NCLEX-RN Preparation Book PDF 2026 (Free Download)

What is in the NCLEX-RN book

Each model paper carries the same number of MCQs per subject as the real NCLEX-RN paper, so sitting it is a rehearsal of the real thing, not a random worksheet.

Sample MCQs from the NCLEX-RN book

The first 10 questions of model paper 1.

1. Medical Surgical Nursing

   1. A patient with severe hypothyroidism is drowsy, hypothermic and breathing slowly. Which assessment is the priority?

   • A. Assess airway patency and respiratory effectiveness
   • B. Measure the patient’s usual daily calorie intake
   • C. Inspect the skin for changes in pigmentation
   • D. Ask about the patient’s recent bowel pattern
   Show answer

   Answer: A, Assess airway patency and respiratory effectiveness. See the explanation

2. Fundamentals of Nursing

   2. A patient with suspected spinal injury must be turned in bed. Which technique should the nurse use?

   • A. Turn the patient as one unit while maintaining alignment
   • B. Ask the patient to twist the trunk during the turn
   • C. Pull the shoulders first and then move the legs
   • D. Raise the head and turn the patient into a sitting position
   Show answer

   Answer: A, Turn the patient as one unit while maintaining alignment. See the explanation

3. Nursing Pharmacology

   3. A patient taking long-term prednisolone reports severe muscle weakness, vomiting and dizziness after several days of diarrhoea. Which complication should the nurse suspect?

   • A. Acute adrenal insufficiency
   • B. Excess thyroid hormone activity
   • C. Acute iron toxicity
   • D. Uncomplicated drug tolerance
   Show answer

   Answer: A, Acute adrenal insufficiency. See the explanation

4. International Nursing Practice

   4. A patient with a new ileostomy becomes dizzy when standing. The stoma output has increased greatly during the last shift, and the mucous membranes are dry. What should the nurse do first?

   • A. Assess vital signs and notify the nurse in charge promptly
   • B. Ask the patient to walk slowly to improve circulation
   • C. Restrict fluids until the stoma output decreases
   • D. Give an antidiarrhoeal medicine without further assessment
   Show answer

   Answer: A, Assess vital signs and notify the nurse in charge promptly. See the explanation

5. Mental Health Nursing

   5. A malnourished patient with long-term alcohol use has confusion, unsteady gait, and abnormal eye movements. Which treatment should the nurse anticipate first?

   • A. Intravenous thiamine administration
   • B. Oral iron supplementation
   • C. Intramuscular vitamin K administration
   • D. Increased dietary calcium intake
   Show answer

   Answer: A, Intravenous thiamine administration. See the explanation

6. Paediatric Nursing

   6. A caregiver prepares complementary food in the morning and leaves it uncovered at room temperature until evening. Which teaching is the priority?

   • A. Prepare small fresh portions and cover them safely
   • B. Add extra water so the food remains soft
   • C. Store the food uncovered to allow cooling
   • D. Reheat the same food repeatedly throughout the day
   Show answer

   Answer: A, Prepare small fresh portions and cover them safely. See the explanation

7. Midwifery and Obstetric Nursing

   7. A newborn is placed in skin-to-skin contact with the mother. Which position is safest during this care?

   • A. Prone with the face covered by a blanket
   • B. Upright with the head turned and airway visible
   • C. Supine with the chin pressed against the chest
   • D. Side-lying with the neck flexed forward
   Show answer

   Answer: B, Upright with the head turned and airway visible. See the explanation

8. Community Health Nursing

   8. A Lady Health Worker finds several children in a village who have missed routine preventive services. Which action is most appropriate?

   • A. Wait until the families attend the hospital
   • B. Record the children and arrange follow-up with the health facility
   • C. Give every child an antibiotic without assessment
   • D. Remove the children from the community register
   Show answer

   Answer: B, Record the children and arrange follow-up with the health facility. See the explanation

9. Medical Surgical Nursing

   9. A patient with open-angle glaucoma is prescribed latanoprost eye drops. Which finding should the nurse include in the teaching?

   • A. The treated iris may gradually become darker
   • B. The medication commonly causes severe hearing loss
   • C. The drops should be stopped when vision improves
   • D. The patient should expect complete loss of night vision
   Show answer

   Answer: A, The treated iris may gradually become darker. See the explanation

10. Fundamentals of Nursing

    10. Which action is appropriate when caring for a patient with an indwelling urinary catheter during routine hygiene?

    • A. Clean the meatus and catheter from the urethra outward
    • B. Pull the catheter gently while cleaning the meatus
    • C. Clean from the drainage bag toward the urethral opening
    • D. Disconnect the catheter from the bag before cleaning the area
    Show answer

    Answer: A, Clean the meatus and catheter from the urethra outward. See the explanation

Practise NCLEX-RN online, free

A PDF cannot time you or tell you which chapter is costing you marks. Every NCLEX-RN subject can be practised free on TestUstad, chapter by chapter, with each answer marked as you go.