NURS_902: NCLEX-PN NGN Practice Questions
2026/2027 Next-Generation Edition Detailed
Rationales and Verified Answers
Course Code: NURS_902
Course Name: NCLEX-PN Next-Generation Comprehensive Review
Topic: Next-Generation Clinical Judgment, Multi-System High-Yield Concepts,
and Priority Nursing Interventions
Academic Year: 2026/2027
1. A licensed practical nurse (LPN) is reinforcing discharge teaching for a
client with chronic heart failure who is prescribed furosemide daily.
Which statement by the client indicates the correct answer or proper
understanding of safety monitoring?
A. "I will limit my fluid intake to less than two cups per day."
B. "I will weigh myself every morning at the same time and report a
gain of more than 3 pounds in one day."
C. "I should take this medication right before going to bed."
D. "I will stop taking this pill if my legs no longer look swollen."
CORRECT ANSWER: B. "I will weigh myself every morning at the same
time and report a gain of more than 3 pounds in one day."
RATIONALE: Furosemide is a potent loop diuretic used to eliminate excess
fluid volume in heart failure. Clients must monitor for sudden fluid retention by
performing daily weights in the morning after voiding but before breakfast. A
rapid weight gain of more than 3 pounds (1.4 kg) in 24 hours or 5 pounds (2.3
kg) in one week indicates worsening fluid overload and must be reported
immediately. Restricting fluid under two cups is dangerously restrictive. Diuretics
should be taken in the morning to prevent nocturia, and they must never be stopped
abruptly without consulting the healthcare provider.
2. A client diagnosed with type 1 diabetes mellitus is found sweating
profusely, shaking, and disoriented. The LPN obtains a fingerstick blood
glucose reading of 48 mg/dL. The client is conscious and able to swallow.
Which intervention represents the correct answer or priority nursing action?
A. Provide 15 grams of simple carbohydrates, such as 4 ounces (120
, mL) of fruit juice or regular soda.
B. Administer a rapid subcutaneous injection of 10 units of regular insulin.
C. Offer a high-fat snack consisting of whole milk and peanut butter
immediately.
D. Maintain strict NPO status and request a stat laboratory blood draw.
CORRECT ANSWER: A. Provide 15 grams of simple carbohydrates, such
as 4 ounces (120 mL) of fruit juice or regular soda.
RATIONALE: The client is experiencing symptomatic hypoglycemia (blood
glucose <70 mg/dL). Because the client is conscious and can safely swallow, the
nurse must immediately implement the "Rule of 15": administer 15 grams of
rapid-acting simple carbohydrates (e.g., 4 oz of juice, soda, or glucose tablets).
Insulin would lower blood sugar further and could be fatal. High-fat or high-
protein foods delay glucose absorption and should not be used for initial acute
reversal.
3. The LPN is monitoring a client who underwent a total thyroidectomy 12
hours ago. The client reports a tingling sensation around the mouth and
fingertips. The nurse notes involuntary muscle twitching of the facial
muscles when tapping the facial nerve. Which electrolyte imbalance
represents the correct answer as the underlying cause?
A. Hypercalcemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
CORRECT ANSWER: C. Hypocalcemia
RATIONALE: Inadvertent surgical trauma or removal of the parathyroid glands
during a thyroidectomy can abruptly stop parathyroid hormone production,
causing severe hypocalcemia. Classic clinical signs include circumoral numbness,
tingling in the extremities, and neuromuscular irritability, which is demonstrated
here by a positive Chvostek's sign (facial twitching). Immediate replacement via
calcium gluconate is required to prevent seizures and laryngospasm.
4. A client returns to the unit following a cardiac catheterization via the right
femoral artery access site. Which post-procedure nursing intervention is the
correct answer to prevent severe bleeding complications?
A. Assist the client to ambulate around the nursing unit within 15 minutes of
, arrival.
B. Keep the client on strict bed rest with the right leg kept completely
straight for 4 to 6 hours.
C. Flex the client's right hip to a 90-degree angle using pillows to maximize
comfort.
D. Apply a cold wet washcloth directly over the pressure dressing.
CORRECT ANSWER: B. Keep the client on strict bed rest with the right leg
kept completely straight for 4 to 6 hours.
RATIONALE: Following a femoral artery catheterization, the primary
mechanical risk is puncture site disruption leading to hematoma or retroperitoneal
hemorrhage. The nurse must maintain strict bed rest with the affected leg kept
completely straight for 4 to 6 hours to facilitate proper arterial sealing. Early
ambulation, hip flexion, or poor pressure maintenance will induce immediate
arterial bleeding.
5. A nurse is assigned to care for four clients. Which client scenario represents
the correct answer as the highest clinical priority to be evaluated first?
A. A client with chronic bronchitis who has a baseline oxygen saturation of
91% on room air.
B. A client post-op day 1 from an abdominal surgery who reports a
sudden onset of crushing chest pain and shortness of breath.
C. A client diagnosed with gastroenteritis who exhibits dry mucous
membranes and trace dark urine.
D. A client with an established colostomy whose stoma appears pink, moist,
and intact.
