NGN NCLEX /NCLEX NGN RN EXAM 300
ACTUAL QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST UPDATE ALREADY
GRADED A+
Section 1: Management of Care (Questions 1-40)
Question 1
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task
is appropriate for the nurse to delegate?
A) Performing a sterile wound irrigation
B) Administering oral medications
C) Assisting a client with ambulation using a gait belt
D) Assessing a client's lung sounds
Answer: C
Rationale: UAPs can assist with activities of daily living and mobility under the
nurse's supervision. Assessment and sterile procedures require a licensed nurse's
training .
Question 2
A charge nurse is making assignments for a medical-surgical unit. Which client
should be assigned to the most experienced nurse?
A) A client with stable angina who is scheduled for discharge tomorrow
B) A client newly diagnosed with diabetes requiring initial teaching
C) A client who is 24 hours post-hemorrhagic stroke with fluctuating vital signs
D) A client with a urinary tract infection
Answer: C
Rationale: Unstable or high-acuity clients, such as one with a recent stroke and
fluctuating vital signs, require the expertise of the most experienced nurse .
Question 3
,A nurse is caring for a client who is a Jehovah's Witness and refuses a life-saving
blood transfusion. What is the nurse's priority action?
A) Ask the client to reconsider because the transfusion is life-saving
B) Inform the client of the risks and benefits, then respect the client's decision
C) Contact the client's family for consent
D) Proceed with the transfusion under implied consent
Answer: B
Rationale: Competent adults have the right to refuse treatment based on religious
beliefs. The nurse must respect autonomy after ensuring the client is fully informed
.
Question 4
The nurse is preparing a client for discharge after a myocardial infarction. Which
action best promotes continuity of care?
A) Provide the client with a written list of medications only
B) Schedule a follow-up appointment with the primary care provider and provide a
verbal report
C) Call the client's pharmacy to arrange refills
D) Instruct the family to set up the home environment
Answer: B
Rationale: Coordinating a follow-up appointment and communicating with the next
care provider ensures continuity and reduces readmission risk .
Question 5
A client's family member asks the nurse for the client's lab results. What is the
nurse's best response?
A) Provide the results because the family has a right to know
B) Ask the client for permission to share the results with the family
C) Tell the family member they are not allowed access
D) Write down the results for the family member
Answer: B
Rationale: HIPAA requires the client's explicit consent before sharing health
information with family unless the client is incapacitated .
Question 6
A nurse is leading an interdisciplinary team meeting for a client with complex
needs. Which statement reflects effective collaboration?
A) We will implement the care plan as the physician has ordered
B) Let's discuss the client's progress and each discipline's observations to develop a
plan
,C) The occupational therapist will decide the discharge goals
D) The client's family should not be involved
Answer: B
Rationale: Effective collaboration involves sharing perspectives and developing a
plan together .
Question 7
A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client's
family requests that CPR be performed if the client's heart stops. What is the
appropriate action?
A) Initiate CPR as the family requests
B) Explain that the DNR order is a legal document and CPR will not be performed
C) Contact the hospital ethics committee
D) Perform CPR but document the family's request
Answer: B
Rationale: A valid DNR order must be honored. The nurse should explain this to
the family compassionately .
Question 8
A nurse is triaging clients in the emergency department. Which client should the
nurse assess first?
A) A client with a fever and productive cough
B) A client with chest pain and diaphoresis
C) A client with an ankle sprain
D) A client requesting a refill of a prescription
Answer: B
Rationale: Chest pain with diaphoresis indicates a potential cardiac event and is a
high-priority emergency .
Question 9
A nurse is serving as a preceptor for a newly licensed nurse. Which action by the
new nurse requires immediate intervention?
A) Documenting client care at the end of the shift
B) Asking a UAP to check a client's blood pressure
C) Administering a medication without scanning the client's barcode
D) Delegating bathing tasks to a UAP
Answer: C
Rationale: Failing to scan the barcode or use the "five rights" before administering
medication is a significant safety violation .
, Question 10
A nurse manager is working to reduce costs on a nursing unit without
compromising quality. Which action is appropriate?
A) Reduce the number of wound care supplies available
B) Decrease the frequency of client assessments
C) Implement a program to reduce pressure injuries
D) Discontinue client education materials
Answer: C
Rationale: Preventing complications like pressure injuries reduces costs and
improves quality by preventing expensive treatments .
Question 11
A nurse receives a verbal prescription from a provider. What is the correct action
for the nurse to take?
A) Write the prescription in the client's chart, read it back, and verify with the
provider
B) Administer the medication immediately
C) Write the prescription and ask the provider to sign it later
D) Call another nurse to hear the prescription
Answer: A
Rationale: Verbal orders must be written down, read back to the provider to
confirm accuracy, and signed as a "read-back" .
Question 12
A nurse is preparing to discharge a client after a stroke. Which action best supports
the client's safety at home?
A) Provide the client with a list of foods to avoid
B) Assess the home environment for hazards and recommend modifications
C) Arrange for home health to visit once a week
D) Tell the family to remove all throw rugs
Answer: B
Rationale: Assessing the home environment and recommending modifications
creates a safe environment .
Question 13
A nurse is caring for a client with an advance directive. Which statement by the
client indicates a misunderstanding of the document?
