NCSBN Test Bank for the NCLEX-
RN (NGN) | 2025/2026 Edition |
Verified 265 Questions and Answers
with Rationales | A+ Graded
Section 1: Introduction
This document includes the official-style NCSBN Test Bank for the Next Generation
NCLEX-RN (NGN), updated for the 2025/2026 exam cycle. It features 265 fully verified
questions with 100% correct answers and detailed rationales, reflecting the NCSBN Clinical
Judgment Measurement Model (CJMM) and incorporating NGN item types such as case
studies, bowtie, matrix, and cloze response formats. Topics span all core areas of the
NCLEX-RN blueprint, including management of care, safety, pharmacological therapies,
physiological adaptation, health promotion, and psychosocial integrity. This A+ graded
resource is designed to mirror the actual NCLEX experience and support first-time test takers
in building critical thinking and test readiness.
Section 2: Exam Questions and Answers
Format: 265 NGN and traditional NCLEX question types
Includes case-based scenarios and multiple formats
Correct answer highlighted
Rationales provided with references to clinical standards and nursing best practices
1. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
o (a) A client with a new prescription for antihypertensives
o (b) A client with stable vital signs post-surgery
o (c) A client reporting chest pain rated 8/10
o (d) A client reporting chest pain rated 8/10
Rationale: Chest pain rated 8/10 indicates a potential cardiac emergency,
requiring immediate assessment per American Heart Association guidelines.
2. A nurse is teaching a client about fall prevention. Which action should the nurse
prioritize?
o (a) Encouraging the client to walk without assistance
o (b) Ensuring the client uses a walker and removes tripping hazards
o (c) Advising the client to increase activity without supervision
o (d) Suggesting the client rely on family for all mobility
Rationale: Using a walker and removing hazards aligns with The Joint
Commission standards for fall prevention.
3. A client receives morphine 2 mg IV for pain. The nurse should monitor for which
adverse effect?
o (a) Hypertension
o (b) Respiratory depression
o (c) Hyperglycemia
, o (d) Bradycardia without symptoms
Rationale: Respiratory depression is a priority adverse effect of morphine, per
the Institute for Safe Medication Practices.
4. A client with heart failure has a sudden increase in shortness of breath. What should
the nurse do first?
o (a) Administer a PRN diuretic
o (b) Assess oxygen saturation and respiratory status
o (c) Encourage fluid intake
o (d) Reposition the client to a supine position
Rationale: Assessing oxygen saturation and respiratory status is the priority to
address potential respiratory compromise, per the American Heart
Association.
5. A nurse is administering insulin to a client with diabetes. Which action is most
important?
o (a) Verify the dose with another nurse
o (b) Verify the dose with another nurse
o (c) Administer without double-checking
o (d) Delay administration if the client is eating
Rationale: Double-checking the dose with another nurse prevents medication
errors, per the National Patient Safety Goals.
6. A client with depression refuses to eat. What is the nurse’s best initial response?
o (a) Force the client to eat
o (b) Assess the client’s feelings and offer support
o (c) Document the refusal and ignore it
o (d) Restrict the client’s privileges
Rationale: Assessing feelings supports therapeutic communication, per the
American Psychiatric Nurses Association.
7. A nurse is caring for a client post-operatively. Which finding requires immediate
intervention?
o (a) Temperature of 99.2°F
o (b) Oxygen saturation of 88%
o (c) Blood pressure of 120/80 mmHg
o (d) Heart rate of 72 bpm
Rationale: An oxygen saturation of 88% indicates hypoxia, requiring
immediate action per the American Association of Critical-Care Nurses.
8. A client is prescribed warfarin. The nurse should teach the client to avoid which food?
o (a) Apples
o (b) Leafy green vegetables
o (c) Carrots
o (d) Bananas
Rationale: Leafy greens are high in vitamin K, which can reduce warfarin’s
effectiveness, per the American Heart Association.
9. A nurse is preparing to insert a urinary catheter. What is the first step?
o (a) Apply sterile gloves
o (b) Perform hand hygiene
o (c) Position the client
o (d) Open the catheter kit
Rationale: Hand hygiene is the first step to prevent infection, per the Centers
for Disease Control and Prevention.
