Latest NCLEX-RN NGN 2026 Practice Exam verified with correct answers with
rationales A+ Graded/instant pdf
1. The nurse receives report on four clients. Which client should the nurse assess
first?
A. A client with chronic arthritis reporting pain of 6/10
B. A client 1 day postoperative requesting assistance to the bathroom
C. A client with pneumonia who has an oxygen saturation of 86%
D. A client awaiting discharge instructions
Correct Answer: C. A client with pneumonia who has an oxygen saturation of 86%
Rationale: Hypoxemia is an immediate threat to oxygenation and requires priority assessment.
2. A client with suspected hypoglycemia is confused, diaphoretic, and shaky.
What is the nurse's priority action?
A. Administer prescribed rapid-acting insulin
B. Check the client's blood glucose level
C. Encourage the client to ambulate
D. Provide a high-fat meal
Correct Answer: B. Check the client's blood glucose level
Rationale: The nurse should rapidly assess glucose status to confirm and guide treatment.
3. Which finding requires immediate intervention in a client receiving an IV
potassium infusion?
A. Urine output of 40 mL/hr
B. Heart rate of 82/min
C. Burning and swelling at the IV site
D. Blood pressure of 128/76 mmHg
Correct Answer: C. Burning and swelling at the IV site
Rationale: These findings suggest infiltration or extravasation and require prompt assessment
and intervention.
4. Which task is appropriate for the RN to delegate to an experienced UAP?
A. Assessing a new pressure injury
B. Teaching a client how to use an incentive spirometer
C. Obtaining vital signs for a stable client
D. Evaluating a client's response to pain medication
,Correct Answer: C. Obtaining vital signs for a stable client
Rationale: Routine data collection for a stable client may be delegated; assessment, teaching,
and evaluation remain with the nurse.
5. A client taking warfarin should be taught to report:
A. Mild thirst
B. Black, tarry stools
C. Increased appetite
D. Occasional sneezing
Correct Answer: B. Black, tarry stools
Rationale: Black, tarry stools may indicate gastrointestinal bleeding.
6. Which intervention is appropriate for a client with suspected tuberculosis?
A. Place the client on airborne precautions
B. Use only standard precautions
C. Place the client in a positive-pressure room
D. Allow unrestricted visitors without PPE
Correct Answer: A. Place the client on airborne precautions
Rationale: Tuberculosis requires airborne infection-control measures.
7. A client receiving morphine has a respiratory rate of 8/min and is difficult to
arouse. What is the priority action?
A. Administer another dose of morphine
B. Assess airway and breathing
C. Offer oral fluids
D. Place the client in Trendelenburg position
Correct Answer: B. Assess airway and breathing
Rationale: Respiratory depression is a potentially life-threatening opioid complication.
8. Which finding is most concerning in a client with heart failure?
A. Mild ankle edema at the end of the day
B. Sudden weight gain of 2.3 kg in 48 hours
C. Heart rate of 78/min
D. Blood pressure of 118/72 mmHg
Correct Answer: B. Sudden weight gain of 2.3 kg in 48 hours
Rationale: Rapid weight gain suggests fluid retention and worsening heart failure.
, 9. A client with a new tracheostomy becomes restless and develops increasing
respiratory distress. What should the nurse do first?
A. Leave the room to obtain the medical record
B. Assess airway patency and oxygenation
C. Offer oral fluids
D. Place the client flat
Correct Answer: B. Assess airway patency and oxygenation
Rationale: Respiratory distress after tracheostomy requires immediate airway assessment.
10. Which finding is expected in a client experiencing diabetic ketoacidosis?
A. Kussmaul respirations
B. Severe bradycardia
C. Low serum glucose
D. Respiratory depression
Correct Answer: A. Kussmaul respirations
Rationale: Deep, rapid respirations occur as the body attempts to compensate for metabolic
acidosis.
11. A client with a potassium level of 2.8 mEq/L is at greatest risk for:
A. Cardiac dysrhythmias
B. Hyperactive reflexes only
C. Increased bone density
D. Severe hyperthermia
Correct Answer: A. Cardiac dysrhythmias
Rationale: Hypokalemia can cause dangerous cardiac conduction abnormalities.
12. Which assessment finding suggests increased intracranial pressure?
A. Improved level of consciousness
B. Decreasing headache
C. Change in level of consciousness
D. Increased appetite
Correct Answer: C. Change in level of consciousness
Rationale: A change in mental status is an important early sign of neurological deterioration.
