NGN NCLEX / NCLEX NGN RN ACTUAL EXAM
LATEST TEST BANK QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | AGRADE
2026/2027 NCSBN NGN NCLEX Test Plan Aligned | Clinical Judgment Measurement Model | 150 Questions
SECTION 1: MANAGEMENT OF CARE
Client Rights, Advocacy, Delegation, Legal/Ethical Issues, and Informed Consent
[NGN Item Type: Competent adults have the legal right to refuse any treatment, including life-saving interventions, based on personal or religious beliefs
(Client Rights: Autonomy and Self-Determination, CJMM Layer 3: Generate Solutions). The nurse must respect this decision even when family members
disagree. Administering blood against the client's will constitutes battery. The provider cannot override a competent client's informed refusal, and
delaying until unconsciousness to administer treatment violates ethical and legal standards.]
1. A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The client's spouse insists the
nurse administer the blood. Which action should the nurse take?
A. Administer the blood transfusion as the spouse requests
B. Honor the client's refusal and document the decision **[CORRECT]**
C. Ask the healthcare provider to override the client's decision
D. Delay the transfusion until the client becomes unconscious
Correct Answer: B
B. Honor the client's refusal and document the decision **[CORRECT]**
[NGN Item Type: LPNs can administer oral medications under the supervision of an RN for stable clients with predictable outcomes (Delegation: RN vs.
LPN Scope of Practice, CJMM Layer 4: Take Action). Developing care plans and performing initial assessments require RN-level education and clinical
judgment. Discharge teaching for newly diagnosed conditions requires RN-level assessment, evaluation, and the ability to address complex questions that
may arise during education.]
2. Which task is most appropriate for the charge nurse to delegate to a licensed practical nurse (LPN)?
A. Develop the nursing care plan for a newly admitted client with pneumonia
B. Perform the initial admission assessment on a client transferred from the emergency department
C. Administer oral medications to a stable client with hypertension **[CORRECT]**
D. Provide discharge teaching to a client diagnosed with newly onset diabetes mellitus
Correct Answer: C
C. Administer oral medications to a stable client with hypertension **[CORRECT]**
[NGN Item Type: The nurse's role in informed consent is to witness the client's signature and verify that the client has received adequate information
from the provider and appears to understand the procedure (Legal/Ethical: Informed Consent, CJMM Layer 4: Take Action). The provider is responsible
for explaining risks, benefits, and alternatives. The nurse does not provide the medical diagnosis or offer personal opinions about the procedure, as these
actions exceed the nursing scope and may unduly influence the client's decision.]
3. A nurse is obtaining informed consent from a client scheduled for a colonoscopy. Which action is within the nurse's
role?
A. Explain the risks and benefits of the procedure in detail
B. Witness the client's signature on the consent form after ensuring understanding **[CORRECT]**
C. Provide a medical diagnosis that justifies the need for the procedure
D. Offer personal opinions about whether the client should undergo the procedure
Correct Answer: B
B. Witness the client's signature on the consent form after ensuring understanding **[CORRECT]**
[NGN Item Type: This response demonstrates therapeutic communication, empathy, and appropriate action to facilitate resolution (Client Rights:
Advance Directives, CJMM Layer 3: Generate Solutions). The nurse should facilitate communication between the healthcare team and family rather than
dismissing concerns or making unilateral decisions. A DNR order does not eliminate all treatment; it only limits resuscitative efforts. The nurse must also
verify the DNR status and ensure all documentation is current, but the immediate priority is addressing the family's distress through collaboration.]
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,NGN NCLEX RN - Actual Exam Test Bank 2026/2027 NCSBN Test Plan Aligned
4. A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's family member becomes upset and
demands full resuscitation. Which response by the nurse is most appropriate?
A. "The DNR order is legally binding, and there is nothing we can do about it."
B. "I understand this is difficult. Let me arrange a meeting with the healthcare team and the family to discuss the plan of
care." **[CORRECT]**
C. "Since the family disagrees, we will proceed with full resuscitation measures."
D. "The client signed the DNR, so the family has no say in the matter."
Correct Answer: B
B. "I understand this is difficult. Let me arrange a meeting with the healthcare team and the family to discuss the plan of care." **[CORRECT]**
[NGN Item Type: The first step in addressing a colleague's unsafe practice is to approach them privately and directly (Legal/Ethical: Peer Reporting,
CJMM Layer 4: Take Action). This follows the chain of communication and gives the colleague an opportunity to correct the behavior. Reporting to the
board of nursing without first addressing the issue directly is premature. Confronting someone publicly is unprofessional and undermines team trust.
