NCLEX-RN Exam Prep 2026 | NGN Practice Questions & Detailed
Rationales
This comprehensive study resource is a premier test bank designed for nursing
graduates preparing for the National Council Licensure Examination for Registered
Nurses (NCLEX-RN). It features high-yield practice questions, 100% verified correct
answers, and thorough clinical rationales meticulously aligned with the 2026/2027
Next Generation NCLEX (NGN) blueprint. Utilizing these premium assessment
materials ensures deep competence across complex unfolding case studies,
prioritization questions, and standalone alternate-format items to maximize your
clinical judgment and guarantee a passing score on your first attempt.
1. A nurse is caring for a client who is receiving mechanical ventilation. Which of
the following findings indicates the client may be experiencing ventilator-
associated pneumonia (VAP)?
A. Increased respiratory rate
B. New onset of fever and purulent secretions
C. Decreased oxygen saturation
D. Increased tidal volume
Correct Answer: B
Rationale: VAP is characterized by new fever, purulent tracheal secretions, infiltrates on
chest X-ray, and leukocytosis. While increased respiratory rate (A) and decreased oxygen
saturation (C) can occur, they are nonspecific. Increased tidal volume (D) is not a sign of
VAP.
2. A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should the nurse take first?
A. Verify the client's identity with two identifiers
B. Obtain the client's vital signs
C. Start the transfusion slowly
D. Stay with the client for the first 15 minutes
Correct Answer: A
,Rationale: Verifying the client's identity with two identifiers is the first step to ensure the
correct blood product is given to the correct client. Vital signs (B) are also obtained but
identity verification is the priority. Starting the transfusion (C) and staying with the client
(D) come after verification.
3. A nurse is teaching a client about a new prescription for warfarin. Which of the
following statements by the client indicates a need for further teaching?
A. "I will avoid eating large amounts of green leafy vegetables."
B. "I will use a soft toothbrush to prevent bleeding gums."
C. "I will take aspirin for headaches."
D. "I will have my INR checked regularly."
Correct Answer: C
Rationale: Aspirin increases the risk of bleeding when taken with warfarin. The client
should avoid aspirin and other NSAIDs unless prescribed. Avoiding large amounts of
vitamin K–rich foods (A), using a soft toothbrush (B), and monitoring INR (D) are correct.
4. A nurse is assessing a client who has been diagnosed with a urinary tract
infection. Which of the following findings should the nurse expect?
A. Polyuria
B. Dysuria
C. Hematuria
D. All of the above
Correct Answer: D
Rationale: Urinary tract infection is characterized by dysuria (painful urination), frequency,
urgency, and hematuria. Polyuria can also occur. All are expected findings.
,5. A nurse is caring for a client who is postoperative following a total hip
replacement. Which of the following positions should the nurse avoid?
A. Supine with a pillow between the legs
B. Side-lying with a pillow between the legs
C. Flexing the hip beyond 90 degrees
D. Using an abduction wedge
Correct Answer: C
Rationale: Flexing the hip beyond 90 degrees can cause dislocation of the hip prosthesis.
The nurse should avoid this position. Supine with a pillow (A), side-lying with a pillow (B),
and using an abduction wedge (D) are appropriate.
6. A nurse is administering an intramuscular injection to a 6-month-old infant.
Which of the following sites should the nurse use?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Correct Answer: C
Rationale: The vastus lateralis is the preferred IM site for infants under 12 months because
it is well-developed and has few major nerves or blood vessels. The deltoid (A) is used for
older children and adults. Ventrogluteal (B) and dorsogluteal (D) are used for older
children and adults.
7. A nurse is teaching a client about the use of a metered-dose inhaler (MDI).
Which of the following instructions should the nurse include?
A. "Shake the inhaler before each use."
B. "Inhale quickly and deeply."
C. "Hold your breath for 10 seconds after inhaling."
D. "Use the inhaler immediately after eating."
, Correct Answer: C
Rationale: Holding the breath for 10 seconds allows the medication to deposit in the lungs.
Shaking (A) is correct but not the priority. Inhaling quickly (B) is incorrect; a slow, deep
inhalation is recommended. Using after eating (D) is not necessary.
8. A nurse is assessing a client who has a new prescription for digoxin. Which of
the following findings indicates digoxin toxicity?
A. Heart rate 88 bpm
B. Nausea and vomiting
C. Blood pressure 118/76 mm Hg
D. Respiratory rate 18/min
Correct Answer: B
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are signs of
digoxin toxicity.
9. A nurse is reviewing the medication list of a client taking metformin. Which of
the following findings indicates an adverse effect?
A. Hypoglycemia
B. Lactic acidosis
C. Hypertension
D. Bradycardia
Correct Answer: B
Rationale: Metformin can cause lactic acidosis, a rare but life-threatening adverse effect.
Hypoglycemia (A) is rare with metformin alone. Hypertension (C) and bradycardia (D) are
not typical.
