NCLEX-RN · full test
NCLEX-RN case study 1: new confusion on the night shift
One unfolding case study in the Next Generation format: an older adult on a medical-surgical unit whose condition changes overnight. Six items follow the six clinical judgment steps in order (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, evaluate outcomes). Open every tab of the chart before you answer. Select-all and highlight items are scored by the NCSBN plus/minus rule: a point for each correct choice, a point off for each wrong one, never below zero. Drop-down and matrix items, where the number of answers is stated, earn a point for each correct choice with no deduction. Content follows the 2026 NCLEX-RN Test Plan (effective April 1, 2026).
The real NCLEX-RN is computer-adaptive: 85 to 150 items in up to five hours, and it stops when it is 95% certain you are above or below the passing standard. This is fixed-length practice of the same item types, so it gives a percentage and a client-needs breakdown, not a pass or fail.
Exam mode: timed, answers at the end, like the real test. Practice mode: untimed, the answer and explanation after each question.
What is in this test
Covers: clinical judgment (6)
A sample question
Generate solutions. The nurse reports the findings and the provider starts the sepsis protocol. Which orders should the nurse expect in the first hour? Select all that apply.
- Two sets of blood cultures before the first antibiotic dose
- A broad-spectrum IV antibiotic within one hour
- Furosemide 20 mg IV to improve urine output
- IV crystalloid 30 mL/kg for low blood pressure
- Urinalysis and urine culture
- Oral antibiotic to start with breakfast
- Restrict IV fluids to protect the kidneys
- Repeat lactate after the fluid bolus
Marked when you take the test; the explanation appears in your review.