Delaying action while waiting for a pattern places patients at ongoing risk for healthcare-associated infections.]
5. A nurse discovers that a colleague routinely fails to perform hand hygiene between client contacts. Which action should
the nurse take first?
A. Report the colleague to the state board of nursing immediately
B. Confront the colleague in front of other staff members to ensure accountability
C. Speak privately with the colleague about the concern and remind them of facility policy **[CORRECT]**
D. Document the incidents and wait for a pattern to develop before taking action
Correct Answer: C
C. Speak privately with the colleague about the concern and remind them of facility policy **[CORRECT]**
[NGN Item Type: Restraints must be removed at least every 2 hours for assessment and to provide basic needs such as hydration, toileting, and range of
motion (Legal/Ethical: Restraint Use, CJMM Layer 4: Take Action). Restraints require a new order every 24 hours (not 8 hours) for adults, and more
frequent assessment is typically required. Restraints should never be used as preventive measures; they require a clinical indication. Tying restraints to
side rails is dangerous because movement of the rail could cause injury or inadvertent strangulation.]
6. A nurse is caring for a client who is receiving physical restraints. Which action by the nurse demonstrates adherence to
legal and ethical standards?
A. Apply restraints as a preventive measure for a client who is confused
B. Obtain a new order for restraints every 8 hours and assess the client every 2 hours
C. Remove restraints at least every 2 hours to assess circulation, skin integrity, and range of motion **[CORRECT]**
D. Tie the restraints to the side rails for easy access during emergencies
Correct Answer: C
C. Remove restraints at least every 2 hours to assess circulation, skin integrity, and range of motion **[CORRECT]**
[NGN Item Type: During interdisciplinary hand-off communication, the nurse must prioritize information that directly affects client safety and continuity
of care (Interdisciplinary Collaboration, CJMM Layer 4: Take Action). Current medications, code status, and pending results are critical safety data that
the receiving nurse needs to manage the client effectively. Dietary preferences and visitor information are important but are not priority safety
information. Insurance details are not relevant to direct clinical hand-off communication.]
7. A nurse is preparing to transfer a client from the intensive care unit to a medical-surgical unit. Which information is
most critical to communicate during the interdisciplinary hand-off report?
A. The client's dietary preferences and television viewing habits
B. The client's current medications, code status, and pending diagnostic results **[CORRECT]**
C. The client's insurance information and billing status
D. The number of visitors the client has received during the hospital stay
Correct Answer: B
B. The client's current medications, code status, and pending diagnostic results **[CORRECT]**
[NGN Item Type: HIV status is protected health information under HIPAA, and disclosing it in a location visible to staff who do not have a direct care
need is a confidentiality breach (HIPAA and Client Privacy, CJMM Layer 1: Analyze Cues). The nurse should report this through the appropriate
channels (charge nurse and risk management) rather than taking independent action. Removing the record could disrupt medication administration, and
confronting the individual directly does not address the systemic issue or ensure proper documentation and follow-up.]
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,NGN NCLEX RN - Actual Exam Test Bank 2026/2027 NCSBN Test Plan Aligned
8. A nurse is reviewing the medical record of a client and discovers that the client's diagnosis of HIV has been
documented on the medication administration record visible to all staff. Which action should the nurse take?
A. No action is needed because all healthcare workers have a need to know
B. Report the breach of confidentiality to the charge nurse and risk management **[CORRECT]**
C. Remove the record from the medication room to prevent further exposure
D. Confront the nurse who documented the information on the MAR
Correct Answer: B
B. Report the breach of confidentiality to the charge nurse and risk management **[CORRECT]**
[NGN Item Type: The nurse should provide non-directive information and support the family's decision-making process without applying pressure
(Client Rights: Advocacy, CJMM Layer 3: Generate Solutions). Statements that apply guilt, urgency, or personal bias are non-therapeutic and violate
ethical principles of autonomy and informed consent. The nurse should contact the organ procurement organization as required by federal regulations
and allow the family to make their own decision.]
9. A nurse is caring for a client who has been declared brain dead. The family is considering organ donation. Which
statement by the nurse is most appropriate?
