Preparing for the NCLEX can be overwhelming, but focusing on high-yield questions can make a huge difference.
Here are the top 50 NCLEX questions you must know, complete with rationales to help you understand
why each answer is correct.
NCLEX Question Categories
- Safety and Infection Control
- Pharmacology & Medication Administration
- Medical-Surgical Nursing
- Maternity & Pediatrics
- Mental Health Nursing
- Management of Care & Delegation
Top 50 NCLEX Questions (Sample)
1. Safety and Infection Control
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- Question: Which patient should a nurse assess first?Answer: A patient with sudden chest pain and shortness of breath.
Rationale: ABCs (Airway, Breathing, Circulation) prioritize life-threatening conditions first.
- Question: What is the correct order to don PPE?Answer: Gown → Mask → Goggles → Gloves.
Rationale: Ensures maximum protection from contamination.
- Question: Which patient should a nurse assess first?Answer: A patient with sudden chest pain and shortness of breath.
2. Pharmacology & Medication Administration
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- Question: Which medication requires the nurse to monitor potassium levels?Answer: Furosemide (Lasix)
Rationale: Loop diuretics can cause hypokalemia; monitoring is essential.
- Question: What is the antidote for heparin overdose?Answer: Protamine sulfate.
Rationale: Protamine sulfate neutralizes heparin and prevents bleeding complications.
- Question: Which medication requires the nurse to monitor potassium levels?Answer: Furosemide (Lasix)
3. Medical-Surgical Nursing
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- Question: Which post-operative patient requires immediate intervention?Answer: A patient with hypotension and tachycardia.
Rationale: Signs of hypovolemic shock; early intervention is critical.
- Question: What is the first action for a patient with suspected stroke?Answer: Assess airway, breathing, and circulation.
Rationale: Prioritize ABCs before further interventions.
- Question: Which post-operative patient requires immediate intervention?Answer: A patient with hypotension and tachycardia.
4. Maternity & Pediatrics
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- Question: What is the priority for a newborn immediately after birth?Answer: Ensure airway is clear and breathing is established.
Rationale: Neonates are highly susceptible to respiratory compromise.
- Question: Which maternal vital sign change indicates postpartum hemorrhage?Answer: Rapid pulse and decreasing blood pressure.
Rationale: Hypovolemia due to bleeding requires immediate intervention.
- Question: What is the priority for a newborn immediately after birth?Answer: Ensure airway is clear and breathing is established.
5. Mental Health Nursing
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- Question: Which patient requires the highest priority in a psychiatric unit?Answer: A patient threatening self-harm.
Rationale: Safety is always the first priority.
- Question: Which intervention is most effective for a patient with severe anxiety?Answer: Encourage deep breathing and grounding techniques.
Rationale: Non-pharmacological interventions help reduce anxiety and promote coping.
- Question: Which patient requires the highest priority in a psychiatric unit?Answer: A patient threatening self-harm.
6. Management of Care & Delegation
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- Question: Which task can an RN delegate to an LPN?Answer: Administer routine medications to stable patients.
Rationale: Delegation must align with LPN scope of practice and patient stability.
- Question: Which patient should the RN assess personally?Answer: Newly admitted patient with complex needs.
Rationale: RNs retain responsibility for assessment and initial care planning.
- Question: Which task can an RN delegate to an LPN?Answer: Administer routine medications to stable patients.
Tips for Using These Questions Effectively
- Review rationales thoroughly, even for correct answers
- Practice consistently—daily or several times per week
- Focus on ABCs, Maslow, and nursing priorities
- Simulate exam conditions to build stamina and timing skills
Conclusion
These top 50 NCLEX questions and rationales cover high-yield topics that are commonly tested on the exam.
Using them for practice can enhance your critical thinking, reinforce important concepts, and
increase your chances of passing the NCLEX on your first try.
