KAPLAN NGN ASSESSMENT B PRACTICE TEST QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Clinical Judgment and Decision-Making*
*- Patient Safety and Risk Reduction*
*- Pharmacology and Medication Management*
*- Health Assessment and Diagnostic Reasoning*
*- Acute and Chronic Care Management*
*- Ethics, Legal Compliance, and Professional Standards*
*- Infectious Disease and Immune Response*
*- Psychosocial and Mental Health Nursing*
Introduction
This practice assessment is designed to prepare nursing students for the Kaplan NGN Assessment B, a comprehensive evaluation aligned with the
Next Generation NCLEX (NGN) framework. The exam assesses critical clinical judgment skills, applied professional knowledge, regulatory
compliance understanding, and ethical decision-making capacity essential for entry-level nursing practice. The multiple-choice and scenario-
based structure emphasizes real-world application, requiring candidates to recognize cues, analyze information, prioritize hypotheses, generate
solutions, take actions, and evaluate outcomes per the NCSBN Clinical Judgment Model. Questions span foundational theory, applied clinical
knowledge, regulatory standards, ethics, and complex patient scenarios that mirror actual healthcare settings. Success on this assessment
demonstrates readiness for high-stakes nursing licensure examinations and professional practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A 65-year-old patient with hypertension presents with sudden onset of severe headache, confusion, and blood pressure of 220/120 mmHg. Which
action should the nurse prioritize first?
A. Administer prescribed IV antihypertensive medication
B. Obtain a CT scan of the head
C. Assess neurological status and pupil response
D. Place the patient in a supine position
🟢 Correct answer: C
,🔴 RATIONALE: The nurse must first assess neurological status and pupil response to recognize cues about potential stroke or hemorrhage before
initiating interventions. Assessment precedes action in the clinical judgment model, and neurological assessment provides critical information
guiding subsequent CT scan and medication decisions.
Question 2
Which medication requires the nurse to monitor for a prolonged QT interval as a adverse effect?
A. Amoxicillin
B. Metoprolol
C. Ciprofloxacin
D. Lisinopril
🟢 Correct answer: C
🔴 RATIONALE: Ciprofloxacin, a fluoroquinolone antibiotic, is associated with QT interval prolongation and increased risk of torsades de pointes.
Nurses must monitor cardiac status and electrolytes, particularly in patients with existing cardiac conditions or those taking other QT-prolonging
medications.
Question 3
A patient with type 2 diabetes is prescribed metformin. Which laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Renal function (BUN and creatinine)
C. Platelet count
D. Thyroid function tests
🟢 Correct answer: B
🔴 RATIONALE: Metformin is contraindicated in patients with renal impairment due to increased risk of metformin-associated lactic acidosis.
Monitoring renal function (BUN and creatinine) is essential before initiation and periodically during treatment to ensure safe medication use.
Question 4
During medication administration, the nurse notices the patient's allergy label indicates penicillin allergy, but the prescribed medication is
amoxicillin. What is the appropriate action?
,A. Administer the medication as ordered since it's different from penicillin
B. Contact the prescribing provider to clarify the order
C. Document the allergy and give half the dose
D. Skip the medication and notify pharmacy later
🟢 Correct answer: B
🔴 RATIONALE: Amoxicillin is a penicillin-class antibiotic and poses the same allergy risk. The nurse must contact the provider to clarify and
request an alternative medication, demonstrating proper safety protocols and professional communication to prevent adverse allergic reactions.
Question 5
A postoperative patient reports pain level 8/10. Which assessment finding indicates the need to reassess before administering opioid analgesia?
A. Blood pressure 145/90 mmHg
B. Respiratory rate 10 breaths/min
C. Heart rate 88 beats/min
D. Oxygen saturation 96%
🟢 Correct answer: B
🔴 RATIONALE: A respiratory rate of 10 breaths/min is below the normal range (12-20) and indicates potential respiratory depression.