A. "Organ donation is the right thing to do. Most families choose it."
B. "I can provide you with information about the organ donation process so you can make an informed decision."
**[CORRECT]**
C. "Since your loved one is brain dead, the organs will go to waste if you do not donate."
D. "You should decide quickly before the organs are no longer viable."
Correct Answer: B
B. "I can provide you with information about the organ donation process so you can make an informed decision." **[CORRECT]**
[NGN Item Type: Nurses are mandatory reporters of suspected elder abuse under all state and federal laws (Mandatory Reporting, CJMM Layer 4: Take
Action). The nurse has a legal obligation to report, regardless of the caregiver's or client's requests. Waiting for further evidence or making the report
conditional places the vulnerable adult at continued risk. The nurse must report to Adult Protective Services or law enforcement as required by the
jurisdiction.]
10. A nurse is caring for a client who was admitted for suspected elder abuse. The client's adult child, who is the primary
caregiver, asks the nurse not to report the situation. Which response is most appropriate?
A. I will respect your wishes and not report it since you are the caregiver.
B. I understand your concern, but I am legally mandated to report suspected abuse to the appropriate authorities.
**[CORRECT]**
C. Let me wait until the client can tell me what happened before making any decisions.
D. I will report it only if the abuse happens again in the future.
Correct Answer: B
B. "I understand your concern, but I am legally mandated to report suspected abuse to the appropriate authorities." **[CORRECT]**
[NGN Item Type: Social workers are the interdisciplinary team members who specialize in connecting clients with financial assistance programs,
medication assistance programs, and community resources (Discharge Planning, CJMM Layer 3: Generate Solutions). Physical therapists address
mobility, respiratory therapists manage ventilatory support, and dietitians provide nutritional counseling. Medication cost concerns are best addressed by
the social worker who can identify patient assistance programs, generic alternatives, and insurance navigation.]
11. A nurse is planning discharge for a client with heart failure. Which member of the interdisciplinary team should the
nurse consult to address the client's medication cost concerns?
A. Physical therapist
B. Social worker **[CORRECT]**
C. Respiratory therapist
D. Dietitian
Correct Answer: B
B. Social worker **[CORRECT]**
[NGN Item Type: Using a stiff-bristled toothbrush on an unconscious client poses a risk of oral mucosa injury and aspiration (Delegation and Supervision,
CJMM Layer 4: Take Action). The nurse must intervene immediately to prevent patient harm, then use this as a teaching opportunity. Documentation
and reporting are important but should not delay immediate patient safety intervention. Reassignment does not address the knowledge deficit and fails to
Page 3
, NGN NCLEX RN - Actual Exam Test Bank 2026/2027 NCSBN Test Plan Aligned
provide education.]
12. A nurse observes a nursing assistant provide mouth care to an unconscious client using a stiff-bristled toothbrush.
Which action should the nurse take?
A. Praise the nursing assistant for providing hygiene care to the client
B. Stop the action and demonstrate the correct technique using a soft-bristled sponge swab **[CORRECT]**
C. Document the incident and report it to the charge nurse at the end of the shift
D. Reassign the client to a different nursing assistant
Correct Answer: B
B. Stop the action and demonstrate the correct technique using a soft-bristled sponge swab **[CORRECT]**
[NGN Item Type: Redness, warmth, and tenderness along a PICC line tract suggest catheter-related thrombophlebitis or infection (Reduction of Risk
Potential: Complication Identification, CJMM Layer 0: Recognize Cues). The nurse must stop the infusion immediately to prevent further complications
such as sepsis or septic emboli. Warm compresses, analgesics, and dressing changes are interventions that may be implemented after the provider
evaluates the situation and provides orders.]
13. A nurse is caring for a client who is receiving chemotherapy through a peripherally inserted central catheter (PICC)
line. The nurse notes redness, warmth, and tenderness along the catheter tract. Which action should the nurse take first?
A. Apply a warm compress to the site and continue monitoring
B. Stop the infusion and notify the healthcare provider immediately **[CORRECT]**
C. Administer prescribed analgesics for pain relief
D. Change the dressing using sterile technique
Correct Answer: B
B. Stop the infusion and notify the healthcare provider immediately **[CORRECT]**
[NGN Item Type: While a living will is a legal document, conflicts between advance directives and family wishes require careful ethical navigation
(Advance Directives, CJMM Layer 3: Generate Solutions). The nurse should facilitate a multidisciplinary approach involving the provider, ethics
committee, and social worker to resolve the conflict. Simply refusing or complying without discussion fails to address the complexity of the situation.
