Free NCLEX practice questions with full rationales
Five free NCLEX-RN practice questions spanning the categories the NCSBN test plan weights most heavily — pharmacology safety, prioritization, SATA, and clinical judgment. Every question includes the correct answer, the clinical reasoning, and a note on why each distractor is wrong. No signup required.
Why "free NCLEX practice questions" rarely match the real exam
Most free NCLEX question sets fall into one of three traps: they were written before the 2023 Next Generation NCLEX update, they're medical-knowledge quizzes dressed up as nursing questions, or they're so easy that they give a false sense of readiness. The real NCLEX-RN tests clinical judgment — the ability to recognize what's changing in a patient and pick the safest next action — not memorized facts.
The five questions on this page were written to NCSBN's published item-writing standards and reviewed for accuracy. Every distractor (wrong answer) is something a student could plausibly choose, and the rationale explains the specific clinical error in each option rather than a generic "this is wrong."
What categories are on the NCLEX-RN?
The 2026 NCSBN test plan covers eight client need areas:
- Management of Care (15–21%) — delegation, prioritization, advocacy.
- Safety and Infection Control (10–16%) — falls, restraints, isolation, error prevention.
- Health Promotion and Maintenance (6–12%) — screening, developmental stages, prenatal care.
- Psychosocial Integrity (6–12%) — crisis, grief, addiction, therapeutic communication.
- Basic Care and Comfort (6–12%) — ADLs, nutrition, mobility, sleep.
- Pharmacological and Parenteral Therapies (13–19%) — administration, monitoring, adverse effects.
- Reduction of Risk Potential (9–15%) — diagnostic tests, lab values, complications.
- Physiological Adaptation (11–17%) — medical-surgical conditions, hemodynamics, fluid/electrolytes.
The questions below sample across these categories so you can gauge the breadth of what you'll face.
The 3 question-reading habits of students who pass first-try
- Identify the question type first. Is it asking for a priority, an expected outcome, an unexpected finding, or a teaching evaluation? The verb in the stem ("first," "best," "most concerning," "requires further teaching") tells you the rule to apply.
- Predict the answer before reading the options. If you can't predict, you don't understand the question. Reread the stem.
- Use ABCs and Maslow only as tiebreakers. Don't default to "airway" every time. If two options both address airway, pick the one that's least invasive, most reversible, or that uses the nursing process step the question is testing.
How many questions are on the NCLEX-RN?
The exam delivers between 75 and 145 questions using a computerized adaptive testing (CAT) format. The test ends when the algorithm is 95% confident you're above or below the passing standard. Roughly 15 of your items are unscored "tryout" questions — you won't know which.
What the full Clarity bank looks like
The bank has 5,000+ NCLEX practice items spanning every category above, including 50+ real multi-step NGN case studies, 30+ bow-tie items, 200+ pharmacology drug cards linked from rationales, and 5 timed readiness exams that simulate the real adaptive test. The full bank is $9.99/mo — less than a single month of UWorld.
Try these 5 questions now
No signup required. Tap an answer to reveal the rationale.
- Question 1 · Cardiac · NGN case study
A 62-year-old client arrives in the ED with crushing substernal chest pain radiating to the left arm, diaphoresis, and a heart rate of 112 bpm. The 12-lead ECG shows ST elevation in leads II, III, and aVF. Troponin is 4.8 ng/mL. The provider orders aspirin 325 mg, sublingual nitroglycerin, and prepares for cardiac catheterization. Which finding would most prompt the nurse to hold the nitroglycerin?
- a.Blood pressure 88/52 mmHg
- b.Heart rate 102 bpm
- c.Reports pain of 7/10
- d.SpO2 95% on 2L nasal cannula
Show answer + rationale
Correct: A. Inferior wall MI (II, III, aVF) frequently involves the right ventricle, which is preload-dependent. Nitroglycerin causes venodilation, dropping preload, and in RV infarction can precipitate profound hypotension and shock. A systolic of 88 with an inferior STEMI is an absolute contraindication. Heart rate 102 is appropriate sympathetic response, pain warrants treatment, and SpO2 95% is acceptable.
- Question 2 · Respiratory · NGN case study
A 4-year-old with a known peanut allergy is brought to the clinic after accidentally eating a granola bar. The child has stridor, lip swelling, and audible wheezing. Vital signs: HR 148, RR 38, BP 78/40, SpO2 88% on room air. Which intervention is the priority?
