+/- scoring · 24 questions in 6 sets
NCLEX Highlight Practice Questions (Text and Table)
Practice NCLEX highlight questions: click the findings in notes or a table that need follow-up, with full rationales. Sets 1 and 2 are free, with no sign-up.
The format
What is a Highlight question on the NCLEX?
Highlight items show part of the client's record, either a nurse's note or a table of findings by body system, and ask you to click the findings that matter, such as those that require immediate follow-up.
Only certain phrases can be selected. Hovering over one turns it yellow, and clicking it keeps it highlighted.
Practice sets
24 Highlight questions in 6 sets
Each set covers one clinical topic and opens in the NCLEX-style test interface. Submit each answer to see the correct answer and a rationale for every option. Your progress and score are saved in this browser.
Neuro
Maternity
Pediatrics
Mental Health
Sample question
Try a Highlight question
Open the sample to see the format on the exam screen, with the correct answer marked and the reason each option is right or wrong. To answer questions yourself, start a set above.
Sample question: answer and rationaleClick to highlight the findings below that require immediate follow-up.
The nurse in the rehabilitation unit is caring for a 74-year-old female client.
Click to highlight the findings below that require immediate follow-up.
1210: History of a stroke with dysphagia and weakness of the right arm. Lunch observed. The unlicensed assistive personnel (UAP) helping with the meal is trained to feed clients with dysphagia. Client is sitting upright in a chair. The UAP gave mouth care before the meal. A visitor poured the client a glass of plain, unthickened water. Client coughed right after swallowing the water, and her voice now sounds wet and gurgling. Client takes small bites of the pureed food and eats slowly. She tucks the chin toward the chest with each swallow but falls asleep between bites and has to be woken to eat. Weakness of the right arm is unchanged since admission.
Green underline: a correct finding. Red strike-through: a finding you chose that is not correct.
Correct answer and rationale
Highlight · +/- scoring
The client has dysphagia, so each observation is compared with safe-swallowing practice and the ordered plan. Coughing right after swallowing and a wet, gurgling voice are signs of aspiration risk: the meal is stopped, and no food, fluid or medicine is given by mouth until the primary health care provider (PHCP) has been told. A client eats only when fully awake, so one who keeps falling asleep is not fed. Plain water does not match the ordered liquid thickness. Sitting upright in a chair, mouth care before the meal, small bites, a slow pace and the chin tuck chosen by the speech-language pathologist are correct. The arm weakness is known and unchanged.
Takeaway: stop the meal and report when a client with dysphagia coughs after swallowing, has a wet voice or is too drowsy to eat.
Why each option is right or wrong
- sitting upright in a chair: No follow-up. A client with dysphagia sits in a chair or in high Fowler's position to eat.
- gave mouth care before the meal: No follow-up. Oral care before the meal is part of feeding a client with dysphagia safely.
- poured the client a glass of plain, unthickened water: Follow up. The order is for thickened liquids, and the ordered liquid thickness is followed for every drink.
- coughed right after swallowing the water: Follow up. Coughing right after swallowing is a sign of aspiration risk: the meal is stopped and the primary health care provider (PHCP) is notified.
- voice now sounds wet and gurgling: Follow up. With a wet, gurgling voice, nothing more is given by mouth until the PHCP has been told.
- takes small bites of the pureed food and eats slowly: No follow-up. Small bites and a slow pace are how a client who is cleared for oral intake eats safely.
- tucks the chin toward the chest with each swallow: No follow-up. The chin tuck is the swallowing technique the speech-language pathologist chose for this client.
- falls asleep between bites and has to be woken to eat: Follow up. A client eats only when fully awake. A drowsy client is given no food or fluids until a clinician has evaluated the client.
- Weakness of the right arm is unchanged since admission: No immediate follow-up. The arm weakness is a known effect of the stroke and has not changed.
Sources
- Open RN Nursing Skills, 15.2 Basic Concepts of Administering Medications (LibreTexts mirror)
- Open RN Nursing Fundamentals, 14.3 Applying the Nursing Process (nutrition; LibreTexts mirror)
- Open RN Nursing Assistant, 5.7 Assisting With Nutrition and Fluid Needs (LibreTexts mirror)
- Open RN Nursing Fundamentals, 13.2 Mobility: Basic Concepts (LibreTexts mirror)
- StatPearls: Aspiration Risk (NCBI Bookshelf)
- StatPearls: Dysphagia (NCBI Bookshelf)
- Open RN Nursing Management and Professional Concepts 2e, 3.3 Assignment
Scoring
How Highlight questions are scored
Scored +/-: each correct highlight earns a point and each incorrect one loses a point, never going below 0. Partial credit applies on the NCLEX to items with more than one correct answer, so every correct choice counts.
Scoring rules: NCSBN, Next Generation NCLEX. Last reviewed October 13, 2026.
How to answer Highlight questions
- Compare every finding with normal for this client's age and condition.
- Expected findings for the client's diagnosis are usually not the ones needing immediate follow-up.
- Don't highlight a finding just because it's abnormal; the question may ask only about new or worsening problems.
FAQ
Highlight questions: FAQ
How is the NCLEX highlight question scored?
Can you highlight on the NCLEX?
How do you answer an NCLEX highlight question?
Keep practicing
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Next practice exercise
Pick up the set you started, or go on to the next question type. Every set opens in the NCLEX-style test interface.
Bow-Tie set 1 · Prioritization & Safety