select all that apply .

Buck traction is a type of skin traction used to immobilize hip fractures and reduce pain and spasm until the client can undergo surgical repair of the fracture. A traction boot is applied to the leg, below the fracture site. A weight gently and continuously pulls on the leg and hip, helping maintain alignment of the limb. The nurse should ensure that the traction boot is fitted properly and that the limb remains straight in a neutral position (Option 3) .

Skin traction exerts pressure on nerves, blood vessels, and soft tissue. The nurse should frequently assess neurovascular status (eg, pulse, capillary refill, color, temperature, sensation, movement) and skin integrity in the limb to which the boot is applied (Options 1 and 4) . Overall pain level and efficacy of administered pain medications should be monitored closely, as increasing pain in the limb in traction may indicate neurovascular compromise (Option 2) .

(Option 5) Side-to-side repositioning of the client in Buck traction can cause injury. Side-to-side position changes cause the affected leg to be adducted or abducted, which, when paired with the force of traction, can increase spasm and pain and contribute to neurovascular and orthopedic compromise.

Educational objective: Buck traction is used to immobilize hip fractures and reduce pain and spasm until the fracture can be repaired surgically. The nurse caring for a client in Buck traction should frequently assess the neurovascular status and skin integrity of the affected limb and maintain it in a straight, neutral position.

The nurse is assigned to care for four clients. Which client should the nurse see first? .

Compartment syndrome occurs when swelling in a tissue compartment causes compression of arteries and nerves, typically after a direct injury (eg, fracture, dislocation) or medical device placement (eg, cast, splint). Tissue perfusion and nerve function distal to the swelling become impaired, causing signs of neurovascular compromise (eg, severe, unrelenting pain; paralysis ) due to tissue ischemia . Without relieving compartment pressure (ie, cast removal, fasciotomy), ischemia leads to permanent nerve and tissue damage and/or loss of limb (Option 2) .

(Option 1) Edema and numbness or tingling (paresthesia) of the hands and fingers commonly occur from inappropriate sling application. Numbness and tingling also are early signs of compartment syndrome. However, the client with late signs of compartment syndrome (eg, paralysis) should be seen first.

(Option 3) Clients with amputations may experience phantom limb pain that is severe and described as burning or crushing and requires pain management. However, limb-threatening emergencies should be managed first.

(Option 4) Slightly decreased hematocrit and hemoglobin levels (normal male: 39%-50%, 13.2-17.3 g/dL, respectively) are expected after hip arthroplasty due to intra- and postoperative blood loss.

Educational objective : Compartment syndrome is a condition of impaired circulation due to increased tissue pressure, often from edema or medical devices. Clients with signs of compartment syndrome (eg, severe, unrelenting pain; paralysis) require immediate assessment and intervention to prevent permanent tissue damage or loss of limb.

The nurse is reinforcing teaching about constipation prevention to a client. Which of the following client statements indicate appropriate understanding of the teaching? Select all that apply .

Constipation is a symptom of many disease processes (eg, Parkinson disease, diabetic neuropathy, depression), procedures (eg, abdominal surgery, bowel manipulation), and medications (eg, anticholinergics, diuretics, opioids). Immobility, low-fiber diets, decreased fluid intake , and irregular bowel habits increase the likelihood of constipation. Educate clients to prevent constipation by:

• Encouraging a healthy bowel regimen (eg, avoid delaying defecation if the urge is felt, defecate at the same time daily when possible, track bowel movements to identify changes in patterns) (Option 2)
• Increasing consumption of fruits and vegetables to reach a daily fiber intake of at least 20 g (unless contraindicated) because fiber softens and increases the bulk of stool, which promotes defecation (Option 4)
• Increasing daily exercise because activity stimulates peristalsis and promotes defecation (Option 5)
• Drinking 2-3 L of noncaffeinated fluids daily (unless contraindicated), which prevents drying and hardening of stool in the colon

(Option 1) Clients should avoid caffeinated beverages, which promote diuresis and dehydration and may lead to constipation.

(Option 3) Clients should avoid using laxatives and enemas unless prescribed by a health care provider because overuse can result in physical and psychological dependency.

Educational objective: Constipation is a symptom of many disease processes, procedures, and medications. To prevent constipation, educate the client to increase daily fiber intake, drink 2-3 L of fluids daily, increase daily activity levels, and initiate a bowel regimen (eg, avoiding delay of defecation, defecating at the same time each day).

The nurse is assigning client care tasks to unlicensed assistive personnel. Which statement by the nurse is appropriate?

When assigning client care, the nurse must consider the five rights of delegation. Right direction/communication involves clear and precise instructions about assigned tasks, including any specific information necessary for completion . Necessary information includes the specific tasks (eg, take vital signs), the time frame (eg, in 10 minutes), and when to report back to the nurse (eg, if systolic blood pressure is (Option 4) .

(Option 1) Assigning unlicensed assistive personnel (UAP) to measure vital signs “this morning” does not provide a clear time frame (eg, in 1 hour) for completion. In addition, there is no communication about what the nurse expects in terms of follow-up.

(Option 2) Instructing the UAP to monitor the client closely is an unclear direction because it does not provide specific actions to perform (eg, “Set the bed alarm.”), time intervals for performance (eg, “Check on the patient every hour.”), or criteria to report to the nurse (eg, “Notify me if the client attempts to exit the bed unassisted.”).

(Option 3) Instructing the UAP to assist with ambulation “several times” does not give a specific time frame or distance for the client to ambulate. The nurse should also communicate the conditions or aids needed to accomplish the task (eg, walks with assistance or rolling walker).

Educational objective: Nurses assigning client care to unlicensed assistive personnel must consider the five rights of delegation. Right direction/communication involves providing clear instructions about the assigned tasks, specific information needed for task completion, the time frame, and when to report back to the nurse.

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NGN Question Types & Scoring

The Next Generation NCLEX was launched on April 1, 2023 and the updated exam now contains new item types designed to better measure candidates’ clinical judgment. NCSBN also introduced a new partial credit NGN scoring model . Depending on the item type used, the 0/1 scoring rule, +/- scoring rule, or rationales scoring rule may be applied.

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NGN Sample Questions

The future of nursing education is here. We’ve included examples below of the new NGN question types to prepare you for what’s to come.

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NCLEX Practice Questions Test Bank for Free

Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX- RN exam! This updated guide for 2024 includes 1,000+ practice questions, a primer on the NCLEX-RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies.

Table of Contents

Nclex-rn practice questions test bank, what is nclex.

• What is Next Generation NCLEX (NGN)? 

Safe and Effective Care Environment

• Health Promotion and Maintenance 
• Psychosocial Integrity 

Physiological Integrity

Clinical judgment, integrated processes, item writers for nclex, computer adaptive test (cat), 95% confidence interval rule, maximum-length exam, run-out-of-time (r.o.o.t.) rule, zero/one (0/1) scoring, plus/minus (+/-) scoring, rationale scoring, pretest items, testing time, unfolding case study, stand-alone items, multiple response select all that apply.

• Multiple Response Select N 

Multiple Response Grouping

• Highlight in Text 

Highlight in Table

Matrix multiple response, matrix multiple choice.

• Drag and Drop Cloze 

Drag and Drop Rationale

Drop down cloze, drop down rationale, drop down in table, chart or exhibit questions, graphic option, select all that apply or multiple-response, fill-in-the-blank, ordered-response, how to register for the nclex, nclex-rn resources, want more practice questions, recommended resources.

Looking for the complete collection of practice questions? For more NCLEX practice questions, please visit our Nursing Test Bank here .

We have included more than 1,000+ NCLEX practice questions covering different nursing topics for this nursing test bank ! We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning .

We recommend you do all practice questions before you take the actual exam. Doing so will help reduce your test anxiety and help identify nursing topics you need to review. To make the most of the practice exams, try to minimize mistakes to less than 15 questions and take your time answering the questions, especially when reading the rationales.

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Included NCLEX-RN question sets for this nursing test bank are as follows. Please click on the links below and you’ll be redirected to the quiz page:

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The National Council Licensing Examination (NCLEX) is a comprehensive test administered by the National Council of State Boards of Nursing (NCSBN). It assesses whether candidates possess the necessary knowledge and skills to provide safe and effective nursing care at the entry level. The NCLEX is available in two versions: the NCLEX-RN for registered nurses and the NCLEX-PN for practical/vocational nurses.

The NCSBN, composed of nursing regulatory bodies from all 50 states in the US, the District of Columbia, and four US territories, is responsible for safeguarding the public by ensuring safe nursing care. It sets the standards and guidelines for nursing licensure and develops the NCLEX examinations.

Becoming a registered nurse (RN) requires meeting specific licensure requirements determined by the licensing authorities in each jurisdiction governed by the NCSBN. One of these requirements is passing the NCLEX-RN, which evaluates the competencies necessary for practicing safely and effectively as an entry-level RN. The NCLEX-RN is used by member boards of nursing and many Canadian nursing regulatory bodies to inform their licensure decisions.

What is Next Generation NCLEX (NGN)?

The Next Generation NCLEX (NGN) is currently in effect this April 2023 for RN and LPN / LVN candidates. The change in the NCLEX is driven by the need to adapt to the increasing complexity of client care, advancements in healthcare practice, and the demand for safe clinical decision-making . The NGN aims to address the declining ability of new nursing graduates to make safe clinical decisions by integrating clinical judgment as a key competency. The NGN test format will remain adaptive but with fewer test items. Candidates will encounter Unfolding Case Studies and Stand-Alone Items , scored using partial credit with three different scoring rules. These changes in the NGN aim to assess critical thinking and the ability to make safe clinical judgments during various phases of client care.

In summary, the following are the key changes between the previous NCLEX format and the Next Generation NCLEX (NGN): 

• Same adaptive test format but reduced number of items. The Next Generation NCLEX (NGN) will retain the adaptive test format, similar to the current NCLEX, but with fewer test items. Candidates will answer between 85 and 150 items, with 15 as pretest or unscored items. 
• Case studies. All candidates will encounter three (3) Unfolding Case Studies, each consisting of six test items (a total of 18 items). Clinical situation information will be presented to candidates in a medical record format resembling a table-like structure. These situations are designed to assess their ability to think critically and make safe clinical decisions across different phases of client care. In addition to the case studies, some candidates may have Stand-Alone Items for their NGN exam.
• New NGN item types. The NGN exam will feature new item types, which include questions in unfolding cases and stand-alone items, highlight, cloze, matrix, bow-tie, drag and drop, and extended multiple responses. 
• Scoring differences. NGN test items will be scored differently compared to the current NCLEX. They will utilize partial credit scoring with three different scoring rules: the 0/1 scoring rule, the +/- scoring rule, and the rationale scoring rule. These are explained further below. 

NCLEX-RN Test Plan

The NCLEX test plan is a content guideline to determine the distribution of test questions. NCSBN uses the “Client Needs” categories to ensure the NCLEX covers a full spectrum of nursing activities. It is a summary of the content and scope of the NCLEX to serve as a guide for candidates preparing for the exam and to direct item writers in the development of items.  Additionally, to assess the knowledge, skills, abilities, and clinical judgment necessary for entry-level nursing practice , the NCLEX-RN Test Plan utilizes Bloom’s taxonomy for the cognitive domain. This taxonomy provides a foundation for writing and coding examination items, focusing on application-level or higher-level cognitive abilities that require advanced thought processing.

The content of the NCLEX-RN is organized into four major Client Needs categories: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. Some of these categories are divided further into subcategories. Below is the NCLEX-RN test plan effective as of April 2023 until March 2026: 

There are two subcategories under Safe and Effective Care Environment.

• Management of Care category includes content that tests the nurse ‘s knowledge and ability to direct nursing care that enhances the care delivery setting to protect clients, significant others, and healthcare personnel. 
• Safety and Infection Control category includes content that tests the nurse’s ability required to protect clients, families, and healthcare personnel from health and environmental hazards. 

Health Promotion and Maintenance

Health Promotion and Maintenance category includes content that tests the nurse’s ability to provide and direct nursing care to the client that incorporates knowledge of expected growth and development, preventing and early detection of health problems, and strategies to achieve optimal health. 

Psychosocial Integrity

The Psychosocial Integrity category is content related to the promotion and support for the emotional, mental, and social well-being of the client experiencing stressful events and clients with acute or chronic mental illness . 

In the Physiological Integrity category are items that test the nurse’s ability to promote physical health and wellness by providing care and comfort , reducing risk potential, and managing health alterations. There are four subcategories under Physiological Integrity. 

• Basic Care and Comfort are content to test the nurse’s ability to provide comfort and assistance to the client in performing activities of daily living . 
• Pharmacological and Parenteral Therapies category includes content to test the nurse’s ability to administer medications and parenteral therapies ( IV therapy , blood administration, and blood products). 
• Reduction of Risk Potential category includes content to test the nurse’s ability to prevent complications or health problems related to the client’s condition or prescribed treatments or procedures. 
• Physiological Adaptation category includes questions that test the nurse’s ability to provide care to clients with acute, chronic, or life-threatening conditions. 

Clinical judgment is a central component of the NCLEX-RN Test Plan, reflecting the evolving demands and complexity of nursing practice . Nurses must engage in an iterative, multi-step process that utilizes nursing knowledge to observe and assess situations, identify client concerns, and generate evidence-based solutions to ensure safe client care. Clinical judgment questions are represented through Unfolding Case Studies or individual Stand-Alone Items , with case studies addressing each step of clinical judgment. The following are the six clinical judgment cognitive skills: 

• Recognize cues “What matters most?” Identifying relevant and important information from various sources, such as medical history , laboratory studies, and vital signs.
• Analyze cues “What could it mean?” Organizing and connecting recognized cues to the client’s clinical presentation.
• Prioritize hypotheses “Where do I start?”   Evaluating and prioritizing hypotheses based on urgency, likelihood, risk, difficulty, time constraints, and other factors.
• Generate solutions “What can I do?” Identifying expected outcomes and using hypotheses to define a set of interventions aligned with the expected outcomes.
• Take action “What will I do?” Implementing the highest-priority solution(s) identified.
• Evaluate outcomes “Did it help?” Comparing observed outcomes to expected outcomes to assess the effectiveness of interventions.

