NCLEX-RN® Examination
Next Generation NCLEX NGN | 2027/2028
150 Questions & Answers with Rationales
Guaranteed Pass | Brand New | Graded A+
,Q1: The nurse is assessing a client who is 48 hours postoperative from a coronary artery bypass
graft. Which finding requires immediate intervention?
A. Serosanguineous drainage from the chest tube site
B. Sudden onset of atrial fibrillation with a heart rate of 148 beats/min
C. Pain rated 5/10 at the sternal incision
D. Temperature of 100.2°F
Correct Answer: B
Rationale: New-onset atrial fibrillation with rapid ventricular response after CABG indicates a
postoperative dysrhythmia requiring immediate intervention to prevent hemodynamic
compromise.
Q2: The nurse is preparing to administer enoxaparin. Which laboratory value should be reviewed
before administration?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Correct Answer: C
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). Platelet count should
be monitored before and during therapy.
Q3: The nurse is caring for a client with active pulmonary tuberculosis. Which type of room is
required?
A. Private room with door closed
B. Negative-pressure room with door closed
C. Positive-pressure room with door open
D. Standard room with curtain drawn
Correct Answer: B
Rationale: Tuberculosis requires an airborne infection isolation room (AIIR) with negative
pressure and the door closed.
Q4: The nurse is assessing a client with a stage 3 pressure injury. Which description best
characterizes this stage?
,A. Non-blanchable redness of intact skin
B. Partial-thickness skin loss with exposed dermis
C. Full-thickness skin loss with visible subcutaneous fat
D. Full-thickness skin loss with exposed bone
Correct Answer: C
Rationale: Stage 3 pressure injuries involve full-thickness skin loss with visible subcutaneous fat
but no exposed bone, tendon, or muscle.
Q5: The nurse is teaching a client about a new prescription for levothyroxine. Which instruction
is correct?
A. Take the medication with breakfast
B. Take the medication with calcium supplements
C. Take the medication first thing in the morning on an empty stomach
D. Take the medication at bedtime
Correct Answer: C
Rationale: Levothyroxine is best absorbed on an empty stomach, 30–60 minutes before
breakfast.
Q6: The nurse is preparing to administer a measles, mumps, rubella (MMR) vaccine. Which
client should the nurse question receiving this vaccine?
A. A 25-year-old client who is breastfeeding
B. A 30-year-old client who is 10 weeks pregnant
C. A 45-year-old client who had a blood transfusion 3 months ago
D. A 50-year-old client who is immunocompromised
Correct Answer: B
Rationale: MMR is a live attenuated vaccine and is contraindicated in pregnancy due to the
theoretical risk of transmission to the fetus.
Q7: The nurse is assessing a client with a suspected abdominal aortic aneurysm. Which finding
is most concerning?
A. Abdominal bruit
B. Sudden onset of severe abdominal pain with hypotension
C. Mild abdominal discomfort
D. Pulsatile mass in the abdomen
, Correct Answer: B
Rationale: Sudden severe abdominal pain with hypotension indicates a ruptured abdominal aortic
aneurysm, a life-threatening emergency.
Q8: The nurse is teaching a client about a new prescription for carvedilol. Which instruction is
correct?
A. Take the medication with grapefruit juice
B. Check your pulse before taking the medication
C. Double the dose if you miss one
D. Stop taking the medication if you feel tired
Correct Answer: B
Rationale: Beta-blockers require pulse checks. Hold if heart rate is below 60 beats/min.
Q9: The nurse is caring for a client with a nephrostomy tube. Which finding indicates a
complication?
A. Urine output of 30 mL/hr
B. Clear yellow urine
C. Sudden decrease in urine output
D. Small amount of blood at the insertion site
Correct Answer: C
Rationale: A sudden decrease in urine output from a nephrostomy tube may indicate obstruction,
dislodgement, or renal failure.
Q10: The nurse is preparing to administer a medication via a jejunostomy tube. Which action is
correct?
A. Administer as an IV push
B. Crush, mix with water, and flush before and after
C. Administer with the tube clamped
D. Place the medication in the feeding bag
Correct Answer: B
Rationale: Jejunostomy medications are crushed, mixed with water, and flushed to prevent
clogging.
