NCLEX-RN Board Examination (NCSBN) – Next Generation NCLEX (NGN)
Preparation 2026/2027 version updated this month
1. A nurse is caring for a patient who suddenly develops difficulty breathing.
Which assessment finding requires immediate intervention?
A. Temperature of 37.0°C (98.6°F)
B. Oxygen saturation of 84%
C. Heart rate of 82 beats/min
D. Blood pressure of 124/78 mmHg
Correct Answer: B
Rationale:
An oxygen saturation of 84% indicates severe hypoxemia. Airway and breathing problems are
the highest priority according to the ABC (Airway, Breathing, Circulation) approach.
2. A nurse receives report on four patients. Which patient should the nurse assess
first?
A. A patient requesting assistance with bathing
B. A patient with new confusion and decreased oxygen saturation
C. A patient waiting for discharge instructions
D. A patient requesting pain medication for chronic arthritis
Correct Answer: B
Rationale:
A sudden change in mental status with low oxygen saturation may indicate a life-threatening
condition requiring immediate assessment.
3. A nurse is preparing to administer medications. Which action demonstrates
safe medication administration?
A. Verify the patient's identity using two identifiers
B. Ask another patient to confirm the medication
C. Leave medications at the bedside
D. Administer medication without checking allergies
Correct Answer: A
,Rationale:
Using two identifiers prevents medication errors and ensures the medication is given to the
correct patient.
4. A patient reports chest pain. Which additional finding requires immediate
nursing action?
A. Chest pain with sweating and shortness of breath
B. Mild fatigue after walking
C. Request for a meal tray
D. History of seasonal allergies
Correct Answer: A
Rationale:
Chest pain with diaphoresis and shortness of breath may indicate myocardial infarction and
requires urgent evaluation.
5. The nurse is using the nursing process. Which step should occur first?
A. Planning
B. Implementation
C. Assessment
D. Evaluation
Correct Answer: C
Rationale:
Assessment is the first step of the nursing process and involves collecting patient information.
6. A patient says, "I am scared about my surgery tomorrow." Which response by
the nurse is most therapeutic?
A. "Everything will be okay."
B. "Do not worry about it."
C. "Tell me what concerns you most about the surgery."
D. "The surgeon performs this procedure often."
Correct Answer: C
,Rationale:
Open-ended questions encourage communication and allow the nurse to understand the patient's
concerns.
7. Which nursing action demonstrates therapeutic communication?
A. Changing the subject when the patient cries
B. Listening actively and allowing the patient to express feelings
C. Giving personal opinions about the situation
D. Providing false reassurance
Correct Answer: B
Rationale:
Active listening builds trust and allows patients to express thoughts and emotions.
8. A patient with limited English proficiency requires education about a new
medication. Which action should the nurse take?
A. Use a qualified medical interpreter
B. Ask a child family member to translate
C. Speak louder in English
D. Provide instructions without explanation
Correct Answer: A
Rationale:
A qualified interpreter ensures accurate communication and protects patient safety.
9. Which task is appropriate for the nurse to delegate to assistive personnel
(AP)?
A. Assessing a patient's pain
B. Teaching insulin injection
C. Obtaining vital signs for a stable patient
D. Evaluating medication effectiveness
Correct Answer: C
, Rationale:
AP can perform routine tasks such as obtaining vital signs on stable patients. Assessment and
teaching require RN judgment.
10. Which nursing responsibility cannot be delegated?
A. Making a patient's bed
B. Measuring intake and output
C. Performing the initial nursing assessment
D. Obtaining routine vital signs
Correct Answer: C
Rationale:
The initial assessment requires clinical judgment and must be performed by the RN.
11. Which patient requires airborne precautions?
A. Patient with tuberculosis
B. Patient with urinary tract infection
C. Patient with cellulitis
D. Patient with influenza
Correct Answer: A
Rationale:
Tuberculosis spreads through airborne particles and requires airborne isolation precautions.
12. The most effective method for preventing healthcare-associated infections is:
A. Wearing gloves at all times
B. Performing proper hand hygiene
C. Limiting patient interaction
D. Giving antibiotics routinely
Correct Answer: B
Rationale:
Hand hygiene is the most important method for reducing infection transmission.
