Hard NCLEX-RN Practice Questions

284 free hard-difficulty NCLEX-RN questions, drawn live from KomFi's calibrated bank. These are the items that separate top scorers — every one carries a full explanation and trap analysis once you sign in.

1. What is the priority action?
2. Which action is the priority?
3. What is the immediate priority?
4. Using the formula AG = Na - (Cl + HCO_3), what is the result and the clinical priority?
5. What is the priority nursing intervention?
6. According to the 'Trend before label' principle, what is the nurse's priority action after stabilizing the…
7. Which intervention is the priority?
8. Which nursing action is the highest priority?
9. A client with acute pancreatitis is being transferred from the intensive care unit to the step-down unit…
10. The nurse is preparing to receive report on four clients. Using the principles of multi-client…
11. A nurse is planning care for a client with neutropenia. Which interventions should the nurse implement to…
12. Which action is the priority to include in the plan of care?
13. A nurse is caring for a client with peritonitis. Which assessment findings are characteristic of this…
14. The RN is caring for a client with a psychiatric diagnosis who is exhibiting increasing agitation and verbal…
15. A client, Taylor, is hospitalized with disseminated herpes zoster. Which precautions are indicated for this…
16. The nurse is reviewing the 'Five Steps of Clinical Judgment' for a client in shock. Which actions correspond…
17. The nurse is caring for a client with neutropenia following chemotherapy. Which interventions are appropriate…
18. The nurse is supervising an unlicensed assistive person (UAP) in the collection of routine specimens. Which…
19. The RN is caring for a client receiving an IV heparin infusion. Which of the following tasks may be delegated…
20. A nurse is caring for a client with a deep vein thrombosis (DVT) who is receiving a continuous heparin…
21. A nurse is evaluating a client who began Total Parenteral Nutrition (TPN) 24 hours ago after a period of…
22. A client is experiencing anaphylactic shock. The nurse has administered epinephrine. Which findings indicate…
23. A nurse is preparing to transport a client with suspected pertussis (whooping cough) to the radiology…
24. A client is receiving a continuous morphine infusion via a Patient-Controlled Analgesia (PCA) pump for…
25. A client is receiving a continuous infusion of norepinephrine (Levophed) for septic shock. Which assessments…
26. A 24-year-old client is admitted to the intensive care unit following a traumatic brain injury. The nurse…
27. The nurse is reviewing the plan of care for a client prescribed warfarin for atrial fibrillation. Which…
28. The nurse is training a new graduate on isolation engineering. Which statements accurately describe an…
29. In the renal step-down unit, Jordan, age 58, has a potassium level of 6.7 mEq/L and a current ECG showing a…
30. During a cardiac arrest, the monitor shows an organized rhythm (sinus tachycardia), but the nurse cannot…

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