Additionally, In contrast to the nursing process or ADPIE , the NCSBN focuses on AAPIE ( assessment , analysis, planning , intervention, evaluation ), wherein nursing diagnosis is not tested at the current NGN because it is not considered a universal language used in health care or the nursing profession. In nursing practice and for the NGN, students must use their pathophysiology knowledge to analyze client assessments and connect them with common conditions in healthcare settings. 

Integral to nursing practice, several processes are integrated throughout the Client Needs categories and subcategories:

• Caring. In an atmosphere of mutual respect and trust, nurses interact with clients, providing encouragement, hope, support, and compassion to help achieve desired outcomes .
• Clinical Judgment . An observed outcome of critical thinking and decision-making , clinical judgment (discussed above) is a dynamic and iterative process. It involves using nursing knowledge to observe and assess situations, prioritize client concerns, generate evidence-based solutions, and deliver safe client care.
• Communication and Documentation . Verbal and nonverbal interactions between nurses, clients, significant others, and the healthcare team. Accurate and comprehensive documentation ensures adherence to practice standards and accountability in care provision.
• Culture and Spirituality. Recognizing and considering the unique preferences, standards of care, and legal considerations of clients (individuals, families, groups, and populations) in the context of their culture and spirituality.
• Nursing Process. A systematic approach to client care encompassing assessment , analysis, planning, implementation , and evaluation .
• Teaching/Learning. Facilitating acquiring knowledge, skills, and abilities that promote behavioral change.

Who writes questions for the NCLEX? The NCSBN sets the criteria and selection process for item writers who are registered nurses. Many of them are nursing educators with an advanced degrees in nursing, so if you’ve completed an accredited nursing program, you have already taken several tests written by nurses with backgrounds similar to those who write for the NCLEX.

The NCLEX-RN is a crucial step for registered nurse (RN) candidates seeking licensure. Administered through computerized adaptive testing ( CAT ), this examination utilizes computer technology and measurement theory to create a personalized and accurate assessment of each candidate’s knowledge and skills. 

The CAT system employed in the NCLEX-RN ensures that each candidate receives a unique examination tailored to their abilities. As the test progresses, the computer selects items from a large item pool based on the candidate’s previous answers. These items are classified according to the test plan categories, difficulty levels, and clinical judgment steps. The CAT system continually recalculates the candidate’s ability estimate and selects subsequent items accordingly, creating an exam that aligns with the NCLEX-RN Test Plan requirements. This dynamic approach allows candidates to demonstrate their competence effectively.

Additionally, unlike traditional fixed-length exams, which assign the same items to all candidates, CAT selects items based on the candidate’s ability, resulting in a more accurate assessment. The CAT scoring algorithm estimates the candidate’s ability by considering all previous answers and the difficulty level of those items. By administering items that challenge the candidate appropriately, the exam gathers maximum information about their ability.

Pass or Fail Decisions: How to Pass the NCLEX?

Passing the NCLEX-RN requires you, the candidate, to meet a specific passing standard established by the NCSBN Board of Directors (BOD). The passing standard represents the minimum ability level necessary for safe and effective entry-level nursing practice. The BOD reevaluates this standard every three years, considering various factors such as a standard-setting exercise conducted by experts and psychometricians, historical data on candidate performance, and information on the educational readiness of aspiring nurses. Once the passing standard is set, it is uniformly applied to all candidates during the scoring process. The NCSBN indicates that these three rules govern pass-or-fail decisions: the 95% Confidence Interval Rule , Maximum-Length Exam Rule , and Run-Out-Of-Time Rule .

In this scenario, the computer stops administering test questions when it is 95% certain that your ability is clearly above the passing standard or clearly below the passing standard. 

When your ability is close to the passing standard, the CAT gives you items until the maximum number of items is reached. At this point, the computer disregards the 95% confidence rule and decides whether you pass or fail by your final ability estimate. If your final ability estimate is above the passing standard, you pass; if it is below, you fail. 

In the event that a candidate runs out of time before completing the maximum number of items and the computer has not reached a 95% certainty regarding the candidate’s pass or fail status, alternative criteria come into play.

• If the candidate has not answered the minimum required number of items, the candidate will automatically fail.
• If the candidate has answered at least the minimum required number of items, the final ability estimate will be determined based on all the responses given before the exam time expires. If the score meets or exceeds the passing standard, the candidate will pass. Otherwise, the candidate will fail.

New Scoring System in the Next Generation NCLEX

The Next Generation NCLEX (NGN) incorporates different item formats, and for items that have multiple correct answers, partial credit scoring is implemented . Unlike the previous exam format, where items are scored as either all correct or all incorrect, the NGN will use polytomous scoring models to evaluate partial understanding. For example, in the previous version of NCLEX (multiple response) SATA (select-all-that-apply) items, only endorsing all the correct options results in a correct score. However, the new approach will acknowledge partial understanding, allowing differentiation between candidates with different numbers of correct options. This change will provide a more accurate assessment of candidates’ knowledge, skills, and abilities.

Three methods are used to assign partial credit for these items: plus/minus scoring, zero/one scoring, and rationale scoring. Understanding the scoring models is crucial for NCLEX-RN takers to know how their answers are evaluated and how scores are determined.

The 0/1 scoring rule is used for multiple-choice items. Choosing the correct option earns one point while selecting an incorrect option gives a score of zero. This rule applies to single response items, including the example multiple-choice item.

The +/– scoring rule measures a candidate’s ability to identify relevant information. It assigns points for correct options and deducts points for incorrect options. It is used for multi-point items, and the total score is calculated by adding correct options and subtracting incorrect ones. The lowest possible score is zero. This rule is applied to NGN question types such as multiple-response and select all that apply.

The rationale scoring rule is used for questions that assess paired information. To earn a score of one point, both answer options must be correct. If either option is incorrect, the score is 0.

How Many Questions Are on the NCLEX?

All RN candidates must answer a minimum of 85 items , while a maximum of 150 items be administered during the five-hour time allotment. Each NCLEX-RN exam includes 15 pretest items (unscored), which are indistinguishable from operational (scored) items.

To ensure the effectiveness of computerized adaptive testing (CAT) in the NCLEX, the difficulty level of each item needs to be determined beforehand. This is achieved by administering these items as pretest items to a large group of NCLEX candidates. Since the difficulty of pretest items is initially unknown, they are not part of your score and are not considered when evaluating a candidate’s ability or determining pass-fail outcomes. Once a sufficient number of responses are collected, the pretest items undergo statistical analysis and calibration. If they meet the required NCLEX statistical standards, they can be used as operational items in future exams. Therefore, candidates must approach every item with their best effort, regardless of whether it is a pretest or an operational item.

The length of the NCLEX-RN examination varies for each candidate based on their responses, but there is a five-hour time limit for the exam, including all breaks. To ensure completion within the allotted time, candidates must maintain a reasonable pace, spending approximately one to two minutes per item . It’s important to note that the length of the examination does not determine pass or fail outcomes; candidates can succeed or fail regardless of the examination’s duration.

Case Studies in NGN

The Next Generation NCLEX (NGN) has introduced case studies that present practical clinical scenarios and include test items aligned with six cognitive abilities of the clinical judgment model. The scenario can occur in various settings, and the client’s outcome can vary, including improvement, stability, or decline with complications. Laboratory results, if included, are presented in a table, and abnormal values are highlighted with an “L” or “H”. There are two types of case studies: Unfolding Case Study with six test items assessing specific skills and Stand-Alone Items with a single test item independent of a case study.

An Unfolding Case Study presents a realistic client situation with evolving data resembling a medical record. It includes multiple phases over time, reflecting changes in the client’s condition. The case study evaluates all six cognitive skills of the clinical judgment model through six questions. Each test-taker receives three (3) unfolding case studies, totaling 18 items across those cases. 

Stand-Alone Items are case studies with a single question, with the item presented as a bow-tie or a trend question type. Candidates who take more than the minimum number of items on the NCLEX receive around six to seven stand-alone cases. 

Question Types in the NCLEX-RN

The different question types for the NCLEX-RN include the following: 

Extended Multiple Response

In Extended Multiple Response item types, test-takers can choose one or more options in Multiple Response Select All That Apply, select a specific number of items in Multiple Response Select N, or choose options from different groupings presented in a table in Multiple Response Grouping, with scoring rules based on the selected type. Extended multiple response may include the following formats:

The Multiple Response Select All That Apply item type allows test-takers to choose one or more answer options. It uses the +/- Scoring Rule, where selecting correct information earns points (+1), and selecting incorrect information results in points deducted (-1). The maximum points achievable are equal to the number of correct options, and the minimum score is 0, with no negative scores. The item must have a minimum of five options and can have up to ten options, with the possibility of all ten options being correct.

Multiple Response Select N

The Multiple Response Select N item type informs the test-taker about the specific number of items (N) that can be selected. The question provides a range of options, with a minimum of five and a maximum of ten options. It uses the 0/1 Scoring Rule, where each correct response earns 1 point, while any incorrect response results in 0 points.

The Multiple Response Grouping utilizes a table to present options, with a minimum of two and a maximum of five groupings. Each grouping consists of a minimum of two and a maximum of four options, ensuring an equal number of options within each grouping. Test-takers are required to select at least one option from each grouping. The item follows the +/- Scoring Rule, meaning there is no negative score per grouping. The total score for the item is determined by summing the points earned within each grouping. The maximum score achievable equals the number of keys (N).

For this NGN item type, the test-taker is presented with information and must highlight specific parts of the information provided.  Highlight question type include the following formats:

Highlight in Text

It involves a paragraph of information where the test-taker must select (highlight) specific parts of the text based on the question’s requirements. The item can include a maximum of ten options for selection and uses the +/- Scoring Rule. 

The Highlight in Table item type involves a table of information. The candidate is tasked with selecting (highlighting) specific parts of the text within the table based on the question’s prompt. The item can include a maximum of ten options for selection. The table has two columns, including a header, and can have up to five rows. This item type uses the +/- Scoring Rule. 

Matrix/Grid

In the Matrix NGN item type, test-takers are presented with a grid-like structure to which they must respond. There are two variations: Matrix Multiple Response, where each column can have multiple correct responses, and Matrix Multiple Choice, where test-takers select one answer option per row. Extended multiple response may include the following formats:

The Matrix Multiple Response item type consists of response columns, where each column can have multiple correct responses. The item can have between two and ten columns and four to seven rows. In each column, at least one response option must be selected, but it is possible to select one or more responses per column. The item follows the +/- Scoring Rule, with no negative score per column. The total score for the item is determined by summing the points earned within each column. The maximum score achievable is equal to the number of keys (N).

The item includes a minimum of four rows and a maximum of ten rows. It can have either two or three options/columns. Test-takers are allowed to select one answer option per row. The item follows the 0/1 scoring rule, where the test-taker earns 1 point for each correct response and 0 points for incorrect responses. The total score for the item is obtained by summing the scores over the rows. The maximum score achievable is equal to the number of rows.

Drag and Drop

In the Drag and Drop NGN question type, test-takers are presented with options to drag and drop into specific targets. There are two variations: Drag and Drop Cloze, where options are placed in response targets to complete sentences and Drag and Drop Rationale, where options are matched to causes and effects. Drag and drop may include the following formats:

Drag and Drop Cloze

The Drag and Drop Cloze item type includes a range of four to ten options. It can have one or more response targets where the options are dragged to. The item must have a minimum of one sentence with one target per sentence and up to five sentences, each with one target per sentence. The item follows the 0/1 Scoring Rule, where a correct response earns 1 point and incorrect responses earn 0 points. The total score is obtained by summing the scores across all targets, with the maximum score achievable being the number of targets.

The Drag and Drop Rationale type involves one sentence with one cause and one effect or one sentence with one cause and two effects. The sentence can be a single dyad (one sentence with two targets) or a single triad (one sentence with three targets). Each drag & drop target can have three to five options. The item follows the Rationale Scoring Rule where both answer options must be correct to earn a point. 

The Drop Down question type in NGN includes three variations: Drop Down Cloze, Drop Down Rationale, and Drop Down in Table. Drop down may include the following formats:

The Drop Down Cloze item type presents one or two sentences of information that require completion using drop-down options. Each drop-down can contain three to five options. The item must have a minimum of one sentence with one drop-down per sentence and can include up to five sentences, each with one drop-down. The item follows the 0/1 Scoring Rule, where the score is calculated by summing the correct responses across all drop-downs. The maximum score achievable is equal to the number of drop-downs.

The Drop Down Rationale item type presents either one sentence with one cause and one effect or one sentence with one cause and two effects. Each drop-down can contain three to five options. The scoring follows the Rationale Scoring Rule, where X and Y must be correct to earn one point. The maximum points that can be earned are 1 point for a dyad (one sentence with two targets) and 2 points for a triad (one sentence with three targets).

The Drop Down in Table item type presents a table of information with drop-down options located in various parts of the table. The item must have a minimum of three columns and three rows and a maximum of five columns and four rows. One column serves as the header column. Each row contains one drop-down. The item follows the 0/1 Scoring Rule, where the score is calculated by summing the correct responses across all drop-downs. The maximum score achievable is equal to the number of drop-downs.

The Bow-tie item type is visually designed to resemble a bow-tie shape. It consists of five options on the left side, five options on the right side, and four options in the middle well of the bow-tie. The item addresses all of the cognitive skills within a single item. The Bow-tie item follows the 0/1 scoring rule. The left and right wells have two answer options each, while the middle well has one answer option, resulting in a maximum possible score of 5 points. Each correct response earns 1 point, while incorrect responses earn 0 points.

The Trend item type presents information in a medical record or flow sheet format that spans over time, requiring the test-taker to analyze information across different points in time. The item addresses multiple cognitive skills within a single item. It can utilize any NGN item type except for the bow-tie. The scoring rule for the Trend item depends on the specific item type used.

Multiple-Choice Questions

Many questions on the NCLEX are in multiple-choice format. This traditional text-based question will provide you data about the client’s situation, and you can only select one correct answer from the given four options. Multiple-choice questions may vary and include: audio clips, graphics, exhibits, or charts.

