Kaplan NCLEX-RN – Next Generation NCLEX Questions
and Answers with Detailed Rationales 2026/2027
1. A nurse receives report on four clients. Which client should the
nurse assess first?
A. A client with COPD whose oxygen saturation is 91% on prescribed
oxygen
B. A client 1 day postoperative reporting pain of 6/10
C. A client with heart failure who has new-onset severe dyspnea and
pink frothy sputum
D. A client with diabetes requesting assistance with breakfast
Answer: C
Rationale: Severe dyspnea with pink frothy sputum suggests acute
pulmonary edema, which threatens oxygenation and can rapidly progress
to respiratory failure. Airway and breathing take priority over pain and
routine needs.
2. A client with asthma is experiencing wheezing and shortness of
breath. Which medication should the nurse expect to administer for
rapid relief?
A. Albuterol
B. Fluticasone
C. Montelukast
D. Salmeterol
Answer: A
Rationale: Albuterol is a short-acting beta₂-agonist used as a rescue
bronchodilator for acute bronchospasm. Inhaled corticosteroids such as
,fluticasone are controller medications rather than immediate rescue
therapy.
3. A client taking lisinopril develops swelling of the tongue and
difficulty breathing. What is the priority action?
A. Administer the next dose with food
B. Treat the situation as an airway emergency
C. Encourage oral fluids
D. Place the client in a supine position
Answer: B
Rationale: Tongue and facial swelling may indicate ACE-inhibitor-
associated angioedema. Airway compromise can develop rapidly, so
emergency assessment and intervention are required.
4. Which finding in a client with a central venous catheter requires
immediate intervention?
A. Transparent dressing intact
B. Mild tenderness at insertion immediately after placement
C. Sudden dyspnea and chest pain during catheter manipulation
D. Catheter labeled with date and time
Answer: C
Rationale: Sudden dyspnea and chest pain may indicate pneumothorax
or another serious catheter-related complication. The client requires
immediate assessment.
,5. A client with diabetes is conscious and has a blood glucose of 52
mg/dL (2.9 mmol/L). Which intervention is appropriate?
A. Give a rapid-acting carbohydrate
B. Administer additional insulin
C. Restrict oral intake
D. Encourage exercise
Answer: A
Rationale: Conscious clients who can swallow safely should receive a
rapid-acting carbohydrate for hypoglycemia, followed by reassessment
of glucose.
6. A client with severe hypoglycemia is unconscious and has no IV
access. Which medication should the nurse anticipate?
A. Glucagon
B. Metformin
C. Regular insulin
D. Potassium chloride
Answer: A
Rationale: Glucagon can raise blood glucose when oral treatment is
unsafe and IV access is unavailable.
7. A client with suspected stroke has new right-sided weakness and
difficulty speaking. Which information is most important to obtain?
A. Last known well time
B. Favorite food
, C. Childhood illnesses
D. Usual bedtime
Answer: A
Rationale: Stroke therapies are time dependent. Determining when the
client was last known to be neurologically normal is critical for
treatment decisions.
8. Which finding is most concerning for increased intracranial
pressure?
A. Decreasing level of consciousness
B. Increased appetite
C. Warm extremities
D. Mild thirst
Answer: A
Rationale: A declining level of consciousness is an important
neurological warning sign and may indicate increasing intracranial
pressure or worsening brain injury.
9. A client with a head injury begins vomiting repeatedly and
becomes increasingly confused. What should the nurse do?
A. Report the neurological deterioration immediately
B. Encourage oral fluids
C. Allow the client to sleep without reassessment
D. Place the client in Trendelenburg position
Answer: A
and Answers with Detailed Rationales 2026/2027
1. A nurse receives report on four clients. Which client should the
nurse assess first?
A. A client with COPD whose oxygen saturation is 91% on prescribed
oxygen
B. A client 1 day postoperative reporting pain of 6/10
C. A client with heart failure who has new-onset severe dyspnea and
pink frothy sputum
D. A client with diabetes requesting assistance with breakfast
Answer: C
Rationale: Severe dyspnea with pink frothy sputum suggests acute
pulmonary edema, which threatens oxygenation and can rapidly progress
to respiratory failure. Airway and breathing take priority over pain and
routine needs.
2. A client with asthma is experiencing wheezing and shortness of
breath. Which medication should the nurse expect to administer for
rapid relief?
A. Albuterol
B. Fluticasone
C. Montelukast
D. Salmeterol
Answer: A
Rationale: Albuterol is a short-acting beta₂-agonist used as a rescue
bronchodilator for acute bronchospasm. Inhaled corticosteroids such as
,fluticasone are controller medications rather than immediate rescue
therapy.
3. A client taking lisinopril develops swelling of the tongue and
difficulty breathing. What is the priority action?
A. Administer the next dose with food
B. Treat the situation as an airway emergency
C. Encourage oral fluids
D. Place the client in a supine position
Answer: B
Rationale: Tongue and facial swelling may indicate ACE-inhibitor-
associated angioedema. Airway compromise can develop rapidly, so
emergency assessment and intervention are required.
4. Which finding in a client with a central venous catheter requires
immediate intervention?
A. Transparent dressing intact
B. Mild tenderness at insertion immediately after placement
C. Sudden dyspnea and chest pain during catheter manipulation
D. Catheter labeled with date and time
Answer: C
Rationale: Sudden dyspnea and chest pain may indicate pneumothorax
or another serious catheter-related complication. The client requires
immediate assessment.
,5. A client with diabetes is conscious and has a blood glucose of 52
mg/dL (2.9 mmol/L). Which intervention is appropriate?
A. Give a rapid-acting carbohydrate
B. Administer additional insulin
C. Restrict oral intake
D. Encourage exercise
Answer: A
Rationale: Conscious clients who can swallow safely should receive a
rapid-acting carbohydrate for hypoglycemia, followed by reassessment
of glucose.
6. A client with severe hypoglycemia is unconscious and has no IV
access. Which medication should the nurse anticipate?
A. Glucagon
B. Metformin
C. Regular insulin
D. Potassium chloride
Answer: A
Rationale: Glucagon can raise blood glucose when oral treatment is
unsafe and IV access is unavailable.
7. A client with suspected stroke has new right-sided weakness and
difficulty speaking. Which information is most important to obtain?
A. Last known well time
B. Favorite food
, C. Childhood illnesses
D. Usual bedtime
Answer: A
Rationale: Stroke therapies are time dependent. Determining when the
client was last known to be neurologically normal is critical for
treatment decisions.
8. Which finding is most concerning for increased intracranial
pressure?
A. Decreasing level of consciousness
B. Increased appetite
C. Warm extremities
D. Mild thirst
Answer: A
Rationale: A declining level of consciousness is an important
neurological warning sign and may indicate increasing intracranial
pressure or worsening brain injury.
9. A client with a head injury begins vomiting repeatedly and
becomes increasingly confused. What should the nurse do?
A. Report the neurological deterioration immediately
B. Encourage oral fluids
C. Allow the client to sleep without reassessment
D. Place the client in Trendelenburg position
Answer: A
