NCLEX-RN · full test
NCLEX-RN case study 3: a college student with vomiting and fast breathing
One unfolding case study in the Next Generation format: a young adult with type 1 diabetes brought to the emergency department. Six items follow the six clinical judgment steps in order, including a bow-tie item, an ordered-response item and an infusion-rate calculation. Open every tab of the chart before you answer. Select-all 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, bow-tie 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. Potassium on arrival is 5.4 mEq/L. Put the planned treatment steps in the order the nurse should carry them out, first to last.
- Start the IV regular insulin infusion at 0.1 units/kg/h
- Begin the 0.9% sodium chloride infusion, 1,000 mL over 1 hour
- Change to dextrose 5% in 0.45% sodium chloride when glucose falls below 250 mg/dL
- Recheck capillary blood glucose one hour after the insulin infusion starts
Marked when you take the test; the explanation appears in your review.