On this page
What this practice test covers
The test has three sections that mirror what you'll see on exam day:
- Standalone items (43): multiple choice, select all that apply, and two dosage calculations, spread across all eight Client Needs subcategories in the proportions the 2026 RN test plan calls for — prioritization, delegation, infection prevention, pharmacology, labs, and more.
- Case studies (2 × 6 items): an emergency department client and a labor-and-birth triage client. Each case walks through all six clinical judgment steps, from recognizing cues to evaluating outcomes, using multiple response, drop-down, and matrix items.
- Stand-alone NGN (2): one bowtie and one trend item.
Every question is original and written to match the style of the real exam — not copied from NCSBN or any prep book.
How it compares with the real NCLEX-RN
The real exam is adaptive: 85–150 items in up to 5 hours, including three case studies and 15 unscored pretest items, with each item chosen based on how you're doing. This practice test is a fixed form, so everyone sees the same 57 items. It's timed at about 2 minutes per item, the average pace you need to finish a maximum-length exam.
Two other differences: the real exam won't let you go back to earlier items, and it awards partial credit on many multi-part items. Here, multi-part items are scored all-or-nothing, but the review screen shows how many parts you got right.
Exam mode or practice mode?
Exam mode runs each section on a timer and holds the answers until the end. Use it for your first attempt to get an honest baseline — and don't go back to change answers, since you can't on test day.
Practice mode shows the answer and rationale right after each item. Use it on a second pass or when you're drilling a weak area. Read the rationale even when you're right; the explanation of why the tempting answer is wrong is where most of the learning happens.
How the real exam is scored
The NCLEX-RN is pass/fail with no numeric score. After the minimum of 85 items, the exam stops once the computer is 95% certain your ability is clearly above or below the passing standard. Otherwise it continues to 150 items, or until time runs out, and your final ability estimate decides it. There's no percent-correct cutoff, so this test reports your percentage by Client Needs category to show where to focus — not a predicted pass or fail.
What to do after you finish
- Look at your weakest two Client Needs categories and plan a week of focused questions on each.
- For every miss, write down why: knowledge gap, misread stem, or second-guessing. The fix is different for each.
- If the case studies were rough, work through our NGN guide and practice labeling each item with its clinical judgment step.
- Pick a question bank or review book with current NGN content — see our best NCLEX prep books.
Official free resources: NCSBN's Sample Pack and Exam Preview (real NCSBN case studies), the candidate tutorial (the actual testing interface) and the 2026 NCLEX-RN Test Plan. For the full rundown on format, fees, and registration, see the NCLEX-RN guide.
Sample questions
5 questions from this practice test, with answers and explanations. Take the full test above for timing, scoring and your weakest domains.
The nurse receives shift report on four clients. Which client should the nurse assess first?
- A. A client with chronic obstructive pulmonary disease (COPD) whose oxygen saturation is 90% on 2 L/min by nasal cannula
- B. A client 2 days after abdominal surgery who rates incisional pain as 6 on a 0–10 scale
- C. A client who had a thyroidectomy 6 hours ago and now has a hoarse voice and high-pitched, noisy breathing
- D. A client with heart failure whose weight is up 0.5 kg (1.1 lb) since yesterday
Show answerHide answer
Airway wins. High-pitched, noisy breathing (stridor) after a thyroidectomy points to a narrowing airway — from a neck hematoma, laryngeal edema, or laryngospasm (which can come from post-op hypocalcemia). That can become a full obstruction fast, so this client comes first.
The client with COPD is the tempting pick because of the 90% saturation, but many clients with COPD are kept in roughly the 88–92% range on purpose; that number is expected, not an emergency. Pain of 6/10 needs treatment soon but isn't life-threatening. A 0.5-kg overnight gain in heart failure is worth watching, but it's a trend to track, not a crisis.
A client has diarrhea caused by Clostridioides difficile. Which actions should the nurse include in the client's care? Select all that apply.
- A. Put on a gown and gloves before entering the room
- B. Wash hands with soap and water after removing gloves
- C. Use alcohol-based hand rub as the only method of hand hygiene
- D. Keep a dedicated stethoscope and blood pressure cuff in the room
- E. Wear a fit-tested N95 respirator for all care
- F. Clean room surfaces with a sporicidal disinfectant, such as a bleach-based product
Select all that apply.
