NCLEX-RN NGN Actual Exam
Questions 2026 | Pass First
Attempt
QUESTION 1
Which classification of drugs is contraindicated for the client with hypertrophic
cardiomyopathy?
A. Positive inotropes
B. Vasodilators
C. Diuretics
D. Antidysrhythmics
✅ Correct Answer: A
Rationale:
Positive inotropic agents increase myocardial contractility, which worsens left ventricular
outflow tract obstruction in hypertrophic cardiomyopathy. Increased contractility intensifies
obstruction and reduces cardiac output. This can precipitate syncope, dysrhythmias, or
sudden cardiac death. Therefore, positive inotropes are contraindicated in this condition.
QUESTION 2
Signs and symptoms of an allergy attack include which of the following?
A. Wheezing on inspiration
B. Increased respiratory rate
C. Circumoral cyanosis
D. Prolonged expiration
✅ Correct Answer: D
Rationale:
During an allergic reaction, bronchoconstriction causes difficulty with air movement,
especially during expiration. Prolonged expiration occurs due to air trapping in the alveoli.
Wheezing is typically heard on expiration, not inspiration. Early cyanosis is uncommon unless
hypoxia becomes severe.
QUESTION 3
,A client confides to the nurse that he tasted poison in his evening meal. This would be an
example of what type of hallucination?
A. Auditory
B. Gustatory
C. Olfactory
D. Visceral
✅ Correct Answer: B
Rationale:
Gustatory hallucinations involve false perceptions of taste without an external stimulus.
Auditory hallucinations involve hearing sounds or voices, while olfactory hallucinations
involve smell. Visceral hallucinations involve false bodily sensations. Tasting poison without
ingestion is a gustatory hallucination.
QUESTION 4
Which of the following findings would be abnormal in a postpartal woman?
A. Chills shortly after delivery
B. Pulse rate of 60 bpm on the first postdelivery morning
C. Urinary output of 3000 mL on day two postpartum
D. Oral temperature of 101°F (38.3°C) on day three postpartum
✅ Correct Answer: D
Rationale:
A temperature greater than 100.4°F (38°C) after the first 24 hours postpartum suggests
infection and requires evaluation. Postpartum chills and mild bradycardia are common
physiological responses. Increased urinary output occurs due to postpartum diuresis.
Persistent fever is abnormal and concerning.
QUESTION 5
A six-month-old infant is admitted with febrile seizures. Which teaching is appropriate for the
parents?
A. Sustained temperatures over 103°F cause febrile seizures
B. Febrile seizures do not usually recur
C. There is little risk of neurological deficit
D. Febrile seizures indicate CNS disease
✅ Correct Answer: C
Rationale:
Febrile seizures are generally benign and not associated with long-term neurological damage.
, They usually occur during rapid temperature rise rather than sustained fever. Recurrence is
possible, especially in infants under one year. Febrile seizures are not typically linked to CNS
pathology.
QUESTION 6
A client with bipolar disorder is hyperactive and losing weight. Which nutritional intervention
is most therapeutic?
A. Small, frequent portable meals
B. Tube feedings
C. Eat whenever desired
D. Quiet sit-down meals
✅ Correct Answer: A
Rationale:
Manic clients are unable to remain seated long enough to consume full meals. Small,
frequent, high-calorie foods that can be eaten on the move improve intake. Tube feedings are
unnecessary unless severe malnutrition exists. Structured meals are often ineffective during
acute mania.
CONTINUED GENERATED QUESTIONS
QUESTION 7
A client receiving heparin therapy develops bleeding gums. Which lab value should the nurse
review first?
A. INR
B. Platelet count
C. aPTT
D. Hemoglobin
✅ Correct Answer: C
Rationale:
Activated partial thromboplastin time (aPTT) measures the therapeutic effectiveness of
heparin. Prolonged aPTT increases bleeding risk. INR is used to monitor warfarin therapy.
While platelet count and hemoglobin are important, aPTT directly reflects heparin activity.
QUESTION 8
Which finding indicates effective treatment of diabetic ketoacidosis (DKA)?
