NCSBN Test Bank for the NCLEX-RN (NGN) Exam
Questions and Correct Answers
QUESTION 1
A nurse assesses a client with chronic obstructive pulmonary disease (COPD). The client’s
oxygen saturation is 88% on room air. Which action should the nurse take first?
A. Administer oxygen at 6 L/min via nasal cannula
B. Increase fluid intake to thin secretions
C. Position the client in high Fowler’s position
D. Encourage pursed-lip breathing
CORRECT ANSWER: D
RATIONALE: Clients with COPD rely on hypoxic drive for respiration. Administering high-flow
oxygen can suppress respiratory effort. The immediate intervention to improve oxygenation
safely is encouraging pursed-lip breathing, which maintains airway pressure and slows
expiration.
QUESTION 2
A nurse is preparing to administer digoxin to a patient with heart failure. The patient’s apical
pulse is 54 beats per minute. Which is the appropriate nursing action?
A. Administer the medication and monitor closely
B. Hold the medication and notify the healthcare provider
C. Double-check the dose with another nurse and give it
D. Give half the prescribed dose
CORRECT ANSWER: B
RATIONALE: Digoxin should be withheld if the heart rate is below 60 bpm due to risk of
bradycardia and toxicity. The nurse must withhold the dose and report the finding to the
prescriber before proceeding.
QUESTION 3
A client with diabetes mellitus is found diaphoretic, trembling, and pale. Which immediate
intervention is appropriate?
,A. Offer orange juice
B. Check urine for ketones
C. Administer regular insulin IV
D. Encourage exercise
CORRECT ANSWER: A
RATIONALE: These are symptoms of hypoglycemia. Offering a fast-acting carbohydrate such as
orange juice quickly raises blood glucose levels and prevents neurological complications.
QUESTION 4
Which instruction should the nurse include for a client prescribed warfarin therapy?
A. Increase intake of green leafy vegetables
B. Report any signs of bleeding or bruising
C. Avoid all foods containing vitamin C
D. Take the medication on an empty stomach
CORRECT ANSWER: B
RATIONALE: Warfarin increases bleeding risk by inhibiting vitamin K–dependent clotting factors.
Clients must report signs of abnormal bleeding. Consistent, not increased, vitamin K intake is
recommended.
QUESTION 5
The nurse recognizes which client statement demonstrates understanding of self-care following
a total hip replacement?
A. “I will bend at the waist to pick things up.”
B. “I will cross my legs when sitting to stay comfortable.”
C. “I will use a pillow between my knees when lying down.”
D. “I will sit in low chairs to keep swelling down.”
CORRECT ANSWER: C
RATIONALE: A pillow between the knees keeps the legs abducted and prevents dislocation of the
prosthetic hip joint. Flexion beyond 90° or crossing legs must be avoided.
QUESTION 6
,A postoperative client develops shallow respirations and drowsiness after receiving morphine.
What should the nurse do first?
A. Notify the surgeon
B. Check the blood glucose
C. Administer naloxone as prescribed
D. Encourage deep breathing
CORRECT ANSWER: C
RATIONALE: Naloxone is an opioid antagonist that reverses the effects of narcotics causing
respiratory depression. Immediate administration restores adequate ventilation.
QUESTION 7
Which finding requires immediate intervention in a client receiving IV potassium chloride?
A. Mild burning sensation at IV site
B. Serum potassium level 4.0 mEq/L
C. Complaint of chest heaviness
D. Urine output 60 mL/hr
CORRECT ANSWER: C
RATIONALE: Chest heaviness may indicate hyperkalemia causing cardiac dysrhythmia. Stop
infusion immediately and assess cardiac rhythm.
QUESTION 8
A nurse cares for a client with cirrhosis who has ascites. What dietary recommendation should
be made?
A. High protein, low sodium
B. High carbohydrate, low sodium
C. Low fat, high sodium
D. High protein, high sodium
CORRECT ANSWER: B
RATIONALE: Sodium restriction helps control fluid retention and ascites. Carbohydrates supply
energy when protein intake may be limited to prevent hepatic encephalopathy.
, QUESTION 9
The nurse caring for a postpartum client notes a saturated perineal pad with bright red blood
and clots. What is the priority action?
A. Massage the fundus
B. Obtain vital signs
C. Notify the healthcare provider
D. Encourage ambulation
CORRECT ANSWER: A
RATIONALE: A boggy uterus is the most common cause of postpartum hemorrhage. Fundal
massage promotes contraction and reduces bleeding before further actions.
QUESTION 10
A client with a right-sided cerebrovascular accident (CVA) exhibits left-sided neglect. Which
nursing intervention is most effective?
A. Place objects and food on the client’s left side
B. Approach the client from the right side
C. Encourage scanning of the environment
D. Use restraints to prevent injury
CORRECT ANSWER: C
RATIONALE: Encouraging scanning helps the client increase attention to the neglected side and
promotes neurorehabilitation. Approaching from the affected side may increase confusion.
QUESTION 11
A client hospitalized for pneumonia develops Clostridioides difficile–associated diarrhea after
antibiotic therapy. Which nursing intervention is most appropriate?