- a.Administer oral diphenhydramine
- b.Administer IM epinephrine 0.15 mg
- c.Start an IV of 0.9% NaCl bolus
- d.Apply 6 L oxygen via simple mask
Show answer + rationale
Correct: B. Anaphylaxis with airway compromise (stridor), respiratory distress, and hypotension requires immediate IM epinephrine to the mid-anterolateral thigh. Epinephrine reverses bronchoconstriction, restores vascular tone, and stabilizes mast cells. Antihistamines are adjuncts only and do not treat airway swelling. IV fluids and oxygen follow epinephrine, not before it.
- Question 3 · Pharmacology · SATA
A nurse is teaching a client about warfarin therapy. Which statements indicate the teaching has been effective? Select all that apply.
- a.I should call my provider if I see blood in my urine.
- b.I will avoid large amounts of leafy green vegetables.
- c.I can take ibuprofen for headaches.
- d.I will use an electric razor for shaving.
- e.I will get my INR checked as scheduled.
Show answer + rationale
Correct: A, B, D, E. Warfarin increases bleeding risk so hematuria warrants provider notification (A). Vitamin K from leafy greens antagonizes warfarin, so consistency rather than total avoidance is the goal, but large variations are problematic (B is acceptable phrasing). Electric razors reduce cut risk (D). INR monitoring is essential (E). Ibuprofen (C) is an NSAID that increases bleeding risk and is contraindicated — acetaminophen is preferred.
- Question 4 · Pharmacology · MCQ
A client receiving IV heparin has an aPTT of 145 seconds (therapeutic 60–80 seconds). What is the nurse's priority action?
- a.Increase the heparin infusion rate
- b.Stop the infusion and notify the provider
- c.Administer vitamin K
- d.Continue the infusion and recheck in 4 hours
Show answer + rationale
Correct: B. An aPTT nearly double the therapeutic range puts the client at severe bleeding risk. The infusion must be stopped immediately and the provider notified for protamine sulfate (heparin's antidote) consideration. Vitamin K reverses warfarin, not heparin. Continuing or increasing the rate worsens the bleeding risk.
- Question 5 · Prioritization · MCQ
A nurse on a medical unit has received report on four clients. Which client should the nurse assess first?
- a.A client with pneumonia and a temperature of 101.2°F
- b.A client 1 day post-op who reports 6/10 incisional pain
- c.A client with COPD and an SpO2 of 86% on 2L oxygen
- d.A client with cellulitis awaiting IV antibiotics
Show answer + rationale
Correct: C. ABC principles: airway and breathing trump everything else. SpO2 of 86% on supplemental oxygen represents an acute oxygenation problem requiring immediate assessment. While the COPD client's baseline may be lower than 95%, 86% is dangerous and the trajectory matters. The other clients have problems that can be addressed in sequence after the unstable one is stabilized.
These are 5 of 5,000+ NCLEX questions in the Clarity bank. The full bank includes real NGN case studies, bow-tie items, AI tutor follow-up, and 5 readiness exams.
Get 5,000+ more questions free for 10/day →Frequently asked questions
Are these NCLEX practice questions actually free?
Yes. Every question on this page is free with no signup. Clarity also offers 10 free questions per day to anyone with a free account, and a full premium bank from $9.99/mo.
How accurate are these free NCLEX practice questions?
Each question is written to NCSBN item-writing standards, reviewed for clinical accuracy, and aligned to the 2026 NCLEX-RN test plan. We update questions when guidelines change (e.g., ACLS, sepsis bundles, ATI/NCSBN policy updates).
What's a passing score on the NCLEX-RN?
There's no traditional passing percentage. The NCLEX uses logit scoring and computerized adaptive testing. As of April 2023 the passing standard is -0.18 logits. You pass when the algorithm is 95% confident you perform above that standard.
How long should I study for the NCLEX-RN?
Most graduates spend 4–8 weeks of focused prep doing 75–100 questions/day with thorough rationale review. Less than 2 weeks of prep is correlated with higher fail rates; more than 12 weeks tends to produce burnout without further gains.
Is UWorld worth it for NCLEX prep?
UWorld is the most established option but costs ~$109/month. Clarity covers the same NGN item types and adds an AI tutor for $9.99/mo. The questions on this page give you a direct sample so you can judge for yourself.