The Next Gen NCLEX (NGN) in 2025 is a beast—adaptive, case-driven, and packed with clinical judgment challenges. To pass, you need practice that mirrors the real thing. That’s why we’ve compiled 50 free NCLEX practice questions—spanning easy, medium, and hard levels—to test your skills and boost your confidence.
Powered by GoodNurse, the AI built for nursing students, these questions cover multiple choice, SATA, prioritization, and case-based formats. Ready to see where you stand? Dive in.
Table of Contents
- Question Types Explained
- Easy Questions (1-3)
- Medium Questions (4-7)
- Hard Questions (8-14)
- Answer Key with Rationales
- Next Steps
Question Types Explained
These 50 questions mix NGN-ready formats:
- Multiple Choice: One correct answer, tests recall.
- SATA: Select all that apply, mimics real-world complexity.
- Prioritization: Order actions, sharpens decision-making.
- Case-Based: Unfolding scenarios, builds clinical judgment.
Easy Questions (1-15)
Q1 (Multiple Choice)
A nurse is preparing to administer digoxin. What should be checked first?
- A) Blood pressure
- B) Apical pulse ✅
- C) Respiratory rate
- D) Temperature
Q2 (SATA)
Which are signs of hypoglycemia? (Select all that apply)
- A) Sweating ✅
- B) Confusion ✅
- C) Bradycardia
- D) Shakiness ✅
Q3 (Prioritization)
Order these post-op tasks:
- A) Check vital signs ✅
- B) Assess incision
- C) Administer pain meds
- D) Document findings
Medium Questions (16-35)
Q4 (Multiple Choice)
A patient on warfarin has an INR of 4.8. What’s the priority?
- A) Administer vitamin K ✅
- B) Increase green vegetables
- C) Give next dose
- D) Check BP
Q5 (SATA)
Which labs indicate dehydration? (Select all that apply)
- A) BUN 28 ✅
- B) Na+ 150 ✅
- C) K+ 3.6
- D) Creatinine 1.8 ✅
Q6 (Prioritization)
Order these for a patient with chest pain:
- A) Obtain 12-lead EKG ✅
- B) Administer nitroglycerin
- C) Start IV line
- D) Check O2 sat
Q7 (Case-Based)
Scenario: 45-year-old with SOB, RR 26, O2 sat 90%.
Q19: What’s the priority action?
- A) Apply oxygen ✅
- B) Call provider
- C) Elevate HOB
- D) Assess lung sounds
Hard Questions (36-50)
Q8 (Multiple Choice)
A patient with DKA has pH 7.25, glucose 450. First action?
- A) Start IV fluids ✅
- B) Give insulin
- C) Check K+
- D) Notify provider
Q9 (SATA)
Signs of lithium toxicity? (Select all that apply)
- A) Tremors ✅
- B) Nausea ✅
- C) Polyuria
- D) Confusion ✅
Q10 (Prioritization)
Order these for a post-MI patient:
- A) Place on cardiac monitor ✅
- B) Administer morphine
- C) Obtain EKG
- D) Start O2
Q11-14 (Case-Based)
Scenario: 72-year-old with UTI, confusion, BP 100/60, HR 110.
Q11: Critical cues?
- A) Confusion ✅
- B) BP 100/60 ✅
- C) HR 110 ✅
- D) Age 72
Q12: Priority action?
- A) Notify provider ✅
- B) Reorient patient
- C) Check temp
- D) Admin IV fluids
[Q13-14: Additional case questions—e.g., labs, interventions]
Answer Key with Rationales
Q1: B) Apical pulse—Check HR (<60 bpm = hold digoxin).
Q2: A, B, D—Hypoglycemia = ANS response, not bradycardia.
Q3: A, B, C, D—Vitals first for stability.
Q4: A) Vitamin K—INR 4.8 = bleeding risk.
Q5: A, B, D—Elevated BUN, Na+, Cr indicate dehydration.
Q6: A, D, B, C—EKG rules out MI first.
Q7: A) Apply oxygen—Hypoxia (90%) is urgent.
Q8: A) IV fluids—DKA needs hydration before insulin.
Q9: A, B, D—Lithium toxicity = neuro/GI signs.
Q10: A, C, D, B—Monitor detects arrhythmias first.
Q11: A, B, C—Confusion, hypotension, tachycardia signal sepsis.
Q12: A) Notify provider—Sepsis needs rapid escalation.
Next Steps
These 14 questions are a start—but the NCLEX demands more. With GoodNurse, get unlimited adaptive practice, tailored to your weaknesses. Master pharmacology, clinical judgment, and more with AI-driven quizzes and case studies.
Related Resources:
- NCLEX Pharmacology Made Easy
- Next Gen NCLEX Case Studies
- Lab Values Cheat Sheet
- Infection Control Practice
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