CORRECT ANSWER: B. A client post-op day 1 from an abdominal surgery
who reports a sudden onset of crushing chest pain and shortness of breath.
RATIONALE: A sudden onset of crushing chest pain and dyspnea post-
operatively is highly indicative of an acute pulmonary embolism (PE) or a
myocardial infarction (MI). Both represent life-threatening emergencies that
require immediate evaluation, oxygen therapy, and life-saving rescue interventions.
Stable chronic COPD baselines, mild dehydration, and a healthy stoma are stable
and can be managed subsequently.
6. The LPN is caring for a client with a chest tube attached to a disposable
water-seal drainage system. The nurse observes continuous, rapid bubbling
, in the water-seal chamber. How should the nurse document and interpret this
finding as the correct answer?
A. The client's pneumothorax has successfully resolved.
B. This is a normal, expected finding during active expiration.
C. There is an active air leak somewhere within the chest tube system or
connections.
D. The external suction regulator device has been turned off completely.
CORRECT ANSWER: C. There is an active air leak somewhere within the
chest tube system or connections.
RATIONALE: Intermittent bubbling in the water-seal chamber during
exhalation or coughing is expected until the pleural air collection resolves.
However, continuous bubbling in the water-seal chamber indicates an air leak
within the drainage system or at the insertion site. The nurse must check all
connections and look for structural leaks to protect the client's lung expansion.
7. A client is admitted to the medical unit with an acute flare-up of ulcerative
colitis, reporting 12 bloody stools per day and severe abdominal cramping.
Which provider prescription should the LPN anticipate as the correct
answer for acute management?
A. Initiate a high-fiber raw vegetable diet immediately to bulk the stool.
B. Maintain strict NPO or clear liquid bowel rest and administer
prescribed intravenous corticosteroids.
C. Administer an oral stimulant laxative every morning.
D. Encourage high-impact physical exercises to promote peristalsis.
CORRECT ANSWER: B. Maintain strict NPO or clear liquid bowel rest
and administer prescribed intravenous corticosteroids.
RATIONALE: During an acute severe exacerbation of ulcerative colitis, the
primary goal is to minimize intestinal irritation and reduce mucosal inflammation.
This is accomplished by maintaining bowel rest (NPO or clear liquids) and
administering systemic intravenous corticosteroids. High-fiber foods, laxatives,
and heavy physical activity will severely irritate the inflamed bowel wall,
worsening bleeding and risking toxic megacolon.
8. A client with a history of deep vein thrombosis is prescribed warfarin
therapy. Which diagnostic laboratory value represents the correct answer
for ensuring the medication is within the safe therapeutic window?
2026/2027 Next-Generation Edition Detailed
Rationales and Verified Answers
Course Code: NURS_902
Course Name: NCLEX-PN Next-Generation Comprehensive Review
Topic: Next-Generation Clinical Judgment, Multi-System High-Yield Concepts,
and Priority Nursing Interventions
Academic Year: 2026/2027
1. A licensed practical nurse (LPN) is reinforcing discharge teaching for a
client with chronic heart failure who is prescribed furosemide daily.
Which statement by the client indicates the correct answer or proper
understanding of safety monitoring?
A. "I will limit my fluid intake to less than two cups per day."
B. "I will weigh myself every morning at the same time and report a
gain of more than 3 pounds in one day."
C. "I should take this medication right before going to bed."
D. "I will stop taking this pill if my legs no longer look swollen."
CORRECT ANSWER: B. "I will weigh myself every morning at the same
time and report a gain of more than 3 pounds in one day."
RATIONALE: Furosemide is a potent loop diuretic used to eliminate excess
fluid volume in heart failure. Clients must monitor for sudden fluid retention by
performing daily weights in the morning after voiding but before breakfast. A
rapid weight gain of more than 3 pounds (1.4 kg) in 24 hours or 5 pounds (2.3
kg) in one week indicates worsening fluid overload and must be reported
immediately. Restricting fluid under two cups is dangerously restrictive. Diuretics
should be taken in the morning to prevent nocturia, and they must never be stopped
abruptly without consulting the healthcare provider.
2. A client diagnosed with type 1 diabetes mellitus is found sweating
profusely, shaking, and disoriented. The LPN obtains a fingerstick blood
glucose reading of 48 mg/dL. The client is conscious and able to swallow.
Which intervention represents the correct answer or priority nursing action?
A. Provide 15 grams of simple carbohydrates, such as 4 ounces (120
, mL) of fruit juice or regular soda.
B. Administer a rapid subcutaneous injection of 10 units of regular insulin.
C. Offer a high-fat snack consisting of whole milk and peanut butter
immediately.
D. Maintain strict NPO status and request a stat laboratory blood draw.
CORRECT ANSWER: A. Provide 15 grams of simple carbohydrates, such
as 4 ounces (120 mL) of fruit juice or regular soda.
RATIONALE: The client is experiencing symptomatic hypoglycemia (blood
glucose <70 mg/dL). Because the client is conscious and can safely swallow, the
nurse must immediately implement the "Rule of 15": administer 15 grams of
rapid-acting simple carbohydrates (e.g., 4 oz of juice, soda, or glucose tablets).
