NCLEX-RN Next Generation (NGN) Exam Practice
Questions & Verified Answers 2026–2027 | 100 Questions
with Detailed Rationales | Comprehensive Review | Latest
Study Guide | Guaranteed Pass Preparation
Question 1
A nurse is caring for a client admitted with heart failure. Which assessment finding requires
immediate intervention?
A. Weight gain of 1 lb in 24 hours
B. Bilateral ankle edema
C. Oxygen saturation of 86% on room air
D. Fatigue during ambulation
Answer: C. Oxygen saturation of 86% on room air
Rationale: An oxygen saturation below 90% indicates significant hypoxemia and requires
immediate intervention to improve oxygenation and prevent respiratory compromise.
Question 2
A client receiving heparin therapy develops bleeding gums. Which laboratory value should
the nurse review first?
A. Hemoglobin
B. Platelet count
C. aPTT
D. Potassium level
Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) evaluates the therapeutic effect of
heparin and helps determine if over-anticoagulation is causing bleeding.
Question 3
A nurse is teaching a client newly prescribed insulin glargine. Which statement indicates
understanding?
, A. “I will mix this insulin with regular insulin.” B. “I will take this insulin only when my
glucose is high.” C. “I will take this insulin at the same time each day.” D. “I will skip
this insulin when I do not eat.”
Answer: C. “I will take this insulin at the same time each day.”
Rationale: Insulin glargine is a long-acting basal insulin that should be administered
consistently at the same time daily.
Question 4
A client reports crushing chest pain radiating to the left arm. What is the nurse’s priority
action?
A. Obtain a dietary history B. Administer prescribed nitroglycerin C. Encourage
ambulation D. Provide discharge instructions
Answer: B. Administer prescribed nitroglycerin
Rationale: Chest pain suggestive of myocardial ischemia requires immediate intervention
according to provider orders while further assessment continues.
Question 5
A nurse is caring for a postoperative client. Which finding suggests infection?
A. Temperature 38.6°C (101.5°F) B. Mild incisional tenderness C. Decreased appetite
D. Fatigue
Answer: A. Temperature 38.6°C (101.5°F)
Rationale: Fever is a common manifestation of infection and should be investigated
promptly.
Question 6
A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which
action is priority?
A. Encourage oral fluids B. Monitor daily weight C. Notify the provider immediately D.
Restrict sodium intake
Answer: C. Notify the provider immediately
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias and requires
urgent treatment.
, Question 7
Which finding is expected in a client with dehydration?
A. Bounding pulse B. Increased urine output C. Dry mucous membranes D.
Bradycardia
Answer: C. Dry mucous membranes
Rationale: Dry mucous membranes are a common sign of fluid volume deficit.
Question 8
A nurse is caring for a client receiving a blood transfusion who develops chills and back
pain. What should the nurse do first?
A. Slow the transfusion B. Stop the transfusion C. Administer acetaminophen D.
Obtain vital signs in 30 minutes
Answer: B. Stop the transfusion
Rationale: These symptoms may indicate a transfusion reaction. The transfusion should be
stopped immediately.
Question 9
Which client is at highest risk for developing pressure injuries?
A. Ambulatory client with diabetes B. Bedridden client with limited mobility C. Client
recovering from influenza D. Client with seasonal allergies
Answer: B. Bedridden client with limited mobility
Rationale: Immobility significantly increases the risk of pressure injury development.
Question 10
A client with COPD is receiving oxygen therapy. Which finding indicates treatment
effectiveness?
A. Respiratory rate 32/min B. Increased anxiety C. Oxygen saturation 92% D. Cyanotic
nail beds
Answer: C. Oxygen saturation 92%
Rationale: An oxygen saturation around 88–92% is often an acceptable therapeutic target
for COPD clients.
Questions & Verified Answers 2026–2027 | 100 Questions
with Detailed Rationales | Comprehensive Review | Latest
Study Guide | Guaranteed Pass Preparation
Question 1
A nurse is caring for a client admitted with heart failure. Which assessment finding requires
immediate intervention?
A. Weight gain of 1 lb in 24 hours
B. Bilateral ankle edema
C. Oxygen saturation of 86% on room air
D. Fatigue during ambulation
Answer: C. Oxygen saturation of 86% on room air
Rationale: An oxygen saturation below 90% indicates significant hypoxemia and requires
immediate intervention to improve oxygenation and prevent respiratory compromise.
Question 2
A client receiving heparin therapy develops bleeding gums. Which laboratory value should
the nurse review first?
A. Hemoglobin
B. Platelet count
C. aPTT
D. Potassium level
Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) evaluates the therapeutic effect of
heparin and helps determine if over-anticoagulation is causing bleeding.
Question 3
A nurse is teaching a client newly prescribed insulin glargine. Which statement indicates
understanding?
, A. “I will mix this insulin with regular insulin.” B. “I will take this insulin only when my
glucose is high.” C. “I will take this insulin at the same time each day.” D. “I will skip
this insulin when I do not eat.”
Answer: C. “I will take this insulin at the same time each day.”
Rationale: Insulin glargine is a long-acting basal insulin that should be administered
consistently at the same time daily.
Question 4
A client reports crushing chest pain radiating to the left arm. What is the nurse’s priority
action?
A. Obtain a dietary history B. Administer prescribed nitroglycerin C. Encourage
ambulation D. Provide discharge instructions
Answer: B. Administer prescribed nitroglycerin
Rationale: Chest pain suggestive of myocardial ischemia requires immediate intervention
according to provider orders while further assessment continues.
Question 5
A nurse is caring for a postoperative client. Which finding suggests infection?
A. Temperature 38.6°C (101.5°F) B. Mild incisional tenderness C. Decreased appetite
D. Fatigue
Answer: A. Temperature 38.6°C (101.5°F)
Rationale: Fever is a common manifestation of infection and should be investigated
promptly.
Question 6
A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which
action is priority?
A. Encourage oral fluids B. Monitor daily weight C. Notify the provider immediately D.
Restrict sodium intake
Answer: C. Notify the provider immediately
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias and requires
urgent treatment.
, Question 7
Which finding is expected in a client with dehydration?
A. Bounding pulse B. Increased urine output C. Dry mucous membranes D.
Bradycardia
Answer: C. Dry mucous membranes
Rationale: Dry mucous membranes are a common sign of fluid volume deficit.
Question 8
A nurse is caring for a client receiving a blood transfusion who develops chills and back
pain. What should the nurse do first?
A. Slow the transfusion B. Stop the transfusion C. Administer acetaminophen D.
Obtain vital signs in 30 minutes
Answer: B. Stop the transfusion
Rationale: These symptoms may indicate a transfusion reaction. The transfusion should be
stopped immediately.
Question 9
Which client is at highest risk for developing pressure injuries?
A. Ambulatory client with diabetes B. Bedridden client with limited mobility C. Client
recovering from influenza D. Client with seasonal allergies
Answer: B. Bedridden client with limited mobility
Rationale: Immobility significantly increases the risk of pressure injury development.
Question 10
A client with COPD is receiving oxygen therapy. Which finding indicates treatment
effectiveness?
A. Respiratory rate 32/min B. Increased anxiety C. Oxygen saturation 92% D. Cyanotic
nail beds
Answer: C. Oxygen saturation 92%
Rationale: An oxygen saturation around 88–92% is often an acceptable therapeutic target
for COPD clients.