A) This document ensures my wishes are followed if I cannot speak for myself
B) I can change my advance directive at any time
C) This document allows my family to make all my medical decisions
ACTUAL QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST UPDATE ALREADY
GRADED A+
Section 1: Management of Care (Questions 1-40)
Question 1
A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task
is appropriate for the nurse to delegate?
A) Performing a sterile wound irrigation
B) Administering oral medications
C) Assisting a client with ambulation using a gait belt
D) Assessing a client's lung sounds
Answer: C
Rationale: UAPs can assist with activities of daily living and mobility under the
nurse's supervision. Assessment and sterile procedures require a licensed nurse's
training .
Question 2
A charge nurse is making assignments for a medical-surgical unit. Which client
should be assigned to the most experienced nurse?
A) A client with stable angina who is scheduled for discharge tomorrow
B) A client newly diagnosed with diabetes requiring initial teaching
C) A client who is 24 hours post-hemorrhagic stroke with fluctuating vital signs
D) A client with a urinary tract infection
Answer: C
Rationale: Unstable or high-acuity clients, such as one with a recent stroke and
fluctuating vital signs, require the expertise of the most experienced nurse .
Question 3
,A nurse is caring for a client who is a Jehovah's Witness and refuses a life-saving
blood transfusion. What is the nurse's priority action?
A) Ask the client to reconsider because the transfusion is life-saving
B) Inform the client of the risks and benefits, then respect the client's decision
C) Contact the client's family for consent
D) Proceed with the transfusion under implied consent
Answer: B
Rationale: Competent adults have the right to refuse treatment based on religious
beliefs. The nurse must respect autonomy after ensuring the client is fully informed
.
Question 4
The nurse is preparing a client for discharge after a myocardial infarction. Which
action best promotes continuity of care?
A) Provide the client with a written list of medications only
B) Schedule a follow-up appointment with the primary care provider and provide a
verbal report
C) Call the client's pharmacy to arrange refills
D) Instruct the family to set up the home environment
Answer: B
Rationale: Coordinating a follow-up appointment and communicating with the next
care provider ensures continuity and reduces readmission risk .
Question 5
A client's family member asks the nurse for the client's lab results. What is the
nurse's best response?
A) Provide the results because the family has a right to know
B) Ask the client for permission to share the results with the family
C) Tell the family member they are not allowed access
D) Write down the results for the family member
Answer: B
Rationale: HIPAA requires the client's explicit consent before sharing health
information with family unless the client is incapacitated .
Question 6
A nurse is leading an interdisciplinary team meeting for a client with complex
needs. Which statement reflects effective collaboration?
A) We will implement the care plan as the physician has ordered
B) Let's discuss the client's progress and each discipline's observations to develop a
plan
,C) The occupational therapist will decide the discharge goals
D) The client's family should not be involved
Answer: B
Rationale: Effective collaboration involves sharing perspectives and developing a
plan together .
Question 7
A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client's
family requests that CPR be performed if the client's heart stops. What is the
appropriate action?
A) Initiate CPR as the family requests
B) Explain that the DNR order is a legal document and CPR will not be performed
C) Contact the hospital ethics committee
D) Perform CPR but document the family's request
Answer: B
Rationale: A valid DNR order must be honored. The nurse should explain this to
the family compassionately .
Question 8
A nurse is triaging clients in the emergency department. Which client should the
nurse assess first?
A) A client with a fever and productive cough
B) A client with chest pain and diaphoresis
C) A client with an ankle sprain
D) A client requesting a refill of a prescription
Answer: B
Rationale: Chest pain with diaphoresis indicates a potential cardiac event and is a
high-priority emergency .
Question 9
A nurse is serving as a preceptor for a newly licensed nurse. Which action by the
new nurse requires immediate intervention?
A) Documenting client care at the end of the shift
B) Asking a UAP to check a client's blood pressure
C) Administering a medication without scanning the client's barcode
D) Delegating bathing tasks to a UAP
Answer: C
Rationale: Failing to scan the barcode or use the "five rights" before administering
medication is a significant safety violation .
, Question 10
A nurse manager is working to reduce costs on a nursing unit without
compromising quality. Which action is appropriate?
A) Reduce the number of wound care supplies available
B) Decrease the frequency of client assessments
C) Implement a program to reduce pressure injuries
D) Discontinue client education materials
Answer: C
Rationale: Preventing complications like pressure injuries reduces costs and
improves quality by preventing expensive treatments .
Question 11
A nurse receives a verbal prescription from a provider. What is the correct action
for the nurse to take?
A) Write the prescription in the client's chart, read it back, and verify with the
provider
B) Administer the medication immediately
C) Write the prescription and ask the provider to sign it later
D) Call another nurse to hear the prescription
Answer: A
Rationale: Verbal orders must be written down, read back to the provider to
confirm accuracy, and signed as a "read-back" .
Question 12
A nurse is preparing to discharge a client after a stroke. Which action best supports
the client's safety at home?
A) Provide the client with a list of foods to avoid
B) Assess the home environment for hazards and recommend modifications
C) Arrange for home health to visit once a week
D) Tell the family to remove all throw rugs
Answer: B
Rationale: Assessing the home environment and recommending modifications
creates a safe environment .
Question 13
A nurse is caring for a client with an advance directive. Which statement by the
client indicates a misunderstanding of the document?
A) This document ensures my wishes are followed if I cannot speak for myself
B) I can change my advance directive at any time
C) This document allows my family to make all my medical decisions