A chart or exhibit is presented along with a problem. You’ll be provided with three tabs or buttons that you need to click to obtain the information needed to answer the question. Select the correct choice among four multiple-choice answer options. 

In this format, four multiple-choice answer options are pictures rather than text. Each option is preceded by a circle that you need to click to represent your answer.

In an audio question format, you’ll be required to listen to a sound to answer the question. You’ll need to use the headset provided and click on the sound icon for it to play. You’ll be able to listen to the sound as many times as necessary. Choose the correct choice from among four multiple-choice answer options. 

For the video question format, you must view an animation or a video clip to answer the following question. Select the correct choice among four multiple-choice answer options. 

Multiple-response or select all that apply (SATA) alternate format question requires you to choose all correct answer options that relate to the information asked by the question. There are usually more than four possible answer options. No partial credit is given in scoring these items (i.e., selecting only 3 out of the 5 correct choices), so you must select all correct answers for the item to be counted as correct. 

Tips when answering Select All That Apply Questions

• You’ll know it’s a multiple-response or SATA question because you’ll explicitly be instructed to “Select all that apply.”
• Treat each answer choice as a True or False by rewording the question and proceed to answer each option by responding with a “yes” or “no”. Go down the list of answer options one by one and ask yourself if it’s a correct answer.
• Consider each choice as a possible answer separate to other choices. Never group or assume they are linked together.

The fill-in-the-blank question format is usually used for medication calculation, IV flow rate calculation, or determining the intake-output of a client. You’ll be asked to perform a calculation in this question format and type in your answer in the blank space provided. 

Tips when answering Fill-in-the-Blank

• Always follow the specific directions as noted on the screen. 
• There will be an on-screen calculator on the computer for you to use. 
• Do not put any words, units of measurements, commas, or spaces with your answer, type only the number. Only the number goes into the box.
• Rounding an answer should be done at the end of the calculation or as what the question specified, and if necessary, type in the decimal point. 

In an ordered-response question format, you’ll be asked to use the computer mouse to drag and drop your nursing actions in order or priority. Based on the information presented, determine what you’ll do first, second, third, and so forth. Directions are provided with the question. 

Tips when answering Ordered-Response questions

• Questions are usually about nursing procedures. Imagine yourself performing the procedure to help you answer these questions.
• You’ll have to place the options in correct order by clicking an option and dragging it on the box on the right. You can rearrange them before you hit submit for your final answer.

A picture or graphic will be presented along with a question. This could contain a chart, a table, or an illustration where you’ll be asked to point or click on a specific area. Figures may also appear along with a multiple-choice question. Be as precise as possible when marking the location. 

Tips when answering Hotspot questions

• Mostly used to evaluate your knowledge of anatomy, physiology, and pathophysiology.
• Locate anatomical landmarks to help you select the location needed by the item.

So you’ve finally decided to take the NCLEX, the next step is registration or application for the exam. The following are the steps on how to register for the NCLEX, including some tips:

• Application to the Nursing Regulatory Board (NRB). The initial step in the registration process is to submit your application to the state board of nursing in the state in which you intend to obtain licensure. Inquire with your board of nursing regarding the specific registration process as requirements may vary from state to state.
• Registration with Pearson VUE. Once you have received the confirmation from the board of nursing that you have met all of their state requirements, proceed, register, and pay the fee to take the NCLEX with Pearson VUE . Follow the registration instructions and complete the forms precisely and accurately.
• Authorization to Test. If you were made eligible by the licensure board, you will receive an Authorization to Test (ATT) form from Pearson VUE. You must test within the validity dates (an average of 90 days) on the ATT. There are no extensions or you’ll have to register and pay the fee again. Your ATT contains critical information like your test authorization number, validity date, and candidate identification number.
• Schedule your Exam Appointment. The next step is to schedule a testing date, time, and location at Pearson VUE. The NCLEX will take place at a testing center , you can make an exam appointment online or by telephone. You will receive a confirmation via email of your appointment with the date and time you choose including the directions to the testing center. * Changing Your Exam Appointment. You can change your appointment to test via Pearson VUE or by calling the candidate services. Rules for scheduling , rescheduling, and unscheduling are explained further here . Failing to arrive for the examination or failure to cancel your appointment to test without providing notice will forfeit your examination fee and you’ll have to register and pay again. 
• On Exam Day. Arrive at the testing center on your exam appointment date at least 30 minutes before the schedule. You must have your ATT and acceptable identification (driver’s license, passport, etc) that is valid, not expired, and contains your photo and signature.
• Processing Results. You will receive your official results from the board of nursing after six weeks.

Important list and resources you need to know if you’re taking the NCLEX: 

• 2023 NCLEX Candidate Bulletin. This resource is a comprehensive guide for the NCLEX, providing essential information and contact details for candidates. It covers registration procedures, test fees, scheduling , testing accommodations, exam rules, and what to bring to the test site. The guide also includes details on the check-in process, breaks, technical issues, and the testing environment. It explains the results reporting process and retake-policy and provides information on the content, development, and test plans of the NCLEX. Additionally, it discusses the passing standard, item formats, and decision rules for passing or failing the exam.
• Sample Questions and Exam Preview. Get a headstart on your exam preparation with these sample test packs by the NCSBN. 
• Candidate Tutorial. With the new item types, we highly recommend testing how the Next Generation NCLEX (NGN) works. This tutorial guides you on interacting with different question types in your NCLEX exam. It provides a representative sample of items you may encounter during the test, allowing you to practice their functionality.

Please visit our Nursing Test Bank page if you’re looking to answer more practice questions from different topics and different question formats.

Recommended books and resources for your NCLEX success:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

Saunders Comprehensive Review for the NCLEX-RN Saunders Comprehensive Review for the NCLEX-RN Examination is often referred to as the best nursing exam review book ever. More than 5,700 practice questions are available in the text. Detailed test-taking strategies are provided for each question, with hints for analyzing and uncovering the correct answer option.

Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items Next Generation NCLEX®-style practice questions of all types are illustrated through stand-alone case studies and unfolding case studies. NCSBN Clinical Judgment Measurement Model (NCJMM) is included throughout with case scenarios that integrate the six clinical judgment cognitive skills.

Saunders Q & A Review for the NCLEX-RN® Examination This edition contains over 6,000 practice questions with each question containing a test-taking strategy and justifications for correct and incorrect answers to enhance review. Questions are organized according to the most recent NCLEX-RN test blueprint Client Needs and Integrated Processes. Questions are written at higher cognitive levels (applying, analyzing, synthesizing, evaluating, and creating) than those on the test itself.

NCLEX-RN Prep Plus by Kaplan The NCLEX-RN Prep Plus from Kaplan employs expert critical thinking techniques and targeted sample questions. This edition identifies seven types of NGN questions and explains in detail how to approach and answer each type. In addition, it provides 10 critical thinking pathways for analyzing exam questions.

Illustrated Study Guide for the NCLEX-RN® Exam The 10th edition of the Illustrated Study Guide for the NCLEX-RN Exam, 10th Edition. This study guide gives you a robust, visual, less-intimidating way to remember key facts. 2,500 review questions are now included on the Evolve companion website. 25 additional illustrations and mnemonics make the book more appealing than ever.

NCLEX RN Examination Prep Flashcards (2023 Edition) NCLEX RN Exam Review FlashCards Study Guide with Practice Test Questions [Full-Color Cards] from Test Prep Books. These flashcards are ready for use, allowing you to begin studying immediately. Each flash card is color-coded for easy subject identification.

185 thoughts on “NCLEX Practice Questions Test Bank for Free”

How much are you charging for it?

Thanks for being generous

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Thanks Matt Vera for your utmost effort in helping nurses to pass the exam

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Thank you so much Nurse matt vera for this qbank,most beneficial, God bless you., if I may ask for some videos or pictures associated with the questions, will also help e.g lung sounds,abdominal sound etc thank you

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You’re most welcome! :)

i just want to confirm for #39 it state pt need additional teaching so E should also be included to the answer cause it was contraindicated to MS right? . thank you :)

Yes, this has been corrected. Thank you! :)

Very informative and helpful. Thank you so much Sir/ madam

Thank you for providing regarding NCLEX preparation

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Number 58 of NCLEX test 5 does not have the answers listed.

Hi Rebekah, this is now fixed. Thank you for letting us know!

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Thank you Matt Vera for providing information free of charge

Any advice of how well you can do on these question to build up your confidence?

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75% and above, from the analysis I got from a test after getting below 75

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Question 16 on practice test 9 asked about assessment during L sided CHF, yet the correct answer pertained to right sided HF. Just wanted to let you know…. Thanks for the practice questions! Appreciate all the work put into this.

Question 41 of NCLEX-RN Test 2 has two C choices. Thanks.

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Thank you Matt for this practice test. Now I know my strength and weaknesses and will concentrate of the system that needs for further study. Can I practice more in practice test no 2? Please allow me to go trough with it. Kudos to you and your staff.

Hi this is what i got, im so nervous due to my nclex exam its gonna be this coming oct. Its doesnt say pass or not.

Your score 48% Categories Basic Care and Comfort 100% Health Promotion and Maintenance 53.85% Pharmacological and Parenteral Therapies 26.67% Physiological Adaptation 54.55% Psychosocial Integrity 100% Reduction of Risk Potential 36.36% Safety and Infection Control 100%

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I remain speechless but mostly grateful for your unconditional helpful assistance for this awesome richly throughout profound tool and opportunity given to me to increase my confidence, strengthen my knowledge, and be ready for my upcoming exam. Your questions and rationales are beyond my expectations. You are a God’ sent angel. Thank You. God Bless you. I will be forever grateful to you for making my dream come true! 🙌

This website can help me to review for NCLEX and it is for free! Thank you so much!

Amazing and really awesome job to you Matt and your entire team, may God replenish your source for giving us this for free. I have recommended to all my friends and family. Remain blessed and stay safe.

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Your test questions have greatly helped me pass my NCLEX. I passed my NCLEX today and thank you to Nurseslabs. I came across this website by accident and I do not know how but it was divine intervention. I will definitely recommend Nurseslabs to my friends. The quality of the questions and rationales were very good and you would not think this is all for free the kind of work that came with it.

Kudos Nurseslabs and wishing all the future test takers all the best!

Wow Sam, congrats! What materials did you use other than nurseslabs? I’ve been answering nurseslabs also. My exam is on June. I hope I could also make it.

Thank you for this NCLEX sample test,as tool to determine areas i need to review/focus on for the proper exams.

This website can help me to review for NCLEX Thank you so much!

I just wanna ask why is that there are no more rationale posted after answering the question unlike before. Thanks by the way for the free and great Q & A bank. ❤

Sorry, we’re currently having some performance issues with that setup. Until we can resolve it, we have set each quiz to show results and rationales only after you have finished all the questions. Thank you for your understanding.

Hello, how do I get my score after taking the test to know if I am doing well or not

Hi, after you’re done answering all questions, the final item will direct you to the “Quiz Summary,” from there, click on the “Finish Quiz” button to get your final score.

Very great tool to study for the NCLEX. I passed my exam just by focusing on the questions and rationales provided here.

That’s great! Congratulations!

Thank you so much. It’s very helpful. God bless you…

Thank you for being generous. This is a big help.

I got 55/75.

Thank you so much for making this site.

Very helpful. Thank you and God bless…

Thank you so much, Nurse Matt for your generosity. Helping your fellow nurses and aspiring nurses to work abroad is such a selfless and noble act. God bless you and your team!

Thank you for your kind words, JB! Will pass on this message to the team. :) God bless!

The rationale after the question will really help us a lot specially when you are just using the question via online.

Hi Romel, we have temporarily changed this setting so that results and rationales will show only after you’ve finished the quiz. This is because we’re having some performance issues when using the previous setting. We’ll revert the changes once we’re sure the problem is resolved. Thanks for understanding!

I didn’t get my results after answering the 75 questions. Please why?

Hi Esther, did you click on the “Finish Quiz” button?

Thanks for all these questions where/how can i check my answers to these questions?

After answering the last item of the quiz, you’ll be redirected to the quiz summary. From there, click on the “Finish Quiz” button to view your score and results. You can also click on the “View Questions” button to review your answers and read the rationales.

Hi, thanks for providing so much useful information and all the test banks!

In RN practice Quiz 1:75 questions, for question 70, wonder if the correct phrase would be “would you NOT expect”?

Hi Cecilia, thanks for letting us know. We have corrected the question. Thank you! 🥰

Thank you for allowing me to practice the nurseslabs questions. The rationales are well explained. Thank you!

Thank you Ruth. Hope you’ve learned a lot from our practice questions. 🥰

God bless you

My name is Samuel. I just started with the RN practice questions. Thank you for the opportunity.

Hi, thank you so much for your generosity. Using this to prepare for my NCLEX and find it very informative. I will keep you posted on how it goes on the D-day

Frequently throughout the quiz, ARDS is given as “Adult Respiratory Distress Syndrome” instead of “Acute Respiratory Distress Syndrome”. This needs to be corrected.

Hi Bella, thanks for bringing this up.

Technically both terms are correct since “adult respiratory distress syndrome” is an earlier name referred to “acute respiratory distress syndrome” to differentiate it from respiratory distress syndrome in neonates and children. For the sake of uniformity, we have edited them to “acute respiratory distress syndrome”. You can read more about it here: https://doi.org/10.1164/ajrccm.149.3.7509706

This is so kind a gesture, remain blessed .The information is very understandable and helpful

I just wanted to thank you for taking the time to generate this website, this is really helpful and is free. God bless you

Thank you for your support and guide toward my nclex preparation.

Thanks for your generosity. I hope to pass my NCCLEX just on the first attempt Grateful for all your help

thanks for the help

Hi Sir, kindly explain why this question – The client with hyperemesis gravidarum is at risk for developing: Metabolic Acidosis is the answer. Thank you.

Quite familiar with the content. Thanks for this selfless initiative.

It has been a nice experience.

I love these practical questions. So helpful.

Thanks very much this is a good help for all students

Thank you for mett this free test which i have passed yesterday afternoon so ,it is greatest pleasure which will help me

Thank you so much for this great initiative.

Thanks for being kind God bless you

thank you for your help and kindness. It’s difficult to go back to school after 22 years of practice as a RN to take the test where you must cover a vast knowledge, which you do not use in everyday working (depends on the special field you are working. so I really appreciate your effort and dedication.