10. A client with a new colostomy asks about diet. What should the nurse recommend?
, o (a) Avoid all fiber
o (b) Gradually introduce high-fiber foods
o (c) Limit fluids to prevent leakage
o (d) Eat only low-residue foods
Rationale: Gradual fiber introduction supports bowel function, per the Wound,
Ostomy, and Continence Nurses Society.
11. A nurse is assessing a client with a suspected stroke. Which action is priority?
o (a) Obtain a medical history
o (b) Perform the Cincinnati Prehospital Stroke Scale
o (c) Administer aspirin
o (d) Check blood glucose
Rationale: The stroke scale assesses for stroke signs, per the American Stroke
Association.
12. A client with pneumonia has a fever of 102°F. What intervention is most appropriate?
o (a) Apply a heating pad
o (b) Administer antipyretics as prescribed
o (c) Increase room temperature
o (d) Encourage heavy blankets
Rationale: Antipyretics reduce fever safely, per the Infectious Diseases
Society of America.
13. A nurse is teaching a client about hypertension management. Which statement is
correct?
o (a) Salt intake should be increased
o (b) Regular exercise can help lower blood pressure
o (c) Stress has no effect on blood pressure
o (d) Medication is not needed with diet changes
Rationale: Exercise lowers blood pressure, per the American Heart
Association.
14. A client with schizophrenia hears voices. What is the nurse’s best response?
o (a) Tell the client the voices are not real
o (b) Ask the client to describe what they are hearing
o (c) Ignore the client’s reports
o (d) Administer a sedative immediately
Rationale: Describing hallucinations builds trust, per the American Psychiatric
Nurses Association.
15. A nurse is monitoring a client receiving IV fluids. Which finding is abnormal?
o (a) Heart rate of 68 bpm
o (b) Edema at the IV site
o (c) Urine output of 50 mL/hour
o (d) Blood pressure of 118/76 mmHg
Rationale: Edema suggests infiltration, requiring intervention per the Infusion
Nurses Society.
16. A client with a burn injury has singed nasal hairs. What is the priority?
o (a) Apply a topical antibiotic
o (b) Assess for inhalation injury
o (c) Administer pain medication
o (d) Clean the burn site
Rationale: Singed hairs indicate possible inhalation injury, per the American
Burn Association.
17. A nurse is caring for a client with a chest tube. Which action is essential?
, o (a) Clamp the tube during transport
o (b) Keep the drainage system below chest level
o (c) Raise the system above the chest
o (d) Empty the system only when full
Rationale: Keeping the system below chest level prevents air re-entry, per the
American Association for Respiratory Care.
18. A client with a new diagnosis of HIV asks about transmission. What should the nurse
teach?
o (a) HIV is transmitted by casual contact
o (b) HIV is transmitted through blood and bodily fluids
o (c) HIV can be spread by sharing utensils
o (d) HIV is not a concern with proper hygiene
Rationale: Blood and fluids are primary transmission routes, per the CDC.
19. A nurse is assessing a newborn with jaundice. What is the priority intervention?
o (a) Initiate breastfeeding
o (b) Monitor bilirubin levels and consult a provider
o (c) Apply sunlight exposure
o (d) Delay bathing
Rationale: Monitoring bilirubin prevents kernicterus, per the American
Academy of Pediatrics.
20. A client with anxiety exhibits rapid breathing. What should the nurse do first?
o (a) Administer oxygen
o (b) Encourage slow, deep breathing
o (c) Restrain the client
o (d) Call a code
Rationale: Slow breathing reduces hyperventilation, per the Anxiety and
Depression Association of America.
21. A nurse is preparing a client for surgery. Which preoperative teaching is priority?
o (a) Explain postoperative diet
o (b) Instruct on deep breathing and coughing exercises
o (c) Discuss discharge plans
o (d) Review medication history
Rationale: Deep breathing prevents postoperative complications, per the
Association of periOperative Registered Nurses.
22. A client with a fractured hip is on bed rest. What is the nurse’s priority?
o (a) Encourage ambulation immediately
o (b) Apply anti-embolism stockings
o (c) Increase fluid intake only
o (d) Limit turning to avoid pain
Rationale: Stockings prevent deep vein thrombosis, per the National Institute
for Health and Care Excellence.
23. A nurse is administering a blood transfusion. Which sign indicates a transfusion
reaction?
o (a) Normal temperature
o (b) Fever and chills
o (c) Increased urine output
o (d) Stable heart rate
Rationale: Fever and chills suggest a reaction, per the American Red Cross
guidelines.