Blaming the family is non-therapeutic and unprofessional.]
14. A nurse is reviewing the advance directive of a client who has a terminal illness. The client has a living will that states
no artificial nutrition or hydration. The family requests the nurse to initiate tube feeding. Which response by the nurse is
most appropriate?
A. "The living will is a legal document, and I must follow it."
B. "I understand your concern. Let me contact the healthcare provider and ethics committee to facilitate a discussion
about the plan of care." **[CORRECT]**
C. "I will start the tube feeding since the family has requested it."
D. "You should have discussed this with the client before they became unable to communicate."
Correct Answer: B
B. "I understand your concern. Let me contact the healthcare provider and ethics committee to facilitate a discussion about the plan of care."
**[CORRECT]**
[NGN Item Type: The client with chest pain, diaphoresis, and shortness of breath is exhibiting signs of a potential acute cardiac event (Prioritization: ABC
and Safety, CJMM Layer 2: Prioritize Hypotheses). This client requires immediate assessment using the ABC framework (airway, breathing, circulation)
before any medication administration. The other clients have stable, non-urgent needs that can be addressed after the emergent situation.]
15. A nurse is preparing to administer medications to four clients. Which client should the nurse assess first?
A. A client scheduled for a routine dose of lisinopril with a blood pressure of 118/76 mmHg
B. A client reporting chest pain rated 7/10 with diaphoresis and shortness of breath **[CORRECT]**
C. A client requesting a PRN antacid for mild heartburn after lunch
D. A client due for a daily vitamin D supplement with normal calcium levels
Correct Answer: B
B. A client reporting chest pain rated 7/10 with diaphoresis and shortness of breath **[CORRECT]**
[NGN Item Type: Autonomy is the ethical principle that respects the client's right to self-determination and the ability to make independent decisions
about their own care, including the right to withdraw from a clinical trial at any time without penalty (Legal/Ethical: Ethical Principles, CJMM Layer 1:
Page 4
LATEST TEST BANK QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | AGRADE
2026/2027 NCSBN NGN NCLEX Test Plan Aligned | Clinical Judgment Measurement Model | 150 Questions
SECTION 1: MANAGEMENT OF CARE
Client Rights, Advocacy, Delegation, Legal/Ethical Issues, and Informed Consent
[NGN Item Type: Competent adults have the legal right to refuse any treatment, including life-saving interventions, based on personal or religious beliefs
(Client Rights: Autonomy and Self-Determination, CJMM Layer 3: Generate Solutions). The nurse must respect this decision even when family members
disagree. Administering blood against the client's will constitutes battery. The provider cannot override a competent client's informed refusal, and
delaying until unconsciousness to administer treatment violates ethical and legal standards.]
1. A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The client's spouse insists the
nurse administer the blood. Which action should the nurse take?
A. Administer the blood transfusion as the spouse requests
B. Honor the client's refusal and document the decision **[CORRECT]**
C. Ask the healthcare provider to override the client's decision
D. Delay the transfusion until the client becomes unconscious
Correct Answer: B
B. Honor the client's refusal and document the decision **[CORRECT]**
[NGN Item Type: LPNs can administer oral medications under the supervision of an RN for stable clients with predictable outcomes (Delegation: RN vs.
LPN Scope of Practice, CJMM Layer 4: Take Action). Developing care plans and performing initial assessments require RN-level education and clinical
judgment. Discharge teaching for newly diagnosed conditions requires RN-level assessment, evaluation, and the ability to address complex questions that
may arise during education.]
2. Which task is most appropriate for the charge nurse to delegate to a licensed practical nurse (LPN)?
A. Develop the nursing care plan for a newly admitted client with pneumonia
B. Perform the initial admission assessment on a client transferred from the emergency department
C. Administer oral medications to a stable client with hypertension **[CORRECT]**
D. Provide discharge teaching to a client diagnosed with newly onset diabetes mellitus
Correct Answer: C
C. Administer oral medications to a stable client with hypertension **[CORRECT]**
[NGN Item Type: The nurse's role in informed consent is to witness the client's signature and verify that the client has received adequate information
from the provider and appears to understand the procedure (Legal/Ethical: Informed Consent, CJMM Layer 4: Take Action). The provider is responsible
for explaining risks, benefits, and alternatives. The nurse does not provide the medical diagnosis or offer personal opinions about the procedure, as these
actions exceed the nursing scope and may unduly influence the client's decision.]
