Free NCLEX SATA questions — select-all-that-apply practice
Select-all-that-apply (SATA) items are the most-dreaded format on the NCLEX-RN because old-format SATA was all-or-nothing. On the Next Generation NCLEX, most SATA items now use partial-credit scoring — but they still require precision. Five free SATA questions below with full rationales and the reasoning behind each correct and incorrect selection.
How NCLEX SATA scoring actually works in 2026
Pre-2023 SATA was 0/1 — every selection had to be exactly right. The Next Generation NCLEX introduced "extended multiple response" scoring on most SATA items, which uses +1 / 0 / -1 scoring: correct selection earns +1, incorrect selection loses -1, no selection earns 0. The total floors at zero so you can't go negative on any single item.
Translation: shotgun-selecting every option is now punished. Selecting only the ones you're confident in is rewarded. This is a major strategic change from old-format SATA.
The 4 rules for answering SATA questions correctly
- Evaluate each option independently. Treat each choice as its own true/false question. Don't try to find a pattern across options.
- If you're uncertain, leave it unselected. Under partial-credit scoring, no selection (0) beats a wrong selection (-1).
- Watch for absolute words. "Always," "never," "all," and "only" usually make a SATA option wrong. "May," "should," "appropriate" usually make it right.
- Don't second-guess your "yes" selections. The most common SATA error is dropping a correct selection because the student talks themselves out of it. If you know it's right, keep it.
How many SATA questions are on the NCLEX-RN?
Roughly 10–15 SATA items appear on each NCLEX-RN, though the count varies because the test is adaptive. Higher-performing students typically see more SATA because the algorithm is testing them at higher cognitive levels.
Common SATA traps the NCSBN plants on purpose
- The plausible-but-wrong distractor. Every SATA has 1–2 options that sound right but contradict a guideline (e.g., "encourage ambulation" for a client with a DVT before anticoagulation).
- The expected-finding-vs-priority trap. An option might be a true finding for the condition but not what the question is asking. Re-read the stem.
- The overstated absolute. "All clients with X should..." or "Never administer Y" usually makes an option wrong even when it's mostly true.
- The mixed-truth. An option pairs a correct action with an incorrect rationale or vice versa. Both halves must be right for the option to be selected.
Practice the SATA format, not just the topic
Doing 50 SATA items on pharmacology builds different skills than doing 50 standalone multiple choice items on the same content. The format itself is what makes SATA hard. Aim for at least 200 SATA items in your prep period across mixed categories.
Try these 5 questions now
No signup required. Tap an answer to reveal the rationale.
- Question 1 · 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 2 · Cardiac · SATA
Which assessment findings should the nurse expect in a client with left-sided heart failure? Select all that apply.
- a.Crackles in the lung bases
- b.Jugular vein distention
- c.Dyspnea on exertion
- d.Peripheral edema
- e.Orthopnea
Show answer + rationale
Correct: A, C, E. Left-sided failure backs up into the pulmonary circulation, producing pulmonary congestion: crackles, dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea. JVD and peripheral edema are signs of right-sided failure, where venous return backs up systemically. Many patients eventually develop both, but the question asks for left-sided findings.
- Question 3 · Infection control · SATA
A client is admitted with active pulmonary tuberculosis. Which precautions should the nurse implement? Select all that apply.
- a.Place the client in a negative-pressure room
- b.Wear an N95 respirator when entering the room
- c.Use a surgical mask when transporting the client
- d.Have the client wear an N95 during transport
- e.Keep the door open for ventilation
Show answer + rationale
Correct: A, B. TB requires airborne precautions: negative-pressure room with door closed, N95 or PAPR for staff. During transport the client wears a surgical mask (not N95) to contain droplet nuclei — the staff member outside the room can wear a regular mask. Door must remain closed to maintain negative pressure.
- Question 4 · Pediatrics · SATA
Which findings in a 6-month-old infant would prompt immediate provider notification? Select all that apply.
- a.Sunken anterior fontanel
- b.Capillary refill of 4 seconds
- c.Mottled extremities
- d.Wet diaper count of 6 in 24 hours
- e.Lethargy and weak cry
Show answer + rationale
Correct: A, B, C, E. Sunken fontanel signals dehydration. Cap refill greater than 3 seconds and mottling indicate poor perfusion. Lethargy and weak cry are red flags for sepsis or severe dehydration. 6 wet diapers in 24 hours is within normal limits (expected 6–8 daily) — that finding is reassuring, not concerning.
- Question 5 · Mental health · SATA
Which interventions are appropriate when caring for a client in acute alcohol withdrawal? Select all that apply.
- a.Administer lorazepam as prescribed
- b.Initiate seizure precautions
- c.Restrain the client to prevent injury
- d.Monitor vital signs every 4 hours
- e.Provide thiamine before glucose
Show answer + rationale
Correct: A, B, E. Benzodiazepines (lorazepam) are first-line for withdrawal symptom control. Seizure precautions are essential — withdrawal seizures occur 6–48 hours after last drink. Thiamine before glucose prevents Wernicke's encephalopathy. Restraints worsen agitation and are last-resort. Vital signs in active withdrawal need to be every 1–2 hours, not every 4.
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
Is NCLEX SATA still all-or-nothing scoring?
No. As of April 2023, most NCLEX SATA items use polytomous (partial-credit) scoring. Correct selections earn +1, incorrect selections lose -1, no selection earns 0. The total floors at zero so a single item can't drop you into the negatives.
How many SATA questions are on the NCLEX-RN?
About 10–15 SATA items per NCLEX-RN, though the exact count varies because of the adaptive testing format. Higher performers tend to see more SATA at higher cognitive levels.
What's the best strategy for NCLEX SATA questions?
Evaluate each option independently as a true/false question. Select only the ones you're confident are correct. Under partial-credit scoring, leaving uncertain options unselected beats guessing wrong.
Are there free NCLEX SATA practice questions?
Yes. The five SATA items on this page are free with no signup. Clarity premium ($9.99/mo) includes 3,700+ SATA practice items across every NCLEX category.
Why are NCLEX SATA questions so hard?
SATA tests precision rather than recognition. You have to know each option is correct or incorrect, not just narrow to the best of four. Most students need 200+ SATA reps to build this precision.