RN (NGN) | 2025/2026 Edition |
Verified 265 Questions and Answers
with Rationales | A+ Graded
Section 1: Introduction
This document includes the official-style NCSBN Test Bank for the Next Generation
NCLEX-RN (NGN), updated for the 2025/2026 exam cycle. It features 265 fully verified
questions with 100% correct answers and detailed rationales, reflecting the NCSBN Clinical
Judgment Measurement Model (CJMM) and incorporating NGN item types such as case
studies, bowtie, matrix, and cloze response formats. Topics span all core areas of the
NCLEX-RN blueprint, including management of care, safety, pharmacological therapies,
physiological adaptation, health promotion, and psychosocial integrity. This A+ graded
resource is designed to mirror the actual NCLEX experience and support first-time test takers
in building critical thinking and test readiness.
Section 2: Exam Questions and Answers
Format: 265 NGN and traditional NCLEX question types
Includes case-based scenarios and multiple formats
Correct answer highlighted
Rationales provided with references to clinical standards and nursing best practices
1. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
o (a) A client with a new prescription for antihypertensives
o (b) A client with stable vital signs post-surgery
o (c) A client reporting chest pain rated 8/10
o (d) A client reporting chest pain rated 8/10
Rationale: Chest pain rated 8/10 indicates a potential cardiac emergency,
requiring immediate assessment per American Heart Association guidelines.
2. A nurse is teaching a client about fall prevention. Which action should the nurse
prioritize?
o (a) Encouraging the client to walk without assistance
o (b) Ensuring the client uses a walker and removes tripping hazards
o (c) Advising the client to increase activity without supervision
o (d) Suggesting the client rely on family for all mobility
Rationale: Using a walker and removing hazards aligns with The Joint
Commission standards for fall prevention.
3. A client receives morphine 2 mg IV for pain. The nurse should monitor for which
adverse effect?
o (a) Hypertension
o (b) Respiratory depression
o (c) Hyperglycemia
, o (d) Bradycardia without symptoms
Rationale: Respiratory depression is a priority adverse effect of morphine, per
the Institute for Safe Medication Practices.
4. A client with heart failure has a sudden increase in shortness of breath. What should
the nurse do first?
o (a) Administer a PRN diuretic
o (b) Assess oxygen saturation and respiratory status
o (c) Encourage fluid intake
o (d) Reposition the client to a supine position
Rationale: Assessing oxygen saturation and respiratory status is the priority to
address potential respiratory compromise, per the American Heart
Association.
5. A nurse is administering insulin to a client with diabetes. Which action is most
important?
o (a) Verify the dose with another nurse
o (b) Verify the dose with another nurse
o (c) Administer without double-checking
o (d) Delay administration if the client is eating
Rationale: Double-checking the dose with another nurse prevents medication
errors, per the National Patient Safety Goals.
6. A client with depression refuses to eat. What is the nurse’s best initial response?
o (a) Force the client to eat
o (b) Assess the client’s feelings and offer support
o (c) Document the refusal and ignore it
o (d) Restrict the client’s privileges
Rationale: Assessing feelings supports therapeutic communication, per the
American Psychiatric Nurses Association.
7. A nurse is caring for a client post-operatively. Which finding requires immediate
intervention?
o (a) Temperature of 99.2°F
o (b) Oxygen saturation of 88%
o (c) Blood pressure of 120/80 mmHg
o (d) Heart rate of 72 bpm
Rationale: An oxygen saturation of 88% indicates hypoxia, requiring
immediate action per the American Association of Critical-Care Nurses.
8. A client is prescribed warfarin. The nurse should teach the client to avoid which food?
o (a) Apples
o (b) Leafy green vegetables
o (c) Carrots
o (d) Bananas
Rationale: Leafy greens are high in vitamin K, which can reduce warfarin’s
effectiveness, per the American Heart Association.
9. A nurse is preparing to insert a urinary catheter. What is the first step?
o (a) Apply sterile gloves
o (b) Perform hand hygiene
o (c) Position the client
o (d) Open the catheter kit
Rationale: Hand hygiene is the first step to prevent infection, per the Centers
for Disease Control and Prevention.
10. A client with a new colostomy asks about diet. What should the nurse recommend?
, o (a) Avoid all fiber
o (b) Gradually introduce high-fiber foods
o (c) Limit fluids to prevent leakage
o (d) Eat only low-residue foods
Rationale: Gradual fiber introduction supports bowel function, per the Wound,
Ostomy, and Continence Nurses Society.