3. A nurse is obtaining informed consent from a client scheduled for a colonoscopy. Which action is within the nurse's
role?
A. Explain the risks and benefits of the procedure in detail
B. Witness the client's signature on the consent form after ensuring understanding **[CORRECT]**
C. Provide a medical diagnosis that justifies the need for the procedure
D. Offer personal opinions about whether the client should undergo the procedure
Correct Answer: B
B. Witness the client's signature on the consent form after ensuring understanding **[CORRECT]**
[NGN Item Type: This response demonstrates therapeutic communication, empathy, and appropriate action to facilitate resolution (Client Rights:
Advance Directives, CJMM Layer 3: Generate Solutions). The nurse should facilitate communication between the healthcare team and family rather than
dismissing concerns or making unilateral decisions. A DNR order does not eliminate all treatment; it only limits resuscitative efforts. The nurse must also
verify the DNR status and ensure all documentation is current, but the immediate priority is addressing the family's distress through collaboration.]
Page 1
,NGN NCLEX RN - Actual Exam Test Bank 2026/2027 NCSBN Test Plan Aligned
4. A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's family member becomes upset and
demands full resuscitation. Which response by the nurse is most appropriate?
A. "The DNR order is legally binding, and there is nothing we can do about it."
B. "I understand this is difficult. Let me arrange a meeting with the healthcare team and the family to discuss the plan of
care." **[CORRECT]**
C. "Since the family disagrees, we will proceed with full resuscitation measures."
D. "The client signed the DNR, so the family has no say in the matter."
Correct Answer: B
B. "I understand this is difficult. Let me arrange a meeting with the healthcare team and the family to discuss the plan of care." **[CORRECT]**
[NGN Item Type: The first step in addressing a colleague's unsafe practice is to approach them privately and directly (Legal/Ethical: Peer Reporting,
CJMM Layer 4: Take Action). This follows the chain of communication and gives the colleague an opportunity to correct the behavior. Reporting to the
board of nursing without first addressing the issue directly is premature. Confronting someone publicly is unprofessional and undermines team trust.
Delaying action while waiting for a pattern places patients at ongoing risk for healthcare-associated infections.]
5. A nurse discovers that a colleague routinely fails to perform hand hygiene between client contacts. Which action should
the nurse take first?
A. Report the colleague to the state board of nursing immediately
B. Confront the colleague in front of other staff members to ensure accountability
C. Speak privately with the colleague about the concern and remind them of facility policy **[CORRECT]**
D. Document the incidents and wait for a pattern to develop before taking action
Correct Answer: C
C. Speak privately with the colleague about the concern and remind them of facility policy **[CORRECT]**
[NGN Item Type: Restraints must be removed at least every 2 hours for assessment and to provide basic needs such as hydration, toileting, and range of
motion (Legal/Ethical: Restraint Use, CJMM Layer 4: Take Action). Restraints require a new order every 24 hours (not 8 hours) for adults, and more
frequent assessment is typically required. Restraints should never be used as preventive measures; they require a clinical indication. Tying restraints to
side rails is dangerous because movement of the rail could cause injury or inadvertent strangulation.]
6. A nurse is caring for a client who is receiving physical restraints. Which action by the nurse demonstrates adherence to
legal and ethical standards?
A. Apply restraints as a preventive measure for a client who is confused
B. Obtain a new order for restraints every 8 hours and assess the client every 2 hours
C. Remove restraints at least every 2 hours to assess circulation, skin integrity, and range of motion **[CORRECT]**
D. Tie the restraints to the side rails for easy access during emergencies
Correct Answer: C
C. Remove restraints at least every 2 hours to assess circulation, skin integrity, and range of motion **[CORRECT]**
[NGN Item Type: During interdisciplinary hand-off communication, the nurse must prioritize information that directly affects client safety and continuity
of care (Interdisciplinary Collaboration, CJMM Layer 4: Take Action). Current medications, code status, and pending results are critical safety data that
the receiving nurse needs to manage the client effectively. Dietary preferences and visitor information are important but are not priority safety
information. Insurance details are not relevant to direct clinical hand-off communication.]
