NCLEX-RN · full test
NCLEX-RN case study 4: heavy bleeding two hours after birth
One unfolding case study in the Next Generation format: a client on the postpartum unit whose bleeding increases two hours after a vaginal birth. Six items follow the six clinical judgment steps in order (recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, evaluate outcomes), and one of them is an infusion-rate calculation. 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 starts the postpartum hemorrhage protocol. Which actions should the nurse plan for this client? Select all that apply.
- Massage the fundus firmly while supporting the lower uterine segment
- Empty the bladder with a straight catheter as ordered
- Increase the oxytocin infusion to the protocol rate
- Give carboprost tromethamine 250 mcg IM from the protocol
- Keep weighing pads and drapes to measure blood loss
- Raise the head of the bed to high Fowler position
- Hold the IV fluid bolus until a repeat hemoglobin confirms the loss
- Insert a second large-bore IV and send a type and crossmatch
Marked when you take the test; the explanation appears in your review.