Administering opioids could further suppress respiration. The nurse must reassess the patient and contact the provider before giving opioid
analgesia.
Question 6
Which statement by a nurse demonstrates understanding of professional boundaries with patients?
A. "I'll bring you my personal phone number so you can call me anytime"
B. "Let me share my home address so we can meet outside the hospital"
C. "I understand you're comfortable with me, but I need to maintain our professional relationship"
D. "I'll visit you at home after your discharge to check on your progress"
🟢 Correct answer: C
, 🔴 RATIONALE: Maintaining professional boundaries is essential for ethical nursing practice. Option C demonstrates appropriate boundary-setting
while acknowledging the patient's feelings, whereas other options violate professional standards by blurring personal and professional relationships.
Question 7
A patient with suspected pulmonary embolism is experiencing sudden chest pain and shortness of breath. Which diagnostic test is most appropriate
for initial confirmation?
A. Chest X-ray
B. D-dimer blood test
C. CT pulmonary angiography
D. Electrocardiogram
🟢 Correct answer: C
🔴 RATIONALE: CT pulmonary angiography is the gold standard diagnostic test for confirming pulmonary embolism, providing direct visualization
of clots in pulmonary arteries. While D-dimer may be used for screening, CT angiography offers definitive confirmation needed for treatment
decisions.
Question 8
Which intervention is most effective for preventing catheter-associated urinary tract infections (CAUTI)?
A. Administer prophylactic antibiotics daily
B. Use closed drainage system and maintain sterile technique during insertion
C. Irrigate the catheter with normal saline every 4 hours
D. Replace the catheter every 24 hours
🟢 Correct answer: B
🔴 RATIONALE: Using a closed drainage system and maintaining sterile technique during insertion are evidence-based practices that significantly
reduce CAUTI risk. Prophylactic antibiotics increase resistance risk, catheter irrigation introduces infection risk, and frequent replacement is
unnecessary and increases complication risk.
Question 9
A patient receiving warfarin therapy has a prothrombin time (PT) of 28 seconds and INR of 3.5. What is the appropriate nursing action?
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Clinical Judgment and Decision-Making*
*- Patient Safety and Risk Reduction*
*- Pharmacology and Medication Management*
*- Health Assessment and Diagnostic Reasoning*
*- Acute and Chronic Care Management*
*- Ethics, Legal Compliance, and Professional Standards*
*- Infectious Disease and Immune Response*
*- Psychosocial and Mental Health Nursing*
Introduction
This practice assessment is designed to prepare nursing students for the Kaplan NGN Assessment B, a comprehensive evaluation aligned with the
Next Generation NCLEX (NGN) framework. The exam assesses critical clinical judgment skills, applied professional knowledge, regulatory
compliance understanding, and ethical decision-making capacity essential for entry-level nursing practice. The multiple-choice and scenario-
based structure emphasizes real-world application, requiring candidates to recognize cues, analyze information, prioritize hypotheses, generate
solutions, take actions, and evaluate outcomes per the NCSBN Clinical Judgment Model. Questions span foundational theory, applied clinical
knowledge, regulatory standards, ethics, and complex patient scenarios that mirror actual healthcare settings. Success on this assessment
demonstrates readiness for high-stakes nursing licensure examinations and professional practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A 65-year-old patient with hypertension presents with sudden onset of severe headache, confusion, and blood pressure of 220/120 mmHg. Which
action should the nurse prioritize first?
A. Administer prescribed IV antihypertensive medication
B. Obtain a CT scan of the head
C. Assess neurological status and pupil response
D. Place the patient in a supine position
🟢 Correct answer: C
,🔴 RATIONALE: The nurse must first assess neurological status and pupil response to recognize cues about potential stroke or hemorrhage before
initiating interventions. Assessment precedes action in the clinical judgment model, and neurological assessment provides critical information
guiding subsequent CT scan and medication decisions.
Question 2
Which medication requires the nurse to monitor for a prolonged QT interval as a adverse effect?