7. A nurse is preparing to transfer a client from the intensive care unit to a medical-surgical unit. Which information is
most critical to communicate during the interdisciplinary hand-off report?
A. The client's dietary preferences and television viewing habits
B. The client's current medications, code status, and pending diagnostic results **[CORRECT]**
C. The client's insurance information and billing status
D. The number of visitors the client has received during the hospital stay
Correct Answer: B
B. The client's current medications, code status, and pending diagnostic results **[CORRECT]**
[NGN Item Type: HIV status is protected health information under HIPAA, and disclosing it in a location visible to staff who do not have a direct care
need is a confidentiality breach (HIPAA and Client Privacy, CJMM Layer 1: Analyze Cues). The nurse should report this through the appropriate
channels (charge nurse and risk management) rather than taking independent action. Removing the record could disrupt medication administration, and
confronting the individual directly does not address the systemic issue or ensure proper documentation and follow-up.]
Page 2
,NGN NCLEX RN - Actual Exam Test Bank 2026/2027 NCSBN Test Plan Aligned
8. A nurse is reviewing the medical record of a client and discovers that the client's diagnosis of HIV has been
documented on the medication administration record visible to all staff. Which action should the nurse take?
A. No action is needed because all healthcare workers have a need to know
B. Report the breach of confidentiality to the charge nurse and risk management **[CORRECT]**
C. Remove the record from the medication room to prevent further exposure
D. Confront the nurse who documented the information on the MAR
Correct Answer: B
B. Report the breach of confidentiality to the charge nurse and risk management **[CORRECT]**
[NGN Item Type: The nurse should provide non-directive information and support the family's decision-making process without applying pressure
(Client Rights: Advocacy, CJMM Layer 3: Generate Solutions). Statements that apply guilt, urgency, or personal bias are non-therapeutic and violate
ethical principles of autonomy and informed consent. The nurse should contact the organ procurement organization as required by federal regulations
and allow the family to make their own decision.]
9. A nurse is caring for a client who has been declared brain dead. The family is considering organ donation. Which
statement by the nurse is most appropriate?
A. "Organ donation is the right thing to do. Most families choose it."
B. "I can provide you with information about the organ donation process so you can make an informed decision."
**[CORRECT]**
C. "Since your loved one is brain dead, the organs will go to waste if you do not donate."
D. "You should decide quickly before the organs are no longer viable."
Correct Answer: B
B. "I can provide you with information about the organ donation process so you can make an informed decision." **[CORRECT]**
[NGN Item Type: Nurses are mandatory reporters of suspected elder abuse under all state and federal laws (Mandatory Reporting, CJMM Layer 4: Take
Action). The nurse has a legal obligation to report, regardless of the caregiver's or client's requests. Waiting for further evidence or making the report
conditional places the vulnerable adult at continued risk. The nurse must report to Adult Protective Services or law enforcement as required by the
jurisdiction.]
10. A nurse is caring for a client who was admitted for suspected elder abuse. The client's adult child, who is the primary
caregiver, asks the nurse not to report the situation. Which response is most appropriate?
A. I will respect your wishes and not report it since you are the caregiver.
B. I understand your concern, but I am legally mandated to report suspected abuse to the appropriate authorities.
**[CORRECT]**
C. Let me wait until the client can tell me what happened before making any decisions.
D. I will report it only if the abuse happens again in the future.
Correct Answer: B
B. "I understand your concern, but I am legally mandated to report suspected abuse to the appropriate authorities." **[CORRECT]**
[NGN Item Type: Social workers are the interdisciplinary team members who specialize in connecting clients with financial assistance programs,
medication assistance programs, and community resources (Discharge Planning, CJMM Layer 3: Generate Solutions). Physical therapists address
mobility, respiratory therapists manage ventilatory support, and dietitians provide nutritional counseling. Medication cost concerns are best addressed by
the social worker who can identify patient assistance programs, generic alternatives, and insurance navigation.]
11. A nurse is planning discharge for a client with heart failure. Which member of the interdisciplinary team should the
nurse consult to address the client's medication cost concerns?