Preparation 2026/2027 version updated this month
1. A nurse is caring for a patient who suddenly develops difficulty breathing.
Which assessment finding requires immediate intervention?
A. Temperature of 37.0°C (98.6°F)
B. Oxygen saturation of 84%
C. Heart rate of 82 beats/min
D. Blood pressure of 124/78 mmHg
Correct Answer: B
Rationale:
An oxygen saturation of 84% indicates severe hypoxemia. Airway and breathing problems are
the highest priority according to the ABC (Airway, Breathing, Circulation) approach.
2. A nurse receives report on four patients. Which patient should the nurse assess
first?
A. A patient requesting assistance with bathing
B. A patient with new confusion and decreased oxygen saturation
C. A patient waiting for discharge instructions
D. A patient requesting pain medication for chronic arthritis
Correct Answer: B
Rationale:
A sudden change in mental status with low oxygen saturation may indicate a life-threatening
condition requiring immediate assessment.
3. A nurse is preparing to administer medications. Which action demonstrates
safe medication administration?
A. Verify the patient's identity using two identifiers
B. Ask another patient to confirm the medication
C. Leave medications at the bedside
D. Administer medication without checking allergies
Correct Answer: A
,Rationale:
Using two identifiers prevents medication errors and ensures the medication is given to the
correct patient.
4. A patient reports chest pain. Which additional finding requires immediate
nursing action?
A. Chest pain with sweating and shortness of breath
B. Mild fatigue after walking
C. Request for a meal tray
D. History of seasonal allergies
Correct Answer: A
Rationale:
Chest pain with diaphoresis and shortness of breath may indicate myocardial infarction and
requires urgent evaluation.
5. The nurse is using the nursing process. Which step should occur first?
A. Planning
B. Implementation
C. Assessment
D. Evaluation
Correct Answer: C
Rationale:
Assessment is the first step of the nursing process and involves collecting patient information.
6. A patient says, "I am scared about my surgery tomorrow." Which response by
the nurse is most therapeutic?
A. "Everything will be okay."
B. "Do not worry about it."
C. "Tell me what concerns you most about the surgery."
D. "The surgeon performs this procedure often."
Correct Answer: C
,Rationale:
Open-ended questions encourage communication and allow the nurse to understand the patient's
concerns.
7. Which nursing action demonstrates therapeutic communication?
A. Changing the subject when the patient cries
B. Listening actively and allowing the patient to express feelings
C. Giving personal opinions about the situation
D. Providing false reassurance
Correct Answer: B
Rationale:
Active listening builds trust and allows patients to express thoughts and emotions.
8. A patient with limited English proficiency requires education about a new
medication. Which action should the nurse take?
A. Use a qualified medical interpreter
B. Ask a child family member to translate
C. Speak louder in English
D. Provide instructions without explanation
Correct Answer: A
Rationale:
A qualified interpreter ensures accurate communication and protects patient safety.
9. Which task is appropriate for the nurse to delegate to assistive personnel
(AP)?
A. Assessing a patient's pain
B. Teaching insulin injection
C. Obtaining vital signs for a stable patient
D. Evaluating medication effectiveness
Correct Answer: C
, Rationale:
AP can perform routine tasks such as obtaining vital signs on stable patients. Assessment and
teaching require RN judgment.
10. Which nursing responsibility cannot be delegated?
A. Making a patient's bed
B. Measuring intake and output
C. Performing the initial nursing assessment
D. Obtaining routine vital signs
Correct Answer: C
Rationale:
The initial assessment requires clinical judgment and must be performed by the RN.
11. Which patient requires airborne precautions?
A. Patient with tuberculosis
B. Patient with urinary tract infection
C. Patient with cellulitis
D. Patient with influenza
Correct Answer: A
Rationale:
Tuberculosis spreads through airborne particles and requires airborne isolation precautions.
12. The most effective method for preventing healthcare-associated infections is:
A. Wearing gloves at all times
B. Performing proper hand hygiene
C. Limiting patient interaction
D. Giving antibiotics routinely
Correct Answer: B
Rationale:
Hand hygiene is the most important method for reducing infection transmission.