Show answerHide answer
C. difficile needs contact precautions (gown and gloves, dedicated equipment) plus attention to its spores. Alcohol doesn't kill the spores; washing with soap and water physically removes them, and surfaces need a sporicidal agent such as a bleach-based disinfectant.
Alcohol rub alone is the classic trap. An N95 is for airborne organisms — C. difficile spreads by the fecal-oral route on hands and surfaces.
The nurse is about to give digoxin to a client with heart failure. The apical pulse is 72/min. This morning's serum potassium is 3.1 mEq/L. What should the nurse do?
- A. Withhold the dose and notify the provider about the potassium level
- B. Give the dose, because the apical pulse is above 60/min
- C. Give the dose with a glass of orange juice to raise the potassium
- D. Give half the dose and recheck the apical pulse in 1 hour
Show answerHide answer
Normal potassium is about 3.5–5.0 mEq/L. Hypokalemia increases the risk of digoxin toxicity and dangerous dysrhythmias, so hold the dose and report the level so it can be corrected first.
The pulse check is the trap: an apical rate above 60 is necessary, but it isn't the only safety check. Orange juice won't correct a low potassium fast enough to make this dose safe, and changing the dose isn't within the nurse's authority.
A client is prescribed a continuous heparin infusion at 1,200 units/hour. The bag contains heparin 25,000 units in 250 mL of 5% dextrose in water. At what rate should the nurse set the infusion pump, in mL/hour? Record your answer as a whole number.
Show answerHide answer
Concentration: 25,000 units ÷ 250 mL = 100 units/mL.
Rate: 1,200 units/hr ÷ 100 units/mL = 12 mL/hr.
A common slip is dividing the wrong way (100 ÷ 1,200) or forgetting to find the concentration first. Heparin is a high-alert medication, so many facilities require an independent double-check of the pump settings.
A client with a traumatic brain injury is being closely monitored. Which set of findings indicates increasing intracranial pressure?
- A. BP 176/64 mm Hg, heart rate 50/min, irregular respirations
- B. BP 90/58 mm Hg, heart rate 124/min, rapid shallow respirations
- C. BP 132/80 mm Hg, heart rate 88/min, regular respirations at 18/min
- D. BP 110/70 mm Hg, heart rate 110/min, temperature 38.9°C (102°F)
Show answerHide answer
That's Cushing's triad: rising systolic pressure with a widening pulse pressure, bradycardia, and irregular respirations. It's a late, ominous sign of rising ICP and possible herniation — notify the provider immediately.
Low BP with a fast pulse is the pattern of hypovolemic shock, the opposite direction. The third set is normal. Fever with tachycardia suggests infection, not ICP.
More NCLEX-RN guides
NCLEX-RN 2026: What’s on the Exam and How to Pass It
The NCLEX-RN is the licensing exam every new registered nurse has to pass.
Read Book picksBest NCLEX-RN Prep Books and Question Banks for 2026
You don’t need a shelf of books. You need one solid content review, a large bank of NGN-style questions with real…
Read GuideNext Generation NCLEX (NGN): Every Question Type, Explained
NGN items test clinical judgment, not trivia. Learn the six steps they’re built on, what each item format looks like…
Read ComparisonNCLEX-RN vs NCLEX-PN: Side-by-Side Comparison (2026)
Same testing engine, same length, same item formats — different jobs.
ReadFrequently asked questions
Is this practice test harder than the real NCLEX?
The items span easy to hard, weighted toward medium. The real exam adapts to you, so most candidates see many items that feel hard — that's normal and says nothing about whether you're passing.
What percentage should I aim for?
There's no official percent-to-pass conversion for the NCLEX. Use your results to compare categories and track improvement across retakes, not as a pass/fail prediction.
Does this test include NCLEX-PN content?
It's built on the RN test plan. Much of the clinical content overlaps, but PN candidates should also study the PN test plan's Coordinated Care category. See RN vs PN.
Sources & official links
- NCSBN — Prepare for the NCLEXnclex.com