NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
New Generation (NGN) NCLEX RN Exam – 2026/2027 Edition – 150-
Question Full-Length Practice Set with Detailed Rationales
NEXT GENERATION NCLEX-RN® • ORIGINAL PRACTICE • 2026/2027
New Generation (NGN)
NCLEX-RN Exam
2026/2027 Edition
150-question full-length practice set • clinical judgment • detailed rationales
150 9 8 2026/2027
QUESTIONS NGN CASES CLIENT NEEDS AREAS EDITION
IMPORTANT PRACTICE DISCLAIMER
This is an original educational practice set. It is not an official NCLEX-RN examination, does not contain recalled or leaked
NCLEX questions, and is not endorsed by NCSBN. The questions are designed to practice clinical judgment and nursing
decision-making using the 2026 NCLEX-RN Test Plan as a framework.
2026 NCLEX-RN SNAPSHOT
The 2026 NCLEX-RN Test Plan is effective April 1, 2026 through March 31, 2029. The RN examination is computerized
adaptive testing (CAT), with a minimum of 85 items and a maximum of 150 items during a five-hour examination. NCSBN
states that 18 items in the minimum-length exam comprise three six-item clinical judgment case studies.
cite turn0search17 turn0search6
NCSBN describes the six clinical-judgment steps measured by case studies as recognizing cues, analyzing cues, prioritizing
hypotheses, generating solutions, taking action, and evaluating outcomes. cite turn0search17
NGN NCLEX-RN Practice | 2026/2027 | 1
, NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
CONTENT BLUEPRINT
CLIENT NEEDS / CASE AREA ITEMS PRACTICE EMPHASIS
Management of Care 12 Clinical application / judgment
Safety & Infection Control 12 Clinical application / judgment
Health Promotion 12 Clinical application / judgment
Psychosocial Integrity 12 Clinical application / judgment
Basic Care & Comfort 12 Clinical application / judgment
Pharmacological Therapies 12 Clinical application / judgment
Reduction of Risk Potential 12 Clinical application / judgment
Physiological Adaptation 12 Clinical application / judgment
CASE 1 — Acute Heart Failure 6 Clinical application / judgment
CASE 2 — Sepsis 6 Clinical application / judgment
CASE 3 — Hypoglycemia 6 Clinical application / judgment
CASE 4 — Stroke 6 Clinical application / judgment
CASE 5 — Postoperative Hemorrhage 6 Clinical application / judgment
CASE 6 — Preeclampsia 6 Clinical application / judgment
CASE 7 — Newborn Respiratory Distress 6 Clinical application / judgment
CASE 8 — Medication Toxicity 6 Clinical application / judgment
CASE 9 — Infection Control 6 Clinical application / judgment
2026 CLIENT NEEDS DISTRIBUTION
• Management of Care — 15–21%
• Safety and Infection Prevention and Control — 10–16%
• Health Promotion and Maintenance — 6–12%
• Psychosocial Integrity — 6–12%
• Basic Care and Comfort — 6–12%
• Pharmacological and Parenteral Therapies — 13–19%
• Reduction of Risk Potential — 9–15%
• Physiological Adaptation — 11–17%
These ranges are taken from the 2026 NCLEX-RN Candidate Bulletin/Test Plan materials published by NCSBN.
cite turn0search18
NGN NCLEX-RN Practice | 2026/2027 | 2
, NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
HOW TO USE THIS FULL-LENGTH PRACTICE SET
• Complete the set under timed conditions if possible.
• Do not look at rationales until you have committed to an answer.
• For priority questions, consider airway, breathing, circulation, acute deterioration, and safety.
• For NGN cases, identify cues first, then connect them to the most likely hypothesis before selecting actions.
• Review every missed item and write the underlying concept in one sentence.
• Use current clinical references and your nursing program materials to verify practice-specific details.
NGN NCLEX-RN Practice | 2026/2027 | 3
, NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
FULL-LENGTH 150-QUESTION PRACTICE EXAM
Directions: Select the best response. For NGN items, select all responses that are correct when indicated by the response
set. These items are original practice questions and are not official NCLEX items.
QUESTION 1 | KNOWLEDGE CHECK | MANAGEMENT OF CARE
A charge nurse is assigning clients to staff. Which client should the RN assess first?
A. A client with new-onset chest pain and diaphoresis
B. A client requesting a routine dressing change
C. A client awaiting discharge instructions
D. A client with chronic arthritis reporting usual pain
CORRECT RESPONSE: A
DETAILED RATIONALE: New-onset chest pain with diaphoresis may indicate an acute cardiac event and requires
immediate assessment.