11. A nurse is assessing a client with a suspected stroke. Which action is priority?
o (a) Obtain a medical history
o (b) Perform the Cincinnati Prehospital Stroke Scale
o (c) Administer aspirin
o (d) Check blood glucose
Rationale: The stroke scale assesses for stroke signs, per the American Stroke
Association.
12. A client with pneumonia has a fever of 102°F. What intervention is most appropriate?
o (a) Apply a heating pad
o (b) Administer antipyretics as prescribed
o (c) Increase room temperature
o (d) Encourage heavy blankets
Rationale: Antipyretics reduce fever safely, per the Infectious Diseases
Society of America.
13. A nurse is teaching a client about hypertension management. Which statement is
correct?
o (a) Salt intake should be increased
o (b) Regular exercise can help lower blood pressure
o (c) Stress has no effect on blood pressure
o (d) Medication is not needed with diet changes
Rationale: Exercise lowers blood pressure, per the American Heart
Association.
14. A client with schizophrenia hears voices. What is the nurse’s best response?
o (a) Tell the client the voices are not real
o (b) Ask the client to describe what they are hearing
o (c) Ignore the client’s reports
o (d) Administer a sedative immediately
Rationale: Describing hallucinations builds trust, per the American Psychiatric
Nurses Association.
15. A nurse is monitoring a client receiving IV fluids. Which finding is abnormal?
o (a) Heart rate of 68 bpm
o (b) Edema at the IV site
o (c) Urine output of 50 mL/hour
o (d) Blood pressure of 118/76 mmHg
Rationale: Edema suggests infiltration, requiring intervention per the Infusion
Nurses Society.
16. A client with a burn injury has singed nasal hairs. What is the priority?
o (a) Apply a topical antibiotic
o (b) Assess for inhalation injury
o (c) Administer pain medication
o (d) Clean the burn site
Rationale: Singed hairs indicate possible inhalation injury, per the American
Burn Association.
17. A nurse is caring for a client with a chest tube. Which action is essential?
, o (a) Clamp the tube during transport
o (b) Keep the drainage system below chest level
o (c) Raise the system above the chest
o (d) Empty the system only when full
Rationale: Keeping the system below chest level prevents air re-entry, per the
American Association for Respiratory Care.
18. A client with a new diagnosis of HIV asks about transmission. What should the nurse
teach?
o (a) HIV is transmitted by casual contact
o (b) HIV is transmitted through blood and bodily fluids
o (c) HIV can be spread by sharing utensils
o (d) HIV is not a concern with proper hygiene
Rationale: Blood and fluids are primary transmission routes, per the CDC.
19. A nurse is assessing a newborn with jaundice. What is the priority intervention?
o (a) Initiate breastfeeding
o (b) Monitor bilirubin levels and consult a provider
o (c) Apply sunlight exposure
o (d) Delay bathing
Rationale: Monitoring bilirubin prevents kernicterus, per the American
Academy of Pediatrics.
20. A client with anxiety exhibits rapid breathing. What should the nurse do first?
o (a) Administer oxygen
o (b) Encourage slow, deep breathing
o (c) Restrain the client
o (d) Call a code
Rationale: Slow breathing reduces hyperventilation, per the Anxiety and
Depression Association of America.
21. A nurse is preparing a client for surgery. Which preoperative teaching is priority?
o (a) Explain postoperative diet
o (b) Instruct on deep breathing and coughing exercises
o (c) Discuss discharge plans
o (d) Review medication history
Rationale: Deep breathing prevents postoperative complications, per the
Association of periOperative Registered Nurses.
22. A client with a fractured hip is on bed rest. What is the nurse’s priority?
o (a) Encourage ambulation immediately
o (b) Apply anti-embolism stockings
o (c) Increase fluid intake only
o (d) Limit turning to avoid pain
Rationale: Stockings prevent deep vein thrombosis, per the National Institute
for Health and Care Excellence.
23. A nurse is administering a blood transfusion. Which sign indicates a transfusion
reaction?
o (a) Normal temperature
o (b) Fever and chills
o (c) Increased urine output
o (d) Stable heart rate
Rationale: Fever and chills suggest a reaction, per the American Red Cross
guidelines.
