Free NCLEX practice questions, with the reasoning explained.

Answer: raise the head of the bed and apply oxygen. Sudden breathlessness and hypoxia after hip surgery suggest a pulmonary embolism. Breathing comes first: position the client upright and give oxygen, then notify the provider. An ECG and the incision do nothing for the hypoxia.

Answer: 15 g of fast-acting carbohydrate. This is hypoglycemia in a client who can swallow, so follow the rule of 15: give 15 g of fast carbohydrate and recheck in 15 minutes. Glucagon is for a client who cannot swallow safely. Insulin would lower the glucose further.

Answer: using alcohol-based rub. C. difficile forms spores that alcohol does not kill. Hands must be washed with soap and water. Gowns, gloves, dedicated equipment and the sign are all correct contact precautions.

Answer: vital signs for a stable client. Routine, predictable tasks for stable clients can be delegated. Assessment, teaching and evaluation stay with the registered nurse.

Answer: nausea and anorexia, visual halos, and bradycardia. These are the classic signs of digoxin toxicity. Low potassium raises the risk, so check the potassium level too. High blood pressure and increased urine output are not typical signs.

Answer: urine output. The kidneys excrete potassium. Without adequate urine output, at least 30 mL per hour, an infusion can cause dangerous hyperkalemia. IV potassium is always diluted and never given as an IV push.

Answer: the client after thyroidectomy. High-pitched noisy breathing is stridor, a sign the airway is narrowing from swelling, bleeding or nerve injury. Airway comes first. A saturation of 88 to 92% is often the target for clients with COPD.

Answer: help the client empty their bladder. A firm fundus that is high and pushed to one side points to a full bladder, which can stop the uterus contracting well and lead to bleeding. Fundal massage is for a boggy fundus.

Answer: ask directly about suicide. The statement may signal suicidal intent. Asking directly does not plant the idea; it opens the assessment of plan and means. The other answers dismiss the client or change the subject.

Answer: 0.5 mL. Desired dose divided by the dose on hand, times the volume: 5,000 ÷ 10,000 × 1 mL = 0.5 mL.

Answer: the client receiving the transfusion. Chills and back pain early in a transfusion suggest an acute hemolytic reaction. Stop the transfusion, keep the IV open with normal saline through new tubing, and notify the provider and the blood bank. The client who wants to walk is a fall risk, so assistive personnel can help while the nurse acts.

Answer: a negative-pressure room, an N95 respirator for staff, and a mask on the client outside the room. Tuberculosis spreads through airborne droplet nuclei. The door stays closed so the negative pressure works, and a surgical mask does not protect staff from airborne particles.

Answer: hold the consent and inform the surgeon. Consent is only valid when the client understands the procedure, its risks and the alternatives. Explaining the surgery is the surgeon's responsibility. The nurse's signature confirms the client signed willingly, so the nurse should not witness it while the client is unsure.

Answer: potassium 3.1 mmol/L. Normal potassium is about 3.5 to 5.0 mmol/L. Furosemide is a loop diuretic that removes potassium, so giving it now could push the level lower and cause dangerous arrhythmias. The other three results are within normal limits.

Answer: Rh immune globulin now. A routine dose at 28 weeks prevents the client from making antibodies against an Rh-positive fetus. Another dose is given within 72 hours after birth if the newborn is Rh positive, and after events such as bleeding. The rubella vaccine is a live vaccine, so it is given after birth and never during pregnancy.

Answer: reposition, keep the head of the bed low, and use a pressure-redistributing mattress. A low head of the bed reduces shear on the sacrum. Massaging reddened skin damages the tissue underneath, and donut cushions cut off blood flow to the skin around them.

Answer: state reality and acknowledge the feeling. The nurse neither argues with the delusion nor agrees with it, and responds to the emotion behind it. "Why" questions put the client on the defensive, arguing damages trust, and turning off the TV treats the messages as real.

Answer: apply firm pressure above the site. A warm, wet feeling at the groin suggests arterial bleeding. Direct pressure controls it while the nurse calls for help and notifies the provider. Raising the head of the bed bends the hip and can make the bleeding worse.

Answer: move the client out of the room. Follow RACE: Rescue anyone in immediate danger, raise the Alarm, Contain the fire by closing doors, then Extinguish if it is safe or evacuate.

Answer: sit upright and tuck the chin. Sitting upright and tucking the chin help protect the airway while swallowing. Follow the diet texture from the swallowing assessment. Straws and thin liquids raise the risk of aspiration, and rushing makes it worse.