Matt Vera and all those helping us through this free medium, May God richly bless you abundantly. And may all your good desires come through

Hello Vera, I would start by thanking you for the great job you’ve done by helping us in our preparation for the exams. secondly would wish to know wther you have audio clips for lung, heart and abdominal sounds. thank you in advance and if any kindly let mh know pls.

What should we be scoring on these practice questions to let us know that we’re ready for the NCLEX

Do you have LPN test also?

Hi, please visit NCLEX-PN Practice Questions & Test Bank (200 Questions)

Thank you so much Nurse Matt you just don’t know how nurseslabs helped me in my nursing career and i even recommended nurseslabs to some of my friends. God bless you😊

Hi Matt, Thank you for this, indeed very helpful practice questions. Just a query though it says here to limit wrong answers to 15 or less? So is that the passing mark ? about 75-80%

Yes, that is correct. :)

Thank you so much for the practice questions. I learned a lot and it helped me to understand why I was getting my answers wrong. I used Kaplan and Saunders but it wasn’t helping me. I feel more confident than ever to retake my boards.

thank you…. wish this help a lot to my daughter to passed please pray for her God bless!!!

hi Matt, can l still use these question banks to study for the new NGN questions

Hi nurse Matt, May I gave all the questions please, need to prepare study for exam after been off school over 30 years, realize it for not giving up not try again, thank you 🙏

Thank you so much Nurselabs! I passed my NCLEX-RN exam using only your practice 75 question per day questions bank. I have a tight budget and not able to purchased online review and I just focused in answering your practice questions in just 2 weeks!!! Thank you for helping nurses! God Bless you more!

I want to practices questions

Hello Thanks so much for your good heart and good wish for us to practice and pass the NCLEX. Well appreciated. Please after your update I can’t get the answers and rationale to the 75 questions. This will help me to know my ability and where am lagging behind. Please how can this be rectified Thanks Hope

Hi Hope, did you finished all of the questions for the quiz? Your score together with the correct answers and rationale will only show after you’ve completed the whole quiz.

Hello Vera I finished all 75 questions submitted but no answer or rationale came up. I tried upto 3 times same. Even my friend I shared your content with complained of same thing, answers not coming. Please what can we do to access the answers and rationale Thanks Hope

What particular quiz?

Hello, great resource! I am a nurse that wants to help student nurses reach their full potential as nurses and pass the nclex. I would like to utilize your tests and quizzes to help my students learn to critically think through the questions and learn how to put their nursing knowledge to use. Would you allow me to utilize your questions in my content?

Thank you for the kind words! It’s awesome to hear that you’re dedicated to helping student nurses thrive. 🌟

Absolutely, you’re more than welcome to utilize our tests and quizzes for your students! We believe in collaborative efforts to strengthen the nursing community. Just ensure to give appropriate credit when using the content.

Out of curiosity, are there specific areas or topics you find students struggle with the most when preparing for the NCLEX? Maybe we can work together to create even more targeted resources!

Best of luck with your mission to guide the next generation of nurses!

Hi, I am studying for med surg 1 and med surg 2 upcoming exam. Need to pass both exams.

Sounds like you’ve got a busy study schedule ahead! MedSurg can be challenging, but with the right resources and dedication, you’ve got this. If you need specific materials, tips, or just a morale boost, don’t hesitate to reach out. Else, you can do practice all MedSurg exams on our Nursing Test Banks . Rooting for you to ace both exams! 💪

thank you so much… a big help

Hi Glacier and what a nice name!

You’re welcome! Really glad to hear the NCLEX practice questions were a big help. If you’ve got any other areas you’re prepping for or need more practice with, just let me know. Here to support your journey!

Thanks a lot @nurseslabs for this initiative I really believe by the time I sit my exam I will be a great nurse than ever before. I am learning a lot from the questions and explanation.

Hey Charles, You’re very welcome! I’m thrilled to hear that you’re finding our initiative helpful in your journey to becoming a great nurse. Remember, continuous learning is a key part of nursing practice, and it’s fantastic to see your dedication to it. If you ever come across any challenging topics or have questions about specific nursing concepts, please don’t hesitate to reach out. We’re here to support you every step of the way. Keep up the excellent work, and you’ll do great on your exam! 📖🏥🌟

Much help for beginners like us

Thank you so much Nurseslabs, I made it!!! Your practice exams, especially the rationales helped me a LOT…thank you!!!

Wow, that’s awesome news! 🌟 Huge congrats on making it through – your hard work and dedication really paid off. It’s super cool to hear how our practice exams and rationales played a part in getting you across the finish line.

Remember, this is just the beginning of an amazing journey in nursing. The field’s always changing and growing, and so will you. Keep that enthusiasm and curiosity going strong!

If you ever need a hand or just want to share your journey as you dive into your nursing career, give us a shout. We’re always here to cheer you on and lend support.

Big congrats again and best of luck out there!

Thanks for the information

thanks for the guide

Thank you for your kindness.

Thank you very much!

Thanks a lot for this whole range of knowledge; it’s now upon me to work extra hard to be a better nurse outside there or help other nurses be better at service delivery.

Hi Evans, You’re so welcome! I’m glad to hear that the range of knowledge from the NCLEX practice questions is empowering you to aim for excellence in nursing. Remember, every bit of effort counts towards becoming not just a better nurse but also a great mentor to others in the field. If you need more resources or advice along the way, I’m here to help. Keep up the fantastic work!

Please how can I practice questions please 🙏

In practice exam 5 question 22 asks about hyperemesis…. wouldn’t that cause alkalosis (rather than acidosis), since its acid from the stomach that is leaving the body?

Can I. Have free practice questions? NGN questions?

Thank you for the opportunity to know about all the information posted here. I strongly believe I will pass the NCLEX-RN exam at my first attempt through these useful resources available here. Thanks

Thanks a lot Nurselabs for the free test banks! It’s all what I focused to practice and read every rationale in each questions given. I just recently took my NCLEX-RN exam last week and i was able to make it. Your website is what i embraced and felt much comfortable and trusted what is in there. Thanks for helping lots of NURSES! Highly recommended!

Hello Brenda, Congratulations on passing your NCLEX-RN exam! 🎉 That’s a fantastic achievement, and I’m so thrilled to hear that our test banks and rationales were a valuable part of your preparation. Thank you for trusting Nurseslabs and for your kind words—it means a lot to us.

If you have any tips for future test-takers or any other resources you found particularly helpful, we’d love to hear about them. Your feedback not only celebrates your success but also helps us continue to improve and assist other nursing students.

Thanks again for recommending us, and best of luck in your exciting nursing career!

THIS IS GREAT. THANK YOU FOR SHARING.

Hello, Thank you for your good work. Are you uploading new practice tests or comprehensive tests for nclex rn or nclex pn soon? It has been a while.

Hi Monica, Thank you for your kind words! We appreciate your support. Yes, we are planning to upload new practice tests and comprehensive tests for both NCLEX RN and NCLEX PN very soon. Stay tuned for updates!

thanks for update ..be blessed

You’re doing great!!!! Thanks

Good day sir, please am Thomas from ghana and I want an assistance to enable me pass NCLEX test.

THANK YOU VERY MUCH.

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NCLEX Study Guides and Practice Tests

Archives: Next Generation NCLEX (NGN) Questions

Identifying Key Clinical Features of Mononucleosis

Infectious Disease, Mononucleosis, Physical Assessment: NCLEX Practice Quiz

Complications and Management of Tube Feeding

Mastering Tube Feeding Challenges: An NCLEX Practice Explanation

NGN Quiz: Assessment in Gastric Cancer Home Care

Gastric Cancer Home Care: Identifying Critical Observations (NCLEX Next Gen Practice Question)

New Year’s Eve 2024 Nursing Prioritization – Next Gen NCLEX Practice Question

NCLEX Next Gen Quiz: Medical Management of Epiglottitis

• 1. Prepare the child for tracheotomy.
• 2. Prepare to administer epinephrine.
• 3. Prepare the child for a chest radiograph.
• 4. Assist the primary health care provider with intubation.

NCLEX NGN Quiz on Side Effects of Chlorpromazine

Chlorpromazine: What Nurses Need to Know

• (A) Dry mouth
• (B) Lip smacking
• (D) Hand tremors
• (D) Increased urinary output

Critical Lab Monitoring for a Pneumonia Patient on Gentamicin

NCLEX NGN Quiz on Critical Lab Monitoring for a Pneumonia Patient on Gentamicin Topic: Pharmacological Management in Pneumonia System: Renal and Hematological Systems

• 1. BUN and creatinine
• 2. Hemoglobin and hematocrit
• 3. Sodium and potassium
• 4. Platelet count and clotting time

NCLEX Pharmacology Quiz: Heparin Sodium Therapeutic Effect Monitoring

• 1. Hematocrit level
• 2. Hemoglobin level
• 3. Prothrombin time (PT)
• 4. Activated partial thromboplastin time (aPTT)

NCLEX NGN Quiz: New Nurse Injection Preparation

NCLEX NGN Quiz: Ampule Injection Preparation/Safety

• 1. Snaps the neck of the ampule gently towards the body.
• 2. Uses a filter needle when drawing up the ampule contents.
• 3. Folds gauze around the ampule neck before snapping open.
• 4. Avoids touching edges of the ampule when inserting needle.

Next Gen Quiz: Neurological Emergencies in Spinal Cord Injury

Next gen nclex quiz: neurological emergencies in spinal cord injury.

• 1. autonomic dysreflexia
• 2. autonomic crisis
• 3. autonomic shutdown
• 4. autonomic failure

Registered Nurse RN

Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. Join the nursing revolution.

Next Generation NCLEX

The NCLEX exam, short for National Council Licensure Examination , is the licensing exam that nurse graduates must pass in order to legally practice nursing in the United States, Canada, and Australia.

Practical (or vocational) nurse graduates must pass the NCLEX-PN exam, and registered nurse graduates must pass the NCLEX-RN exam.

If you’re a nursing student who expects to graduate in the spring of 2023 or later, there are huge changes taking place with the NCLEX exam that you’ll want to know about.

Next Generation NCLEX (NGN)

The National Council of State Boards of Nursing (NCSBN) plans to release a new format of NCLEX called the Next Generation NCLEX , or NGN for short.

When Will The Next Generation NCLEX Go Into Effect?

The NCSBN plans to release the new Next Generation NCLEX format on April 1, 2023. So, unless the release date changes, those of you graduating in spring 2023 or later will likely get the new format.

What is the Next Generation NCLEX? What’s Changing?

All exam details are subject to change before the actual release date. However, one of the big changes that you’ll find on the Next Generation NCLEX is a shift toward case studies (also called scenarios) to help assess the critical thinking ability of test takers.

What’s a case study? It’s a created scenario that could happen in the real world of nursing that assesses the test taker’s ability to handle a particular nursing situation. The test taker is given information about a patient, their diagnosis, current assessment findings, medications, lab results, and a presenting problem.

Based on this information, the testing candidate will be asked several questions on how the nurse would response or deal with the situation. This type of question requires much more critical thinking and nursing knowledge, and it assess whether the person will be able to deliver good, quality patient care.

There will be approximately three case studies with 6 questions each, for a total of 18 items [3], in addition to other types of questions.

There will also be five new item types on the Next Generation NCLEX, including the following:

Extended Multiple Response – Although multiple response items such as SATA questions are on the current NCLEX, “Extended Multiple Response” will expand on the number of options for each question.

Extended Drag and Drop – These question types require you to drag a response into one of the blank answer spaces, and test takers will now have to determine whether they should use some or all of the options available.

Cloze (Drop-Down) – these are the drop-down options that allow you to select a correct response, and there can now be multiple drop-down boxes in a Cloze question type.

Enhanced Hot Spot – this enhanced item type allows you to select (or highlight) the relevant words or phrases from a sample medical record that correspond to the question.

Matrix / Grid – this item type features rows and columns with options that the candidate must select.

Next Generation NCLEX Scoring Changes

If any of that NCLEX news makes you nervous, I have some good news: the Next Generation NCLEX is also changing their scoring model to a polytomous scoring model, which means that you can now get partial credit on some questions with multiple inputs. This is different from the regular NCLEX model, which marked questions as “full credit” or “no credit” only.

And yes, this does include those dreaded “select all that apply” (SATA) questions!

The Next Generation NCLEX will use three different scoring models, depending on the question type [2]:

0/1 scoring means you earn a point for each correct option selected, and zero points when you select an incorrect option. The points are then added together for a total question score. This scoring type is used on questions such as multiple choice, matrix multiple choice, multiple response where you select a specified number of answers (select N), drop-down cloze, drop-down table, and bowtie questions.

+/- scoring means that you can earn a point when you select a correct option, but lose a point when you select an incorrect option. This method is used with select all that apply multiple response questions, matrix multiple response, and MR grouping questions.

Rationale scoring means that you only earn points when you select a response that reflects a proper understanding of the rationale of the question. In this format, you will select the paired options that logically follow (Example: A leads to B). Both options must be selected correctly to earn a point.

How Many Questions are on the Next Generation NCLEX?

Each candidate will receive a minimum of 85 and a maximum of 150 questions on the exam. However, 15 of those questions are pretest questions that are not scored, so test takers can expect between 70-135 questions that are actually scored on the Next Generation NCLEX exam [3].

The exact number of questions a test taker will receive varies because the NCLEX uses Computerized Adaptive Testing (CAT), which continues to provide questions of different difficulty levels based on the test taker’s previous responses.

The test taker will continue to receive questions until the computer can determine with 95% confidence that the individual either passed or failed the exam. The exam will also stop once time is up or the person reaches the maximum number of questions (135).

How Long Do I Have to Complete the Next Generation NCLEX Exam?

You will have 5 hours to complete the Next Generation NCLEX exam.

Can You Use a Calculator on NCLEX?

NCLEX currently allows you to use a provided calculator on the test screen, and this will likely continue for the Next Generation NCLEX.

Don’t Be Intimidated by the Next Generation NCLEX (NGN)

I know that some of you are stressed out about this new NCLEX format, but I don’t think you should worry about it at all.