WHY THE OTHER OPTIONS ARE LESS APPROPRIATE: They do not best address the client's immediate
clinical priority, expected nursing responsibility, safety concern, or physiologic problem presented in the item.
QUESTION 2 | CLINICAL APPLICATION | MANAGEMENT OF CARE
The nurse is caring for the client. a charge nurse is assigning clients to staff. Which client should the RN
assess first?
A. A client with new-onset chest pain and diaphoresis
B. A client requesting a routine dressing change
C. A client awaiting discharge instructions
D. A client with chronic arthritis reporting usual pain
CORRECT RESPONSE: A
DETAILED RATIONALE: New-onset chest pain with diaphoresis may indicate an acute cardiac event and requires
immediate assessment.
WHY THE OTHER OPTIONS ARE LESS APPROPRIATE: They do not best address the client's immediate
clinical priority, expected nursing responsibility, safety concern, or physiologic problem presented in the item.
QUESTION 3 | PRIORITY / SAFETY | MANAGEMENT OF CARE
The nurse is prioritizing care. a charge nurse is assigning clients to staff. Which client should the RN
assess first?
A. A client with new-onset chest pain and diaphoresis
B. A client requesting a routine dressing change
C. A client awaiting discharge instructions
D. A client with chronic arthritis reporting usual pain
CORRECT RESPONSE: A
DETAILED RATIONALE: New-onset chest pain with diaphoresis may indicate an acute cardiac event and requires
immediate assessment.
WHY THE OTHER OPTIONS ARE LESS APPROPRIATE: They do not best address the client's immediate
clinical priority, expected nursing responsibility, safety concern, or physiologic problem presented in the item.
QUESTION 4 | KNOWLEDGE CHECK | SAFETY & INFECTION CONTROL
Which intervention is most appropriate for a client with suspected pulmonary tuberculosis?
A. Place the client in an airborne infection isolation room and use appropriate respiratory protection
B. Use only standard precautions
C. Place the client in a positive-pressure room
D. Allow unrestricted visitors without precautions
CORRECT RESPONSE: A
DETAILED RATIONALE: Suspected pulmonary tuberculosis requires airborne precautions and appropriate
respiratory protection.
NGN NCLEX-RN Practice | 2026/2027 | 4
New Generation (NGN) NCLEX RN Exam – 2026/2027 Edition – 150-
Question Full-Length Practice Set with Detailed Rationales
NEXT GENERATION NCLEX-RN® • ORIGINAL PRACTICE • 2026/2027
New Generation (NGN)
NCLEX-RN Exam
2026/2027 Edition
150-question full-length practice set • clinical judgment • detailed rationales
150 9 8 2026/2027
QUESTIONS NGN CASES CLIENT NEEDS AREAS EDITION
IMPORTANT PRACTICE DISCLAIMER
This is an original educational practice set. It is not an official NCLEX-RN examination, does not contain recalled or leaked
NCLEX questions, and is not endorsed by NCSBN. The questions are designed to practice clinical judgment and nursing
decision-making using the 2026 NCLEX-RN Test Plan as a framework.
2026 NCLEX-RN SNAPSHOT
The 2026 NCLEX-RN Test Plan is effective April 1, 2026 through March 31, 2029. The RN examination is computerized
adaptive testing (CAT), with a minimum of 85 items and a maximum of 150 items during a five-hour examination. NCSBN
states that 18 items in the minimum-length exam comprise three six-item clinical judgment case studies.
cite turn0search17 turn0search6
NCSBN describes the six clinical-judgment steps measured by case studies as recognizing cues, analyzing cues, prioritizing
hypotheses, generating solutions, taking action, and evaluating outcomes. cite turn0search17
NGN NCLEX-RN Practice | 2026/2027 | 1
, NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
CONTENT BLUEPRINT
CLIENT NEEDS / CASE AREA ITEMS PRACTICE EMPHASIS
Management of Care 12 Clinical application / judgment
Safety & Infection Control 12 Clinical application / judgment
Health Promotion 12 Clinical application / judgment
Psychosocial Integrity 12 Clinical application / judgment
Basic Care & Comfort 12 Clinical application / judgment
Pharmacological Therapies 12 Clinical application / judgment
Reduction of Risk Potential 12 Clinical application / judgment
Physiological Adaptation 12 Clinical application / judgment
CASE 1 — Acute Heart Failure 6 Clinical application / judgment
CASE 2 — Sepsis 6 Clinical application / judgment
CASE 3 — Hypoglycemia 6 Clinical application / judgment
CASE 4 — Stroke 6 Clinical application / judgment
CASE 5 — Postoperative Hemorrhage 6 Clinical application / judgment
CASE 6 — Preeclampsia 6 Clinical application / judgment
CASE 7 — Newborn Respiratory Distress 6 Clinical application / judgment
CASE 8 — Medication Toxicity 6 Clinical application / judgment
CASE 9 — Infection Control 6 Clinical application / judgment
2026 CLIENT NEEDS DISTRIBUTION
• Management of Care — 15–21%
• Safety and Infection Prevention and Control — 10–16%
• Health Promotion and Maintenance — 6–12%
• Psychosocial Integrity — 6–12%
• Basic Care and Comfort — 6–12%
• Pharmacological and Parenteral Therapies — 13–19%
• Reduction of Risk Potential — 9–15%
• Physiological Adaptation — 11–17%
These ranges are taken from the 2026 NCLEX-RN Candidate Bulletin/Test Plan materials published by NCSBN.
