Next Generation NCLEX-PN (NGN)
Practice Exam: Questions with
Answers & Rationales
Question 1
The LPN is participating in discharge planning for a client leaving
for home with a new prescription for warfarin. Which action
should the LPN prioritize?
A. Schedule the client's next laboratory appointment
B. Teach the client about signs of bleeding and bruising
C. Provide a list of foods high in vitamin K to avoid
D. Verify the client has a medication administration record
Correct Answer: B
Rationale: Teaching the client about signs of bleeding and
bruising is the priority because warfarin increases bleeding risk,
and early recognition of complications is critical for client safety.
While scheduling labs (A), providing dietary information (C), and
verifying documentation (D) are important, patient education
about warning signs directly prevents harm.
Question 2
A client with a history of substance use disorder is admitted
showing signs of withdrawal. The LPN notices the client is agitated
and attempting to leave. What is the LPN's first action?
,A. Call security to assist with the client
B. Administer the prescribed benzodiazepine
C. Escort the client to a quiet room and assess safety
D. Document the behavior in the client's chart
Correct Answer: C
Rationale: Escorting the client to a quiet room and assessing
safety is the first action because it addresses immediate safety
concerns through de-escalation before implementing other
interventions. Calling security (A) may escalate the situation,
administering medication (B) requires assessment first, and
documentation (D) is not the priority during an active safety crisis.
Question 3
The LPN is preparing to administer a subcutaneous injection of
insulin. Which step is essential before administration?
A. Shake the insulin vial vigorously
B. Check the client's most recent blood glucose level
C. Warm the insulin to body temperature
D. Inject at a 45-degree angle without aspiration
Correct Answer: B
Rationale: Checking the client's most recent blood glucose level
is essential before insulin administration to verify the correct dose
and prevent hypoglycemia. Shaking the vial (A) is not
recommended, warming insulin (C) is unnecessary, and the
injection angle (D) depends on needle length and client factors.
,Question 4
A nurse is caring for a client admitted with heart failure. Which
finding requires immediate intervention?
A. Mild ankle edema
B. Weight gain of 3 pounds overnight
C. Fatigue after activity
D. Heart rate of 80/min
Correct Answer: B
Rationale: Rapid weight gain indicates fluid retention and
worsening heart failure. This may lead to pulmonary edema and
respiratory compromise if not treated promptly.
Question 5
Which intervention is most effective in preventing healthcare-
associated infections?
A. Restricting visitors
B. Proper hand hygiene
C. Limiting oral intake
D. Keeping clients isolated continuously
Correct Answer: B
Rationale: Hand hygiene is the most effective method for
reducing transmission of infectious organisms in healthcare
settings.
, Question 6
A postoperative client suddenly develops shortness of breath and
chest pain. Which complication should the nurse suspect first?
A. Pulmonary embolism
B. Constipation
C. Urinary retention
D. Hypoglycemia
Correct Answer: A
Rationale: Sudden chest pain and dyspnea after surgery may
indicate a pulmonary embolism caused by a blood clot
obstructing pulmonary circulation.
Question 7
Which assessment finding in a client receiving opioids is most
concerning?
A. Mild constipation
B. Respiratory rate of 8/min
C. Dry mouth
D. Mild drowsiness
Correct Answer: B
Rationale: Respiratory depression is the most dangerous
complication associated with opioid use and requires immediate
intervention.
Practice Exam: Questions with
Answers & Rationales
Question 1
The LPN is participating in discharge planning for a client leaving
for home with a new prescription for warfarin. Which action
should the LPN prioritize?
A. Schedule the client's next laboratory appointment
B. Teach the client about signs of bleeding and bruising
C. Provide a list of foods high in vitamin K to avoid
D. Verify the client has a medication administration record
Correct Answer: B
Rationale: Teaching the client about signs of bleeding and
bruising is the priority because warfarin increases bleeding risk,
and early recognition of complications is critical for client safety.
While scheduling labs (A), providing dietary information (C), and
verifying documentation (D) are important, patient education
about warning signs directly prevents harm.
Question 2
A client with a history of substance use disorder is admitted
showing signs of withdrawal. The LPN notices the client is agitated
and attempting to leave. What is the LPN's first action?
,A. Call security to assist with the client
B. Administer the prescribed benzodiazepine
C. Escort the client to a quiet room and assess safety
D. Document the behavior in the client's chart
Correct Answer: C
Rationale: Escorting the client to a quiet room and assessing
safety is the first action because it addresses immediate safety
concerns through de-escalation before implementing other
interventions. Calling security (A) may escalate the situation,
administering medication (B) requires assessment first, and
documentation (D) is not the priority during an active safety crisis.
Question 3
The LPN is preparing to administer a subcutaneous injection of
insulin. Which step is essential before administration?
A. Shake the insulin vial vigorously
B. Check the client's most recent blood glucose level
C. Warm the insulin to body temperature
D. Inject at a 45-degree angle without aspiration
Correct Answer: B
Rationale: Checking the client's most recent blood glucose level
is essential before insulin administration to verify the correct dose
and prevent hypoglycemia. Shaking the vial (A) is not
recommended, warming insulin (C) is unnecessary, and the
injection angle (D) depends on needle length and client factors.
,Question 4
A nurse is caring for a client admitted with heart failure. Which
finding requires immediate intervention?
A. Mild ankle edema
B. Weight gain of 3 pounds overnight
C. Fatigue after activity
D. Heart rate of 80/min
Correct Answer: B
Rationale: Rapid weight gain indicates fluid retention and
worsening heart failure. This may lead to pulmonary edema and
respiratory compromise if not treated promptly.
Question 5
Which intervention is most effective in preventing healthcare-
associated infections?
A. Restricting visitors
B. Proper hand hygiene
C. Limiting oral intake
D. Keeping clients isolated continuously
Correct Answer: B
Rationale: Hand hygiene is the most effective method for
reducing transmission of infectious organisms in healthcare
settings.
, Question 6
A postoperative client suddenly develops shortness of breath and
chest pain. Which complication should the nurse suspect first?
A. Pulmonary embolism
B. Constipation
C. Urinary retention
D. Hypoglycemia
Correct Answer: A
Rationale: Sudden chest pain and dyspnea after surgery may
indicate a pulmonary embolism caused by a blood clot
obstructing pulmonary circulation.
Question 7
Which assessment finding in a client receiving opioids is most
concerning?
A. Mild constipation
B. Respiratory rate of 8/min
C. Dry mouth
D. Mild drowsiness
Correct Answer: B
Rationale: Respiratory depression is the most dangerous
complication associated with opioid use and requires immediate
intervention.