Unlike the meme below, the NCSBN is not some evil organization with an agenda to torture nursing students with the fear of forever failing NCLEX. Instead, these individuals are professionals who want to ensure that you’re equipped with the proper knowledge so that you can offer great care and succeed in practice.

They have a very strict process whereby nursing instructors actually develop questions. Then those questions are peer-reviewed by actual nurses in practice, and they even pretest questions and gather statistics to ensure that the exam is accurate and ready to administer.

So this isn’t something slapped together on a whim by people who know nothing about the nursing profession. It is a long, reviewed process that is continually improved based on feedback and statistics.

How Should Nursing Students Prepare for the Next Generation NCLEX (NGN)?

So how should you prepare for the Next Generation NCLEX right now as a nursing student? First, so many people are asking, “What’s changing with NCLEX?” It’s great to know what’s coming and how the questions will be formatted, and I do think practicing some questions in similar NCLEX format can be helpful.

(For the record, the NCSBN even offers a mock NCLEX exam with actual questions from previous exams that you can take at NCLEX.com for a fee if you want to practice before the actual test.)

However, I wouldn’t spend too much time stressing about the new NCLEX format changes.

If you really want to succeed on NCLEX, you need to ask this question, ”What is NOT going to change about NCLEX?” And what’s not changing is the fact that they are trying to ensure that you know enough about nursing to think critically and make the right clinical decisions so that you can provide safe and effective patient care.

So your study strategy needs to have that focus from day one. How do you do that? I would still offer the same advice that I offered in my recent NCLEX Study Plan video.

1. Start studying as early as possible . I started studying hard during the break before my last semester.

2. Prioritize your weak areas . I talked about how you can assess your strengths and weaknesses through software and so forth.

3. Practice many NCLEX-style questions . I would practice 90-100 questions almost every day.

4. Go back and review questions and topics you keep missing . Look at the pathophysiology of diseases on questions you missed. Look up medications and their mechanism of action, and so forth. Go back and study those important details.

5. Switch between review lectures , textbooks, and notes when you are not practicing questions to help you understand the content in different ways. Your brain will appreciate the switch to different studying formats. In other words, when you are tired of reading, watch a lecture that covers similar topics.

In my review lectures , I always try to help you to understand not just the way something is done, but the “why” something is done. I spend time trying to explain the patho and rationale behind things so that you’ll understand it more deeply and be able to think critically on exams and in real-life nursing practice.

That’s the key to really passing NCLEX. They want you to know enough about nursing to think critically and make the right clinical decisions.

And if you put in the time to understanding those things, it doesn’t matter whether you get a drag and drop, hot spot question, select all that apply, or whatever. You’ll have the knowledge in your head, and you will be able to sift through and choose the correct option(s).

Final Thoughts on Next Generation NCLEX

In conclusion, don’t waste time worrying about the changes coming in Next Generation NCLEX . Instead, stay the course and put in the time studying and practicing questions, and you’re going to do great!

Even if you do fail your first time around, you have the opportunity to take it again, so go into the exam with confidence!

References:

1. https://www.ncsbn.org/11436.htm

2. https://www.ncsbn.org/15991.htm

3. https://www.ncsbn.org/16013.htm

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This sample test comprises 30 realistic questions that blend new NGN item types with traditional NCLEX-RN questions.

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Frequently asked questions about the new NGN item types

The NCLEX exam is currently undergoing a major update that is going into effect on April 1st, 2023. The new format is intended to more effectively test the skills that are required of nurses in today’s healthcare environment, focusing more strongly on clinical judgment and critical thinking.

The NGN exam features new question types like multiple-response questions, bowtie, highlight questions, drag-and-drop, and matrix/grid questions. The new question formats require stronger critical thinking skills of test-takers. New content areas tested are e.g. nursing informatics, genomics, and social determinants of health. 

Multiple-response items require the test-taker to select more than one correct answer from a list of options.

For extended multiple-choice items , students have to select one best answer from a list and additionally have to provide the reasoning for their response. 

Hot spot items assess knowledge with anatomical landmarks, e.g. where to insert IVs or where to listen for a maternal heartbeat. The answer to the question will be given by marking an area on a procided image or graphic.

In highlight-text item type questions, you are required to mark parts of a text that are relevant to your answer. 

In these items, the task is to sort the response items in the correct order, usually by drag-and-drop. It could require the student to order the steps of a dressing change, a procedure like a tube insertion, or deciding which client to see most urgently. 

With the newly-formatted questions, it is even more crucial that aspiring nurses practice for their NCLEX with a properly formatted test environment that simulates the real exam. The earlier you get used to the question mechanics, the more secure you can feel in the exam. Whichever question format you’re facing, always remember why you’re taking this exam: It is to make sure you are  safe to practice as a nurse, and the questions make sure to test that. Read the question thoroughly, identify how it works, the context, and which nursing topics you studied are relevant. Then, always view the questions from the angle how each option might affect the client and choose the response that is safest. 

Aside from studying up on the nursing content, make sure to:

• Review the test blueprint
• Practice with sample NGN questions in the new format
• Focus on developing your clinical judgment and decision-making skills
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• Legal Information

USMLE™ is a joint program of the Federation of State Medical Boards (FSMB®) and National Board of Medical Examiners (NBME®). MCAT is a registered trademark of the Association of American Medical Colleges (AAMC). NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks of the National Council of State Boards of Nursing, Inc (NCSBN®). None of the trademark holders are endorsed by nor affiliated with Lecturio.

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Mastering each question type you'll encounter on exam day is a must. with our qbank boasting over 900 next generation-style nclex questions at no extra cost, you'll effortlessly breeze through them when it's time for the actual test. prepare smarter, and conquer confidently.

New question types in the Next Generation NCLEX might seem overwhelming, but let's simplify it! Dive into Archer's Qbank, loaded with hundreds of each new item type for extensive practice. Here's a glimpse of what you'll encounter:

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• Drag & Drop

Multiple Choice

• Multiple Response & Trend

Drag & Drop Cloze

In a drag-and-drop cloze question, you will rearrange elements or answers by dragging and placing them into the correct order or locations within a sentence or a passage. There will be between 4 and 10 items for you to drag and drop.

Scoring Rule :

Drag & Drop Rationale

For the Drag & Drop Rationale item, you'll encounter sentences presenting one cause and one or two effects. Your task? Drag and drop the correct cause and effect(s) onto the sentence.

In the drop-down cloze, you'll encounter a paragraph with drop-down sections. Each blank will offer 3 to 5 options, and you'll choose one from the drop-down menu to complete it. You'll find a minimum of one sentence with a drop-down and up to five sentences with one drop-down each. Select the right option for each blank to complete the paragraph!

The drop-down rationale assesses your knack for cause-and-effect identification. Encounter a sentence with 1 cause and 1-2 effects. To ace it, choose the correct options from the drop-down to complete the sentence. Remember, you must choose both the cause and effect correctly to get points in this item type!

In the drop-down table item, you'll choose options from drop-down menus within a table. Each drop-down may contain 3 to 5 choices, and you'll pick just one option from each drop-down.

In a multiple-choice question, you can pick just one answer—no more, no less! Remember, if you change your selection by clicking on another answer, your choice will switch to the new one.

Matrix Multiple Choice

In a matrix multiple response, you'll have a grid—a matrix—where you'll pick just ONE option in each row. Don't skip any—each row must have an item selected. There will be at least 4 rows, and there could be up to 10. And remember, you can't move on until you've responded to every row.

Matrix Multiple Response

In a matrix multiple response, brace yourself for a matrix where some rows might have multiple correct answers. Every column must have at least one response selected but can have multiple responses selected if appropriate. You'll spot between 2 and 10 columns and 4 to 7 rows. Ensure each column has at least one response option selected before moving on!

Multiple Response - Select All That Apply

Multiple Response - Select All That Apply items are like the SATA questions you're familiar with, but with more options and a chance for partial credit. You can choose as many or as few responses as you please. There might be just one correct answer, several, or even all options could be correct! Look for at least 5 options, but at most 10.

Multiple Response Select N

In a Multiple Response - Select N item, a specific number of responses is mentioned in the question. That number is exactly how many responses you'll need to choose—no more, no less!

Multiple Response Grouping

In a multiple response grouping item, you'll encounter sets of items grouped together. Your task is to select which responses apply to each group. Expect at least 2 and up to 5 groupings, each containing 2-4 options. Remember, you must pick at least one option from each grouping, but you can choose more!

You'll be tested on how things change over time in a trend NGN item. Look at nurses' notes, lab values, vital signs, progress notes, medications, or other info. Any of the NGN item types can be used!

Highlight Text

In a highlight text item, you will be presented with a paragraph and asked to pick out the important bits of information from the text. As you move your mouse over the text, the options will appear highlighted. You can select up to 10 options and change your selections until you're satisfied with your choices.

Highlight Table

In a highlight text item, you'll see a table. Move your mouse over the various items and pick out the crucial parts from the table. You will be able to choose anywhere from 1 to 10 options and can select and unselect options until you're confident you've got the right combination.

Imagine a bowtie question like a drag-and-drop puzzle. Inside, you'll see 5 spots for 5 correct answers. Your mission? Drag and drop: the correct client condition in the middle, two actions to take on the left side, and two parameters to monitor on the right side.

Scoring Rules

Different types of questions follow different scoring rules. Click here to learn about them all!

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Next Generation NCLEX (NGN) Example Questions

These free practice questions are the best way to familiarize yourself with the style and feel of the new item types that you will encounter on the next generation nclex., frequently asked questions about next gen nclex, when does the next gen nclex start, how are next gen nclex questions different, is the next gen nclex harder, how should i study for the next gen nclex, how many questions is the next gen nclex, what kind of questions are on the next gen nclex, do you get partial credit on next gen nclex, is the new nclex all multiple-choice.

Can you answer these free NGN practice questions for the NCLEX?

Get quality practice for the NCLEX—for free!—by working through these NGN practice questions, learning first-hand from experienced NCLEX tutor Justine Buick about the best ways to apply your knowledge and critical thinking skills to passing the exam!

In April 2023, the NCSBN released a revamped NCLEX to the world—the Next Generation NCLEX (NGN) —compelling nursing students/grads just like you to rethink your studying strategies! (To learn more about the way NGN questions differ from the previous generation exam, check out: What to expect from Next Generation NCLEX .)

So, to help you adapt and prepare, the team here at Brainscape joined forces with NCLEX prep expert Justine Buick ( www.theNCLEXTutor.com ) who has crafted from scratch a collection of Next Gen NCLEX practice questions , which you'll see shortly.

Combined with our digital flashcards for the NCLEX-RN and NCLEX-PN licensing exams, these constitute a powerful resource you can lean on to take your NCLEX prep to the next level!

These flashcards have been carefully curated and vetted to offer nurse students a hyper-efficient way to drill the enormous amounts of content they need to learn and remember in order to answer the more complex questions posed by Next Generation NCLEX questions.

• Get Brainscape’s Nursing Fundamentals flashcards (for nursing school) 
• Get Brainscape’s certified NCLEX-RN flashcards
• Get Brainscape’s certified NCLEX-PN flashcards
• Get Brainscape’s FNP flashcards
• Use Brainscape's free NCLEX study planners and exam countdown sheets to plot your path towards and remain razor focused on your study goals!

And if you're still in nursing school, check out our flashcards for all the topics you'll be learning: Pediatrics flashcards , Adult Health flashcards , Pharmacology flashcards , Management of Care flashcards , Maternity flashcards , Mental Health flashcards , and Safety & Infection flashcards .

Now, let’s dive into some Next Generation NCLEX practice questions with, first, a brief aside on the difference between standalone and case study questions...

Standalone vs case study NGN questions

The NCLEX poses questions either as “stand-alone” questions or as “case studies”. In the case of the former, they are—as their name suggests—one-off, discrete questions. Once you finish answering them, you move on to the next question, which isn’t at all related. 

Case studies, on the other hand, ask a series of questions based on the same patient/case and so it serves you to bear in mind your previous answers and maintain a degree of cohesiveness as you work through them.

The first Next Generation NCLEX practice question we’ll be tackling, however, is a standalone bowtie. This is one of the more common types of standalone questions on the NCLEX, which very simply gives you a patient scenario and then you have one question that you have to answer.

NGN Practice Question: Standalone Bowtie

The nurse is caring for a 67-year-old client in the cardiac care unit. The nurse documents the following data in the Nurses’ Notes.

Nurses' Notes

1530: Client was admitted 2 days ago for a scheduled coronary artery bypass graft (CABG) x 2 vessels. No complications during surgery and recovered in the ICU overnight. Client transferred out of the ICU this morning to the cardiac care unit. History of coronary artery disease, hypertension, hyperlipidemia, and osteoporosis. Assessment findings are as follows: alert and oriented x 3; denies shortness of breath, sore throat or cough, lungs clear bilaterally; irregular heart rhythm auscultated, denies chest pain, skin is warm to touch, cap refill < 3 seconds, no edema and peripheral pulses 2+ and equal bilaterally; denies nausea/vomiting, bowel sounds active x 4 quadrants, reports passing flatus and last bowel movement was the morning of surgery; indwelling foley catheter was discontinued this morning and has been voiding clear, yellow urine without complications; up to bathroom 2 times with assistance; gait steady. Client is currently sitting at bedside and reporting a "racing heartbeat" and "feeling faint". Vital signs are HR 142 beats/min, BP 116/78, RR 18 breaths/min, pulse oximetry 96% on room air, and temperature 98.4 F (36.9 C).

Complete the diagram by selecting from the choices below to specify which potential condition the client is most likely experiencing, 2 actions the nurse takes to address that condition, and 2 parameters the nurse monitors to assess the client's progress.

For the answers...

Simply sign up for Brainscape's nursing flashcard collections (below) and we'll send the detailed answer and rationale to your inbox! These flashcards are FREE to sign up for ; and you can study a certain number of them before being asked to subscribe. But for full access to the Brainscape study experience, which will help you prepare for the NCLEX so much more efficiently , sign up for pro .

NGN Practice Question: Case Study

Now, let's try another type of NGN question: the case study, which, if you remember what we previously explained, poses a series of questions based on the same patient/case. So remember to bear in mind your previous answers and maintain a degree of cohesiveness as you work through them!

