NLN NEX EXAM– QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
CORE DOMAINS
• Fundamentals of Nursing Practice
• Pharmacology and Medication Administration
• Medical-Surgical Nursing
• Maternal-Newborn Nursing
• Pediatric Nursing
• Psychiatric-Mental Health Nursing
• Community and Public Health Nursing
• Leadership, Management, and Delegation
• Research, Informatics, and Evidence-Based Practice
• Legal, Ethical, and Professional Standards
INTRODUCTION
This comprehensive examination is designed to rigorously assess the foundational knowledge, clinical judgment, and
critical thinking skills essential for success on the National League for Nursing (NLN) NEX examination. The assessment
,encompasses a wide range of content domains, from fundamental nursing concepts to complex, multi-system patient
scenarios. It emphasizes the application of theoretical knowledge to real-world clinical situations, challenging
candidates to make sound, patient-centered decisions. The questions integrate principles of safety, pharmacology,
ethics, legal standards, and evidence-based practice. By engaging with these items, candidates will solidify their
understanding and refine their test-taking strategies. This resource serves as a definitive tool for preparation, ensuring
candidates are equipped to demonstrate the competency required for entry into professional nursing practice. The
answer rationales provided offer critical insight into the clinical reasoning process.
SECTION ONE: QUESTIONS 1 – 50
1. A nurse is caring for a patient who is post-operative day one following a total hip arthroplasty. The patient
suddenly complains of sharp chest pain and shortness of breath. The nurse notes the patient's oxygen saturation
is 88% on room air and they are tachycardic. Which action should the nurse take first?
A. Administer a PRN dose of morphine sulfate for pain.
B. Place the patient in a high-Fowler's position and administer oxygen.
C. Prepare to administer a heparin bolus per standing orders.
D. Assist the patient to ambulate to promote lung expansion.
,🟢 Correct Answer: B. Place the patient in a high-Fowler's position and administer oxygen.
🔴 Explanation: The patient's symptoms are classic for a pulmonary embolism. The first priority is to stabilize the
airway, breathing, and circulation (ABCs). Placing the patient in high-Fowler's position optimizes ventilation, and
administering supplemental oxygen addresses the hypoxia. While the nurse should anticipate anticoagulation, the
immediate priority is oxygenation.
2. A nurse is providing discharge teaching to a patient prescribed warfarin. Which of the following statements by
the patient indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I will take the medication at the same time every day."
C. "I will use a soft-bristled toothbrush to prevent gum bleeding."
D. "I will check with my doctor before taking any new over-the-counter medications."
🟢 Correct Answer: A. "I will avoid eating large amounts of leafy green vegetables."
🔴 Explanation: Warfarin's effectiveness is antagonized by vitamin K, which is found in high amounts in leafy green
vegetables. The patient should be taught to maintain a consistent intake of vitamin K, not to avoid it entirely. A
, sudden increase or decrease in dietary vitamin K can alter the INR. The other options are appropriate safety
measures for a patient on an anticoagulant.
3. A patient is admitted with suspected acute pancreatitis. Which laboratory finding is most indicative of this
condition?
A. Elevated serum lipase and amylase
B. Decreased serum calcium
C. Elevated blood urea nitrogen (BUN) and creatinine
D. Increased white blood cell (WBC) count
🟢 Correct Answer: A. Elevated serum lipase and amylase
🔴 Explanation: The hallmark of acute pancreatitis is the elevation of pancreatic enzymes in the serum. Lipase is
considered more specific and sensitive to pancreatic injury than amylase. While decreased serum calcium, elevated
BUN/creatinine, and leukocytosis can occur in pancreatitis, the elevated enzymes are the most direct and indicative
finding.
DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
CORE DOMAINS
• Fundamentals of Nursing Practice
• Pharmacology and Medication Administration
• Medical-Surgical Nursing
• Maternal-Newborn Nursing
• Pediatric Nursing
• Psychiatric-Mental Health Nursing
• Community and Public Health Nursing
• Leadership, Management, and Delegation
• Research, Informatics, and Evidence-Based Practice
• Legal, Ethical, and Professional Standards
INTRODUCTION
This comprehensive examination is designed to rigorously assess the foundational knowledge, clinical judgment, and
critical thinking skills essential for success on the National League for Nursing (NLN) NEX examination. The assessment
,encompasses a wide range of content domains, from fundamental nursing concepts to complex, multi-system patient
scenarios. It emphasizes the application of theoretical knowledge to real-world clinical situations, challenging
candidates to make sound, patient-centered decisions. The questions integrate principles of safety, pharmacology,
ethics, legal standards, and evidence-based practice. By engaging with these items, candidates will solidify their
understanding and refine their test-taking strategies. This resource serves as a definitive tool for preparation, ensuring
candidates are equipped to demonstrate the competency required for entry into professional nursing practice. The
answer rationales provided offer critical insight into the clinical reasoning process.
SECTION ONE: QUESTIONS 1 – 50
1. A nurse is caring for a patient who is post-operative day one following a total hip arthroplasty. The patient
suddenly complains of sharp chest pain and shortness of breath. The nurse notes the patient's oxygen saturation
is 88% on room air and they are tachycardic. Which action should the nurse take first?
A. Administer a PRN dose of morphine sulfate for pain.
B. Place the patient in a high-Fowler's position and administer oxygen.
C. Prepare to administer a heparin bolus per standing orders.
D. Assist the patient to ambulate to promote lung expansion.
,🟢 Correct Answer: B. Place the patient in a high-Fowler's position and administer oxygen.
🔴 Explanation: The patient's symptoms are classic for a pulmonary embolism. The first priority is to stabilize the
airway, breathing, and circulation (ABCs). Placing the patient in high-Fowler's position optimizes ventilation, and
administering supplemental oxygen addresses the hypoxia. While the nurse should anticipate anticoagulation, the
immediate priority is oxygenation.
2. A nurse is providing discharge teaching to a patient prescribed warfarin. Which of the following statements by
the patient indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I will take the medication at the same time every day."
C. "I will use a soft-bristled toothbrush to prevent gum bleeding."
D. "I will check with my doctor before taking any new over-the-counter medications."
🟢 Correct Answer: A. "I will avoid eating large amounts of leafy green vegetables."
🔴 Explanation: Warfarin's effectiveness is antagonized by vitamin K, which is found in high amounts in leafy green
vegetables. The patient should be taught to maintain a consistent intake of vitamin K, not to avoid it entirely. A
, sudden increase or decrease in dietary vitamin K can alter the INR. The other options are appropriate safety
measures for a patient on an anticoagulant.
3. A patient is admitted with suspected acute pancreatitis. Which laboratory finding is most indicative of this
condition?
A. Elevated serum lipase and amylase
B. Decreased serum calcium
C. Elevated blood urea nitrogen (BUN) and creatinine
D. Increased white blood cell (WBC) count
🟢 Correct Answer: A. Elevated serum lipase and amylase
🔴 Explanation: The hallmark of acute pancreatitis is the elevation of pancreatic enzymes in the serum. Lipase is
considered more specific and sensitive to pancreatic injury than amylase. While decreased serum calcium, elevated
BUN/creatinine, and leukocytosis can occur in pancreatitis, the elevated enzymes are the most direct and indicative
finding.