A. Physical therapist
B. Social worker **[CORRECT]**
C. Respiratory therapist
D. Dietitian
Correct Answer: B
B. Social worker **[CORRECT]**
[NGN Item Type: Using a stiff-bristled toothbrush on an unconscious client poses a risk of oral mucosa injury and aspiration (Delegation and Supervision,
CJMM Layer 4: Take Action). The nurse must intervene immediately to prevent patient harm, then use this as a teaching opportunity. Documentation
and reporting are important but should not delay immediate patient safety intervention. Reassignment does not address the knowledge deficit and fails to
Page 3
, NGN NCLEX RN - Actual Exam Test Bank 2026/2027 NCSBN Test Plan Aligned
provide education.]
12. A nurse observes a nursing assistant provide mouth care to an unconscious client using a stiff-bristled toothbrush.
Which action should the nurse take?
A. Praise the nursing assistant for providing hygiene care to the client
B. Stop the action and demonstrate the correct technique using a soft-bristled sponge swab **[CORRECT]**
C. Document the incident and report it to the charge nurse at the end of the shift
D. Reassign the client to a different nursing assistant
Correct Answer: B
B. Stop the action and demonstrate the correct technique using a soft-bristled sponge swab **[CORRECT]**
[NGN Item Type: Redness, warmth, and tenderness along a PICC line tract suggest catheter-related thrombophlebitis or infection (Reduction of Risk
Potential: Complication Identification, CJMM Layer 0: Recognize Cues). The nurse must stop the infusion immediately to prevent further complications
such as sepsis or septic emboli. Warm compresses, analgesics, and dressing changes are interventions that may be implemented after the provider
evaluates the situation and provides orders.]
13. A nurse is caring for a client who is receiving chemotherapy through a peripherally inserted central catheter (PICC)
line. The nurse notes redness, warmth, and tenderness along the catheter tract. Which action should the nurse take first?
A. Apply a warm compress to the site and continue monitoring
B. Stop the infusion and notify the healthcare provider immediately **[CORRECT]**
C. Administer prescribed analgesics for pain relief
D. Change the dressing using sterile technique
Correct Answer: B
B. Stop the infusion and notify the healthcare provider immediately **[CORRECT]**
[NGN Item Type: While a living will is a legal document, conflicts between advance directives and family wishes require careful ethical navigation
(Advance Directives, CJMM Layer 3: Generate Solutions). The nurse should facilitate a multidisciplinary approach involving the provider, ethics
committee, and social worker to resolve the conflict. Simply refusing or complying without discussion fails to address the complexity of the situation.
Blaming the family is non-therapeutic and unprofessional.]
14. A nurse is reviewing the advance directive of a client who has a terminal illness. The client has a living will that states
no artificial nutrition or hydration. The family requests the nurse to initiate tube feeding. Which response by the nurse is
most appropriate?
A. "The living will is a legal document, and I must follow it."
B. "I understand your concern. Let me contact the healthcare provider and ethics committee to facilitate a discussion
about the plan of care." **[CORRECT]**
C. "I will start the tube feeding since the family has requested it."
D. "You should have discussed this with the client before they became unable to communicate."
Correct Answer: B
B. "I understand your concern. Let me contact the healthcare provider and ethics committee to facilitate a discussion about the plan of care."
**[CORRECT]**
[NGN Item Type: The client with chest pain, diaphoresis, and shortness of breath is exhibiting signs of a potential acute cardiac event (Prioritization: ABC
and Safety, CJMM Layer 2: Prioritize Hypotheses). This client requires immediate assessment using the ABC framework (airway, breathing, circulation)
before any medication administration. The other clients have stable, non-urgent needs that can be addressed after the emergent situation.]
15. A nurse is preparing to administer medications to four clients. Which client should the nurse assess first?
A. A client scheduled for a routine dose of lisinopril with a blood pressure of 118/76 mmHg
B. A client reporting chest pain rated 7/10 with diaphoresis and shortness of breath **[CORRECT]**
C. A client requesting a PRN antacid for mild heartburn after lunch
D. A client due for a daily vitamin D supplement with normal calcium levels
Correct Answer: B
B. A client reporting chest pain rated 7/10 with diaphoresis and shortness of breath **[CORRECT]**
[NGN Item Type: Autonomy is the ethical principle that respects the client's right to self-determination and the ability to make independent decisions
about their own care, including the right to withdraw from a clinical trial at any time without penalty (Legal/Ethical: Ethical Principles, CJMM Layer 1:
Page 4