Next Generation NCLEX NGN | 2027/2028
150 Questions & Answers with Rationales
Guaranteed Pass | Brand New | Graded A+
,Q1: The nurse is assessing a client who is 48 hours postoperative from a coronary artery bypass
graft. Which finding requires immediate intervention?
A. Serosanguineous drainage from the chest tube site
B. Sudden onset of atrial fibrillation with a heart rate of 148 beats/min
C. Pain rated 5/10 at the sternal incision
D. Temperature of 100.2°F
Correct Answer: B
Rationale: New-onset atrial fibrillation with rapid ventricular response after CABG indicates a
postoperative dysrhythmia requiring immediate intervention to prevent hemodynamic
compromise.
Q2: The nurse is preparing to administer enoxaparin. Which laboratory value should be reviewed
before administration?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Correct Answer: C
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). Platelet count should
be monitored before and during therapy.
Q3: The nurse is caring for a client with active pulmonary tuberculosis. Which type of room is
required?
A. Private room with door closed
B. Negative-pressure room with door closed
C. Positive-pressure room with door open
D. Standard room with curtain drawn
Correct Answer: B
Rationale: Tuberculosis requires an airborne infection isolation room (AIIR) with negative
pressure and the door closed.
Q4: The nurse is assessing a client with a stage 3 pressure injury. Which description best
characterizes this stage?
,A. Non-blanchable redness of intact skin
B. Partial-thickness skin loss with exposed dermis
C. Full-thickness skin loss with visible subcutaneous fat
D. Full-thickness skin loss with exposed bone
Correct Answer: C
Rationale: Stage 3 pressure injuries involve full-thickness skin loss with visible subcutaneous fat
but no exposed bone, tendon, or muscle.
Q5: The nurse is teaching a client about a new prescription for levothyroxine. Which instruction
is correct?
A. Take the medication with breakfast
B. Take the medication with calcium supplements
C. Take the medication first thing in the morning on an empty stomach
D. Take the medication at bedtime
Correct Answer: C
Rationale: Levothyroxine is best absorbed on an empty stomach, 30–60 minutes before
breakfast.
Q6: The nurse is preparing to administer a measles, mumps, rubella (MMR) vaccine. Which
client should the nurse question receiving this vaccine?
A. A 25-year-old client who is breastfeeding
B. A 30-year-old client who is 10 weeks pregnant
C. A 45-year-old client who had a blood transfusion 3 months ago
D. A 50-year-old client who is immunocompromised
Correct Answer: B
Rationale: MMR is a live attenuated vaccine and is contraindicated in pregnancy due to the
theoretical risk of transmission to the fetus.
Q7: The nurse is assessing a client with a suspected abdominal aortic aneurysm. Which finding
is most concerning?
A. Abdominal bruit
B. Sudden onset of severe abdominal pain with hypotension
C. Mild abdominal discomfort
D. Pulsatile mass in the abdomen
, Correct Answer: B
Rationale: Sudden severe abdominal pain with hypotension indicates a ruptured abdominal aortic
aneurysm, a life-threatening emergency.
Q8: The nurse is teaching a client about a new prescription for carvedilol. Which instruction is
correct?
A. Take the medication with grapefruit juice
B. Check your pulse before taking the medication
C. Double the dose if you miss one
D. Stop taking the medication if you feel tired
Correct Answer: B
Rationale: Beta-blockers require pulse checks. Hold if heart rate is below 60 beats/min.
Q9: The nurse is caring for a client with a nephrostomy tube. Which finding indicates a
complication?
A. Urine output of 30 mL/hr
B. Clear yellow urine
C. Sudden decrease in urine output
D. Small amount of blood at the insertion site
Correct Answer: C
Rationale: A sudden decrease in urine output from a nephrostomy tube may indicate obstruction,
dislodgement, or renal failure.
Q10: The nurse is preparing to administer a medication via a jejunostomy tube. Which action is
correct?
A. Administer as an IV push
B. Crush, mix with water, and flush before and after
C. Administer with the tube clamped
D. Place the medication in the feeding bag
Correct Answer: B
Rationale: Jejunostomy medications are crushed, mixed with water, and flushed to prevent
clogging.