A. Blood glucose 250 mg/dL
B. Serum potassium 3.2 mEq/L
Questions 2026 | Pass First
Attempt
QUESTION 1
Which classification of drugs is contraindicated for the client with hypertrophic
cardiomyopathy?
A. Positive inotropes
B. Vasodilators
C. Diuretics
D. Antidysrhythmics
✅ Correct Answer: A
Rationale:
Positive inotropic agents increase myocardial contractility, which worsens left ventricular
outflow tract obstruction in hypertrophic cardiomyopathy. Increased contractility intensifies
obstruction and reduces cardiac output. This can precipitate syncope, dysrhythmias, or
sudden cardiac death. Therefore, positive inotropes are contraindicated in this condition.
QUESTION 2
Signs and symptoms of an allergy attack include which of the following?
A. Wheezing on inspiration
B. Increased respiratory rate
C. Circumoral cyanosis
D. Prolonged expiration
✅ Correct Answer: D
Rationale:
During an allergic reaction, bronchoconstriction causes difficulty with air movement,
especially during expiration. Prolonged expiration occurs due to air trapping in the alveoli.
Wheezing is typically heard on expiration, not inspiration. Early cyanosis is uncommon unless
hypoxia becomes severe.
QUESTION 3
,A client confides to the nurse that he tasted poison in his evening meal. This would be an
example of what type of hallucination?
A. Auditory
B. Gustatory
C. Olfactory
D. Visceral
✅ Correct Answer: B
Rationale:
Gustatory hallucinations involve false perceptions of taste without an external stimulus.
Auditory hallucinations involve hearing sounds or voices, while olfactory hallucinations
involve smell. Visceral hallucinations involve false bodily sensations. Tasting poison without
ingestion is a gustatory hallucination.
QUESTION 4
Which of the following findings would be abnormal in a postpartal woman?
A. Chills shortly after delivery
B. Pulse rate of 60 bpm on the first postdelivery morning
C. Urinary output of 3000 mL on day two postpartum
D. Oral temperature of 101°F (38.3°C) on day three postpartum
✅ Correct Answer: D
Rationale:
A temperature greater than 100.4°F (38°C) after the first 24 hours postpartum suggests
infection and requires evaluation. Postpartum chills and mild bradycardia are common
physiological responses. Increased urinary output occurs due to postpartum diuresis.
Persistent fever is abnormal and concerning.
QUESTION 5
A six-month-old infant is admitted with febrile seizures. Which teaching is appropriate for the
parents?
A. Sustained temperatures over 103°F cause febrile seizures
B. Febrile seizures do not usually recur
C. There is little risk of neurological deficit
D. Febrile seizures indicate CNS disease
✅ Correct Answer: C
Rationale:
Febrile seizures are generally benign and not associated with long-term neurological damage.
, They usually occur during rapid temperature rise rather than sustained fever. Recurrence is
possible, especially in infants under one year. Febrile seizures are not typically linked to CNS
pathology.
QUESTION 6
A client with bipolar disorder is hyperactive and losing weight. Which nutritional intervention
is most therapeutic?
A. Small, frequent portable meals
B. Tube feedings
C. Eat whenever desired
D. Quiet sit-down meals
✅ Correct Answer: A
Rationale:
Manic clients are unable to remain seated long enough to consume full meals. Small,
frequent, high-calorie foods that can be eaten on the move improve intake. Tube feedings are
unnecessary unless severe malnutrition exists. Structured meals are often ineffective during
acute mania.
CONTINUED GENERATED QUESTIONS
QUESTION 7
A client receiving heparin therapy develops bleeding gums. Which lab value should the nurse
review first?
A. INR
B. Platelet count
C. aPTT
D. Hemoglobin
✅ Correct Answer: C
Rationale:
Activated partial thromboplastin time (aPTT) measures the therapeutic effectiveness of
heparin. Prolonged aPTT increases bleeding risk. INR is used to monitor warfarin therapy.
While platelet count and hemoglobin are important, aPTT directly reflects heparin activity.
QUESTION 8
Which finding indicates effective treatment of diabetic ketoacidosis (DKA)?
A. Blood glucose 250 mg/dL
B. Serum potassium 3.2 mEq/L