The nurse is caring for an older adult in the intermediate care unit.

1000: Client admitted with an exacerbation of chronic obstructive pulmonary disease (COPD). Client has used home oxygen at 3 L/minute by nasal cannula for 4 years but reports increased dyspnea over the last several days. Client increased portable oxygen to 5 L/minute. Currently, the client is fatigued but alert and oriented x 3. Client reports shortness of breath at rest, increased coughing and large amounts of thick, tan sputum. Client has labored breathing and is in the tripod position. Lung sounds with wheezes bilaterally. S1 and S2 heart sounds heard, no murmur or gallop noted. Vital signs obtained. Healthcare provider in to see client and admission laboratory tests completed. Respiratory therapist was in to obtain ABGs.

V ital Signs

Lab Results

The nurse assesses the client, obtains the vital signs and reviews the laboratory results. 1. Which laboratory findings require follow-up? Select all that apply.

2. The nurse reviews the assessment findings and laboratory results. For each client finding, click to select the finding that is most consistent with the condition of hypercapnia or hypoxemia. Each finding may support more than one condition.

3. Complete the following sentence by choosing from the list of options.The client is at highest risk for developing [Option 1] as evidenced by the client's [Option 2] .

4. For each finding below, choose the potential nursing intervention that is appropriate for the nurse to include in the plan of care. Each finding may support more than one intervention.

The nurse reviews the healthcare provider's orders.

• Continuous pulse oximetry monitoring
• Oxygen via venturi face mask, titrate to maintain pulse ox >88% • collect sputum culture for culture and sensitivity
• Repeat ABGs at 1800 today
• X-ray of chest today
• albuterol 2.5 mg via inhaler three times a day
• fluticasone 88 mcg via inhaler three a day guaifenesin 400 mg PO every 4 hours

5. What teaching points does the nurse provide regarding the inhaled medications? Select 3 teaching points.

The nurse assesses the client after implementing the healthcare provider's orders. 

6. Check whether the assessment findings indicate that the client’s condition is either Improved/Stable or Not Improved .

NGN Case Study Answers

For the full answers and rationale, include video explanations, simply sign up for Brainscape’s Nursing Fundamentals flashcards (for nursing school) or our certified NCLEX-RN or NCLEX-PN flashcards , which offer you a hyper-efficient way to drill the enormous amounts of content you need to learn in order to answer the more complex questions posed by Next Generation NCLEX questions. (And YES, they’re fully Next Generation NCLEX aligned.)

Once you've signed up, we'll email you the answers. (By the way, these flashcards are FREE to sign up for ; and you can study a certain number of them before being asked to subscribe.)

Finally, for truly excellent advice on excelling in nursing school, taking the NCLEX, and beyond, make sure you follow Brainscape Nursing on YouTube and check out our free Academy of articles and nursing guides !

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Next Generation NCLEX Practice Test: Case Studies 3-4

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• Basic Care and Comfort 1
• Basic Care and Comfort 2
• Basic Care & Comfort Marathon
• Pharmacological & Parenteral Therapies 1
• Pharmacological & Parenteral Therapies 2
• Pharmacological & Parenteral Therapies 3
• Pharmacological & Parenteral Therapies 4
• Drug Dosage Calculation
• Pharmacological & Parenteral Marathon
• Reduction of Risk Potential 1
• Reduction of Risk Potential 2
• Reduction of Risk Potential 3
• Reduction of Risk Potential 4
• Reduction of Risk Potential Marathon
• Physiological Adaptation 1
• Physiological Adaptation 2
• Physiological Adaptation 3
• Physiological Adaptation 4
• Physiological Adaptation Marathon
• Psychosocial Integrity Test 1
• Psychosocial Integrity Test 2
• Psychosocial Integrity Test 3
• Psychosocial Integrity Test 4
• Psychosocial Integrity Test 5
• Psychosocial Marathon
• Health Promotion and Maintenance 1
• Health Promotion and Maintenance 2
• Health Promotion and Maintenance 3
• Health Promotion and Maintenance 4
• Health Promotion and Maintenance 5
• Health Promotion Marathon
• Management of Care 1
• Management of Care 2
• Management of Care 3
• Management of Care Marathon
• Safety & Infection Control 1
• Safety & Infection Control 2
• Safety & Infection Control 3
• Safety & Infection Control Marathon
• NCLEX Exam Simulator

Next Generation NCLEX®

As your trusted partner in preparing students for NCLEX success, Elsevier wants to help you stay up to date with the latest developments related to the Next Generation NCLEX (NGN). Be sure to bookmark this website as your one-stop destination for all things NGN — from breaking news from the NCSBN, to strategies for incorporating more clinical judgment activities into your curriculum, and everything in between.

New Item Types Overview

The NCSBN has introduced a new format for the NCLEX® exam is now available. The Next Generation NCLEX exam includes a new case study-based format and new question types. The NGN Explainer videos offer a great overview, with visual representations of all the questions and item types! View all NGN item types.

Contact Sales Representative

Elsevier offers a complete, end-to-end solution with the authoritative and consistent content and digital solutions required to help students develop the knowledge and skills necessary to excel on the NCLEX and in practice.

Elsevier’s products and NGN

We’re connecting with industry leaders to host webinars that provide you with the latest information and tools you need to prepare for what’s next. See what’s coming for NGN online events or view our recording archive.

At Elsevier Education, we work closely with educators to understand trends and challenges across disciplines and specialties. That’s why we’re always working to provide you with relevant resources and educational content that you can use in your classroom.

Expertise library      NGN Item Types

NGN for All

Elsevier is proud to introduce NGN for All—an initiative to get all students ready for the types of questions they’ll receive on the Next Generation NCLEX®. NGN questions will now be integrated and available in everyone’s HESI Next Generation exams where content is available. Once students complete an exam, they’ll see reporting on how they performed on these new questions. While these new items are optional and won’t impact final HESI scores, they allow you to prepare students early and put your program one step ahead towards being NGN-ready.

Getting Ready for the Next-Generation NCLEX® (NGN): How to Shift from the Nursing Process to Clinical Judgment in Nursing

The  nursing process has been used for over 50 years as the systematic, stepwise method for problem-solving to make safe, client-centered clinical decisions. In the early 1970s, the North American Nursing Diagnosis Association (NANDA, currently called NANDA-I) was formed to develop a common language to identify standardized nursing diagnoses based on a nurse’s interpretation of assessment data.

Using Graphic Organizers To Develop Clinical Judgment In Prelicensure Nursing Students

The term  graphic organizers  refers to a variety of learning tools that visually present relationships between and among pieces of knowledge or concepts. These tools can be very simple or more complex and can be used for students at any learning level. Graphic organizers can be educator-generated or learner-developed, depending on their specific purpose.

Writing Case-Based Next-Gen NCLEX Questions

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• Strategies to Transform the Clinical to Develop Clinical Judgment

Developing Clinical Judgment in Simulation

• How to best develop clinical judgment in nursing students (video series)

Keith Rischer – Ph.D., RN, CCRN, CEN

As a nurse with over 35 years of experience who remained in practice as an educator, I’ve witnessed the gap between how nursing is taught and how it is practiced, and I decided to do something about it! Read more…

The Ultimate Solution to Develop Clinical Judgment Skills

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Connetics USA Video Media

Next generation nclex (ngn) questions and case study.

Dr. Paul Biluan, CEO Aspire RN:  Thank you for attending Connetics College. This is a Connetics USA Initiative, where we do classes every Monday. This is Dr. Nurse Paul is tasked to do classes for free every first Monday of the month.

Thank you guys for joining today. Please kindly tag your friends and share this to your pages so we can reach more nurses for today we're going to talk about next-generation NCLEX I'm going to show you guys a case study. So you guys get to have clarifications with your questions about the next-gen NCLEX but next-gen NCLEX is happening April 1 2023.

We're gonna get our first batches of nurses that will be taking the next-gen NCLEX if you guys are not familiar I've done a couple of live shows both for Connetics USA but I also do my own show and my own social media and Facebook and YouTube and Instagram and TikTok at doctor nurse Paul and you can just search my playlists in YouTube. And you'll see there all the best shows that I did about next-generation NCLEX. Again welcome everyone to Connetics you as a watch Aspire RN NCLEX review provider in partnership with Connetics USA every first Monday of the month. We have classes every Monday it's different companies different ethics providers and English exam providers. But doctor nurse Paul and Aspire RN hosts their shows every first Monday we have Charles watching from Uganda and Dorothy is tagging your friends thank you guys for joining us today April is also here. Thank you for joining me Good job guys. Please tag more of your friends and charities to your pages so we can reach more friends today and again Connetics USA is offering anklet scholarships you must meet the requirements that Connetics USA have set but in partnership with in partnership with Aspire RN Connetics, USA is offering NCLEX scholarships if this is what you are interested with. We have posted the garments of the link it's HTTP s, colon, backslash cu as a dot Lin backslash Aspire RN so click that link right now. And one of the Connetics students a recruiter is going to talk to you and check your qualifications and you can pass a qualifying exam for scholarship but this is entirely free. So if you are short on budget but you want to do or want to get a quality review for foreign graduate nurses like you and me this is the best time to click that link right now and as a contact Connetics USA or if you're having issues looking at this link you can also directly send me a message and I can help you as well. All right. Again welcome to Connetics USA Connetics College in partnership with Aspire RN we are doing a Connetics college NCLEX class today and we're going to talk about next gen NCLEX Yay. I'm so excited. We are less than 60 days away from the next generation NCLEX. Any nurses will be taking the NCLEX soon after April one If you're taking the NCLEX before April 1, please make sure you pass the NCLEX.

So you don't have to deal with next gen NCLEX. If God forbid, you fail your exam, and you have to retake, you're gonna retake it the next gen NCLEX format, so everybody that are yet to take the NCLEX are choosing or deciding if they want to take the NCLEX or will be taking the NCLEX very soon after April 1 we're going to do the next generation NCLEX and Aspire RN is one of the leading foreign graduate NCLEX review provider with me as the CEO, doctor nurse Paul. And I will be one of your instructors and mentors. We are one of the leading providers providing next gen ethics for foreign graduate nurses, a lot of Next Gen X compatible providers are targeted for Americans. But there is a special, you know way of delivering review programs for foreign graduates like us because our competencies are not really exactly the same as American graduates. There's a reason why there's a national pass rates for foreign graduates for first time takers of only 46% Compared to 86% of the Americans. So more than 54 55% fail the NCLEX the first time and it's a very difficult exam because of the educational differences in competencies, and now their next gen NCLEX. But don't worry if you enroll with my program, if you don't go sorry about that. If you don't qualify for this scholarship and you're enrolling my program, I will make sure that you will pass the NCLEX through my program and today we'll be releasing a new program. We call it the doctor nurse Paul method or DNP method. All of our classes are going to be next gen NCLEX compatible. And you will get 42 live classes up to the time that you will be taking your exam to final coaching from the orientation to final coaching, you're gonna get 42 live classes with me and many of my instructors, the most number of live classes and the NCLEX review industry nobody else could provide you better, right? Because I've added more days for NG and glasses. I called it the NG and masterclass that's where all we talked about is Ng and types of questions and we're going to answer this just like what I'm going to do right now I'm going to give you a preview of what's going to happen if you're enrolled in that program. Right or, again Connetics USA can also provide you scholarship let's flash that link again at the bottom. So we're gonna see the link right now being flashed on the screen.

This is how you avail or get or get qualified for the NCLEX scholarship being provided by Connetics USA in partnership with Aspire RN the link is cusa.link/AspireRN that is how you get connected with us or send us a message through social media channels as well and we can send you a message back so we can answer your questions. All right, I guess many people are joining today thank you again let me know where you guys are located for those that are haven't called yet and many people are joining us today Mani is here from India. She wants to apply as an RN please get a hold of one of our Connetics you as a rigors again the link is cusa.link/Aspirern okay, let me have coffee real quick. It's too early or at 7am Haven't had sleep because of jetlag.

We're going to talk about case studies today case studies will be an integral or vital part of the next gen NCLEX each case study. So case studies involving case we're going to show you what it looks like. Each case study will have six questions. So one case study six questions. This will be talking about the clinical judgment model of the next gen NCLEX. Question wanted a case study would always be about recognizing cues. Question number two is about analyzing cues. Question number three is about prioritizing. I suppose he says question number four is about generating solutions. Question number five, it's going to be about taking actions. And question number six, it will be about evaluating outcomes. So we're gonna have six questions today six questions from one case study. All right. And we have Youssef joining us in linked in from Nigeria Yousef, thank you for joining us today. We have joy, also watching us from Nigeria. Wow, we're all over the world today. Anyone here from the Americas Latin Americas or Northern Americas? Because I've only seen people from the African European and Asian continent but haven't seen that American continent people yet. Just to make sure that we're covering the whole world but thank you guys for joining today. And Um, when are you guys planning to take your NCLEX exam while we're still waiting for more people to join anyone? Anyone will be taking the next gen NCLEX very soon after April one. You're gonna have your next gen and click Screen is joining us from Philippines. Hi Karen. Thank you for joining baya is joining us from Philippines as well thank you for joining me today. This is gonna be an interactive show people I want you guys to help me answer the case study that I'm gonna be showing in a little bit. Alright, again, for those that just came in thank you for joining Connetics College, by Connetics, you as an Aspire RN. Today we're going to talk about the next generation NCLEX case study and there will be six questions per case study. And each question will meet the competency of the clinical judgment model by the NCS the and we observed from UAE and Felicity from Nigeria Thank you. Joy said she will be taking the NCLEX soon using the next gen FX format and she is under Connetics right now.

Thank you joy for joining and essentially we'll be taking the exam in July and a bond Julie's taking it on June this year. Good luck guys. If you need help with NCLEX preparation and next gen NCLEX preparation just send me a message and the doctor nurse Paul social media pages or you can also log onto my website Aspire RN. We'll be launching today our new NCLEX program called the doctor nurse Paul method which will include next generation NCLEX preparation and review classes in to the review program Alright, so if this is what you are interested with, send me a message Oh Bom Julie said you send me a message on Facebook. Well, I'm sorry if I don't reply as fast as I can. I have a team that helps me answer messages as well because I'm flooded with a lot of messages. If I don't respond back send your message again. So you get the top of the list because we do get hundreds of questions every day in all my social media channels but I will be gladly I will be glad to answer I'll be happy to answer your question today after this show. Okay, thank you guys. Now let's talk about the case study. We're going to have case study number two today. Worse Number One Number one was shown back in December or January I think in one of my past shows, with Connetics you as a I gave you an example of case study number one is this the first time that you're joining me today or have you seen me do this class in the past.

