KAPLAN NEXT GENERATION NCLEX (NGN) PRACTICE ASSESSMENT QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027.
CORE DOMAINS
Safe and Effective Care Environment
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Management of Care
Ethics and Legal Standards
INTRODUCTION
This comprehensive assessment is designed to prepare candidates for the Next Generation NCLEX (NGN)
examination. It evaluates critical thinking, clinical judgment, and the application of nursing knowledge across a
variety of settings. The exam incorporates both multiple-choice and scenario-based questions to mimic the
complexity of real-world nursing practice. Emphasis is placed on decision-making, prioritization, and the ability to
synthesize information to ensure patient safety and positive outcomes. This tool serves as a benchmark for exam
readiness.
,SECTION ONE: QUESTIONS 1-100
1. A client with chronic obstructive pulmonary disease (COPD) is admitted with increasing shortness of
breath. The nurse notes the client is using pursed-lip breathing. What is the primary purpose of this
breathing technique?
A. To increase the inspiratory reserve volume
B. To decrease the amount of trapped air in the lungs
C. To strengthen the diaphragm
D. To decrease the respiratory rate
🟢 B. To decrease the amount of trapped air in the lungs
🔴 RATIONALE: Pursed-lip breathing creates back pressure in the airways, which helps to keep the small airways
open during exhalation. This prevents airway collapse and air trapping, a common problem in COPD. It does not
primarily strengthen the diaphragm, increase inspiratory reserve, or solely decrease the respiratory rate, though
it may help regulate breathing.
2. A nurse is preparing to administer a blood transfusion. Which assessment finding would indicate a
potential acute hemolytic reaction?
A. Flushing of the face
B. Urticaria on the chest
C. Low back pain and chills
D. Hypertension
,🟢 C. Low back pain and chills
🔴 RATIONALE: Acute hemolytic reactions occur due to ABO incompatibility. The classic signs include chills,
fever, low back pain, and hypotension. Flushing and urticaria are signs of a mild allergic reaction. Hypertension
is not typical; hypotension is more common.
3. A patient is prescribed digoxin and furosemide. Which electrolyte imbalance should the nurse monitor for
that increases the risk of digoxin toxicity?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hyperphosphatemia
🟢 B. Hypokalemia
🔴 RATIONALE: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia (low potassium)
increases the risk of digoxin toxicity, as digoxin binds to the sodium-potassium pump. Hypercalcemia can also
increase toxicity, but hypokalemia is the primary concern with furosemide use.
4. A charge nurse is making assignments on a medical-surgical unit. Which client should be assigned to the
most experienced nurse?
, A. A client with a fractured hip who is 2 days post-operative
B. A client newly diagnosed with type 1 diabetes requiring education
C. A client with a chest tube who is unstable and has a suspected pneumothorax
D. A client with a urinary tract infection requiring IV antibiotics
🟢 C. A client with a chest tube who is unstable and has a suspected pneumothorax
🔴 RATIONALE: The unstable client with a chest tube and a suspected pneumothorax requires the highest level
of skill and experience. This client is at risk for respiratory compromise and requires complex assessment and
intervention. The other clients are more stable and appropriate for less experienced staff.
5. A nurse is evaluating the care of a client with a new tracheostomy. Which observation indicates the client
is at risk for a pressure injury from the tracheostomy tube?
A. The tube is secured with a twill tape that allows for one finger to fit under the tie
B. The client's neck is hyperextended
C. The cuff pressure is maintained at 20 cm H₂O
D. The stoma site is pink and moist
🟢 C. The cuff pressure is maintained at 20 cm H₂O
🔴 RATIONALE: The normal range for tracheostomy cuff pressure is 20-30 cm H₂O. A pressure of 20 cm H₂O is
within the acceptable range and does not directly indicate a pressure injury risk. A pressure injury is more
related to pressure from the tube itself. However, the question asks for the observation that indicates a risk. A
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027.
CORE DOMAINS
Safe and Effective Care Environment
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Management of Care
Ethics and Legal Standards
INTRODUCTION
This comprehensive assessment is designed to prepare candidates for the Next Generation NCLEX (NGN)
examination. It evaluates critical thinking, clinical judgment, and the application of nursing knowledge across a
variety of settings. The exam incorporates both multiple-choice and scenario-based questions to mimic the
complexity of real-world nursing practice. Emphasis is placed on decision-making, prioritization, and the ability to
synthesize information to ensure patient safety and positive outcomes. This tool serves as a benchmark for exam
readiness.
,SECTION ONE: QUESTIONS 1-100
1. A client with chronic obstructive pulmonary disease (COPD) is admitted with increasing shortness of
breath. The nurse notes the client is using pursed-lip breathing. What is the primary purpose of this
breathing technique?
A. To increase the inspiratory reserve volume
B. To decrease the amount of trapped air in the lungs
C. To strengthen the diaphragm
D. To decrease the respiratory rate
🟢 B. To decrease the amount of trapped air in the lungs
🔴 RATIONALE: Pursed-lip breathing creates back pressure in the airways, which helps to keep the small airways
open during exhalation. This prevents airway collapse and air trapping, a common problem in COPD. It does not
primarily strengthen the diaphragm, increase inspiratory reserve, or solely decrease the respiratory rate, though
it may help regulate breathing.
2. A nurse is preparing to administer a blood transfusion. Which assessment finding would indicate a
potential acute hemolytic reaction?
A. Flushing of the face
B. Urticaria on the chest
C. Low back pain and chills
D. Hypertension
,🟢 C. Low back pain and chills
🔴 RATIONALE: Acute hemolytic reactions occur due to ABO incompatibility. The classic signs include chills,
fever, low back pain, and hypotension. Flushing and urticaria are signs of a mild allergic reaction. Hypertension
is not typical; hypotension is more common.
3. A patient is prescribed digoxin and furosemide. Which electrolyte imbalance should the nurse monitor for
that increases the risk of digoxin toxicity?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hyperphosphatemia
🟢 B. Hypokalemia
🔴 RATIONALE: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia (low potassium)
increases the risk of digoxin toxicity, as digoxin binds to the sodium-potassium pump. Hypercalcemia can also
increase toxicity, but hypokalemia is the primary concern with furosemide use.
4. A charge nurse is making assignments on a medical-surgical unit. Which client should be assigned to the
most experienced nurse?
, A. A client with a fractured hip who is 2 days post-operative
B. A client newly diagnosed with type 1 diabetes requiring education
C. A client with a chest tube who is unstable and has a suspected pneumothorax
D. A client with a urinary tract infection requiring IV antibiotics
🟢 C. A client with a chest tube who is unstable and has a suspected pneumothorax
🔴 RATIONALE: The unstable client with a chest tube and a suspected pneumothorax requires the highest level
of skill and experience. This client is at risk for respiratory compromise and requires complex assessment and
intervention. The other clients are more stable and appropriate for less experienced staff.
5. A nurse is evaluating the care of a client with a new tracheostomy. Which observation indicates the client
is at risk for a pressure injury from the tracheostomy tube?
A. The tube is secured with a twill tape that allows for one finger to fit under the tie
B. The client's neck is hyperextended
C. The cuff pressure is maintained at 20 cm H₂O
D. The stoma site is pink and moist
🟢 C. The cuff pressure is maintained at 20 cm H₂O
🔴 RATIONALE: The normal range for tracheostomy cuff pressure is 20-30 cm H₂O. A pressure of 20 cm H₂O is
within the acceptable range and does not directly indicate a pressure injury risk. A pressure injury is more
related to pressure from the tube itself. However, the question asks for the observation that indicates a risk. A