cite turn0search18
NGN NCLEX-RN Practice | 2026/2027 | 2
, NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
HOW TO USE THIS FULL-LENGTH PRACTICE SET
• Complete the set under timed conditions if possible.
• Do not look at rationales until you have committed to an answer.
• For priority questions, consider airway, breathing, circulation, acute deterioration, and safety.
• For NGN cases, identify cues first, then connect them to the most likely hypothesis before selecting actions.
• Review every missed item and write the underlying concept in one sentence.
• Use current clinical references and your nursing program materials to verify practice-specific details.
NGN NCLEX-RN Practice | 2026/2027 | 3
, NGN NCLEX-RN • ORIGINAL PRACTICE SET • 2026/2027
FULL-LENGTH 150-QUESTION PRACTICE EXAM
Directions: Select the best response. For NGN items, select all responses that are correct when indicated by the response
set. These items are original practice questions and are not official NCLEX items.
QUESTION 1 | KNOWLEDGE CHECK | MANAGEMENT OF CARE
A charge nurse is assigning clients to staff. Which client should the RN assess first?
A. A client with new-onset chest pain and diaphoresis
B. A client requesting a routine dressing change
C. A client awaiting discharge instructions
D. A client with chronic arthritis reporting usual pain
CORRECT RESPONSE: A
DETAILED RATIONALE: New-onset chest pain with diaphoresis may indicate an acute cardiac event and requires
immediate assessment.
WHY THE OTHER OPTIONS ARE LESS APPROPRIATE: They do not best address the client's immediate
clinical priority, expected nursing responsibility, safety concern, or physiologic problem presented in the item.
QUESTION 2 | CLINICAL APPLICATION | MANAGEMENT OF CARE
The nurse is caring for the client. a charge nurse is assigning clients to staff. Which client should the RN
assess first?
A. A client with new-onset chest pain and diaphoresis
B. A client requesting a routine dressing change
C. A client awaiting discharge instructions
D. A client with chronic arthritis reporting usual pain
CORRECT RESPONSE: A
DETAILED RATIONALE: New-onset chest pain with diaphoresis may indicate an acute cardiac event and requires
immediate assessment.
WHY THE OTHER OPTIONS ARE LESS APPROPRIATE: They do not best address the client's immediate
clinical priority, expected nursing responsibility, safety concern, or physiologic problem presented in the item.
QUESTION 3 | PRIORITY / SAFETY | MANAGEMENT OF CARE
The nurse is prioritizing care. a charge nurse is assigning clients to staff. Which client should the RN
assess first?
A. A client with new-onset chest pain and diaphoresis
B. A client requesting a routine dressing change
C. A client awaiting discharge instructions
D. A client with chronic arthritis reporting usual pain
CORRECT RESPONSE: A
DETAILED RATIONALE: New-onset chest pain with diaphoresis may indicate an acute cardiac event and requires
immediate assessment.
WHY THE OTHER OPTIONS ARE LESS APPROPRIATE: They do not best address the client's immediate
clinical priority, expected nursing responsibility, safety concern, or physiologic problem presented in the item.
QUESTION 4 | KNOWLEDGE CHECK | SAFETY & INFECTION CONTROL
Which intervention is most appropriate for a client with suspected pulmonary tuberculosis?
A. Place the client in an airborne infection isolation room and use appropriate respiratory protection
B. Use only standard precautions
C. Place the client in a positive-pressure room
D. Allow unrestricted visitors without precautions
CORRECT RESPONSE: A
DETAILED RATIONALE: Suspected pulmonary tuberculosis requires airborne precautions and appropriate
respiratory protection.
NGN NCLEX-RN Practice | 2026/2027 | 4
