NCLEX-RN Next Generation (NGN) Practice Exam | 100
Comprehensive Practice Questions with Verified
Answers & Detailed Rationales (2026–2029 Test Plan)
1. A nurse is assessing a client with heart failure. Which finding requires immediate
intervention?
A. Weight gain of 1 kg (2.2 lb) in 3 days
B. Bilateral ankle oedema
C. Oxygen saturation of 84% on room air
D. Fatigue with activity
Answer: C
Rationale: An oxygen saturation of 84% indicates severe hypoxaemia and requires
immediate intervention.
2. A client with diabetes is prescribed insulin lispro. When should the nurse administer it?
A. 1 hour before meals
B. Immediately before eating
C. At bedtime
D. Two hours after meals
Answer: B
Rationale: Lispro is rapid-acting insulin and should be administered just before meals.
3. Which client should the nurse assess first?
A. Postoperative client with pain rated 8/10
B. Client with blood glucose of 42 mg/dL and confusion
C. Client requesting a blanket
D. Client awaiting discharge instructions
Answer: B
Rationale: Severe hypoglycaemia with altered mental status is life-threatening.
,4. Which finding indicates effective treatment of pneumonia?
A. Increased white blood cell count
B. Oxygen saturation increased from 88% to 95%
C. Increased productive cough
D. Respiratory rate of 30 breaths/min
Answer: B
Rationale: Improved oxygenation indicates recovery.
5. Which electrolyte imbalance is expected in a client with prolonged vomiting?
A. Hyperkalaemia
B. Hypokalaemia
C. Hypercalcaemia
D. Hypermagnesaemia
Answer: B
Rationale: Vomiting causes potassium loss.
6. A client receiving heparin develops bleeding gums. Which action is the priority?
A. Stop the infusion and notify the provider.
B. Encourage oral hygiene.
C. Document the finding.
D. Increase IV fluids.
Answer: A
Rationale: Bleeding suggests excessive anticoagulation.
7. Which client is at highest risk for pressure injuries?
A. Ambulatory client with diabetes
B. Bedbound older adult with incontinence
C. Client with asthma
D. Young adult with influenza
, Answer: B
Rationale: Immobility and moisture greatly increase risk.
8. Which medication requires monitoring of serum potassium?
A. Furosemide
B. Acetaminophen
C. Aspirin
D. Metformin
Answer: A
Rationale: Loop diuretics can cause hypokalaemia.
9. Which statement by a client taking warfarin requires further teaching?
A. “I’ll use an electric razor.”
B. “I’ll notify my provider if I have black stools.”
C. “I’ll double my dose if I miss one.”
D. “I’ll use a soft toothbrush.”
Answer: C
Rationale: Missed doses should not be doubled.
10. Which assessment finding is expected after morphine administration?
A. Respiratory depression
B. Hypertension
C. Tachycardia
D. Hyperactivity
Answer: A
Rationale: Respiratory depression is a major adverse effect.
11. A client suddenly develops facial drooping and slurred speech. What is the nurse’s
priority?
A. Offer water.
Comprehensive Practice Questions with Verified
Answers & Detailed Rationales (2026–2029 Test Plan)
1. A nurse is assessing a client with heart failure. Which finding requires immediate
intervention?
A. Weight gain of 1 kg (2.2 lb) in 3 days
B. Bilateral ankle oedema
C. Oxygen saturation of 84% on room air
D. Fatigue with activity
Answer: C
Rationale: An oxygen saturation of 84% indicates severe hypoxaemia and requires
immediate intervention.
2. A client with diabetes is prescribed insulin lispro. When should the nurse administer it?
A. 1 hour before meals
B. Immediately before eating
C. At bedtime
D. Two hours after meals
Answer: B
Rationale: Lispro is rapid-acting insulin and should be administered just before meals.
3. Which client should the nurse assess first?
A. Postoperative client with pain rated 8/10
B. Client with blood glucose of 42 mg/dL and confusion
C. Client requesting a blanket
D. Client awaiting discharge instructions
Answer: B
Rationale: Severe hypoglycaemia with altered mental status is life-threatening.
,4. Which finding indicates effective treatment of pneumonia?
A. Increased white blood cell count
B. Oxygen saturation increased from 88% to 95%
C. Increased productive cough
D. Respiratory rate of 30 breaths/min
Answer: B
Rationale: Improved oxygenation indicates recovery.
5. Which electrolyte imbalance is expected in a client with prolonged vomiting?
A. Hyperkalaemia
B. Hypokalaemia
C. Hypercalcaemia
D. Hypermagnesaemia
Answer: B
Rationale: Vomiting causes potassium loss.
6. A client receiving heparin develops bleeding gums. Which action is the priority?
A. Stop the infusion and notify the provider.
B. Encourage oral hygiene.
C. Document the finding.
D. Increase IV fluids.
Answer: A
Rationale: Bleeding suggests excessive anticoagulation.
7. Which client is at highest risk for pressure injuries?
A. Ambulatory client with diabetes
B. Bedbound older adult with incontinence
C. Client with asthma
D. Young adult with influenza
, Answer: B
Rationale: Immobility and moisture greatly increase risk.
8. Which medication requires monitoring of serum potassium?
A. Furosemide
B. Acetaminophen
C. Aspirin
D. Metformin
Answer: A
Rationale: Loop diuretics can cause hypokalaemia.
9. Which statement by a client taking warfarin requires further teaching?
A. “I’ll use an electric razor.”
B. “I’ll notify my provider if I have black stools.”
C. “I’ll double my dose if I miss one.”
D. “I’ll use a soft toothbrush.”
Answer: C
Rationale: Missed doses should not be doubled.
10. Which assessment finding is expected after morphine administration?
A. Respiratory depression
B. Hypertension
C. Tachycardia
D. Hyperactivity
Answer: A
Rationale: Respiratory depression is a major adverse effect.
11. A client suddenly develops facial drooping and slurred speech. What is the nurse’s
priority?
A. Offer water.