A. Amoxicillin
B. Metoprolol
C. Ciprofloxacin
D. Lisinopril
🟢 Correct answer: C
🔴 RATIONALE: Ciprofloxacin, a fluoroquinolone antibiotic, is associated with QT interval prolongation and increased risk of torsades de pointes.
Nurses must monitor cardiac status and electrolytes, particularly in patients with existing cardiac conditions or those taking other QT-prolonging
medications.
Question 3
A patient with type 2 diabetes is prescribed metformin. Which laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Renal function (BUN and creatinine)
C. Platelet count
D. Thyroid function tests
🟢 Correct answer: B
🔴 RATIONALE: Metformin is contraindicated in patients with renal impairment due to increased risk of metformin-associated lactic acidosis.
Monitoring renal function (BUN and creatinine) is essential before initiation and periodically during treatment to ensure safe medication use.
Question 4
During medication administration, the nurse notices the patient's allergy label indicates penicillin allergy, but the prescribed medication is
amoxicillin. What is the appropriate action?
,A. Administer the medication as ordered since it's different from penicillin
B. Contact the prescribing provider to clarify the order
C. Document the allergy and give half the dose
D. Skip the medication and notify pharmacy later
🟢 Correct answer: B
🔴 RATIONALE: Amoxicillin is a penicillin-class antibiotic and poses the same allergy risk. The nurse must contact the provider to clarify and
request an alternative medication, demonstrating proper safety protocols and professional communication to prevent adverse allergic reactions.
Question 5
A postoperative patient reports pain level 8/10. Which assessment finding indicates the need to reassess before administering opioid analgesia?
A. Blood pressure 145/90 mmHg
B. Respiratory rate 10 breaths/min
C. Heart rate 88 beats/min
D. Oxygen saturation 96%
🟢 Correct answer: B
🔴 RATIONALE: A respiratory rate of 10 breaths/min is below the normal range (12-20) and indicates potential respiratory depression.
Administering opioids could further suppress respiration. The nurse must reassess the patient and contact the provider before giving opioid
analgesia.
Question 6
Which statement by a nurse demonstrates understanding of professional boundaries with patients?
A. "I'll bring you my personal phone number so you can call me anytime"
B. "Let me share my home address so we can meet outside the hospital"
C. "I understand you're comfortable with me, but I need to maintain our professional relationship"
D. "I'll visit you at home after your discharge to check on your progress"
🟢 Correct answer: C
, 🔴 RATIONALE: Maintaining professional boundaries is essential for ethical nursing practice. Option C demonstrates appropriate boundary-setting
while acknowledging the patient's feelings, whereas other options violate professional standards by blurring personal and professional relationships.
Question 7
A patient with suspected pulmonary embolism is experiencing sudden chest pain and shortness of breath. Which diagnostic test is most appropriate
for initial confirmation?
A. Chest X-ray
B. D-dimer blood test
C. CT pulmonary angiography
D. Electrocardiogram
🟢 Correct answer: C
🔴 RATIONALE: CT pulmonary angiography is the gold standard diagnostic test for confirming pulmonary embolism, providing direct visualization
of clots in pulmonary arteries. While D-dimer may be used for screening, CT angiography offers definitive confirmation needed for treatment
decisions.
Question 8
Which intervention is most effective for preventing catheter-associated urinary tract infections (CAUTI)?
A. Administer prophylactic antibiotics daily
B. Use closed drainage system and maintain sterile technique during insertion
C. Irrigate the catheter with normal saline every 4 hours
D. Replace the catheter every 24 hours
🟢 Correct answer: B
🔴 RATIONALE: Using a closed drainage system and maintaining sterile technique during insertion are evidence-based practices that significantly
reduce CAUTI risk. Prophylactic antibiotics increase resistance risk, catheter irrigation introduces infection risk, and frequent replacement is
unnecessary and increases complication risk.
Question 9
A patient receiving warfarin therapy has a prothrombin time (PT) of 28 seconds and INR of 3.5. What is the appropriate nursing action?
