NCLEX-RN Practice Test: Free Questions with Case Studies and NGN Items, 2026 Test Plan
602 practice questions for the NCLEX-RN, written to the 2026 test plan, in the formats the real exam uses since the Next Generation NCLEX: multiple choice, select all that apply, matrix grids, drop-down sentences, highlight-the-chart, bow-ties, and 15 unfolding case studies where the client's chart opens in tabs and updates as the case moves. They follow the eight Client Needs categories, weighted like the real exam. Multi-part questions earn partial credit the way NCSBN scores them, so you see "3 of 5 points," not just wrong. Every answer explains why the best choice is best and why each other choice lost, and names its source.
The real test: Computerized adaptive: 85 to 150 questions in up to 5 hours. The minimum 85 are 52 stand-alone questions, 3 case studies of 6 questions and 15 unscored pretest questions. It stops once it is 95% sure you are above or below NCSBN's passing standard, at 150 questions, or when time runs out; there is no percent to pass. Multi-part questions earn partial credit. Our practice test is the minimum-length exam, 70 scored questions with 3 whole case studies plus 15 unscored, with a 60% practice mark of the points.
Here: 602 questions. Our own practice questions on the 2026 NCLEX-RN test plan, written from open nursing textbooks (Open RN and OpenStax, CC BY 4.0) and U.S. government sources (CDC, FDA, NIH, AHRQ), with every answer's source named. Topics are the eight Client Needs categories plus case studies. Not NCSBN's questions and never recalled exam items. Free.
"On the test" is the rough share of a 70-question test for each topic, following the exam's published weights.
10 sample questions
The RN sees a UAP taking a blood pressure with a cuff that is clearly too small for the client's arm. What should the RN do?
A.Record the reading, since a small cuff changes the number only slightly
B.Show the UAP how to pick the right cuff size, then have them recheck it
C.Have the UAP wait 5 minutes and recheck with the same cuff on the same arm
D.Take over every blood pressure on the unit for the rest of the shift
Show answer
B. Show the UAP how to pick the right cuff size, then have them recheck it
MOC-46 · Management of Care
Several clients on a unit have sudden vomiting and diarrhea, and norovirus is suspected. Which cleaning practice is correct?
A.Clean only the bathrooms and leave bed rails for later
B.Use a quaternary ammonium wipe, since it kills most germs on contact
C.Wipe surfaces with alcohol pads after each episode of vomiting or diarrhea
D.Clean surfaces with a bleach-based product the facility approves
Show answer
D. Clean surfaces with a bleach-based product the facility approves
SIP-34 · Safety and Infection Prevention and Control
At a 2-month well-baby visit, which milestone does the nurse expect?
A.Smiles socially at people
B.Picks up a pea with thumb and finger
C.Rolls from back to front
D.Sits without support
Show answer
A. Smiles socially at people
HPM-01 · Health Promotion and Maintenance
A client says, "I'm really scared about my surgery tomorrow." What is the nurse's best response?
A."You sound scared. What worries you most about tomorrow?"
B."Let me bring you a booklet that explains what to expect."
C."Your surgeon has done this operation hundreds of times."
D."Why do you feel scared when it's such a routine surgery?"
Show answer
A. "You sound scared. What worries you most about tomorrow?"
PSY-01 · Psychosocial Integrity
A client with left-leg weakness is learning to use a cane. Which technique is correct?
A.Step out first with the right leg, then bring the cane up to meet it
B.Hold the cane in the right hand and move it forward with the left leg
C.Hold the cane in the right hand and swing it ahead with the right leg
D.Hold the cane in the left hand so it props up the weaker leg directly
Show answer
B. Hold the cane in the right hand and move it forward with the left leg
BCC-01 · Basic Care and Comfort
The nurse is preparing to give digoxin 0.125 mg to a client with heart failure and atrial fibrillation. Which assessment must the nurse do right before giving it?
A.Apical pulse for 1 full minute
B.Lung sounds in all lobes
C.Radial pulse for 30 seconds, doubled
D.Blood pressure lying and standing
Show answer
A. Apical pulse for 1 full minute
PHA-01 · Pharmacological and Parenteral Therapies
The nurse reviews the morning labs for a client admitted with pneumonia. Which result should the nurse report to the provider right away?
A.Sodium 138 mEq/L
B.Potassium 6.1 mEq/L
C.Fasting glucose 96 mg/dL
D.BUN 16 mg/dL
Show answer
B. Potassium 6.1 mEq/L
RRP-01 · Reduction of Risk Potential
A client taking furosemide has a potassium of 2.9 mEq/L. Which ECG change does the nurse expect to see?
A.Tall, narrow, peaked T waves in most leads
B.A shortened QT interval with a short ST segment
C.Flattened T waves with a U wave after them
D.A widened QRS that merges into a sine-wave pattern
Show answer
C. Flattened T waves with a U wave after them
PHYS-01 · Physiological Adaptation
Two staff nurses are arguing loudly at the nurses' station about an assignment. What should the charge nurse do first?
A.Tell both nurses to stop now and go back to work without discussion
B.Move the conversation to a private room and hear both nurses out
C.Change both assignments so neither nurse gets what they wanted
D.Report both nurses to the unit manager for unprofessional conduct
Show answer
B. Move the conversation to a private room and hear both nurses out
MOC-47 · Management of Care
A client in a long-term care facility is diagnosed with scabies. Which action is correct?
A.Use contact precautions and treat close contacts as ordered
B.Wait to treat the roommate until the roommate starts to itch
C.Place the client in a negative-pressure room for 24 hours
D.Use droplet precautions until the itching and the rash completely stop
Show answer
A. Use contact precautions and treat close contacts as ordered
SIP-35 · Safety and Infection Prevention and Control