Anyone here is joining me for the first time and has never seen me do this because I don't only do this with Connetics USA nursing agency I also do this every Saturday in my own social media channel, the doctor nurse Paul show and let me see how many of you guys have just joined me today or have never seen me do the classes in the past. For those who do not know me, I'm the CEO of Aspire R which is an NCLEX review provider based here in Houston Texas. And I am an NCLEX instructor for 15 years 15 years that's what I'm bringing my experiences both outside the US in my hometown Philippines and also here in the US and I'm combining them to create a very high quality NCLEX review program under Aspire art and this is the reason why Connetics USA which is one of the largest foreign graduate nurse recruiters trust Aspire RN because of the quality that we bring onto the table thank you guys for joining me thank you Connetics of course for trusting my company Aspire RN and my team if I was part of Aspire RN last year do I need to join an engine program? Nope. If you are already a current aspiring student you will be transitioned to the next gen program so don't worry about it. We're gonna be transitioning you for free if you are already our student right so don't worry about it. And Craig said she has also seen me before in my doctor nurse Paul Fit Page and she said I'm a fan. Thank you for that and feel flattered. I'm just here to like do free classes online. That's my passion ever since right? And let's see Stephanie if you want if you're interested, go to AspireRN.com or send us a message on Facebook Aspire RN or doctor nurse Paul in one of my team members will get a hold of you. All right. Let's see case study number two today.

Are you guys ready? Right now Okay, can you guys pass the next gen NCLEX. I want you to write this in the comment section. We With all gaps, yes, I can, if we are manifesting that you're passing the NCLEX write it down right now on common section. Yes, I can. Are you going to pass the next gen NCLEX? Write it down, type it down right now. Yes, I can. There you go. Good morning to those that are just joining us today. Please tag your friends. Yes, I can. Yes, I can. Yes, I can. Ooh, let's go. All right, let's do it. You guys are going to help me answer these questions. All right. We're right. I think everybody's ready now because everybody's responding in the comment section. Yes, I can. All right. Okay. This case, I'm sorry, it's not as big as I can. I want to do it. But you can zoom it in. If you're using your phone. I'm going to read it for you. All right, we're going to answer this together. The nurse in the emergency department is caring for a 17, one seven year old male client.

Let's check the tabs because you're gonna have to flip through the tabs, open all the tabs to see the whole chart. It's like an emerge. Sorry, it's like an electronic medical records like a patient chart, you're gonna have to open all the chart to see what's going on with a case. Remember, a case is a story about a patient and this story changes over time. Just like how will you deal with a patient clinically, right when you're in the hospital, right. And a lot of you foreign grad nurses like me, are already experienced nurses at bedside so this will give you a little advantage because you're already you already have developed the clinical judgment but you're just gonna put it to test right now.

Okay, let's read history and physicals for body system pulmonary. We're going to read the question first. The nice shortness of breath reports discomfort in the lower left side of chest when taking a deep breath, gastrointestinal reports feeling abdominal fullness, and occasionally nauseated, muscular skeletal. The patient sustained an injury to the left ribcage after being struck by a mechanically beach baseball in a batting cage last week. Right battling cage last week, reports intermitted pain in the left shoulder six over 10 and the numerical rating scale feels lightheaded, significant bruising through their left shoulder or at the scoping repair to the left shoulder for a torn rotator cuff. Last year psychosocial client has not felt well enough don't that baseball practice since the injury? So we're seeing a lot of red flags here. Right. There's respiratory issues for sure. There's gastrointestinal issues. There's Musculoskeletal and Skin issues. We're seeing bruises there and pain. Alright, so let's remember that it's going to be important to answer the question later. Now let's click nurses notes right there. If I click nurses notes, this is what we see. At nine o'clock the client appears fail and slightly diaphoretic large amount of bruising noted along the left torso and over the left upper quadrant of the abdomen, tenderness, guarding dullness to percussion noted in the abdominal assessment, slightly diminished breath sounds noted and the left lung fields and auscultation blind does a productive guff EKG shows normal sinus rhythm. Alright, remember, remember those spots any flags, flags, bail, diaphoretic, bruising, tenderness, garden dullness to percussion to the abdomen, diminish breath sounds productive guff. Those are positive sides are significant findings, vital signs, what can you see? What are the abnormal findings in the vital signs here? What are the abnormal findings we have both degrees are decreased BP is also decreased. Right? So what's our concern here? Be our blood pressure both I mean, all of them are all decreased. Right? How about the labs? About the labs, the good the labs? What are our normal?

Look at the white blood cell count. It's 19,000 your hemoglobin and hematic. Great H and H is nine and 27. So all of them are AB nor Mo? Correct. All of them are abnormal. Now that we've seen the whole case of what's going on, let's now proceed to the question on the right side of your screen right there. Okay, Which of the following assessment findings require immediate follow up, immediate follow up? All right. Your options are lung sounds, shoulder pain, productive abdominal assessment findings, pulse, respiration, blood pressure and temperature and pulse oximetry reading. What are your answers? This is a select all that apply. It's also right minus wrong question. What are your answers? Anyone? Anyone? Please tell your friends and more people can join us today. Anyone? What are your answers? Lila already showed me her answers. But what about the rest?

I'm still waiting for everyone's answers. I'm not sure if I got disconnected though. I don't think so. All right. Michi gave her answers already. Oh, by the others. We have more than 100 viewers today. I want to see your answers. Don't go the question which assessment findings would require follow up?

Who's attended my class in the past? Some of you guys, right. We prioritize lung sounds. Yes. Because there's shortness of reading and decrease breaths out on the left side. Do we prioritize shoulder pain? There's pain here. There's Rousses. Yes, let's consider that. Right, because that's still a significant finding. lab results, obviously. Yes. productive cough. Yes. abdominal assessment, fullness, nausea. Yes. Both respiration and blood pressure. Yes. The only not included here is temperature and pulse oximetry, because your bowls and temps I'm sorry, pulse oximetry reading attempts are both normal. There are both normal address 123456. Right. 123456. Okay. 123456 are the answers everything that has an abnormal finding you include, that's just how it is. Okay. Everything that has abnormal finding, you include with the exception of number seven. Alright, that's number seven. All right. John Doe is an Aspire RN NCLEX passer. Congratulations. Let's all clap our hands agenda.

Can we feature that? Common miscellaneous? So we can everybody could see that John Doe, is one of our NCLEX passers. Congratulations, John Doe sent me a message I want to interview you all of my pastors, I want to put on a little video chat and see what we can help you with after Okay, thank you, John Doe for trusting Aspire RN my team, thank you for being in my class. Thank you for being one of the Aspire RN Lister. That's why we call our ambassadors. Thank you. Congratulations. That's all say congratulations, Gendo. I don't know if it's full name, but you can say jazz. Congratulations. All right. Anyway, and hopefully we can get that energy from John as well. So we can pass our NCLEX you guys are ready to achieve your American dream? Yes. Can you pass your NCLEX? Yes, I can. All right, let's dive it down.

Congratulations, Jan, you're receiving a lot of compliments. Right on the comment section. Thank you. Thank you. We want that energy from Jan to fill us up right now. Right? We want that faster energy to be with us today. Right? Anyway, thank you, John, for sharing that information. And thank you for sharing your victory efforts is very tough. I can tell you, I've been teaching this for 15 years, I wouldn't be here teaching you guys. Connetics, don't even invite me. If this is not valuable at all. We're here because there's so many people failing, we're here to help solve that problem. And I'm still here educating nurses 15 generations down since I graduated nursing and started teaching, but I'm happy with what I'm doing. Okay, this is my passion. So thank you, John, for trusting Aspire RN in my team and for everybody. I wish you all good luck right. Now let's go to question number two. Same situation. Same case, nothing was ever added to the notes. Let's go through the question right away. Which of the following issues is the client at risk for developing or off developing? Let's do your differential diagnosis, differential diagnosis, stroke pneumothorax or hemothorax. I'm sorry, bowel perforation, spleen, a glass array. pulmonary embolism abdominal aortic aneurysm? What are your answers? This is select all that apply. I want to put your assessment skills to the test. Let's see if you know your signs and symptoms for all of these conditions.

So you see the thing would next generics while I'm waiting for you guys to answer put your answers on the comment section is the contents are the same. It's just a different way of showing the questions and providing the answers. There's just more different types of questions this time, but contents are the same. So it's still important that you know your contents.

If you don't know your contents, then you will have a difficult time answering next gen NCLEX very important that you know your contents means when we talk about stroke, you should know your signs and symptoms there your pathophysiology, your priority assessment, priority management, positioning, medications to use, what are the side effects of those medications? That's only stroke. We're not talking about the others yet. So you have to have a very good grasp or mastery of skills. I keep talking about this in my TikTok and Instagram. Mastery of concept is the most important test taking strategy for the NCLEX. Now we'll put this to the test. Let me see what your answers are. We have diverse answers. Does this look like stroke? No, because there's no Henry Prius. It's right or he may Perris it Nope. hemothorax. Yes, because there's difficulty of breathing decreased breath sounds on one side, and this is trauma. Yes. bowel perforation.

Does this look like a bowel perforation? Are there two sides of bowel perforation to you guys? Rigid abdomen fever, nausea, vomiting, constipation, shock like symptoms. I have not seen fever. I have not seen rigid abdomen. It just says feeling full but not rigid because it shouldn't be peritonitis. There shouldn't be fever, right? So we're gonna remove number three, does it look like valid birth? You don't get Bruce's with Bible birth. Right? About splenic. laceration. I'll include that just because the case was a baseball bat. Alright, it's a trauma. The patient was hit on the left side with a baseball bat. The spleen could have ruptured. Right. So spleen laceration, yes. How about pulmonary embolism? Guys, if there's pulmonary embolism there's shortness of breathing decrease SPO to right patients having chest pain, lightheadedness, dizziness, mainly chest pain. We don't have it. It literally says there. I mean shortness of breath do it literally says there denies shortness of breath. Remember pulmonary embolism is occlusion of the pulmonary arteries, which can lead to both respiratory and cardiac collapse.

So there shouldn't be signs of respiratory problems like shortness of breathing, right? We don't have that. So pulmonary embolism is ruled out. abdominal aortic aneurysm? Yes, because we have abdominal fullness and the blood pressure is going down. It might ever ruptured. So adds her ear is two, four, and six to four and six to four and six. All right, very good. All right. Now question number three, same situation. Same situation right. Nothing was added so I'm not going to flip through the different tabs anymore. I'm not going to open these three nurses notes vital signs and lab but during your NCLEX please open it make sure that you guys have read everything and that nothing changed right?

Complete the following sentence matches it from the list of offerings the nurse should first address the clients or choose from this clients what all of them are part of her priority but now you can only pick one what is our priority? And only pick one what is our priority? We're on my people from YouTube and LinkedIn haven't seen them for a bit I've only been seeing the Facebook people joining us but the linked in people and YouTube. Are you guys still here? What's your priority? wunderbar is also here. He was also in my class last night and it's also our Aspire RN students. Thank you Please don't miss your class. It's wonder burger this far in right. But Trisha already has answers Sal already has answer.

Can you already provide her answer Troy I'm still waiting for more people. I've only seen like 20 people. I want at least half of the attendees to give me the answers. This is fairly easy for me. All right. I hope it is also easy for you but what will you prioritize it's principle of ABC airway, breathing and circulation. respiratory takes priority. You've already seen signs like, decrease breaths on one side, you've already seen signs like chest pain, guys, there might be a hemothorax there, right? This is a trauma.

So you think about those things answer is respiratory status. Very good. You guys are enjoying case studies. I think for me, it's straightforward for as long as your concept is good. So you see, when you check my tech talk, people go crazy about when I say something about natural quick, some people are saying, oh my god, I'm so scared, like, what am I going to do? Like? How can you help me? While other people would say, Why are you guys scared about Next Gen X? It's pretty easy. That's all that's both right and wrong. Right? Remember, each student have different learning abilities, right? Those students that are saying next gen and what slips easy for me it is because all the case that all the information that I need is already there, right? If I if I'm good with my signs and symptoms, and I know what they are, if I know my pathophysiology, and my meds and all my treatments, I can honestly answer this easily. So if my concept is master, if I've mastered a concept, if my foundation for nursing concepts are good, then I want to have problems with ng n. The same is true with view. Now, if your problem is Foundation, like if I talk about hemothorax, and you can even define oh my god, what is seam authority? So Oh, my God, why is there lung collapse and pneumothorax? What happened? Guys, you have to go back to your books, you have to go back to your lectures. That's what we're doing as fire art. And we train you first with your concepts. And if you progress and we think you're good with your concepts, then you can proceed to the NG and master classes.

That way, there's correct progression. And we make sure that you actually complete all the objectives that Dr. Nurse Paul has set in our program. Okay. Anyway, question number five, we have a new data from 10 o'clock am right. Emma said she couldn't near me from LinkedIn. I'm so sorry about that. We were having technical issues. Thank you for jumping in and joining us in Facebook. Right. Anyway, let's look at 10 o'clock. It says glide was diagnosed with splenic, laceration and left sided hemothorax Oh, now we have dramatic obligations, bleeding lacerations, lift left sided Demuth arcs, what's your major complication? For both? For both? Both complication for both? Well for left handed pneumothorax, are gonna have lung collapse, a circulatory and respiratory collapse, but both of them are also leaders. So you're gonna have to consider bleeding and shock.

Do you remember your vital signs earlier? What was happening with a blood pressure? They're going up or down? You remember your blood pressure earlier? What was going on? Up or down? They're going down. It's going down. Right? How about the pulse and our respirations? They're, they're both going up. These are signs of shock. Typical dry adverse shock. Is the patient having shock already? Yes. Is the patient possibly bleeding at this point? Yes. You look at your H and H earlier, it's also down to patients bleeding, right? What's our management here? Do we need to send the patient if I'm in the ER who are ER nurses here, I'm an ER nurse.