13. A client with a suspected stroke has facial drooping and slurred speech. What
is the priority?
rationales A+ Graded/instant pdf
1. The nurse receives report on four clients. Which client should the nurse assess
first?
A. A client with chronic arthritis reporting pain of 6/10
B. A client 1 day postoperative requesting assistance to the bathroom
C. A client with pneumonia who has an oxygen saturation of 86%
D. A client awaiting discharge instructions
Correct Answer: C. A client with pneumonia who has an oxygen saturation of 86%
Rationale: Hypoxemia is an immediate threat to oxygenation and requires priority assessment.
2. A client with suspected hypoglycemia is confused, diaphoretic, and shaky.
What is the nurse's priority action?
A. Administer prescribed rapid-acting insulin
B. Check the client's blood glucose level
C. Encourage the client to ambulate
D. Provide a high-fat meal
Correct Answer: B. Check the client's blood glucose level
Rationale: The nurse should rapidly assess glucose status to confirm and guide treatment.
3. Which finding requires immediate intervention in a client receiving an IV
potassium infusion?
A. Urine output of 40 mL/hr
B. Heart rate of 82/min
C. Burning and swelling at the IV site
D. Blood pressure of 128/76 mmHg
Correct Answer: C. Burning and swelling at the IV site
Rationale: These findings suggest infiltration or extravasation and require prompt assessment
and intervention.
4. Which task is appropriate for the RN to delegate to an experienced UAP?
A. Assessing a new pressure injury
B. Teaching a client how to use an incentive spirometer
C. Obtaining vital signs for a stable client
D. Evaluating a client's response to pain medication
,Correct Answer: C. Obtaining vital signs for a stable client
Rationale: Routine data collection for a stable client may be delegated; assessment, teaching,
and evaluation remain with the nurse.
5. A client taking warfarin should be taught to report:
A. Mild thirst
B. Black, tarry stools
C. Increased appetite
D. Occasional sneezing
Correct Answer: B. Black, tarry stools
Rationale: Black, tarry stools may indicate gastrointestinal bleeding.
6. Which intervention is appropriate for a client with suspected tuberculosis?
A. Place the client on airborne precautions
B. Use only standard precautions
C. Place the client in a positive-pressure room
D. Allow unrestricted visitors without PPE
Correct Answer: A. Place the client on airborne precautions
Rationale: Tuberculosis requires airborne infection-control measures.
7. A client receiving morphine has a respiratory rate of 8/min and is difficult to
arouse. What is the priority action?
A. Administer another dose of morphine
B. Assess airway and breathing
C. Offer oral fluids
D. Place the client in Trendelenburg position
Correct Answer: B. Assess airway and breathing
Rationale: Respiratory depression is a potentially life-threatening opioid complication.
8. Which finding is most concerning in a client with heart failure?
A. Mild ankle edema at the end of the day
B. Sudden weight gain of 2.3 kg in 48 hours
C. Heart rate of 78/min
D. Blood pressure of 118/72 mmHg
Correct Answer: B. Sudden weight gain of 2.3 kg in 48 hours
Rationale: Rapid weight gain suggests fluid retention and worsening heart failure.
, 9. A client with a new tracheostomy becomes restless and develops increasing
respiratory distress. What should the nurse do first?
A. Leave the room to obtain the medical record
B. Assess airway patency and oxygenation
C. Offer oral fluids
D. Place the client flat
Correct Answer: B. Assess airway patency and oxygenation
Rationale: Respiratory distress after tracheostomy requires immediate airway assessment.
10. Which finding is expected in a client experiencing diabetic ketoacidosis?
A. Kussmaul respirations
B. Severe bradycardia
C. Low serum glucose
D. Respiratory depression
Correct Answer: A. Kussmaul respirations
Rationale: Deep, rapid respirations occur as the body attempts to compensate for metabolic
acidosis.
11. A client with a potassium level of 2.8 mEq/L is at greatest risk for:
A. Cardiac dysrhythmias
B. Hyperactive reflexes only
C. Increased bone density
D. Severe hyperthermia
Correct Answer: A. Cardiac dysrhythmias
Rationale: Hypokalemia can cause dangerous cardiac conduction abnormalities.
12. Which assessment finding suggests increased intracranial pressure?
A. Improved level of consciousness
B. Decreasing headache
C. Change in level of consciousness
D. Increased appetite
Correct Answer: C. Change in level of consciousness
Rationale: A change in mental status is an important early sign of neurological deterioration.
13. A client with a suspected stroke has facial drooping and slurred speech. What
is the priority?