Rationales
This comprehensive study resource is a premier test bank designed for nursing
graduates preparing for the National Council Licensure Examination for Registered
Nurses (NCLEX-RN). It features high-yield practice questions, 100% verified correct
answers, and thorough clinical rationales meticulously aligned with the 2026/2027
Next Generation NCLEX (NGN) blueprint. Utilizing these premium assessment
materials ensures deep competence across complex unfolding case studies,
prioritization questions, and standalone alternate-format items to maximize your
clinical judgment and guarantee a passing score on your first attempt.
1. A nurse is caring for a client who is receiving mechanical ventilation. Which of
the following findings indicates the client may be experiencing ventilator-
associated pneumonia (VAP)?
A. Increased respiratory rate
B. New onset of fever and purulent secretions
C. Decreased oxygen saturation
D. Increased tidal volume
Correct Answer: B
Rationale: VAP is characterized by new fever, purulent tracheal secretions, infiltrates on
chest X-ray, and leukocytosis. While increased respiratory rate (A) and decreased oxygen
saturation (C) can occur, they are nonspecific. Increased tidal volume (D) is not a sign of
VAP.
2. A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should the nurse take first?
A. Verify the client's identity with two identifiers
B. Obtain the client's vital signs
C. Start the transfusion slowly
D. Stay with the client for the first 15 minutes
Correct Answer: A
,Rationale: Verifying the client's identity with two identifiers is the first step to ensure the
correct blood product is given to the correct client. Vital signs (B) are also obtained but
identity verification is the priority. Starting the transfusion (C) and staying with the client
(D) come after verification.
3. A nurse is teaching a client about a new prescription for warfarin. Which of the
following statements by the client indicates a need for further teaching?
A. "I will avoid eating large amounts of green leafy vegetables."
B. "I will use a soft toothbrush to prevent bleeding gums."
C. "I will take aspirin for headaches."
D. "I will have my INR checked regularly."
Correct Answer: C
Rationale: Aspirin increases the risk of bleeding when taken with warfarin. The client
should avoid aspirin and other NSAIDs unless prescribed. Avoiding large amounts of
vitamin K–rich foods (A), using a soft toothbrush (B), and monitoring INR (D) are correct.
4. A nurse is assessing a client who has been diagnosed with a urinary tract
infection. Which of the following findings should the nurse expect?
A. Polyuria
B. Dysuria
C. Hematuria
D. All of the above
Correct Answer: D
Rationale: Urinary tract infection is characterized by dysuria (painful urination), frequency,
urgency, and hematuria. Polyuria can also occur. All are expected findings.
,5. A nurse is caring for a client who is postoperative following a total hip
replacement. Which of the following positions should the nurse avoid?
A. Supine with a pillow between the legs
B. Side-lying with a pillow between the legs
C. Flexing the hip beyond 90 degrees
D. Using an abduction wedge
Correct Answer: C
Rationale: Flexing the hip beyond 90 degrees can cause dislocation of the hip prosthesis.
The nurse should avoid this position. Supine with a pillow (A), side-lying with a pillow (B),
and using an abduction wedge (D) are appropriate.
6. A nurse is administering an intramuscular injection to a 6-month-old infant.
Which of the following sites should the nurse use?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Correct Answer: C
Rationale: The vastus lateralis is the preferred IM site for infants under 12 months because
it is well-developed and has few major nerves or blood vessels. The deltoid (A) is used for
older children and adults. Ventrogluteal (B) and dorsogluteal (D) are used for older
children and adults.
7. A nurse is teaching a client about the use of a metered-dose inhaler (MDI).
Which of the following instructions should the nurse include?
A. "Shake the inhaler before each use."
B. "Inhale quickly and deeply."
C. "Hold your breath for 10 seconds after inhaling."
D. "Use the inhaler immediately after eating."
, Correct Answer: C
Rationale: Holding the breath for 10 seconds allows the medication to deposit in the lungs.
Shaking (A) is correct but not the priority. Inhaling quickly (B) is incorrect; a slow, deep
inhalation is recommended. Using after eating (D) is not necessary.
8. A nurse is assessing a client who has a new prescription for digoxin. Which of
the following findings indicates digoxin toxicity?
A. Heart rate 88 bpm
B. Nausea and vomiting
C. Blood pressure 118/76 mm Hg
D. Respiratory rate 18/min
Correct Answer: B
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are signs of
digoxin toxicity.
9. A nurse is reviewing the medication list of a client taking metformin. Which of
the following findings indicates an adverse effect?
A. Hypoglycemia
B. Lactic acidosis
C. Hypertension
D. Bradycardia
Correct Answer: B
Rationale: Metformin can cause lactic acidosis, a rare but life-threatening adverse effect.
Hypoglycemia (A) is rare with metformin alone. Hypertension (C) and bradycardia (D) are
not typical.