I'm a trauma nurse. And that's why I like case studies because they always talk about the patients in the ER the patients in the ER patients in the ER so that's what I can help you with because I'm an ER nurse and I'm going to do the edge in masterclasses myself and inspire art and as many instructors, all of them are good night quality because I chose them. But I'm going to do the NG and masterclasses myself. Alright, back to the situation. Right? So what is the priority if m&e are nurses and this patient is diagnosed and splenic, laceration and pneumothorax? My priority is to send this patient right away to the trauma surgeon into the O R. Correct. All right. So what's your management here? Do we give IV fluids indicated or not indicated in the gate a very good April we have to bring the patient start o r but while waiting for the O R we can start our trauma management if you got some taken your trauma nursing course it's a B, C, D E, F G H I J K LMNOP.

So many letters, but all of those means something right? Part of that is stabilizing the patient or IV fluid indicated serum typing screen in the gated chest physiotherapy not indicated it's gonna cause more injuries. No, no, no, no CPT insertion of ng t. Now right now, right because there's splenic ends or injury we don't have there's diaphragmatic trauma as well. Right? Don't do ng t yet, because the patient has probably a diaphragmatic trauma as well. So what's the problem? If there's a diaphragmatic trauma if there's a tear you might be able to, like the tube might feel left and go back to the respiratory or you can have more complications. What if the esophagus is also bleeding or trachea? So you don't want to do ng D for now until there's a clearance from the doctor. That's usually after intubation. So don't do MGT right now. Not yet. Not yet. How about administer prescribed pain medication? Pain medication? I think I've seen someone here said no.

The other one said yes. Pain medication. Yes or no? Yes or no? Guys, ng t is not a priority right now. It will be done later. But NCLEX is all about priority. It's about right now. All right, baby. Yes, don't we don't pay medicine if you're in the US and you would have been medicine the patient can sue you for under medicating the patient

. That's for nursing care. Yes, we need to give pain medicine right. So again, IV fluids indicated zero typing screen indicated CP teach as physiotherapy not indicated MGT not indicated. Administration prescribe a medication about question number five look at 1030 The client is now referred to immediate or for immediate surgery, we're not going to go to the or no look at your right side of the screen right there. This is select all that apply which of the following actions should the nurse take letter A provide or mark the surgical site provide a client with isotopes number two, three, perform med reconciliation for obtain consent five, insert IV fluids six I'm sorry, five is insert burden for a VAD or IV six inform the client about risks and benefits. Seven assess declines previous experience with surgery or ASIC line spirits to wait in the waiting room no plan of care discuss with the client. All right, what's your answers? Or answer ads? Or ads? Or what's your answer? And one this is OR nurses here? Please stand up. Please stand up. Anyone?

Please don't forget to follow doctor nurse Pauline, Facebook, YouTube and Instagram for more shows like this. I do this almost every week. Every Saturday I have the show doctor nurse Paul show. Right? Oh, that's a lot of answers. Are you guys sure about this? Oh, anyone who? Some people just like to check everything. Remember in next gen lecture select all that apply becomes right minus wrong say if you're answering too much. And that's not required, you are going to get zero points. Can you mark the surgical site? No, that's for the surgeon? Can you provide a client with ice chips? No patients on NPO? Can you perform medication reconciliation? No, that's the primary responsibility of the prescriber or the surgeon or the anesthesiologist. Can you obtain consent from surgery?

No, the doctor has to do it. You can only witness if you're updating, explaining the risks and benefits that's for the doctor. Can you insert IV? Yes, you need that for the medicines and IV fluids and blood transfusion? Can you inform the client about the risks and benefits of surgery? No, that's for the doctor. Can you assess the client's previous experience with surgery and anesthesia? Yes, because this is both the responsibility of the nurse and the anesthesiologist. That's part of your assessment. You have to know present illness, past medical history past surgical history you have to know that because there might be an allergy to certain medications. How about as the client's parents doing in the waiting room? No, the patient is a minor. So what are our answers people? What's the answers? Wonder Bert is leading the way.

W hat's the answer? five and seven only? All right, a lot of people have answered multiple answers. I'm so sorry. But you guys get zero points because this is a right minus wrong kind of thing. Right? This is a right minus wrong question. So if you answer too much, you're gonna get a penalty. That's one of the things you need to remember with next gen NCLEX. But don't be scared. That's why we're doing these glasses to help you understand and guide you how to answer these things properly. Right? For many people that have consistently getting incorrect answers from number one through number five, I can honestly say that your problem as an expert for NCLEX instruction is with the concepts, right? Go to classes, attend review classes, if you don't have the money, go grab the adequate scholarship by Connetics USA or if not, then tried to talk to one of my team members who might be able to help you but you need to invest on yourself.

And NCLEX is a very expensive exam, you don't want to be taking it multiple times because you keep failing. I've had a student fail seven times, right seven times on the seventh time, or no, no, failed six times, I think, the seventh time she joined us by our and finally after trying so many different programs that actually didn't work for her. Because all they do is take your money and put you in a group class that's doing the same thing all the time. Each student is different. That's why yes, we do group classes and aspire are in but you get your own personal student advisor and personal mentor that tracks your progress and make sure you're progressing correctly and in a timely fashion.

If not, we can tell you, you're not ready. Maybe you need to spend more time in this space. Or maybe take more of these exams first, before we can proceed, we can help you proceed to the next phase. That's called guidance. That's called mentorship. Not a lot of review providers do that because they don't have time for that. But in Aspire RN, we care for you. We treat you as an individual not as another number or student Right? Very important to partner with the right people and invest with yourself. All right answers five and seven Riza. And Jen classes will start on March. Right now we're still transitioning the students to the from the old program to the new program, everybody that will start so my Ng and masterclasses EB three phases in my review program. Just watch my TikTok, I'm gonna release a video, I guess tomorrow. The first phase is the concept building phase. It takes eight weeks to finish that that's 24 live classes every week and in the remaining days of the week, you have activities like both tests and certain stuff. And then after eight weeks on your month number three, or month number two, for four weeks, you do Ng and masterclasses every week and right. And after that, you do your final coaching face or hit classes, which is 10 days of live classes, question and answer only just like this for the next 10 days. But you progress to different phases .

Depending on your ability, you're not going to get to Ng and master classes if your concepts are not good. Because even if I teach you for 10 hours a day, if your concepts are not good, it's not going to help you write for reason, my whole review program is $550. But we're going to be offering promotions this month. Alright in connection to the NG and program that we're going to be releasing. So please watch out, follow Dr. Neurospora and inspiring. We're going to be announcing very important things this week. Right? I'm going to talk to you about the program and private message because some other people are here online and they're waiting for the answers number five and seven are the answers here. Let's go to question number six. All right, nothing was changed in the case.

It's still the same case. Right? Same situation. They do mar I think Maura was one of my students in the past. Thank you. I've been in the teaching industry for 15 years before I left the Philippines. I was teaching there for 10 years 10 generations of and of nurses that have thought so I'm an old guy now. I'm an old man, but uh, happy to be able to help a lot of nurses. I feel like I still have more to be able to help more nurses to become quality, safe and effective nurses that we need because we have so much shortages right now in America's right. Anyway, guys, we're gonna have to highlight the findings that indicate a worsening of the client status. I'm not I don't have the ability to do it right now with stream yard. But let's highlight. Alright, the findings that indicate your worsening of the client status.

So what are you going to highlight? Clients post operative day after a split neck tummy is able to ambulate in the corridor three to four times a day with minimal assistance. assistance so there's no problem there. How about the second sentence? Client is clear bread sounds a left sided chest tube in place attach or close? Just raise just if there's no problem there. How about sentence number three titling of the water chamber no other than deep inspiration. Is this correct? Is this normal? That is normal. How about the fourth statement or scent? Client refuses to use the incentive spirometer it causes left sided chest pain. Is that normal or abnormal? Is that correct or incorrect statement? Should we highlight that? Should we highlight that yes, you can start highlighting from client refuses or you can also start with a word refuse as action word so I prefer that you guys start highlighting from refuses to use incentives for ramen or consequence causes left sided just me right either or it's going to score you the same, okay?

But sometimes there are compound sentences here we go with the English classes. And this is why I like ng because now you have to learn English as well. Sometimes there's compound sentences like okay, the titling is found on deep inspiration. And the suction chamber has absent bubbling so now there's two sentences in one sentence, it's compound sentence. So you only highlight those things that are being looked for or that we are looking for in this case, worsening glad status. All right, how about the next sentence Glide is using prescribed patient controlled analgesia device maximally every hour and still continues to have nausea and vomiting so I will highlight that right because the patients are already on maximum pain management but still nauseated and is vomiting which means the patient still uncomfortable and is still in pain, which means the medication is not working. It's not enough those the patients in pain patients uncomfortable.

If you don't address this, they can sue you. So we're gonna, we're gonna highlight that as well. How about the next adequate URI now but nope. Abdominal surgical incision redressing screen dry intact with no erythema, edema or drainage. That's also Nope. So there are only two things that I will highlight the clog review systems incentive spirometer and blindness using prescribed BCA device maximally every hour continuous to intermittent nausea and vomiting. Those are two signs that the patient is not improving and is worsening. All right. So in the actual NCLEX are actually going to click a nightlight, I hope you guys can do that. That's basic computer skill. Just like you're highlighting words in the internet and copying it and pasting it to your Facebook posts, or copying and pasting in Microsoft Word. It's the same, but you're gonna have to highlight it. And it's going to turn color yellow during the emphasis once you highlight so click and then drag to highlight, right. That's one of the new things in NCLEX highlighting. All right, April, please send me a message, a doctor nurse Paul in Facebook, and I'm going to be able to help you and my team, right. All right, you guys have questions? Who found it easy? Who found it difficult? Who found it challenging? Be honest with me? Be honest, I know some people found it easy. Some people found it confusing. But that's why we're doing a lot of these drills to train you live, how to answer these types of questions and how to attack them. And so you can also figure out your deficiencies. All right. Will there be penalty if you highlighted the whole sentence instead of just some parts of sentence? Shelley? No. But then again, that's only for simple sentences.

If this is a compound sentence, where one sentence is composed of two standalone sentences connected by what they call that interjections I forgot, I'm not an English major, but the end or but or, or if they're connected sentences, then you cannot highlight the whole thing. Because that's two sentences that you're highlighting. Right? So it's only per sentence or phrase need to review concepts, Shelly said tricky but passable, of course. Michi. Alright, with proper training. Yes, you can. Can you guys pass your NCLEX? Can you guys pass your next generation NCLEX? Very good road that this is a very important comment by Rhoda. Can we flash that on the screen member Linus. She said it is challenging, but easy if you are equipped with the content, information. That's right. So that's why I keep emphasizing next gen NCLEX is just another way to test your knowledge. Don't get me Don't get scared with that. What you actually need to prepare with is your concepts because now in the form of case scenario where you are overwhelmed reading hundreds of words to find out the problem.

It can easily trick you if you don't know the concept. So a lot of people are not able to answer the first few questions because they don't have a full grasp of what is pulmonary embolism versus what is bowel perforation versus what is Wieneke laceration versus what is hypovolemic shock versus what is stroke? So that's a problem because you get confused with things like that. All right. And thank you guys, I do this every Saturdays please join me can you faster next gen networks Yes, I can follow doctor nurse Paul in Facebook, YouTube, Instagram and TikTok. I do live classes every Saturday 8am Central US time. That's Texas time. And I do secrets of next generation and blitz every first and third Saturdays of the month. Every second and fourth Saturdays of the month I do us a nurse series that's very good conversation with experts with people have experiences migrating to the US and we're talking about many things like contracts and moving into the United States and settling into your work and finding jobs and bringing your family. So many learnings I love talking to my peers here in the US. So please follow and support doctor nurse Paul as I do these free classes so we can help more nurses. I know a lot of nurses don't have adequate funds to really be in a review program. And that's why Connetics is offering anklet scholarship. We're going to flash that one more time on the screen. Here in the bottom right, we're going to flash the link where you can apply for NCLEX scholarship under Connetics USA and aspire are in Alright, so go click that link right now fill up the form and one of the Connetics recruiters or get ahold of you and explain to you how the scholarship program works. But we have hundreds of Connetics scholars in Aspire are in right now. 

Thank you guys for dressing Aspire RN and doctor nurse Paul. I am here to help you. If you guys have questions, send me an email info at doctor nurse Paul.com That's info at doctor nurse Paul.com Or just follow me on social media and we're gonna get ahold of you once we can we have tons of messages but we're still trying to like respond to everybody. So please be patient with us. Alright, and also follow up Connetics USA we do this classes every Monday with other human Connetics partners.

And there's a lot of shows that Connetics do actually which I love because they do immigration Q&A day. They do their onwards and upwards days. So many shows. I love working with Connetics USA I've been doing shows with them for a long time before I put up my own show. And that's why I have my own show because I was inspired what Connetics is doing. Alright, thank you guys for allowing me to help you guys today. Thank you for being patient with me while we are going to connection issues at the beginning.

If you guys have questions, drop a message in my Facebook, Instagram or TikTok and I will respond to you as soon as I can. All right, you guys have a great day. Thank you so much. I'll see you soon every first Monday Connetics college with Connetics USA and Aspire RN with doctor nurse Paul have a great day. Bye

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The Republican Plan to Challenge a Harris Victory

How a right-wing takeover of an obscure, unelected board in georgia could swing the election..

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At the Democratic National Convention, party officials are celebrating polls showing that Kamala Harris is now competitive with Donald Trump in every major swing state across the country.

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Nick Corasaniti, a Times reporter who focuses on voting and elections, explains.

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Nick Corasaniti , a reporter covering national politics for The New York Times.

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The unelected body that shapes voting rules in Georgia has a new conservative majority, whose members question the state’s 2020 results. They now have new power to influence the results in 2024 .

Kamala Harris and Donald Trump are in close races across Arizona, Georgia, Nevada and North Carolina , crucial swing states that Mr. Trump had seemed poised to run away with.

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