A. Administer an antidiarrheal as prescribed
B. Maintain the client in a private room under contact precautions
C. Encourage high-protein, low-fiber diet
D. Withhold oral fluids
CORRECT ANSWER: B
Questions and Correct Answers
QUESTION 1
A nurse assesses a client with chronic obstructive pulmonary disease (COPD). The client’s
oxygen saturation is 88% on room air. Which action should the nurse take first?
A. Administer oxygen at 6 L/min via nasal cannula
B. Increase fluid intake to thin secretions
C. Position the client in high Fowler’s position
D. Encourage pursed-lip breathing
CORRECT ANSWER: D
RATIONALE: Clients with COPD rely on hypoxic drive for respiration. Administering high-flow
oxygen can suppress respiratory effort. The immediate intervention to improve oxygenation
safely is encouraging pursed-lip breathing, which maintains airway pressure and slows
expiration.
QUESTION 2
A nurse is preparing to administer digoxin to a patient with heart failure. The patient’s apical
pulse is 54 beats per minute. Which is the appropriate nursing action?
A. Administer the medication and monitor closely
B. Hold the medication and notify the healthcare provider
C. Double-check the dose with another nurse and give it
D. Give half the prescribed dose
CORRECT ANSWER: B
RATIONALE: Digoxin should be withheld if the heart rate is below 60 bpm due to risk of
bradycardia and toxicity. The nurse must withhold the dose and report the finding to the
prescriber before proceeding.
QUESTION 3
A client with diabetes mellitus is found diaphoretic, trembling, and pale. Which immediate
intervention is appropriate?
,A. Offer orange juice
B. Check urine for ketones
C. Administer regular insulin IV
D. Encourage exercise
CORRECT ANSWER: A
RATIONALE: These are symptoms of hypoglycemia. Offering a fast-acting carbohydrate such as
orange juice quickly raises blood glucose levels and prevents neurological complications.
QUESTION 4
Which instruction should the nurse include for a client prescribed warfarin therapy?
A. Increase intake of green leafy vegetables
B. Report any signs of bleeding or bruising
C. Avoid all foods containing vitamin C
D. Take the medication on an empty stomach
CORRECT ANSWER: B
RATIONALE: Warfarin increases bleeding risk by inhibiting vitamin K–dependent clotting factors.
Clients must report signs of abnormal bleeding. Consistent, not increased, vitamin K intake is
recommended.
QUESTION 5
The nurse recognizes which client statement demonstrates understanding of self-care following
a total hip replacement?
A. “I will bend at the waist to pick things up.”
B. “I will cross my legs when sitting to stay comfortable.”
C. “I will use a pillow between my knees when lying down.”
D. “I will sit in low chairs to keep swelling down.”
CORRECT ANSWER: C
RATIONALE: A pillow between the knees keeps the legs abducted and prevents dislocation of the
prosthetic hip joint. Flexion beyond 90° or crossing legs must be avoided.
QUESTION 6
,A postoperative client develops shallow respirations and drowsiness after receiving morphine.
What should the nurse do first?
A. Notify the surgeon
B. Check the blood glucose
C. Administer naloxone as prescribed
D. Encourage deep breathing
CORRECT ANSWER: C
RATIONALE: Naloxone is an opioid antagonist that reverses the effects of narcotics causing
respiratory depression. Immediate administration restores adequate ventilation.
QUESTION 7
Which finding requires immediate intervention in a client receiving IV potassium chloride?
A. Mild burning sensation at IV site
B. Serum potassium level 4.0 mEq/L
C. Complaint of chest heaviness
D. Urine output 60 mL/hr
CORRECT ANSWER: C
RATIONALE: Chest heaviness may indicate hyperkalemia causing cardiac dysrhythmia. Stop
infusion immediately and assess cardiac rhythm.
QUESTION 8
A nurse cares for a client with cirrhosis who has ascites. What dietary recommendation should
be made?
A. High protein, low sodium
B. High carbohydrate, low sodium
C. Low fat, high sodium
D. High protein, high sodium
CORRECT ANSWER: B
RATIONALE: Sodium restriction helps control fluid retention and ascites. Carbohydrates supply
energy when protein intake may be limited to prevent hepatic encephalopathy.
, QUESTION 9
The nurse caring for a postpartum client notes a saturated perineal pad with bright red blood
and clots. What is the priority action?
A. Massage the fundus
B. Obtain vital signs
C. Notify the healthcare provider
D. Encourage ambulation
CORRECT ANSWER: A
RATIONALE: A boggy uterus is the most common cause of postpartum hemorrhage. Fundal
massage promotes contraction and reduces bleeding before further actions.
QUESTION 10
A client with a right-sided cerebrovascular accident (CVA) exhibits left-sided neglect. Which
nursing intervention is most effective?
A. Place objects and food on the client’s left side
B. Approach the client from the right side
C. Encourage scanning of the environment
D. Use restraints to prevent injury
CORRECT ANSWER: C
RATIONALE: Encouraging scanning helps the client increase attention to the neglected side and
promotes neurorehabilitation. Approaching from the affected side may increase confusion.
QUESTION 11
A client hospitalized for pneumonia develops Clostridioides difficile–associated diarrhea after
antibiotic therapy. Which nursing intervention is most appropriate?
A. Administer an antidiarrheal as prescribed
B. Maintain the client in a private room under contact precautions
C. Encourage high-protein, low-fiber diet
D. Withhold oral fluids
CORRECT ANSWER: B