Insulin would lower blood sugar further and could be fatal. High-fat or high-
protein foods delay glucose absorption and should not be used for initial acute
reversal.
3. The LPN is monitoring a client who underwent a total thyroidectomy 12
hours ago. The client reports a tingling sensation around the mouth and
fingertips. The nurse notes involuntary muscle twitching of the facial
muscles when tapping the facial nerve. Which electrolyte imbalance
represents the correct answer as the underlying cause?
A. Hypercalcemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
CORRECT ANSWER: C. Hypocalcemia
RATIONALE: Inadvertent surgical trauma or removal of the parathyroid glands
during a thyroidectomy can abruptly stop parathyroid hormone production,
causing severe hypocalcemia. Classic clinical signs include circumoral numbness,
tingling in the extremities, and neuromuscular irritability, which is demonstrated
here by a positive Chvostek's sign (facial twitching). Immediate replacement via
calcium gluconate is required to prevent seizures and laryngospasm.
4. A client returns to the unit following a cardiac catheterization via the right
femoral artery access site. Which post-procedure nursing intervention is the
correct answer to prevent severe bleeding complications?
A. Assist the client to ambulate around the nursing unit within 15 minutes of
, arrival.
B. Keep the client on strict bed rest with the right leg kept completely
straight for 4 to 6 hours.
C. Flex the client's right hip to a 90-degree angle using pillows to maximize
comfort.
D. Apply a cold wet washcloth directly over the pressure dressing.
CORRECT ANSWER: B. Keep the client on strict bed rest with the right leg
kept completely straight for 4 to 6 hours.
RATIONALE: Following a femoral artery catheterization, the primary
mechanical risk is puncture site disruption leading to hematoma or retroperitoneal
hemorrhage. The nurse must maintain strict bed rest with the affected leg kept
completely straight for 4 to 6 hours to facilitate proper arterial sealing. Early
ambulation, hip flexion, or poor pressure maintenance will induce immediate
arterial bleeding.
5. A nurse is assigned to care for four clients. Which client scenario represents
the correct answer as the highest clinical priority to be evaluated first?
A. A client with chronic bronchitis who has a baseline oxygen saturation of
91% on room air.
B. A client post-op day 1 from an abdominal surgery who reports a
sudden onset of crushing chest pain and shortness of breath.
C. A client diagnosed with gastroenteritis who exhibits dry mucous
membranes and trace dark urine.
D. A client with an established colostomy whose stoma appears pink, moist,
and intact.
CORRECT ANSWER: B. A client post-op day 1 from an abdominal surgery
who reports a sudden onset of crushing chest pain and shortness of breath.
RATIONALE: A sudden onset of crushing chest pain and dyspnea post-
operatively is highly indicative of an acute pulmonary embolism (PE) or a
myocardial infarction (MI). Both represent life-threatening emergencies that
require immediate evaluation, oxygen therapy, and life-saving rescue interventions.
Stable chronic COPD baselines, mild dehydration, and a healthy stoma are stable
and can be managed subsequently.
6. The LPN is caring for a client with a chest tube attached to a disposable
water-seal drainage system. The nurse observes continuous, rapid bubbling
, in the water-seal chamber. How should the nurse document and interpret this
finding as the correct answer?
A. The client's pneumothorax has successfully resolved.
B. This is a normal, expected finding during active expiration.
C. There is an active air leak somewhere within the chest tube system or
connections.
D. The external suction regulator device has been turned off completely.
CORRECT ANSWER: C. There is an active air leak somewhere within the
chest tube system or connections.
RATIONALE: Intermittent bubbling in the water-seal chamber during
exhalation or coughing is expected until the pleural air collection resolves.
However, continuous bubbling in the water-seal chamber indicates an air leak
within the drainage system or at the insertion site. The nurse must check all
connections and look for structural leaks to protect the client's lung expansion.
7. A client is admitted to the medical unit with an acute flare-up of ulcerative
colitis, reporting 12 bloody stools per day and severe abdominal cramping.
Which provider prescription should the LPN anticipate as the correct
answer for acute management?
A. Initiate a high-fiber raw vegetable diet immediately to bulk the stool.
B. Maintain strict NPO or clear liquid bowel rest and administer
prescribed intravenous corticosteroids.
C. Administer an oral stimulant laxative every morning.
D. Encourage high-impact physical exercises to promote peristalsis.
CORRECT ANSWER: B. Maintain strict NPO or clear liquid bowel rest
and administer prescribed intravenous corticosteroids.
RATIONALE: During an acute severe exacerbation of ulcerative colitis, the
primary goal is to minimize intestinal irritation and reduce mucosal inflammation.
This is accomplished by maintaining bowel rest (NPO or clear liquids) and
administering systemic intravenous corticosteroids. High-fiber foods, laxatives,
and heavy physical activity will severely irritate the inflamed bowel wall,
worsening bleeding and risking toxic megacolon.
8. A client with a history of deep vein thrombosis is prescribed warfarin
therapy. Which diagnostic laboratory value represents the correct answer
for ensuring the medication is within the safe therapeutic window?
